Preventing alcohol abuse and alcohol-related problems through community interventions: A review of evaluation studies

In recent years community-based initiatives have emerged as the most widely heralded and promoted alcohol and drug abuse prevention strategy in the USA. In this paper we critically review those studies (n = 8) that have presented data designed to assess the effectiveness of community-based alcohol abuse prevention programs. The majority of these studies report minimal program effects, even over the immediate post-intervention period. Their principal limitations appear to be (1) a failure to generate community involvement in the design and implementation of program activities and (2) an inability to impact upon community-level processes. Three studies recently initiated in the USA are then discussed. These address more directly than previous efforts the issue of whether change in systems-level influences can be achieved through community-based interventions, while also attempting to broaden the target audience of intervention programs and encouraged greater community participation. Among the numerous challenges that remain in the area of alcohol abuse prevention research is to develop and implement community-based programs in "high risk" urban settings, where the markets for alcohol and other drugs tend to concentrate due to economic conditions.