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Binge drinking can result in various types of harms including traffic crashes. Bars and restaurants that serve alcohol to patrons who are obviously intoxicated (i.e., overservice) contribute to these crashes. One strategy to address overservice is place of last drink (POLD) where law enforcement officers responding to alcohol-related incidents inquire about where the individuals last drank alcohol. This information may then be used to identify bars and restaurants that frequently overserve alcohol. There is limited evaluation of the effectiveness of POLD in reducing overservice, traffic crashes and other harms.We evaluated effects of a POLD initiative, developed by some law enforcement agencies in Minnesota (USA), on alcohol-related traffic crashes from 2010 to 2019. Among 89 intervention (POLD) vs. comparison communities, we fit regression models with participation in POLD as the predictor. As secondary analyses, we fit models with POLD implementation level as the predictor (implementation levels were assessed via a survey of law enforcement agencies). We controlled for relevant community and agency characteristics.In the model with participation in POLD as a predictor, there was little difference in the rate of total alcohol-related crashes (rate ratio [RR] = 1.07, 95% CI: 0.85-1.34). In the model with level of implementation as a predictor, the rate of total alcohol-related crashes was comparable between communities with high implementation and those with no implementation (RR = 0.89; 95% CI: 0.71-1.10). Similar results were seen for non-fatal injury and property damage alcohol-related crash outcomes.This study found little evidence that the POLD initiative, as currently implemented, was associated with reductions in traffic crashes across communities in Minnesota. Further research could explore whether specific characteristics of POLD are particularly important and whether POLD could be combined with other strategies to reduce traffic crashes as well as other alcohol-related harms.

Excessive alcohol consumption leads to a range of public health problems and social and financial burdens. Traffic crashes resulting from alcohol-involved driving are a major contributor to the overall health consequences of alcohol. Various laws and enforcement strategies aim to prevent alcohol-involved driving. The extent to which law enforcement agencies prioritize enforcement of alcohol-impaired driving laws can help to reduce alcohol-impaired driving. Among law enforcement agencies in the US, we examined prioritization of alcohol-impaired driving enforcement and how it is associated with use of specific enforcement strategies, as well as agency and community characteristics.We conducted a survey of a national sample of 1,024 US police and sheriff agencies in 2019. We assessed prioritization of alcohol-impaired driving enforcement, use of specific enforcement strategies (saturation patrols, sobriety checkpoints, open container law enforcement, training field officers to identify driving impairment), and agency and jurisdiction characteristics. We assessed how priority of enforcement (high vs. low) was associated with use of specific strategies, and agency and jurisdiction characteristics using regression models that accounted for agencies nesting within states.A majority of agencies (68%) placed a high priority on alcohol-impaired driving enforcement. Almost all agencies (93%) reported performing at least one alcohol-impaired driving enforcement strategy and the most common strategy used was saturation patrols. Agencies that prioritized alcohol-impaired driving enforcement were more likely to use sobriety checkpoints and saturation patrols, conduct enforcement of open container laws and train field officers in identifying driving impairment (p 0.05). They were also more likely to have an officer assigned primarily to alcohol enforcement, have an alcohol division, and serve jurisdictions that had fewer Black residents (p 0.05).Many law enforcement agencies utilize strategies to address alcohol-impaired driving, however, some strategies are underutilized and an opportunity exists for agencies to incorporate additional strategies to help prevent alcohol-impaired driving. Agencies that made alcohol-impaired driving enforcement a priority were more likely to conduct related enforcement strategies. Encouraging police and sheriff agencies to prioritize alcohol-impaired driving enforcement may be an effective approach for preventing alcohol-related harms.

Neighborhood context may influence alcohol use, but effects may be heterogeneous, and prior evidence is threatened by confounding. We leveraged a housing voucher experiment to test whether housing vouchers' effects on alcohol use differed for families of children with and without socioemotional health or socioeconomic vulnerabilities.In the Moving to Opportunity (MTO) study, low-income families in public housing in five US cities were randomized in 1994 to 1998 to receive one of three treatments: (1) a housing voucher redeemable in a low-poverty neighborhood plus housing counseling, (2) a housing voucher without locational restriction, or (3) no voucher (control). Alcohol use was assessed 10 to 15 years later (2008 to 2010) in youth ages 13 to 20, N = 4600, and their mothers, N = 3200.Using intention-to-treat covariate-adjusted regression models, we interacted MTO treatment with baseline socioemotional health vulnerabilities, testing modifiers of treatment on alcohol use.We found treatment effect modification by socioemotional factors. For youth, MTO voucher treatment, compared with controls, reduced the odds of ever drinking alcohol if youth had behavior problems (OR = 0.26, 95% CI [0.09, 0.72]) or problems at school (OR = 0.46, [0.26, 0.82]). MTO low-poverty treatment (vs. controls) also reduced the number of drinks if their health required special medicine/equipment (OR = 0.50 [0.32, 0.80]). Yet treatment effects were nonsignificant among youth without socioemotional vulnerabilities. Among mothers of children with learning problems, MTO voucher treatment (vs. controls) reduced past-month drinking (OR = 0.69 [0.47, 0.99]), but was harmful otherwise (OR = 1.22 [0.99, 1.45]).For low-income adolescents with special needs/socioemotional problems, housing vouchers protect against alcohol use.

In the first round of this Delphi study 14 experts suggested strategies for improving life-satisfaction. In a second round, experts rated these strategies for (a) effectiveness, (b) feasibility and (c) cost-effectiveness. They considered 56 strategies policy makers can use to raise average happiness in a nation and 68 ways in which individuals can raise their own happiness. Experts were informed about the average ratings made by the panel and about the arguments advanced. Then, in a third round, experts made their final judgments. Summed ratings for average effectiveness and feasibility of the strategies ranged between 8.4 and 4.9 on scale 2–10, which means that most of the recommendations were deemed suitable. Agreement was slightly higher on policy strategies than on individual ways to greater happiness. Policy strategies deemed the most effective and feasible are: (1) investing in happiness research, (2) support of vulnerable people and (3) improving the social climate, in particular by promoting voluntary work and supporting non-profits. Individual strategies deemed most effective are: (a) investing in social networks, (b) doing meaningful things and (c) caring for one’s health.

