Alcohol use is associated with a wide array of public health problems. Theory and research suggest that enactment of alcohol policies can reduce alcohol use and related problems. Most previous research has focused on evaluating effects of individual alcohol policies;however, a few studies have started assessing effects of "counts" of state alcohol policies measured through simple indices. This approach has advanced the research literature however it is limited because simply counting or summing whether policies are present does not provide information to states about what optimal combination of alcohol policies may effectively reduce alcohol use and related problems. Summing policies also does not take into account the varying strength of specific alcohol policies across states. Furthermore, most previous studies are limited in terms of inclusion of control variables and/or critical intervening variables such as enforcement practices. The research team will build upon previous studies by conducting a study which will address four specific aims: (1) Develop a measure of the strength of specific alcohol control policies across states;(2) Measure the overall state alcohol policy environment using latent variable analyses;(3) Assess levels of enforcement of alcohol policies within each state;and (4) Assess the relationships between the alcohol policy environment and related consequences (including alcohol consumption levels and rates of traffic crashes and injury mortality), and assess how enforcement levels influence these relationships. We will conduct the project across four years. In Year 1 we will collect enforcement data, and develop measures of alcohol policies that include differences in the strength of policies across states. In Year 2 we will develop measurement models for the alcohol policy environment and levels of enforcement, and collect outcome variable data. In Year 3 we will conduct analyses to assess the relationships between the state alcohol policy environment and our various outcome measures, and how enforcement affects these relationships. In Year 4 we will conduct sub-analyses to assess whether effects of state alcohol policy environment on our outcomes vary by age or race/ethnicity. The project will expand the field's understanding of the effects of combinations or patterns of alcohol policies on alcohol consumption and related problems. The proposal addresses recommendations from several national-level institutions, provides a tool for future research studies, and will inform states'decisions about how to change their alcohol policy environments to address a variety of public health issues.
We propose to first determine the optimal way to measure state alcohol policy environments. We will then assess associations between the newly developed measures of alcohol policy environments and several measures of alcohol use and alcohol-related problems. Results from this study can help guide decisions among policy makers as they attempt to reduce a wide array of alcohol-related problems.
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|Lenk, Kathleen M; Toomey, Traci L; Nelson, Toben F et al. (2014) State and local law enforcement agency efforts to prevent sales to obviously intoxicated patrons. J Community Health 39:339-48|