The objective of this prevention trial is to implement and evaluate a comprehensive five-year community intervention to reduce alcohol-involved trauma, i.e., alcohol-involved traffic crashes including injuries and fatalities, and alcohol-involved non-traffic fatalities and unintentional injuries including burns, drownings, and falls. To achieve these two goals, the research consists of the implementation and evaluation of a community-based intervention using five interacting and supportive components: A COMMUNITY KNOWLEDGE, VALUES, AND MOBILIZATION component which consists of working with existing community coalitions in the experimental communities to implement specific interventions and developing an integrated public awareness and education program which support overall goals and those of individual components, including concern about alcohol-involved trauma, the relationship of Blood Alcohol Concentration and impairment as related to increased risk of death or injury, and skills in estimating BAC. A RESPONSIBLE 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 the development of school (including a normative curriculum complement) and community programs for parents and adolescents concerned with issues of sales and access to alcohol by minors, and the training of off-premise alcohol retailers to reduce sales to minors. A RISK OF DRINKING AND DRIVING component that increases the actual and perceived risk of apprehension rate of drivers who are under the influence of alcohol. This component consists of increasing DWI efficiency through training enforcement officers in new techniques for identifying DWI drivers and the use of passive alcohol sensors to increase the probability of detection. An ACCESS TO ALCOHOL component includes the use of local zoning powers and other municipal control of outlet density to reduce the availability of alcohol. The research design is quasi-experimental with three pairs of experimental and comparison communities: Salinas and Modesto, CA; Florence and Sumter Counties, SC; and Whatcom and Cowlitz Counties, WA. The first year is a baseline data collection and planning phase involving a combination of community and emergency room surveys as well as the use of archival records. Years Two through Four are intervention phases which make use of an iterative process evaluation and media-based feedback to the community. The final project year has three parts: (a) outcome evaluation including the analysis of community-level crash and accident data, (b) process evaluation of the total project and component implementation, and (c) the institutionalization of the community program components in order to ensure continuity after the research is completed.
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