Older drivers are expected to make up about 25% of licensed U.S. drivers by 2050. Describing early predictors of driving difficulty can identify interventions that might delay driving cessation or support successful transition to driving retirement. In this exploratory study, we analyzed nationally representative data from the longitudinal National Social Life, Health, and Aging Project (NSHAP) conducted in 2005–06, 2010-11, and 2015-16. Our purpose was to ascertain mental health and physical functioning correlates of increased nighttime driving difficulty, which often precedes daytime difficulties. The sample included 1,454 drivers with observations at all 3 waves aged 57 to 85 at baseline. By wave three, adjusting for non-response and sampling bias, 59% reported no driving difficulty, 23% reported some or much difficulty, and 17% reported no longer being able to drive at night. Results of mixed-effect ordinal logistic models, adjusting for demographics, showed increased inability to drive at night was associated most strongly with self-report of poor or fair physical health (OR=10.4, 95%CI=6.2,17.5; OR=2.4, 95%CI=1.8,3.2), considering oneself “not at all active” (OR=2.9, 95%CI=1.3, 6.4), and being unable to balance heel-to-toe for 10 seconds (unsuccessful attempt: OR=4.8,95%CI=1.5,15.5; less than 10 seconds: OR=2.3, 95%CI=1.1,4.9). Although generalized self-reported mental health was not associated with increased nighttime driving difficulty, each additional depressive symptom (CESD-11) increased the odds of having greater driving difficulty by 12% (95%CI=1.1, 1.5). This study found early predictors of increased nighttime driving difficulty and retirement, providing opportunity to inform interventions to reduce roadway risk to older adults and others.

OBJECTIVE. Over 10,000 people die in alcohol-impaired-driving traffic crashes every year in the U.S. Approximately half of alcohol-impaired drivers report their last drink was at a bar or restaurant, and most bars and restaurants serve alcohol to patrons who are already intoxicated, known as overservice. Law enforcement agencies use various strategies to address alcohol-impaired driving and overservice but research on the effectiveness of these strategies is limited. Our objective was to assess whether law enforcement efforts focusing on alcohol-impaired driving and alcohol overservice were associated with alcohol-impaired-driving fatal traffic crashes. METHODS. We conducted a survey of police and sheriff agencies in 1,082 communities across the U.S. in 2010 regarding their alcohol enforcement practices. We assessed whether the agency conducted: (1) alcohol overservice enforcement and (2) alcohol-impaired driving enforcement (sobriety checkpoints, saturation patrols, open container, overall alcohol-impaired driving enforcement). From the Fatality Analysis Reporting System (2009–2013), we obtained counts of alcohol-impaired-driving fatal traffic crashes (at least one driver had blood alcohol content ≥ 0.08) within the agency’s jurisdiction boundary and within a 10-mile buffer. Using multi-level regression, we assessed whether each enforcement type was associated with alcohol-impaired-driving fatal crashes (per 100,000 population). For both the jurisdiction boundary and 10-mile buffer, we ran stratified models based on community/agency type: (1) small town/rural police; (2) urban/suburban police and (3) sheriffs. RESULTS. In jurisdiction boundary models, urban/suburban communities where police conducted overservice enforcement (compared to those that did not) had fewer alcohol-impaired-driving fatal crashes (5.0 vs. 6.6; p=0.01). For the 10-mile buffer, small town/rural communities where police agencies conducted overservice enforcement (compared to those that did not) had fewer alcohol-impaired-driving fatal crashes (16.9 vs. 21.2; p=0.01); we found similar results for small town/rural communities where police used saturation patrols (18.7 vs. 22.1; p=0.05) and had overall high alcohol-impaired driving enforcement (18.7 vs. 22.1; p=0.05). The direction and the size of the effects for other types of enforcement and agencies were similar, but not statistically significant. CONCLUSIONS. Alcohol enforcement strategies among police agencies in small town/rural communities may be particularly effective in reducing alcohol-impaired fatal traffic crashes. Results varied by enforcement, agency and community type.

Objective:Medical amnesty policies aim to encourage individuals to help their peers who have been drinking too much by providing immunity for alcohol policy violations. We examined college students...

OBJECTIVES: The fit of measured variables into a social-ecological model of correlates of physical activity is rarely tested. In this study, we examined the factor structure of correlates of moderate/vigorous physical activity (MVPA) within a hypothesized social-ecological model. METHODS: We measured 46 possible personal, social and environmental correlates of MVPA in 2779 adolescents participating in the Project EAT-2010 study. Confirmatory (CFA) and exploratory factor analyses (EFA) were used to determine the factor structure. Associations of factor scores with self-reported MVPA were calculated with linear regression. RESULTS: A 6-factor CFA model did not show adequate fit. Eight factors were identified using EFA (Root Mean Square Error [RMSEA] 90% CI: 0.053 to 0.055; CFI = 0.82). A factor representing the mix of personal and social correlates showed the strongest association with MVPA. CONCLUSIONS: The 8-factor model supports independent clustering of possible environmental correlates of MVPA, but indicates that social and personal correlates may not cluster independently. The factor most strongly correlated with MVPA represented a mix of personal and social correlates. Future work will be needed to better understand how mechanisms for developing physical activity work within and across levels of the social-ecological framework.

Background We evaluated the effectiveness of Alcohol Impact Areas (AIA) in reducing crime around off-premise alcohol outlets in 3 AIAs in Spokane and Tacoma, Washington, using an interrupted time series design with comparison groups. AIAs only exist in Washington and include designated areas in a city where specific brands of malt liquor are restricted. We hypothesized that mandatory restrictions on malt liquor sales in AIAs would be significantly associated with decreases in crime, especially less-serious crime. Methods In Spokane and Tacoma, targets were 3 AIAs and 3 comparison areas with demographically similar neighborhoods without malt liquor restrictions in the same respective city. Nine different crime outcomes were evaluated: Part I selected crimes, Part II selected crimes (further split into nuisance crimes and other Part II crimes), assaults, vandalism, narcotics, disorderly conduct, and all selected crimes combined. Crime was typically compared 3 years prior to and 3 years following policy adoption using time series and negative-binomial modeling. Separate models were run for each area and each crime. Results Study hypotheses were partially supported. Malt liquor restrictions in AIAs were associated with significant decreases in crime, particularly certain Part II crimes and assaults (simple and aggravated) in 12 of the 23 models. The strength of the observed associations varied by AIA. Average monthly crime counts across all crime categories decreased more in the Tacoma AIA than in Spokane AIAs, and average monthly crime decreased more in Spokane AIA 2 (East Central) than in AIA 1 (Downtown Core). Malt liquor restrictions were significantly associated with increases in disorderly conduct in the Tacoma AIA; the increase, however, was small. Conclusions Findings suggest that malt liquor policies such as AIAs may be one of a number of tools local officials can use to reduce alcohol-related crime in cities, especially less-serious crime.

