Serve Smart and Sell Smart Alcohol Retailer Toolkit and Evaluation

Theoretical Background and research questions/hypothesis:  There is a critical need for evaluations of environmental approaches to underage alcohol use in the United States. The Massachusetts Department of Public Health’s Bureau of Substance Abuse Services (BSAS) contracted with Health Resources in Action (HRiA) to specifically address youth alcohol access through the commercial retail environment. The objective of this study was to assess the impact of a direct-mail alcohol retailer toolkit based on social marketing principles, which included best practices for management, educational materials for employees, and signage for the establishments. Goals of this study included: increasing positive alcohol retailer attitudes towards checking IDs; encouraging retail managers to formalize ID checking procedures with their employees; and promoting consumers to be prepared to show ID when purchasing alcohol.

Methods:  To obtain an adequate sample size, only communities with at least 50 total alcohol licenses were considered for inclusion in the study. A total of ten communities were selected, where five community pairs were matched on several characteristics including the number of licenses, geographic region, presence and type of alcohol programming, total population, and median income. Matched pairs were identified within regions by their similarities on each of these characteristics. One community from each matched pair was then randomly chosen to receive the intervention. A list of current liquor license holders from on-premise and off-premise establishments was provided by the Massachusetts Alcoholic Beverages Control Commission. Owners or managers from these alcohol establishments were asked to participate in a telephone survey at two different time points. The baseline survey was conducted, the intervention toolkits were then mailed to all retail establishments in the five randomly selected intervention cities, and, three months after the intervention was disseminated, follow-up surveys were then attempted with the 410 establishments who had participated in the baseline survey. Follow-up surveys were completed with 269 establishments with a post wave response rate of 65.6%.

Results: The analysis sample consisted of 209 retailers (77 intervention; 132 control). In models adjusted for baseline response and matching community and establishment characteristics, intervention communities reported posting, on average, one additional sign or wall decal in their establishments (β = 0.937, P = 0.0069), and a twofold higher odds of handing out written materials on ID checking to staff (OR: 2.074, 95% CI; 1.003-4.288) compared to control establishments. Intervention retailers perceived all components of the toolkit to be very useful (for their establishments), and nearly all reported sharing materials with their employees and customers. These results suggest that some significant environmental changes in alcohol retailer establishment practices can be achieved among motivated owners or managers by making best retailer practices accessible.

Conclusions:  Planning for evaluation early and working in collaboration with key stakeholders was essential to the development and distribution of an accurate, appealing, and comprehensive resource.

Implications for research and/or practice:  Health communication practitioners should not underestimate the value of developing an evaluation plan and identifying key stakeholders at the beginning stages of planning a campaign.