Section of General Internal Medicine, Boston Medical Center, Boston, Massachusetts; Department of Community Health Sciences, Boston, Massachusetts.
Section of General Internal Medicine, Boston Medical Center, Boston, Massachusetts.
Am J Prev Med. 2014 Jan;46(1):10-6. doi: 10.1016/j.amepre.2013.07.015.
Of outcomes related to excessive drinking, binge drinking accounts for approximately half of alcohol-attributable deaths, two thirds of years of potential life lost, and three fourths of economic costs. The extent to which the alcohol policy environment accounts for differences in binge drinking in U.S. states is unknown.
The goal of the study was to describe the development of an Alcohol Policy Scale (APS) designed to measure the aggregate state-level alcohol policy environment in the U.S. and assess the relationship of APS scores to state-level adult binge drinking prevalence in U.S. states.
Policy efficacy and implementation ratings were developed with assistance from a panel of policy experts. Data on 29 policies in 50 states and Washington DC from 2000-2010 were collected from multiple sources and analyzed between January 2012 and January 2013. Five methods of aggregating policy data to calculate APS scores were explored; all but one was weighted for relative policy efficacy and/or implementation. Adult (aged ≥18 years) binge drinking prevalence data from 2001-2010 was obtained from the Behavioral Risk Factor Surveillance System surveys. APS scores from a particular state-year were used to predict binge drinking prevalence during the following year.
All methods of calculating APS scores were significantly correlated (r >0.50), and all APS scores were significantly inversely associated with adult binge drinking prevalence. Introducing efficacy and implementation ratings optimized goodness of fit in statistical models (e.g., unadjusted beta=-3.90, p<0.0001, R(2)=0.31).
The composite measure(s) of the alcohol policy environment have internal and construct validity. Higher APS scores (representing stronger policy environments) were associated with less adult binge drinking and accounted for a substantial proportion of the state-level variation in binge drinking among U.S. states.
在与过量饮酒相关的后果中， binge drinking（狂饮）约占酒精相关死亡的一半、丧失三分之二的预期寿命年数和三分之四的经济成本。美国各州 binge drinking（狂饮）差异在多大程度上与酒精政策环境有关尚不清楚。
本研究的目的是描述一种酒精政策量表（APS）的开发，该量表旨在衡量美国各州的总体州级酒精政策环境，并评估 APS 评分与美国各州成年 binge drinking（狂饮）流行率之间的关系。
在一组政策专家的协助下，制定了政策效果和实施评分。2000-2010 年，从 50 个州和华盛顿特区收集了 29 项政策的数据，数据来源于多个来源，并于 2012 年 1 月至 2013 年 1 月进行了分析。探索了五种聚合政策数据以计算 APS 评分的方法；除一种方法外，所有方法都对相对政策效果和/或实施进行了加权。从 2001-2010 年的行为风险因素监测系统调查中获得了成年 binge drinking（狂饮）流行率数据。特定州年的 APS 评分用于预测次年的 binge drinking（狂饮）流行率。
所有计算 APS 评分的方法均显著相关（r>0.50），所有 APS 评分均与成年 binge drinking（狂饮）流行率呈显著负相关。引入效果和实施评分可优化统计模型的拟合优度（例如，未经调整的β=-3.90，p<0.0001，R(2)=0.31）。
酒精政策环境的综合指标具有内部和结构有效性。更高的 APS 评分（代表更强的政策环境）与更少的成年 binge drinking（狂饮）相关，并解释了美国各州 binge drinking（狂饮）水平的很大一部分州级差异。
