Mills Britain A, Caetano Raul, Vaeth Patrice
University of Texas School of Public Health - Dallas , Dallas, Texas.
Alcohol Clin Exp Res. 2014 Nov;38(11):2809-15. doi: 10.1111/acer.12548. Epub 2014 Oct 21.
Rates of alcohol-related outcomes are sensitive to policy differences in politically distinct, adjacent territories. Factors that shape these cross-border effects, particularly when the policy differences are longstanding, remain poorly understood. We compared the ability of 2 classes of variables with theoretical relevance to the U.S.-Mexico border context-bar attendance and alcohol-related social-cognitive variables-to explain elevated drinking on the U.S. side of the border relative to other areas of the United States.
Data were collected from multistage cluster samples of adult Mexican Americans on and off the U.S.-Mexico border (current drinker N = 1,351). Structural equation models were used to test drinking context (frequency of bar attendance) and 6 different social-cognitive variables (including alcohol-related attitudes, norms, motives, and beliefs) as mediators of border effects on a composite drinking index.
The border effect on drinking varied by age (with younger adults showing a stronger effect), consistent with previous findings and known risk factors in the region. Contrary to theoretical expectations, 6 different social-cognitive variables-despite relating strongly with drinking-were comparable in border and nonborder areas (within and across age) and played no role in elevated drinking on the border. Conversely, elevated drinking among border youth was mediated by bar attendance. This mediated moderation effect held after adjusting for potential sociodemographic and neighborhood-level confounders.
Increased drinking among U.S.-Mexico border youth is explained by patterns of bar attendance, but not by more permissive alcohol-related social-cognitive variables in border areas: Border youth attend bars and drink more than their nonborder counterparts, despite having comparable alcohol-related beliefs, attitudes, norms, and motives for use. Alcohol's heightened availability and visibility on both sides of the border may create opportunities for border youth to drink that otherwise would not be considered.
与酒精相关后果的发生率对政治上不同的相邻地区的政策差异很敏感。影响这些跨境效应的因素，尤其是当政策差异长期存在时，仍知之甚少。我们比较了两类与美墨边境情况具有理论相关性的变量——酒吧光顾情况和与酒精相关的社会认知变量——来解释边境美国一侧相对于美国其他地区饮酒量增加的情况。
从美墨边境内外的成年墨西哥裔美国人的多阶段整群样本中收集数据（当前饮酒者N = 1351）。结构方程模型用于测试饮酒环境（酒吧光顾频率）和6种不同的社会认知变量（包括与酒精相关的态度、规范、动机和信念）作为边境效应在综合饮酒指数上的中介变量。
边境对饮酒的影响因年龄而异（年轻人的影响更强），这与之前的研究结果以及该地区已知的风险因素一致。与理论预期相反，6种不同的社会认知变量——尽管与饮酒密切相关——在边境和非边境地区（在年龄组内和年龄组间）相当，并且在边境饮酒量增加方面没有起到作用。相反，边境青少年饮酒量增加是由酒吧光顾情况介导的。在调整了潜在的社会人口学和邻里层面的混杂因素后，这种中介调节效应依然存在。
美墨边境青少年饮酒量增加是由酒吧光顾模式所解释的，而不是边境地区更宽松的与酒精相关的社会认知变量：边境青少年光顾酒吧且饮酒比非边境同龄人更多，尽管他们在与酒精相关的信念、态度、规范和使用动机方面相当。边境两侧酒精的可得性和可见度增加可能为边境青少年创造了原本不会被考虑的饮酒机会。