AIMS To test how a housing voucher generating residential mobility to lower-poverty neighborhoods, compared with public housing controls, influenced adolescent binge drinking, and whether gender modified effects. DESIGN A multi-site household-level three-arm randomized trial of a housing intervention executed 1994-98, evaluated 2001-02. SETTING Five US cities: Baltimore, MD; Boston, MA; Chicago, IL; Los Angeles, CA; and New York, NY. PARTICIPANTS A total of 3537 adolescents in 4248 low-income eligible families were randomized; 2829 adolescents were analyzed at the interim evaluation (1950 in treatment; 879 in the control group). Attrition bias was accounted for with a 3-in-10 oversampling of hard-to-reach participants (effective response rate: 89%). INTERVENTIONS The Moving to Opportunity (MTO) trial randomized volunteer low-income families in public housing to receive (1) rental subsidies redeemable in neighborhoods with

Background: Two Healthy People 2020 goals are to increase physical activity (PA) and to reduce disparities in PA. We explored whether PA at the school level changed over time in Minnesota schools and whether differences existed by demographic and socioeconomic factors. Methods: We examine self-reported PA (n = 276,089 students; N = 276 schools) for 2001–2010 from the Minnesota Student Survey linked to school demographic data from the National Center for Education Statistics and the Rural–Urban Commuting Area Codes. We conducted analyses at the school level using multivariable linear regression with cluster-robust recommendation errors. Results: Overall, students who met PA recommendations increased from 59.8% in 2001 to 66.3% in 2010 (P P Conclusions: We found increasing inequalities in school-level PA by racial/ethnic characteristics of their schools and communities among secondary school students. Future research should monitor patterns of PA over time and explore mechanisms for patterns of inequality.

Background:Interventions to raise population physical activity generally show modest effects; one possible reason is that trends and determinants of moderate to vigorous physical activity (MVPA) differ between population subgroups. This study examined differences in trends and determinants of reported MVPA by ethnicity/race and sex in a 15-year longitudinal study.Methods:Participants (n = 2092) in the Project Eating and Activity in Teens and Young Adults study were surveyed on MVPA behavior and potential determinants from adolescence to young adulthood. Generalized estimating equations were used to model age trends in MVPA and associations with determinants.Results:Mean MVPA declined by 2.1 hours per week over 15 years of follow-up from adolescence to young adulthood. Asian males reported the lowest levels of MVPA at each age. Nonwhite females reported less MVPA than white females at each age. The association of body mass index (BMI) with MVPA differed by sex and ethnicity/race. Asian males and females showed lower levels of MVPA at both low and high BMI.Conclusions:Interventions to increase MVPA may need to begin earlier among Asian men and nonwhite women than among other groups. Asian adolescents with lower BMI show lower MVPA and may benefit from additional intervention efforts compared with Asian adolescents with normal BMI.

INTRODUCTION AND AIMS Irresponsible and illegal serving practices at bars and restaurants, such as sales to obviously intoxicated patrons, can lead to various public health harms. Training managers of bars and restaurants in the development and promotion of responsible alcohol policies may help prevent risky and illegal alcohol serving practices. DESIGN AND METHODS We implemented a training program for managers of bars/restaurants designed to establish and promote responsible beverage service policies/practices. The program included online and in-person components. Bars/restaurants were randomised to intervention (n = 171) and control (n = 163) groups. To assess changes in policies/practices, we surveyed managers prior to and at 1 and 6 months post-training. Logistic regression models assessed changes in policies/practices across time points. RESULTS The proportion in the intervention group that had written alcohol policies increased from 62% to 95% by 6 months post-training while the control group increased from 65% to 79% (P

Despite calls for more cross-sector collaboration on obesity prevention, little is known about the role of collaborative partnerships, or groups of organizations from different sectors working together toward a shared goal, in state policy activities. This study examined associations between competitive food/beverage and physical education policies and state-level collaboration and state characteristics (obesity, socioeconomic indicators, public health funding levels) for all 50 states and the District of Columbia, USA, in 2012. We examined cross-sectional associations between evidence-based competitive food/beverage and physical education policies from the Classification of Laws Associated with School Students and state characteristics from the School Health Policies and Practices Study and other national data sources using prevalence ratios and generalized linear models. Analyses were conducted in 2016. Cross-sector collaboration (i.e., state staff reports of working together on school nutrition or physical education activities) between state-level nutrition and physical education staff and ten types of organizations was not significantly associated with having state policies. Childhood obesity (RR=1.78, 95% CI[1.11,2.85]), high-school non-completion (RR=2.35, 95% CI[1.36,4.06]), poverty (RR=1.89, 95% CI[1.16,3.09]) and proportion non-white or Hispanic residents (RR=1.75, 95% CI[1.07, 2.85]) were positively associated with the presence of elementary school competitive food/beverage policies. Fewer indicators were associated with policies for middle and high schools. The large investment of time and resources required for cross-sector collaboration demands greater research evidence on how to structure and manage collaborative partnerships for the greatest impact.

Many US cities have adopted legal restrictions on high-alcohol malt liquor sales in response to reports of crime and nuisance behaviors around retail alcohol outlets. We assessed whether these policies are effective in reducing crime in urban areas. We used a rigorous interrupted time-series design with comparison groups to examine monthly crime rates in areas surrounding alcohol outlets in the 3 years before and after adoption of malt liquor sales restrictions in two US cities. Crime rates in matched comparison areas not subject to restrictions served as covariates. Novel methods for matching target and comparison areas using virtual neighborhood audits conducted in Google Street View are described. In Minneapolis, Minnesota, sales of single containers of 16 oz or less were prohibited in individual liquor stores (n = 6). In Washington, D.C., the sale of single containers of any size were prohibited in all retail alcohol outlets within full or partial wards (n = 6). Policy adoption was associated with modest reductions in crime, particularly assaults and vandalism, in both cities. All significant outcomes were in the hypothesized direction. Our results provide evidence that retail malt liquor sales restrictions, even relatively weak ones, can have modest effects on a range of crimes. Policy success may depend on community support and concurrent restrictions on malt liquor substitutes.

Excessive alcohol consumption can result from illegal sales to intoxicated patrons at bars and restaurants. We surveyed bar/restaurant managers about their practices in reducing illegal sales to intoxicated patrons. We found that managers were confident that they could refuse service to intoxicated customers but were less likely to have communicated necessary information to their staff on how to refuse such sales. Managers who agreed that a business in their community would be cited for overservice were more likely to be confident that they could handle customers who had been cut off from alcohol service. Our study suggests that bar/restaurant managers may need training to improve their communication with staff and that increased enforcement may lead to an increase in manager confidence in handling intoxicated patrons.

Background: Policy restrictions on malt liquor sales have been adopted in several cities throughout the United States in an effort to reduce crime around off-premise alcohol outlets. Although California has implemented the most restrictions on malt liquor sales, no studies in the published literature have evaluated the effects of these policies on reducing crime. Objectives: We evaluated the effectiveness of malt liquor restrictions on reducing crime around off-premise alcohol outlets in six California cities. We hypothesized that adoption of malt liquor policies would be significantly associated with decreases in crime within areas surrounding targeted outlets. Methods: We used an interrupted time-series design with control areas to examine the relationship between malt liquor policies and crime reduction. We compared crime rates three years prior and following adoption of malt liquor policies. Results: Malt liquor policies were associated with modest decreases in crime, largely Part II or less serious crimes such as simple assaults. The effectiveness of malt liquor policies varied by city, with reductions in crime greatest in Sacramento where policies were more restrictive than in other cities. Malt liquor policies were also associated with small increases in nuisance crime, especially in San Francisco. Conclusion: Results suggest that malt liquor policies may have modest effects on reducing crime when they include strong restrictions on the sale of malt liquor products. Results may be informative to other cities considering whether to maintain or change their malt liquor policies as well as cities considering placing restrictions on other high content beverages.

