This prevention trial is to implement and evaluate a community level intervention to reduce: (1) alcohol-involved traffic crashes including injuries and fatalities, and (2) alcohol-involved non-traffic unintential injuries including burns, drownings, and falls. The task of the evaluation design is to determine if a statistically significant change in these targets has been achieved and that the change can be attributed to the combination of interventions employed. In addition, process evaluation will indicate the level of success of prevention components on intervening variables. But in the end, the study's goal is to test the efficacy of integrated structural changes in a community to reduce alcohol trauma. The research involves five components: A NORMATIVE component that objectifies implicit social norms concerning alcohol and risk behaviors for community residents and decision makers through measurement of the BAC levels of residents during risk activities; an ENFORCEMENT component that increases the actual and perceived risk of apprehension rate of drivers who are under the influence of alcohol; a BEVERAGE SERVICE component that includes training of servers and owner/managers of on-premise alcohol outlets to identify intoxicated and/or underage customers in bars and restaurants and to develop and implement beverage service policies that reduce the probability of customers becoming intoxicated or of driving when intoxicated; an UNDERAGE DRINKING component that includes increased enforcement of laws regarding sales of alcohol to minors, the training of off-premise alcohol retailers, and programs for parents and adolescents concerned with issues of sales and access to alcohol by minors; and an ACCESS component which includes the use of local zoning powers and other municipal control of outlet number and density to reduce the availability of alcohol. The research design is quasi-experimental with two treatment (Stockton and Oceanside, CA) and two comparison communities. The two treatment communities will also permit comparison of two models of community organization. The implementation plan for the research includes a baseline data collection phase followed by activities in which community monitoring systems are designed, validated, and implemented through a combination of community surveys and the use of archival records.
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