Improving the Alcohol Retail Environment to Reduce Youth Access

There is a critical need to evaluate environmental approaches to prevent underage alcohol use in the United States. 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. The intervention was designed to increase positive alcohol retailer attitudes towards checking IDs, encourage retail managers to formalize ID checking procedures with their employees, and promote consumers to be prepared to show ID when purchasing alcohol. This community randomized study included five matched Massachusetts community pairs. Our 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 the 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.