INTRODUCTION: Common life events such as getting married or gaining employment may be opportunities to intervene on health behaviors like physical activity. The purpose of this study was to determine the changes in moderate-to-vigorous physical activity (MVPA) associated with several common life events from adolescence to young adulthood. METHODS: Participants in Project EAT (ages 11 to 18 at baseline and 25 to 36 at wave 4) were surveyed at four time points from 1998 to 2016. Questions included marital status, employment status, post-secondary education completion and enrollment, and living situation between each wave. Linear regression was used to model the effect of each life event on change in self-reported MVPA. Post-hoc mediation analysis was conducted to examine whether having a child mediated the effect of getting married on the change in MVPA. RESULTS: Average MVPA declined from 6.5 hours per week at baseline to 4.3 hours per week at wave 4. Having a child was associated with a significant decrease in MVPA between waves 2 and 3 and between waves 3 and 4. Getting married and leaving parents’ home were associated with significant decreases in MVPA between waves 3 and 4. Having a child both mediated and moderated the effect of getting married on MVPA. CONCLUSION: This study provides evidence that MVPA declines both after getting married and after having a child and that these effects are not independent. Interventions to maintain or increase MVPA could profitably target couples planning to get married or have a child.

Introduction The School Obesity-related Policy Evaluation (ScOPE) Study uses existing public surveillance data and applies a rigorous study design to evaluate effectiveness of school policies and practices impacting student behavioral and weight outcomes. Methods The ScOPE Study used a cohort of 50 combined junior−senior and high schools in Minnesota to evaluate the change in weight-related policy environments in 2006 and 2012 and test the effect of policy change on students attending those schools in 2007 and 2013. Exposure variables included school practices about foods and beverages available in school vending machines and school stores, physical education requirements, and intramural opportunities. Primary study outcomes were average school-level ninth grade student BMI percentile, obesity prevalence, daily servings of fruits/vegetables, and daily glasses of soda. Results Availability of fruits/vegetables in schools was associated with a significant increase in total daily intake among ninth grade students by 0.4 servings. Availability of soda in schools was associated with a significant increase in total daily intake among ninth grade boys by 0.5 servings. Less-healthy snack and drink availability in schools was associated with a small, significant increase (1%) in student BMI percentile at the school level. Conclusions Use of a school-level longitudinal cohort study design over a 6-year period uniquely adds to the methodologic rigor of school policy and practice evaluation studies. The ScOPE Study provides marginal evidence that school policies and practices, especially those that restrict vending and school store offerings, may have small effects on weight status among ninth grade students.

The objective of this study was to assess how 2 types of drinking-driving laws-permitting sobriety checkpoints and prohibiting open containers of alcohol in motor vehicles-are associated with drinking-driving and how enforcement efforts may affect these associations.We obtained 2010 data on state-level drinking-driving laws and individual-level self-reported drinking-driving from archival sources (Alcohol Policy Information System, NHTSA, and Behavioral Risk Factor Surveillance System). We measured enforcement of the laws via a 2009 survey of state patrol agencies. We computed multilevel regression models (separate models for each type of law) that first examined how having the state law predicted drinking-driving, controlling for various state- and individual-level covariates; we then added the corresponding enforcement measure as another potential predictor.We found that states with a sobriety checkpoint law, compared with those without a law, had 18.2% lower drinking-driving; states that conducted sobriety checks at least monthly (vs. not conducting checks) had 40.6% lower drinking-driving (the state law variable was not significant when enforcement was added). We found no significant association between having an open container law and drinking-driving, but states that conducted open container enforcement, regardless of having a law, had 17.6% less drinking-driving.Our results suggest that having a sobriety checkpoint law and conducting checkpoints as well as enforcement of open containers laws may be effective strategies for addressing drinking-driving.

BACKGROUND: Excessive alcohol consumption at licensed alcohol establishments (i.e., bars and restaurants) has been directly linked to alcohol-related problems such as traffic crashes and violence. Historically, alcohol establishments have had a high likelihood of selling alcohol to obviously intoxicated patrons (also referred to as "overservice") despite laws prohibiting these sales. Given the risks associated with overservice and the need for up-to-date data, it is critical that we monitor the likelihood of sales to obviously intoxicated patrons. METHODS: To assess the current likelihood of a licensed alcohol establishment selling alcohol to an obviously intoxicated patron, we conducted pseudo-intoxicated purchase attempts (i.e., actors attempt to purchase alcohol while acting out obvious signs of intoxication) at 340 establishments in 1 Midwestern metropolitan area. We also measured characteristics of the establishments, the pseudo-intoxicated patrons, the servers, the managers, and the neighborhoods to assess whether these characteristics were associated with likelihood of sales of obviously intoxicated patrons. We assessed these associations with bivariate and multivariate regression models. RESULTS: Pseudo-intoxicated buyers were able to purchase alcohol at 82% of the establishments. In the fully adjusted multivariate regression model, only 1 of the characteristics we assessed was significantly associated with likelihood of selling to intoxicated patrons-establishments owned by a corporate entity had 3.6 greater odds of selling alcohol to a pseudo-intoxicated buyer compared to independently owned establishments. CONCLUSIONS: Given the risks associated with overservice of alcohol, more resources should be devoted first to identify effective interventions for decreasing overservice of alcohol and then to educate practitioners who are working in their communities to address this public health problem. Language: en

OBJECTIVE: We evaluated the effects of outlet and small area level malt liquor policies on crime in 10 U.S. cities and hypothesized that more restrictive malt liquor policies would be associated with greater reductions in crime. METHOD: We used a pooled time-series study design (i.e., panel regression) with comparison areas to test our hypothesis. Quarterly crime rates in targeted areas were compared 3 years before and after policy adoption. Four crime outcomes were analyzed: Selected Part II crimes, assaults, vandalism/property damage, and disorderly conduct. Both the presence and absence of a malt liquor policy (yes, no) and degree of restrictiveness of the malt liquor policy were assessed using a newly created measure of malt liquor policy restrictiveness developed by the investigators. Results were analyzed using a series of linear mixed models. RESULTS: Adoption of malt liquor policies was not associated with Part II selected crimes. For individual crimes (e.g., assaults, vandalism, disorderly conduct), we found mixed results as more restrictive malt liquor policies were significantly associated with decreases as well as increases in crime. In general, the evaluated policies were considered to be not highly restrictive. CONCLUSIONS: Our findings suggest that malt liquor policies at the outlet or small area level alone may not be sufficient to reduce crime associated with malt liquor use. Policies that are more restrictive or cover larger areas than assessed in the current study may be required to have an independent effect on crime outcomes.

