Development and evaluation of a community-based environmental intervention to reduce alcohol use and access among adolescents

• Grant number: 23/14565-1
• Support Opportunities: Scholarships in Brazil - Doctorate (Direct)
• Start date: December 01, 2023
• End date: May 31, 2027
• Field of knowledge: Health Sciences - Collective Health - Epidemiology
• Agreement: Global Alliance for Chronic Diseases (GACD)
• Principal Investigator: Zila van der Meer Sanchez Dutenhefner
• Grantee: Matheus de Carlos Silva Oliveira
• Host Institution: Escola Paulista de Medicina (EPM). Universidade Federal de São Paulo (UNIFESP). Campus São Paulo. São Paulo , SP, Brazil
• Associated research grant: 22/03145-9 - Reducing alcohol use among adolescents through a community-based multicomponent intervention: an implementation research approach, AP.TEM

Abstract

The primary objective of this project is to develop and evaluate environmental prevention actions aimed at reducing adolescents' access to, consumption of, and social acceptability of alcohol. The study focuses on environmental prevention strategies designed through a community co-creation process. This participatory approach is fundamental for the formulation and implementation of interventions, which aim to regulate alcohol sales, reinforce local laws prohibiting alcohol sales to minors, and strengthen enforcement mechanisms. These actions are intended to expand restrictions on adolescent access to alcohol. The research will be conducted in four small municipalities in the state of São Paulo, Brazil-two designated as intervention sites and two as control sites. The study adopts a mixed-methods approach (quantitative and qualitative) to assess outcomes related to alcohol use, access, and social perceptions, as well as perceived ease of alcohol acquisition, at two time points (pre- and post-intervention). Descriptive analyses will be conducted using chi-square tests and t-tests. Inferential analyses will include logistic regression for binary outcomes and multinomial regression for outcomes with more than two categories. Additionally, Structural Equation Modeling (SEM) will be employed for mediation analysis, based on the Intention-To-Treat (ITT) framework. Observational data will also be collected to assess compliance of commercial establishments with existing laws prohibiting alcohol sales to minors. It is expected that the study will contribute to greater awareness of the harms associated with adolescent alcohol consumption and the importance of preventive measures. Furthermore, the project aims to strengthen community engagement and promote positive changes in key indicators such as permissiveness, acceptability, and normative beliefs regarding adolescent alcohol use. Upon completion, the study aims to deliver detailed guidelines for the development, implementation, and evaluation of community co-created environmental interventions, establishing a replicable model for future prevention initiatives.