Abstract
Underage drinking is a serious public health problem in the Unites States. Alcohol is the most misused substance by youth under 21 years of age. In the past few decades since the passage of the Minimum Legal Drinking Age Act in 1984, several federally funded underage drinking prevention interventions have been implemented in the United States. Extensive research has been conducted on the topic including causes, consequences and mediating factors that result in high levels of underage drinking. The Substance Abuse and Mental Health Services Administration (SAMHSA) and the Center for Substance Abuse Prevention (CSAP), both federal agencies that oversee prevention of substance use problems in communities, have promoted the use of community-based strategies, including the Strategic Prevention Framework (SPF) as a theoretical model. This dissertation study uses a behavioral community approach to examine the effects of implementing the Strategic Prevention Framework (SPF) as a model to prevent underage drinking in seven Kansas communities. A multiple baseline study design with seven communities was used to examine the effectiveness of SPF implementation in reducing underage drinking outcomes in Kansas. Study findings indicate that the SPF implementation may have contributed to reducing underage drinking prevalence in treatment communities in which program, policy, and practice changes were implemented for a considerable period. All intervention communities had a decrease in prevalence and an increase in capacity, but there was variability in the results. The SPF also resulted in increased capacity and community readiness for change to implement underage drinking prevention interventions. These findings have implications for coalitions and funding agencies to understand the conditions under which underage drinking interventions are effective.