Background: This study tested for differences in personal, social, and environmental correlates of moderate to vigorous physical activity (MVPA) across ethnicity/race in male and female adolescents. Methods: Self-reported MVPA and 47 potential correlates of MVPA were measured in an ethnically/racially diverse cross-sectional sample of adolescents, in Minnesota, who participated in EAT-2010 (Eating and Activity in Teens). Interactions of potential correlates with ethnicity/race on MVPA were tested in linear hierarchical regression models in boys and girls. Results: Boys reported 1.7 more weekly hours of MVPA than girls. White adolescents reported 1.1 to 2.1 more weekly hours of MVPA than nonwhite adolescents. Among girls, neighborhood road connectivity was negatively correlated with MVPA among Hispanic and Asian participants. Among boys, sports participation was positively correlated with MVPA among all ethnicities/races, except Asians. Home media equipment was positively correlated with MVPA among Hispanic boys, but negatively correlated among white boys. Conclusions: A few correlates of physical activity among adolescents differed intersectionally by ethnicity/race and sex. Sports participation and home media equipment may have differing impacts on physical activity across ethnicities and races in boys, whereas neighborhood features like road connectivity may have differing impacts on physical activity across ethnicities and races in girls.

Purpose: To test the effectiveness of an intervention to increase motivation for physical activity in racially diverse third- through fifth-grade students. Design: Natural experiment. Setting: Elementary schools in Minneapolis, Minnesota. Participants: Two hundred ninety-one students in 18 Minne-Loppet Ski Program classes and 210 students in 12 control classrooms from the same schools. Intervention: The Minne-Loppet Ski Program, an 8-week curriculum in elementary schools that teaches healthy physical activity behaviors through cross-country skiing. Measures: Pretest and posttest surveys measured self-determination theory outcomes: intrinsic exercise motivation, intrinsic ski motivation, autonomy, competence, and relatedness. Analysis: Hierarchical linear regression models tested treatment effects controlled for grade, race, sex, and baseline measures of the outcomes. Results: Minne-Loppet program students showed significantly greater motivation to ski (β = 0.95, 95% confidence interval [CI]: 0.15-1.75) and significantly greater perceived competence (β = 0.78, 95% CI: 0.06-1.50) than students in control classrooms. Treatment effects for general exercise motivation and perceived competence differed by race. African American students in Minne-Loppet classes showed significantly greater general exercise motivation (β = 1.08, 95% CI: 0.03-2.14) and perceived competence (β = 1.95, 95% CI: 0.91-2.99) than African American students in control classes. Conclusion: The Minne-Loppet program promoted perceived competence and motivation to ski. Future improvements to the Minne-Loppet and similar interventions should aim to build general motivation and provide support needed to better engage all participants.

Supplemental Material, Appendix_Tables for The Minne-Loppet Motivation Study: An Intervention to Increase Motivation for Outdoor Winter Physical Activity in Ethnically and Racially Diverse Elementary Schools by Jonathan M. Miller, Julian Wolfson, Melissa N. Laska, Toben F. Nelson, and Mark A. Pereira in American Journal of Health Promotion

BACKGROUND: The relationship between the alcohol policy environment (ie, the combined effectiveness and implementation of multiple existing alcohol policies) and youth drinking in the United States has not been assessed. We hypothesized that stronger alcohol policy environments are inversely associated with youth drinking, and this relationship is partly explained by adult drinking. METHODS: Alcohol Policy Scale (APS) scores that characterized the strength of the state-level alcohol policy environments were assessed with repeated cross-sectional Youth Risk Behavior Survey data of representative samples of high school students in grades 9 to 12, from biennial years between 1999 and 2011. RESULTS: In fully adjusted models, a 10 percentage point increase in APS scores (representing stronger policy environments) was associated with an 8% reduction in the odds of youth drinking and a 7% reduction in the odds of youth binge drinking. After we accounted for youth-oriented alcohol policies, the subgroup of population-oriented policies was independently associated with lower odds of youth drinking (adjusted odds ratio 0.94; 95% confidence interval 0.92–0.97) and youth binge drinking (adjusted odds ratio 0.96; 95% confidence interval 0.94–0.99). State-level per capita consumption mediated the relationship between population-oriented alcohol policies and binge drinking among youth. CONCLUSIONS: Stronger alcohol policies, including those that do not target youth specifically, are related to a reduced likelihood of youth alcohol consumption. These findings suggest that efforts to reduce youth drinking should incorporate population-based policies to reduce excessive drinking among adults as part of a comprehensive approach to preventing alcohol-related harms. Future research should examine influence of alcohol policy subgroups and discrete policies.

Objectives. We examined the relationships of the state-level alcohol policy environment and policy subgroups with individual-level binge drinking measures. Methods. We used generalized estimating equations regression models to relate the alcohol policy environment based on data from 29 policies in US states from 2004 to 2009 to 3 binge drinking measures in adults from the 2005 to 2010 Behavioral Risk Factor Surveillance System surveys. Results. A 10 percentage point higher alcohol policy environment score, which reflected increased policy effectiveness and implementation, was associated with an 8% lower adjusted odds of binge drinking and binge drinking 5 or more times, and a 10% lower adjusted odds of consuming 10 or more drinks. Policies that targeted the general population rather than the underage population, alcohol consumption rather than impaired driving, and raising the price or reducing the availability of alcohol had the strongest independent associations with reduced binge drinking. Alcohol taxes and outlet density accounted for approximately half of the effect magnitude observed for all policies. Conclusions. A small number of policies that raised alcohol prices and reduced its availability appeared to affect binge drinking.

Enforcement of alcohol-impaired driving laws is an important component of efforts to prevent alcohol-involved motor vehicle fatalities. Little is known about the use of drinking-driving enforcement strategies by state and local law enforcement agencies or whether the use of strategies differs by agency and jurisdiction characteristics.We conducted two national surveys, with state patrol agencies (n = 48) and with a sample of local law enforcement agencies (n = 1,082) selected according to state and jurisdiction population size. We examined 3 primary enforcement strategies (sobriety checkpoints, saturation patrols, and enforcement of open container laws) and tested whether use of these strategies differed by jurisdiction and agency characteristics across state and local law enforcement agenciesMost state patrol agencies reported conducting sobriety checkpoints (72.9%) and saturation patrols (95.8%), whereas less than half (43.8%) reported enforcing open container laws. In contrast, a lower proportion of local law enforcement agencies reported using these alcohol-impaired driving enforcement strategies (41.5, 62.7, and 41.1%, respectively). Sobriety checkpoint enforcement was more common in states in the dry South region (vs. wet and moderate regions). Among local law enforcement agencies, agencies with a full-time alcohol enforcement officer and agencies located in areas where drinking-driving was perceived to be very common (vs. not/somewhat common) were more likely to conduct multiple types of impaired driving enforcement.Recommended enforcement strategies to detect and prevent alcohol-impaired driving are employed in some jurisdictions and underutilized in others. Future research should explore the relationship of enforcement with drinking and driving behavior and alcohol-involved motor vehicle fatalities.

