Wagenaar Alexander C, Toomey Traci L, Erickson Darin J
University of Florida, College of Medicine, Department of Epidemiology and Health Policy Research, USA.
Addiction. 2005 Mar;100(3):335-45. doi: 10.1111/j.1360-0443.2005.00973.x.
AIMS/INTERVENTION: The Complying with the Minimum Drinking Age project (CMDA) is a community trial designed to test effects of two interventions designed to reduce alcohol sales to minors: (1) training for management of retail alcohol establishments and (2) enforcement checks of alcohol establishments.
CMDA is a multi-community time-series quasi-experimental trial with a nested cohort design.
SETTING/PARTICIPANTS: CMDA was implemented in 20 cities in four geographic areas in the US Midwest.
The core outcome, propensity for alcohol sales to minors, was directly tested with research staff who attempted to purchase alcohol without showing age identification using a standardized protocol in 602 on-premise and 340 off-premise alcohol establishments. Data were collected every other week in all communities over 4 years. Mixed-model regression and Box-Jenkins time-series analyses were used to assess short- and long-term establishment-specific and general community-level effects of the two interventions.
Effects of the training intervention were mixed. Specific deterrent effects were observed for enforcement checks, with an immediate 17% reduction in likelihood of sales to minors. These effects decayed entirely within 3 months in off-premise establishments and to an 8.2% reduction in on-premise establishments.
Enforcement checks prevent alcohol sales to minors. At the intensity levels tested, enforcement primarily affected specific establishments checked, with limited diffusion to the whole community. Finally, most of the enforcement effect decayed within 3 months, suggesting that a regular schedule of enforcement is necessary to maintain deterrence.
目的/干预措施：遵守最低饮酒年龄项目（CMDA）是一项社区试验，旨在测试两种旨在减少向未成年人售酒的干预措施的效果：（1）对酒类零售场所管理人员的培训；（2）对酒类场所的执法检查。
CMDA是一项多社区时间序列准实验性试验，采用嵌套队列设计。
地点/参与者：CMDA在美国中西部四个地理区域的20个城市实施。
核心结果，即向未成年人售酒的倾向，由研究人员直接测试，他们使用标准化方案，在602家店内售酒场所和340家店外售酒场所不出示年龄证明试图购买酒类。在4年时间里，每隔一周在所有社区收集数据。使用混合模型回归和Box-Jenkins时间序列分析来评估这两种干预措施对特定场所和整个社区层面的短期和长期影响。
培训干预的效果参差不齐。观察到执法检查有特定的威慑作用，向未成年人售酒的可能性立即降低了17%。这些效果在店外场所3个月内完全消失，在店内场所降至8.2%。
执法检查可防止向未成年人售酒。在所测试的强度水平下，执法主要影响接受检查的特定场所，对整个社区的传播有限。最后，大多数执法效果在3个月内消失，这表明需要定期进行执法以维持威慑力。
