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限制军队社区内酒精饮料的零售时间。

Restricting Retail Hours of Alcohol Sales within an Army Community.

作者信息

Grattan Lauren E, Mengistu Brittney S, Bullock Steven H, Santo Theresa Jackson, Jackson Dawnyéa D

机构信息

Public Health Research Division, RTI International, 3040 East Cornwallis Road, P.O. Box 12194, Research Triangle Park, NC 27709-2194.

Oak Ridge Institute for Science and Education (ORISE), Oak Ridge Associated, Universities (ORAU), Former Participant in Support of U.S. Army Public Health Center, Health Promotion and Wellness Directorate, Public Health Assessment Division, ORAU, 4692 Millennium Drive, Suite 101, Belcamp, MD 21017.

出版信息

Mil Med. 2019 Oct 1;184(9-10):e400-e405. doi: 10.1093/milmed/usz044.

Abstract

INTRODUCTION

Excessive alcohol consumption continues to be a significant concern to overall military readiness; each year, it results in non-deployable active duty service members and service members separated from service. In 2009, The Community Preventive Services Task Force recommended limiting the hours of alcohol sales as an evidence-based and effective intervention to reduce alcohol-related harms. In June 2014, partnerships at an Army Installation in the Midwestern United States implemented a policy to reduce excessive alcohol consumption and associated alcohol-related harms. Although community-based interventions have been shown to successfully reduce alcohol-related negative consequences, little research has explored the effects of these interventions in military communities.

MATERIALS AND METHODS

The intervention reduced the retail sale of alcoholic beverages by eight hours daily (11:01 pm to 6:59 am) within the installation community. The U.S. Army Public Health Review Board approved this study as public health practice. The quantitative assessment from a mixed-methods evaluation implemented an interrupted time series design to assess changes in the community resulting from the intervention. Revenue and crime data were collected 11 months and 12 months prior to and after the onset of the intervention, respectively, to quantify the adherence to and effectiveness of the policy. The outcome variables measured in the evaluation were Serious Incident Reports (SIRs) and Driving Under the Influence/Driving While Intoxicated (DUI/DWI) citations. A Wilcoxon Signed-Rank Test of significance was used to measure changes in crime outcomes post-policy.

RESULTS

The results indicated that pre-policy rates of overall DUI/DWI citations, and DUI/DWI citations on-post were significantly higher than post-policy DUI/DWI citations (p < 0.05). The results also indicated that pre-policy rates of overall SIRS, alcohol-related SIRs, and SIRs occurring at night were not statistically higher than post-policy rates (p ≥ 0.05). The pre-policy DUI/DWI citations occurring off-post and DUI/DWI citations occurring at night did not reach statistical significance (p > 0.05). Policy adherence was good and total alcohol sales revenue remained stable before and after policy implementation.

CONCLUSIONS

This was the first known evaluation within a military community to report improvements in crime statistics following an eight hour reduction in daily retail sale hours of alcohol. The reduction in alcohol-related harms presented in this evaluation are typical for small communities implementing alcohol-related policies; however, the effect sizes reported here are larger than those reported in the current literature, suggesting that the policy positively impacted the installation community in decreasing alcohol-related harms. Evaluation data did not show statistically significant reductions in DUI/DWI citations and SIRs occurring during night hours. Further, the evaluation design disallows the ability to draw a causal relationship between the intervention and measured outcomes. Additional installations should consider implementing similar policies to determine if observed effects are replicable. Future studies should include a longitudinal design that would allow for long-lasting changes to be observed within the population, measurement of additional proximal outcomes (e.g., reported alcohol consumption), and investigating social and health outcomes both inside and outside the confines of the installation community.

摘要

引言

过量饮酒仍然是影响军队整体战备状态的一个重大问题;每年,它都会导致现役军人无法部署以及军人退役。2009年,社区预防服务工作组建议限制酒精销售时间,作为一项基于证据的有效干预措施,以减少与酒精相关的危害。2014年6月,美国中西部一个陆军基地的合作伙伴实施了一项政策,以减少过量饮酒及相关的酒精相关危害。尽管基于社区的干预措施已被证明能成功减少与酒精相关的负面后果,但很少有研究探讨这些干预措施在军事社区中的效果。

材料与方法

该干预措施将基地社区内酒精饮料的零售时间每天减少8小时(晚上11:01至次日早上6:59)。美国陆军公共卫生审查委员会批准了这项研究作为公共卫生实践。一项混合方法评估的定量评估采用了中断时间序列设计,以评估该干预措施给社区带来的变化。分别在干预措施实施前11个月和实施后12个月收集收入和犯罪数据,以量化该政策的执行情况和有效性。评估中测量的结果变量是严重事件报告(SIRs)以及酒后驾车/醉酒驾车(DUI/DWI)罚单。采用Wilcoxon符号秩检验来衡量政策实施后犯罪结果的变化。

结果

结果表明总体DUI/DWI罚单的政策实施前比率以及基地内DUI/DWI罚单的政策实施前比率显著高于政策实施后的DUI/DWI罚单比率(p < 0.05)。结果还表明总体SIRs、与酒精相关的SIRs以及夜间发生的SIRs的政策实施前比率在统计学上并不高于政策实施后比率(p≥0.05)。基地外发生的政策实施前DUI/DWI罚单以及夜间发生的DUI/DWI罚单未达到统计学显著性(p > 0.05)。政策执行情况良好,政策实施前后酒精销售总收入保持稳定。

结论

这是军事社区内首次有已知的评估报告称,在将酒精零售时间每日减少8小时后犯罪统计数据有所改善。本评估中呈现的与酒精相关危害的减少在实施酒精相关政策的小社区中很典型;然而,这里报告的效应大小大于当前文献中报告的效应大小,这表明该政策对基地社区减少与酒精相关危害产生了积极影响。评估数据未显示夜间发生的DUI/DWI罚单和SIRs有统计学上的显著减少。此外,评估设计不允许在干预措施与测量结果之间建立因果关系。其他基地应考虑实施类似政策,以确定观察到的效果是否可复制。未来的研究应包括纵向设计,以便能够观察到人群中的长期变化,测量更多的近端结果(如报告的酒精消费量),并调查基地社区范围内外的社会和健康结果。

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