A considerable amount of attention and research has been dedicated to addressing alcohol use and related problems among students at 4-year colleges; however, less attention has been given to alcohol-related issues among students at 2-year technical/ community colleges. Total enrollment at US public 2-year colleges is approximately 10 million nationwide, which is about equal to undergraduate enrollment at public 4-year institutions (National Center for Education Statistics, 2013) In addition, many 2-year college students are young adults (American Association of Community Colleges, 2013), an age where alcohol use rates tend to be high (Maggs & Schulenberg, 2004), increasing the risk of alcohol-related problems such as poor academic performance (Singleton, 2007), relationship and legal issues (Sheffield, Darkes, Del Boca, & Goldman, 2005), and injuries and violence (Chen & Paschall, 2003). Two recent studies of college students across Minnesota (VanKim, Laska, Ehlinger, Lust, & Story, 2010; Velazquez et al., 2011) found that about two thirds of 2-year college students drank alcohol in the past month and at least one third reported binge drinking. Although these rates were somewhat lower than those among students at 4-year colleges, the differences were generally not statistically significant in adjusted analyses. A few earlier studies assessed prevalence of alcohol use among students at a single community college, finding somewhat lower rates of alcohol use than the more recent studies (Chen & Paschall, 2003; Sheffield et al., 2005). We identified only one peer-reviewed scientific study that examined what 2-year colleges are doing to address alcohol-related issues among their students. Chiauzzi and colleagues (2011) surveyed leaders at 100 community colleges in the United States (one respondent per college) regarding alcohol and other drug (AOD) prevention and programming efforts on their campuses. Respondents reported a high level of concern for underage drinking and binge drinking among students. About half of the respondents reported that their college had a staff person who devoted part of his or her time to AOD issues, and nearly all reported health awareness campaigns and counseling services that addressed AOD issues. Few respondents ( < 10%) reported implementation of alcohol screening and intervention services on their campus. Barriers to offering student health programs were funding (82%) and staffing (73%), as well as lack of time that students spend on campus.

AIMS: U.S. studies contribute heavily to of the literature about the tax elasticity of demand for alcohol, and most U.S. studies have relied on specific excise (volume-based) taxes for beer as a proxy for alcohol taxes. The purpose of this paper was to compare this conventional alcohol tax measure with more comprehensive tax measures (incorporating multiple tax and beverage types) in analyses of the relationship between alcohol taxes and adult binge drinking prevalence in U.S. states. DESIGN: Data on U.S. state excise, ad valorem, and sales taxes from 2001-2010 were obtained from the Alcohol Policy Information System and other sources. For N = 510 state-year strata, we developed a series of weighted tax-per-drink measures that incorporated various combinations of tax and beverage types, and related these measures to state-level adult binge drinking prevalence data from the Behavioral Risk Factor Surveillance System surveys. FINDINGS: In analyses pooled across all years, models using the combined tax measure explained approximately 20% of state binge drinking prevalence, and documented more negative tax elasticity (-0.09, p = 0.02) and price elasticity (-1.40, p CONCLUSIONS: Compared with volume-based tax measures, combined tax measures (i.e., those incorporating volume-based tax and value-based taxes) yield substantial improvement in model fit and find more negative tax elasticity and price elasticity predicting adult binge drinking prevalence in U.S. states. This article is protected by copyright. All rights reserved. Language: en

We investigated what local enforcement agencies are doing to target adults who provide alcohol to underage youth; what types of enforcement activities are being conducted to target adult providers; and factors that encourage enforcement activities that target adult providers. We surveyed 1,056 local law enforcement agencies in the US and measured whether or not the agency conducted enforcement activities that target adults who provide alcohol to underage youth. We also measured whether certain agency and jurisdiction characteristics were associated with enforcement activities that target adults who provide alcohol to underage youth. Less than half (42%) of local enforcement agencies conducted enforcement efforts targeting adults who provide alcohol to underage youth. Agencies that conducted the enforcement activities targeting adult providers were significantly more likely to have a full time officer specific to alcohol enforcement, a division specific to alcohol enforcement, a social host law, and to perceive underage drinking was very common. Results suggest that targeting social providers (i.e., adults over 21 years of age) will require greater law enforcement resources, implementation of underage drinking laws (e.g., social host policies), and changing perceptions among law enforcement regarding underage drinking. Future studies are needed to identify the most effective enforcement efforts and to examine how enforcement efforts are prospectively linked to alcohol consumption.

AIMS: To test how a housing voucher generating residential mobility to lower-poverty neighborhoods, compared to public housing controls, influenced adolescent binge drinking, and whether gender modified effects. DESIGN: A multi-site household-level 3-arm randomized trial of a housing intervention executed 1994–1998, evaluated 2001–2002. SETTING: Five US cities: Baltimore, MD, Boston, MA, Chicago, IL, Los Angeles, CA, New York, NY INTERVENTIONS: The Moving to Opportunity trial randomized volunteer low-income families in public housing to receive 1) rental subsidies redeemable in neighborhoods with

Overservice of alcohol (i.e., selling alcohol to intoxicated patrons) continues to be a problem at bars and restaurants, contributing to serious consequences such as traffic crashes and violence. We developed a training program for managers of bars and restaurants, eARM™, focusing on preventing overservice of alcohol. The program included online and face-to-face components to help create and implement establishment-specific policies.We conducted a large, randomized controlled trial in bars and restaurants in one metropolitan area in the midwestern United States to evaluate effects of the eARM program on the likelihood of selling alcohol to obviously intoxicated patrons. Our outcome measure was pseudo-intoxicated purchase attempts-buyers acted out signs of intoxication while attempting to purchase alcohol-conducted at baseline and then at 1 month, 3 months, and 6 months after training. We conducted intention-to-treat analyses on changes in purchase attempts in intervention (n = 171) versus control (n = 163) bars/restaurants using a Time × Condition interaction, as well as planned contrasts between baseline and follow-up purchase attempts.The overall Time × Condition interaction was not statistically significant. At 1 month after training, we observed a 6% relative reduction in likelihood of selling to obviously intoxicated patrons in intervention versus control bars/restaurants. At 3 months after training, this difference widened to a 12% relative reduction; however, at 6 months this difference dissipated. None of these specific contrasts were statistically significant (p = .05).The observed effects of this enhanced training program are consistent with prior research showing modest initial effects followed by a decay within 6 months of the core training. Unless better training methods are identified, training programs are inadequate as the sole approach to reduce overservice of alcohol.

