The authors previously reported effects of the CMCA (Communities Mobilising for Change on Alcohol) intervention in reducing social and commercial access to alcohol by youth, and reducing alcohol use by 18-20-year-olds. This paper reports on effects of CMCA on arrests and car crashes. CMCA was a group-randomised trial that implemented and evaluated a community-organising effort to change community policies and practices to reduce youth access to alcohol. Seven Midwestern communities were randomly assigned to the intervention condition and eight communities were assigned to the control condition. For 2.5 years, a part-time community organiser worked in each of the seven intervention communities with local public officials, enforcement agencies, alcohol merchants, the media, schools and other community groups to reduce youth access to alcohol. The authors collected annual arrest and quarterly traffic crash data for the years 1987-1995, providing a 6-year baseline and 3 years of data during the intervention. Data were stratified into two target age groups (15-17 and 18-20) and a control group (age 21 and over). Analyses were random-coefficient models because the authors had repeated observations for each unit of assignment in a group-randomised trial with heterogeneous trends across communities. The authors observed net declines in the intervention communities for all arrest and traffic crash indicators. The decline was statistically significant for DUI arrests aiming 18-20-year-olds and approached significance for DUI arrests and disorderly conduct violations among 15-17-year-olds. Together with previously published results from this study, the results reported here suggest that a community-organising approach to limit access to alcohol may be effective, at least for selected endpoints and subgroups. The authors conclude that this approach may be useful, but that a longer intervention period is required to increase effectiveness. (Author/publisher)
Samenvatting