Examining the Effects of a Comprehensive Community Intervention on Underage Drinking in Seven Kansas Communities

Abstract

In the United States, underage drinking, or alcohol consumption by individuals younger than 21 years, is the most common type of substance abused by youth. Underage drinking is associated with violent and risky sexual behaviors, and is a major predictor of later alcohol abuse in adulthood. A number of antecedents are associated with underage drinking including social norms, social access, and enforcement of alcohol policies. The Strategic Prevention Framework (SPF) is a model developed by the Substance Abuse and Mental Health Services Administration to guide communities in addressing substance abuse through effective prevention efforts. While most states in the nation have received funding to implement the framework, there are few published studies that exist examining the effects of SPF implementation on underage drinking outcomes. The two studies presented in the dissertation used a mixed-methods approach to examine the effects of a comprehensive community intervention on underage drinking outcomes in seven Kansas communities implementing the SPF model. The second study further examines the association between the level of intensity, or dose, of the comprehensive community change interventions (i.e., program, policy, practice changes) across the seven communities and improvements in underage drinking outcomes over time. The results show a 34.3% reduction in past 30-day self-reported alcohol consumption among youth between 2006 and 2012. Additionally, a strong and statistically significant correlation existed between the intensity of community change interventions and underage drinking outcomes. The study provides empirical support for the Strategic Prevention Framework as an effective approach for implementing comprehensive interventions to reduce and prevent underage drinking in communities.