AIMS: To examine state alcohol control policy implementation by policy efficacy and intent. DESIGN: A descriptive longitudinal analysis of policy implementation. SETTING: The United States, 1999-2011. PARTICIPANTS: 50 states and the District of Columbia. MEASUREMENTS: 29 state-level policies were rated based on an implementation rating (IR; range = 0.0-1.0) gathered from the Alcohol Policy Information System, government and industry reports, and other sources; and expert judgment about policy efficacy for addressing binge drinking and alcohol-impaired driving among the general population and youth, respectively. FINDINGS: On average, implementation of the most effective general population policies did not change (mean IR 0.366 in 1999; 0.375 in 2011; slope for annual change = 0.001; 95% confidence interval for the slope -0.001, 0.002). In contrast, implementation increased over time for less effective policies (mean IR 0.287 in 1999; 0.427 in 2011; slope for annual change compared with most effective policies = 0.009; slope 95% CI 0.002-0.007), youth-oriented policies (mean IR 0.424 in 1999; 0.511 in 2011; slope for annual change compared with most effective policies = 0.007; slope 95% CI 0.005-0.009), and impaired driving policies (mean IR 0.493 in 1999; 0.608 in 2011; slope for annual change compared with most effective policies = 0.0105; slope 95% CI 0.007-0.014). CONCLUSIONS: Implementation of politically palatable state alcohol policies, such as those targeting youth and alcohol-impaired driving, and less effective policies increased during 1999-2011 in the US, while the most effective policies that may maximally protect public health remained underused. Language: en

Purpose We describe a multi-step method of coding the strength of 18 alcohol policies included in the Alcohol Policy Information System for each of the 50 states. Method After thoroughly reviewing each policy area, we chose components that were most important in categorizing the strength or restrictiveness of the policy using the following criteria: overall reach, enforceability, and implementation. We determined a unique coding scheme for each policy area. Results The total number of categories per policy area ranged from two to six, with categories numbered in an ordered sequence from least to most restrictive. We provide three examples of our coding schemes: Keg Registration, Underage Possession, and Sunday Sales. We also rank the states on their alcohol policy sum score. Discussion This study demonstrates how alcohol policies can be measured quantitatively, an important step for assessing the effects of alcohol policies on various outcomes.

This study draws on a nationally representative sample to examine the relationship between participation in organized sport and alcohol use. We build on prior studies by re-examining the relationship between participation in organized sport and binge drinking and how this varies by both race and gender. We expand upon previous research by analyzing the long-term effects of involvement in organized athletics among both current and former sport participants and how this compares to patterns of binge drinking among the general college student population. To do so, our analysis compares rates of binge drinking among current college athletes, former athletes, and college students who were never involved in interscholastic sport. We find that: (1) organized sports participation is associated with binge drinking; (2) that this relationship holds across racial and gendered lines; (3) that the effects of exposure extend beyond time of involvement. The paper concludes with a discussion of possible explanations for the relationship between binge drinking and athletics, and the long-lasting effect of participation in organized sport.

Background Compliance checks conducted by law enforcement agents can significantly reduce the likelihood of illegal alcohol sales to underage individuals, but these checks need to be conducted using optimal methods to maintain effectiveness. Methods We conducted a national survey of local and state enforcement agencies from 2010 to 2011 to assess: (i) how many agencies are currently conducting underage alcohol compliance checks, (ii) how many agencies that conduct compliance checks use optimal methods—including checking all establishments in the jurisdiction, conducting checks at least 3 to 4 times per year, conducting follow-up checks within 3 months, and penalizing the licensee (not only the server/clerk) for failing a compliance check, and (iii) characteristics of the agencies that conduct compliance checks. Results Just over one-third of local law enforcement agencies and over two-thirds of state agencies reported conducting compliance checks. However, only a small percentage of the agencies (4 to 6%) reported using all of the optimal methods to maximize effectiveness of these compliance checks. Local law enforcement agencies with an alcohol-related division, those with at least 1 full-time officer assigned to work on alcohol, and those in larger communities were significantly more likely to conduct compliance checks. State agencies with more full-time agents and those located in states where the state agency or both state and local enforcement agencies have primary responsibility (vs. only the local law agency) for enforcing alcohol retail laws were also more likely to conduct compliance checks; however, these agency characteristics did not remain statistically significant in the multivariate analyses. Conclusions Continued effort is needed to increase the number of local and state agencies conducting compliance checks using optimal methods to reduce youth access to alcohol.

Objective: To investigate two risky behaviours (i.e. binge drinking and drinking and driving) and their individual- and college-level correlates among South Korean international college students in the USA Design: Cross-sectional online survey (student response rate = 41.6%). Setting: South Korean college students ( N = 1201) were recruited from 52 different four-year universities in the USA in 2009. Method: Self-reported binge drinking, drinking and driving, smoking, study-related stress, life dissatisfaction, region lived in, and type of university attended, were assessed using already-validated instruments. Results: A total of 92% of the sample reported at least one occasion of binge drinking in the previous 30 days. Among those who had driven a motor vehicle in the previous 30 days ( n = 950; 79% of the overall sample), 67% had engaged in drinking and driving. Students’ binge drinking was positively associated with current cigarette use and higher levels of life dissatisfaction at college and study-related stress. Students’ drinking and driving was also positively associated with higher levels of life dissatisfaction at college and study-related stress. These relationships were stronger among students attending private institutions than among those attending public institutions. While both college-level correlates (university region and university type) were significantly associated with drinking and driving, none of the college-level correlates were significant in the binge drinking models. Conclusion: A very high proportion of South Korean international students attending colleges in the USA appear to engage in binge drinking and drinking and driving. Development of intervention programmes designed specifically for them is necessary.

Objective and Participants: This study explored (1) the prevalence of cigarette smoking among South Korean international college students in the United States, (2) differences in smoking between on- and off-campus living arrangements, and (3) predictors of an increase in smoking over time in the United States Methods: An online survey was completed by 1,201 students at 52 4-year US universities (34% response rate). Results: The overall smoking prevalence was 43.5%. The smoking rate (29.0%) of female students was higher than that (4%) of female college students in South Korea. Sex, living place, living situation, length of stay as a student in the United States, home smoking rules, campus-wide tobacco-free policies, and levels of acculturative stress, anxiety, and depression were significantly associated with an increase in smoking (p < .05). Conclusions: Given the high smoking prevalence among the South Korean students on US college campuses, targeted prevention efforts for these students may be ...

