A critical barrier to progress in preventing alcohol-related intimate partner violence (IPV) is that little is known about how an individual's specific drinking contexts (i.e., where, how often, and with whom one drinks) are related to IPV, or how these contexts are affected by environmental characteristics, such as alcohol outlet density and neighborhood disadvantage. The putative mechanism is the social environment in which drinking occurs that may promote or strengthen aggressive norms. Once these contexts are known, specific prevention measures can be put in place, including policy-oriented (e.g., regulating outlet density) and individually- oriented (e.g., brief interventions to reduce risk for spousal aggression) measures targeting at-risk populations, and reducing IPV-related disparities. Building on findings that link IPV risk with certain drinking venues (e.g., bars), and density of liquor stores and bars, the objective of this application is to identify how alcohol consumption and drinking contexts affect likelihood for IPV among an at-risk, underserved population of men and women recruited from an urban public hospital's Emergency Department (ED). Since ED patients have elevated rates of IPV, heavy drinking, depression, and other social problems, we purposefully seek to test study hypotheses among a sample recruited in this setting. The project's long-term goal is to develop strategies and policies that reduce alcohol-related IPV by targeting modifiable aspects of the drinking environment (e.g., venue utilization; alcohol outlet zoning regulations). The central hypotheses are that drinking contexts (where, how often, and with whom one drinks) will be associated with risk for IPV; that known IPV risk factors (e.g., adverse childhood experiences; impulsivity; depression) will be associated with drinking contexts, and risk for IPV; and that the associations between known IPV risk factors and drinking contexts will be moderated by density of off-premise outlets and bars and by neighborhood disadvantage. Guided by a multidisciplinary team of social epidemiologists, Emergency Medicine physicians, and alcohol-related injury experts, the project's objective will be addressed with three specific aims: (1) Identify aspects of alcohol consumption and drinking context that are associated with the occurrence and frequency of IPV; (2) Determine the extent that known IPV risk factors are associated with drinking contexts; and (3) Determine if the associations between known IPV risk factors and drinking contexts are moderated by density of off-premise outlets and bars and by neighborhood social disadvantage. As a secondary aim, gender differences will be explored for all drinking context-IPV outcomes. Project innovation includes a new application of social ecology theory and use of context-specific dose-response models that differentiate between the effects of the drinker's social environment (e.g., exposure to bars in respondent and adjacent neighborhoods) and amount of alcohol consumed in that environment. The proposed research is significant because it will advance understandings of how IPV is related to frequency of venue use and other contextual and environmental factors.
The proposed research is relevant to public health because the findings will provide new insights into how individual, contextual aspects of drinking, and environmental factors influence alcohol-related intimate partner violence. These findings can be used to design interventions aimed at preventing alcohol-related IPV among at-risk populations, and inform policy recommendations concerning alcohol outlet densities (e.g., zoning regulations).
