STAD, Centre for Psychiatry Research, Department of Clinical Neuroscience, Stockholm Health Care Services, Karolinska Institutet, & Region Stockholm, Stockholm, Sweden.
Department of Global Public Health, Centre for Psychiatry Research, Karolinska Institutet, & Region Stockholm, Stockholm, Sweden.
Front Public Health. 2024 Aug 7;12:1423708. doi: 10.3389/fpubh.2024.1423708. eCollection 2024.
In 1996, a multicomponent community-based alcohol prevention program in Responsible Beverage Service (RBS) targeting licensed premises was developed by STAD (Stockholm Prevents Alcohol and Drug Problems) and implemented in Stockholm, Sweden. The program consists of community mobilization and collaboration, training, and enforcement. Early evaluations have shown a significant increase in the refusal rates of alcohol service to intoxicated patrons, from 5% in 1996 to 70% in 2001, and a 29% decrease in the frequency of police-reported violence. A cost-effectiveness analysis showed a cost-saving ratio of 1:39. The program was institutionalized by a collaborative steering group consisting of community stakeholders. This study aimed to evaluate the long-term effects over 20 years of the RBS program. The indicator chosen was the rate of alcohol overserving to obviously intoxicated patrons at licensed premises in Stockholm.
A 20-year follow-up study was conducted using the same procedure as the baseline and previous follow-ups. Professional male actors (pseudopatrons) were trained by an expert panel to enact a standardized scene of obvious alcohol-intoxication. In 2016, 146 licensed premises located in the central part of Stockholm were randomly selected and visited. A review of program implementation from its initiation 1996 was conducted, examining critical events, including commitment from key actors in the community, training of bar staff, and enforcement.
At the 20-year follow-up, pseudopatrons were refused alcohol service in 76.7% of the attempts, which was at the same level (70%) as in the follow-up in 2001, thus indicating sustained effects of the RBS program. Compared with previous follow-ups, serving staff used more active intervention techniques in 2016 toward intoxicated patrons, such as refusing to take the order (56.9% in 2016 vs. 42.0% in 2001), and fewer passive techniques, such as ignoring patrons (6.5% in 2016 vs. 15.5% in 1999) or contacting a colleague (4.1% in 2016 vs. 25% in 2001).
The sustained long-term effects of the RBS program are unique and can be explained by the high level of institutionalization of the multicomponent program, which is still ongoing in Stockholm. These findings can inform the dissemination of the program to other countries and settings.
1996 年，STAD（斯德哥尔摩预防酒精和毒品问题）开发并在瑞典斯德哥尔摩实施了一项多组分基于社区的负责任饮料服务（RBS）酒精预防计划，针对持牌场所。该计划包括社区动员和合作、培训和执法。早期评估显示，拒绝向醉酒顾客提供酒精服务的比率显著增加，从 1996 年的 5%增加到 2001 年的 70%，警察报告的暴力事件频率下降了 29%。成本效益分析显示节省比例为 1:39。该计划由一个由社区利益相关者组成的合作指导小组制度化。本研究旨在评估 RBS 计划 20 多年的长期效果。选择的指标是斯德哥尔摩持牌场所向明显醉酒顾客提供酒精过量服务的比率。
使用与基线和以前的随访相同的程序进行了为期 20 年的随访研究。专业男演员（假顾客）由专家小组培训，以表演一个标准化的明显醉酒场景。2016 年，随机选择斯德哥尔摩中心区的 146 家持牌场所进行访问。审查了该计划从 1996 年开始实施的情况，审查了关键事件，包括社区关键行为者的承诺、酒吧员工的培训和执法。
在 20 年的随访中，假顾客在 76.7%的尝试中被拒绝提供酒精服务，这与 2001 年的随访水平（70%）相同，这表明 RBS 计划的持续效果。与以前的随访相比，2016 年服务人员对醉酒顾客使用了更多的主动干预技术，例如拒绝点菜（2016 年为 56.9%，2001 年为 42.0%），而较少使用被动技术，例如忽略顾客（2016 年为 6.5%，1999 年为 15.5%）或联系同事（2016 年为 4.1%，2001 年为 25%）。
RBS 计划的持续长期效果是独特的，可以用该多组分计划的高度制度化来解释，该计划仍在斯德哥尔摩进行。这些发现可以为该计划在其他国家和地区的传播提供信息。
