Sacramento study finds that after seven years, alcohol control program still reduces child abuse

A neighborhood alcohol control project in Sacramento that reduced cases of child abuse and neglect soon after implementation still had a positive impact seven years later, a new study found. The study was published in the journal Drug and Alcohol Review.

Results showed that, in one of the neighborhoods where the program was put into place, total entries into foster care were reduced by 11.8% and alcohol-related foster care entries were reduced by 11.2% a full seven years after implementation.

These new results were not as strong as those found right after the project was implemented, and there are other caveats to the success of the program. But the results are still very encouraging, said Bridget Freisthler, lead author of the study and professor of social work at The Ohio State University.

"We knew that this project had short-term success, but it is rare to have the opportunity to see if an intervention like this continues to be effective years afterwards," Freisthler said.

"Now we have evidence that it actually does have a positive long-term effect."

In this study, the researchers examined the effect of the Sacramento Neighborhood Alcohol Prevention Project (SNAPP), an intervention implemented from 1999–2003 aimed at reducing alcohol-related problems in two neighborhoods in the city. The project wasn't designed specifically to reduce child abuse and neglect, but the researchers believed it would have that positive effect, based on previous studies.

For example, one study led by Freisthler showed that the number of stores selling alcohol in a neighborhood is linked to cases of child abuse and neglect in the same area. Another study found that a 1% increase in the volume of alcohol consumption per capita in Sacramento was related to 3.2% more alcohol-related foster care entries.

The two low-income, racially diverse neighborhoods in the study—dubbed the North area and South area—were selected because they had high rates of crime and alcohol-related problems.

SNAPP was a community-based intervention focused on reducing alcohol supply, namely to underage youth and already intoxicated people. The project included mobilization of local leaders, community awareness activities for neighborhood residents, responsible beverage service training for managers and staff at alcohol outlets, and increased enforcement of alcohol-related laws.

An earlier study showed that, shortly after SNAPP was implemented, alcohol-related foster care entries were reduced by 24% in the North area, but actually increased in the South area.

There may be several reasons for that finding in the South area, Freisthler said. One is that there was a cluster of serious child abuse and neglect cases in the South area during the intervention period, so case workers may have been more likely to place children into foster care when a parent was misusing alcohol during this time period.

In addition, the study implementation for the South area (but not the North) began right before the Sept. 11, 2001, terrorist attacks. Research has shown that alcohol use across the country rose right after the attacks, which may have led to more child abuse cases.

But in this new study, there was no longer any increase in foster care entries in the South area after seven years.

"The increases in child abuse and neglect that we saw in the South area are gone seven years later, but the decreases in the North area are continuing. That's great news," Freisthler said.

The researchers don't know how many parts of SNAPP were still being implemented seven years later. It is possible that some parts were dropped, and others were no longer a priority, Freisthler said.

So the fact that this intervention program was still having a significant positive impact should encourage similar efforts, according to the researchers.

Freisthler noted that most interventions to stop alcohol misuse and its effects on child abuse happen at the individual and family level.

The power of SNAPP is that it is a community-level intervention that is designed to change the neighborhood environment, reducing the easy access to alcohol throughout the entire community.

"Changing the environment surrounding alcohol is more effective and less costly than working just with individuals and families," Freisthler said.

"This study provides evidence that effects of environmental prevention efforts can be maintained for a significant period of time after they are implemented."

And an environmental intervention like SNAPP has a lot of positive effects on the neighborhood.

"It reduces traffic crashes, it reduces assaults, it reduces child abuse and neglect," Freisthler said. "One project like this does a lot to improve public health."

Freisthler conducted the study with Jennifer Price Wolf, associate professor of social work at San Jose State University.