About this item:

465 Views | 261 Downloads

Author Notes:

Alexander C. Wagenaar, Rollins School of Public Health, 1518 Clifton Rd NE, GCR 556, Atlanta, GA 30322, USA. wagenaar@gmail.com.

The content is solely the responsibility of the authors and does not necessarily represent the views of the National Institutes of Health, our universities, or the Cherokee Nation.

This project would not have been possible without the significant contributions of the CMCA organizers (Charlotte Howe, Kathleen Kennedy, Amber Sparks); Diane Riibe (alcohol prevention and community organizer trainer); Sarah D. Lynne;Jessica Douthitt (coordinator of data collection);Kim Lynch and Neighbors Building Neighborhoods Nonprofit Resource Center; the Cherokee Nation; participating school districts and high schools; students; parents, and communities.

As a condition of cooperation and approval of the study protocol by the Cherokee Nation Industrial Review Board (IRB), the IRB required all presentations and manuscripts from the study be submitted to the Cherokee Nation IRB for review and approval before presentation or publication.

The Cherokee Nation institutional review board approved the article for publication.


Research Funding:

This research was supported by the National Institute on Alcohol Abuse and Alcoholism, with co-funding from the National Institute on Drug Abuse, U.S. National Institutes of Health (award 5R01AA02069).


  • Science & Technology
  • Life Sciences & Biomedicine
  • Substance Abuse
  • Psychiatry
  • Alcohol access
  • Cherokee nation
  • cluster randomized trial
  • community organizing
  • intensive longitudinal
  • native American
  • RCT
  • youth drinking prevention

Communities mobilizing for change on alcohol (CMCA): secondary analyses of a randomized controlled trial showing effects of community organizing on alcohol acquisition by youth in the Cherokee nation


Journal Title:



Volume 113, Number 4


, Pages 647-655

Type of Work:

Article | Post-print: After Peer Review


Aims: We evaluated the effects of a community organizing intervention, Communities Mobilizing for Change on Alcohol (CMCA), on the propensity of retail alcohol outlets to sell alcohol to young buyers without age identification and on alcohol acquisition behaviors of underage youth. Design: Random assignment of community to treatment (n = 3) or control (n = 2). Student surveys were conducted four times per year for 3 years; the cohort was in 9th and 10th grades in the 2012–13 academic year. Alcohol purchase attempts were conducted every 4 weeks at alcohol retailers in each community (31 repeated waves). Setting: The Cherokee Nation, located in northeastern Oklahoma, USA. Participants: A total of 1399 high school students (50% male; 45% American Indian) and 113 stores licensed to sell alcohol across five study communities. Intervention: Local community organizers formed independent citizen action teams to advance policies, procedures and practices of local institutions in ways to reduce youth access to alcohol and foster community norms opposed to teen drinking. Measurements: Perceptions regarding police enforcement and perceived difficulty of and self-reported actual acquisition of alcohol from parents, adults, peers and stores. Findings: Alcohol purchases by young-appearing buyers declined significantly, an 18 [95% confidence interval (CI) = 3, 33] percentage-point reduction over the intervention period. Student survey results show statistically significant differences in the trajectory of perceived police enforcement, increasing 7 (4, 10) percentage points, alcohol acquisition from parents, decreasing 4 (0.1, 8) percentage points, acquisition from 21+ adults, decreasing 6 (0.04, 11) percentage points, from < 21 peers decreasing 8 (3, 13) percentage points and acquisition from stores decreasing 5 (1, 9) percentage points. Conclusions: A community organizing intervention, Communities Mobilizing for Change on Alcohol (CMCA), is effective in reducing the availability of alcohol to underage youth in the United states. Furthermore, results indicate that the previously reported significant effects of CMCA on teen drinking operate, at least in part, through effects on alcohol access.

Copyright information:

© 2017 Society for the Study of Addiction

Export to EndNote