Program Profile: Communities Mobilizing for Change on Alcohol

This is a community program designed to reduce youth’s access to alcohol by changing community and law enforcement policies, attitudes, and practices. The program is rated Ineffective. There were no statistically significant differences between treatment sites and control sites in youth’s drinking prevalence, number of past-month drinking occasions, number of drinks consumed, attempts to purchase alcohol, or in alcohol merchants’ behavior.

An Ineffective rating implies that implementing the program is unlikely to result in the intended outcome(s) and may result in a negative outcome(s).

Program Goals

Communities Mobilizing for Change on Alcohol (CMCA) is a community organizing program designed to reduce youth access to alcohol by changing community and law enforcement policies, attitudes, and practices. The program, which was initiated in 1991, aims to decrease the number of outlets that sell alcohol to youth, lessen the availability of alcohol from noncommercial sources (such as peers or adults), and reduce the community’s tolerance for underage drinking. The ultimate goal of CMCA is to prevent and reduce youth alcohol use.

Target Population and Target Sites

Although CMCA specifically targets youth in the community to prevent underage drinking, the program also targets all community members to raise awareness of underage drinking. Part of the intervention involves specific targeting of certain sites within a community, including commercial premises of on-sale (e.g., bar, restaurant) and off-sale (e.g., liquor store, convenience store) alcohol vendors. These sites are targeted to limit the availability of alcohol to underage, potential buyers.

Program Activities

CMCA employs a range of social organizing techniques addressing legal, institutional, social, and health issues to reduce youth alcohol use by eliminating illegal alcohol sales and obstructing adult provision of alcohol to youth. The organizing process includes:

1. Assessing the community
2. Creating a core leadership group
3. Developing a plan of action
4. Building a mass base of support
5. Implementing the action plan
6. Maintaining the organization and institutionalizing change
7. Evaluating changes

Program Theory

CMCA draws on the social influences model based in the community that concentrates on resistance skills within youth and widespread organization to stop underage drinking in the community. The program combines the principles of this model and organized efforts with a focus on supply reduction to limit access of alcohol among underage drinkers (Wagenaar et al. 2000).

Study

Communities Mobilizing for Change on Alcohol (CMCA) was evaluated by Wagenaar and colleagues (2000) in a fully randomized 5-year research trial across 15 geographically and socially distinct communities located in the upper Midwestern region. Seven communities were randomized to the treatment condition and eight served as control sites. During the program’s first phase at the treatment sites, organizers completed 1,518 interviews with local leaders and citizens to build relationships, better understand the community by reviewing local enforcement and policies, and search for potential recruits for the core of community organizing activities. During the second phase, a strategy team of core local leaders worked with organizers to gain widespread support, including media attention. The final implementation phase involved establishing policy changes within the community, media, law enforcement, local businesses, alcohol vendors, and religious organizations as directed in the plans customized for each treatment site.

There were two primary outcome measures of interest: 1) access to alcohol from commercial and social sources; and 2) drinking behaviors. Data was collected at baseline (1992) before the random assignment of communities to the intervention or control condition, and again at follow-up after a 2½-year intervention period (1995). Data collection included in-school surveys of 9th graders (n = 5,885) and 12th graders (n = 4,506); telephone surveys of 18- to 20-year-olds (n = 3,095) and alcohol merchants (including direct testing of the likelihood of alcohol sales to youth at on-sale and off-sale establishments [using 21-year-old college students who appeared younger and attempted purchases]); and monitoring changes in relevant practices of community institutions. The CrimeSolutions review of this study focused on the data collected from telephone surveys of 18- to 20-year-old youth in the treatment sites, compared with the control sites.

Analyses were based on mixed-model regression and multiple time-series design, and used the community as the unit of assignment. Analyses also accounted for the nesting of individual respondents or alcohol outlets within each community, and controlled for relevant covariates. No subgroup analysis was conducted.

These sources were used in the development of the program profile:

These sources were used in the development of the program profile: