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Aims-The goal of this group-randomized trial was to test the effectiveness of an adapted alcohol use preventive intervention for urban, low-income and multi-ethnic settings.Design and Setting-Sixty-one public schools in Chicago were recruited to participate, were grouped into neighborhood study units, and randomly assigned to intervention or "delayed program" control condition.Participants-The study sample (n=5812 students) was primarily African American, Hispanic and low-income.Intervention-Students, beginning in sixth grade (age 12), received three years of intervention strategies (curricula, family interventions, youth-led community service projects, community organizing).Measurements-Students participated in yearly classroom-based surveys to measure their alcohol use and related risk and protective factors. Additional evaluation components included a parent survey, a community leader survey, and alcohol purchase attempts. NIH-PA Author ManuscriptNIH-PA Author Manuscript NIH-PA Author ManuscriptFindings-Overall the intervention, compared with a control condition receiving "prevention as usual," was not effective in reducing alcohol use, drug use or any hypothesized mediating variables (i.e., related risk and protective factors). There was a nonsignificant trend (p = .066) that suggested the ability to purchase alcohol by young appearing buyers was reduced in the intervention communities compared to the control communities, but this could be due to chance. Secondary outcome analyses to assess the effects of each intervention component indicated that the home-based programs were associated with reduced alcohol, marijuana, and tobacco use combined (p = .01), with alcohol use alone approaching statistical significance (p = .06).Conclusions-Study results indicate the importance of conducting evaluations of previously validated programs in contexts that differ from the original study sample. Also, the findings highlight the need for further research with urban, low-income adolescents from different ethnic backgrounds to identify effective methods to prevent and reduce alcohol use.

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ABSTRACT. Objective:We examined whether relationships of neighborhood disadvantage with drinker status, heavy drinking, alcoholrelated consequences, and dependence differed by race and/or gender. We hypothesized that neighborhood disadvantage would be negatively associated with drinker status but positively associated with heavy and problem drinking, with more pronounced relationships among African American and Hispanic men than other groups. Method: Data consisted of nationally representative, randomly selected, cross-sectional samples of White, African American, and Hispanic adults (N = 13,864, of which 52% were female; with 7,493 drinkers, of which 48% were female) from the 2000 and 2005 National Alcohol Surveys merged with 2000 Census data. Analyses included logistic and linear regression using weights to adjust for sampling and nonresponse. Results: Hypotheses were partly supported. Bivariate relationships were in the expected direction. Multivariate main effect models showed that neighborhood disadvantage was signifi cantly associated with increased abstinence and marginally associated with increased negative consequences experienced by drinkers, but race/ethnicity and gender modifi ed these associations. Disadvantage was signifi cantly associated with increased abstinence for all groups except African American and Hispanic men. Among drinkers, disadvantage was signifi cantly negatively associated with heavy drinking by Whites but signifi cantly positively associated with heavy drinking by African Americans. Disadvantage also was associated with elevated alcohol-related consequences for White women and African American men. Conclusions: The fi ndings have implications for the development of targeted interventions to reduce the unequal impacts of neighborhood disadvantage on alcohol outcomes. Future research should examine the contribution of multiple types of disadvantage to heavy drinking and alcohol problems. (J. Stud. Alcohol Drugs, 73, 865-873, 2012)