Background The Child Nutrition and WIC Reauthorization Act of 2004 (hereafter called the 2004 Reauthorization Act) was federal legislation that required school districts participating in the federally funded school meal program to develop and implement policies addressing nutrition guidelines for all foods and beverages available on school campuses by the onset of the 2006/2007 school year. Purpose Vending machine and school store (VMSS) availability and low-nutrient, energy-dense snacks and beverages in VMSS were assessed in a statewide sample of Minnesota secondary schools before and after the 2004 Reauthorization Act was implemented in 2006/2007. Methods The CDC School Health Profiles principal survey was collected from a representative sample of middle ( n =170) and high ( n =392) schools biennially from 2002 to 2010. Trends were estimated using general linear models with a logit link and linear spline modeling. Analyses were conducted in 2012. Results Among high schools, VMSS ( p =0.001) and sugar-sweetened beverages ( p =0.004), high-fat salty snacks ( p =0.001), and candy ( p =0.001) in VMSS decreased from 2002 to 2008. In 2008, a change in slope direction from negative to positive occurred for all food practices and an increase in VMSS ( p =0.014) and sugar-sweetened beverages ( p =0.033) was seen. Among middle schools, VMSS ( p =0.027), sugar-sweetened beverages ( p =0.001), high-fat salty snacks ( p =0.001), and candy ( p =0.029) decreased from 2002 to 2010. Conclusions This study supports a link between policy and sustainable decreases in some food practices but not others and a differential effect that favors middle schools over high schools. Policy-setting is a dynamic process requiring ongoing surveillance to identify shifting trends.

Introduction Cross-sector collaboration on child obesity prevention is common, yet little research has examined the context of collaboration at the state level. This study describes secular trends in collaboration between state agency staff responsible for school nutrition and physical education activities and other organizations from 2000 to 2012. Methods Data from the School Health Policies and Practices Study were used to describe collaboration between state agency staff and 13 types of public, private, and nonprofit organizations. Breadth of collaboration in 2012 was examined across political, social, and economic conditions. Results Collaboration between state agency staff and other organization types increased from 2000 to 2006 and decreased or stabilized from 2006 to 2012. Breadth of collaboration was greater in states with a physical education coordinator, higher levels of poverty, higher prevalence of childhood obesity, and more public health funding. Breadth was similar across states by census region, political party of governor, majority party in state legislature, percentage non-Hispanic white population, high school graduation rate, and unemployment rate. Conclusion Cross-sector collaboration on school nutrition and physical education was widespread and did not vary substantially across most political, social, and economic measures. Expanded monitoring and surveillance of state-level collaboration would assist efforts to understand how state agencies work across sectors and whether this collaboration affects the support they provide to schools.

Xuan, Z., Blanchette, J., Nelson, T., Heeren, T., Nguyen, T., & Naimi, T. (2015). Alcohol policies and impaired driving in the United States: Effects of driving- vs. drinking-oriented policies. The International Journal Of Alcohol And Drug Research, 4 (2), 119-130. doi: http://dx.doi.org/10.7895/ijadr.v4i2.205 Aims: To test the hypotheses that stronger policy environments are associated with less impaired driving and that driving-oriented and drinking-oriented policy subgroups are independently associated with impaired driving. Design: State-level data on 29 policies in 50 states from 2001-2009 were used as lagged exposures in generalized linear regression models to predict self-reported impaired driving. Setting: Fifty United States and Washington, D.C. Participants: A total of 1,292,245 adults (≥ 18 years old) biennially from 2002–2010. Measures: Alcohol Policy Scale scores representing the alcohol policy environment were created by summing policies weighted by their efficacy and degree of implementation by state-year. Past-30-day alcohol-impaired driving from 2002–2010 was obtained from the Behavioral Risk Factor Surveillance System surveys. Findings: Higher Alcohol Policy Scale scores are strongly associated with lower state-level prevalence and individual-level risk of impaired driving. After accounting for driving-oriented policies, drinking-oriented policies had a robust independent association with reduced likelihood of impaired driving. Reduced binge drinking mediates the relationship between drinking-oriented policies and impaired driving, and driving-oriented policies reduce the likelihood of impaired driving among binge drinkers. Conclusions: Efforts to reduce alcohol-impaired driving should focus on reducing excessive drinking in addition to preventing driving among those who are impaired.

Purpose. We examined the relationships among fruit and vegetable intake, alcohol consumption, and socioeconomic status (SES). We hypothesized that fruit and vegetable consumption would be inversely associated with alcohol consumption and the relationship would differ by SES. Design. A cross-sectional analysis. Setting. Large, urban Midwestern county. Subjects. A unique, racially/ethnically diverse sample of 9959 adults (response rate: 66.3%). Measures. Fruit and vegetable intake was measured using two items that assessed servings per day. Alcohol consumption was measured in terms of volume of alcohol consumed and binge drinking. Individual measures of SES included education and household income. Analysis. Weighted multivariate linear and Poisson regression were used to estimate effects. Results. The relationship between fruit and vegetable intake and alcohol consumption varied by SES. Those with lower household incomes who consumed five or more servings of fruits and vegetables per day were less likely to engage in binge drinking relative to those consuming zero to one servings of fruits and vegetables per day (risk ratio = .66; 95% confidence interval: .46, .95). No association was observed for higher–household-income individuals. Conclusion. We observed an inverse relationship between fruit and vegetable consumption and alcohol intake in those with lower household incomes but not in those with higher household incomes. Results suggest that the relationship between diet and alcohol consumption may be more relevant in populations with more restricted economic choices. Results are, however, based on cross-sectional data.

The purpose of this study was to assess the prevalence of college alcohol policies and practices and to identify patterns of policies/practices across colleges.An online survey of administrators at a random sample of 351 4-year U.S. colleges was conducted in 2008. The prevalence of 31 alcohol policies and practices was assessed as well as differences across size and type of colleges. Latent class analyses identified classes of colleges based on their alcohol policies/practices.The majority of colleges prohibit alcohol use at sporting events, whereas less than half prohibit alcohol use at fraternity and sorority events. Less than half of the colleges also prohibit alcohol advertising in/on campus newspapers and radio stations. Small colleges are more likely than large colleges to prohibit alcohol use at tailgating events and to prohibit newspaper alcohol advertising. Public colleges are more likely than private colleges to prohibit alcohol use in dorms but less likely to prohibit alcohol advertising. We identified four classes of colleges-the largest class (38%) was characterized by having many alcohol policies/practices, the smallest class (13%) had none or few alcohol policies/practices, and the remainder fit into two middle classes that had certain policies/practices in place but lacked others.Most colleges report implementing some alcohol policies/ practices but are lacking others. Only two of every five colleges fit into a class that has many alcohol policies. More studies are needed to validate our findings and assess whether certain policies/practices and patterns of policies are associated with reducing student alcohol consumption and related problems.