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Reward and Reminder (R&R)
An environmental prevention approach to reduce youth access to alcohol at sales locations.
Reward and Reminder is part of a community-based effort to reduce availability of alcohol to American Indian youth living on or near reservations. Geared to convenience stores that sell alcohol for consumption off-site, R&R uses underage-appearing decoys to attempt alcohol purchases without identification. Depending on their response, clerks are rewarded with gift cards or reminded of the law. Letters describing the program, citing Tribal council proclamations in support, were hand-delivered to each store and discussed with managers prior to the first test visit. Thirteen stores on or within 10 miles of reservations were visited in four waves: one baseline visit and three employing rewards and reminders.
Outcomes
Sales to young-looking purchasers dropped to 0% on the second and third R&R visits.
Sales to underage-appearing decoys were reduced from 33% at baseline and 38% at the first R&R visit, to 0% at the second and third visits. Although the intervention reduced sales to community members appearing to be underage, the number of establishments and visits was small. Plans to continue implementation and follow-up were discussed but not reported.
Costs
Lower costs to implement mostly staff time and reward gift cards.
This intervention requires no utilization of existing infrastructure. Start-up and ongoing costs would be low. Other than staff salaries, the only expenses would be the “reward” gift card ($15), minimal printing costs, and transportation. Time requirements are limited.
Cultural Engagment
Tribal leaders had some involvement in research and provided proclamations. Materials were modified to include Native logos and images.
This intervention, modified from a non-Native program, was tailored to the community. Logos were created, feather imagery was employed, and Tribal resolutions endorsing the program were obtained. Tribal leaders and community members contributed to the research. While there were only surface changes to the program itself, the process used to identify the problem and choose the intervention was consistent with moderate Tribally based participatory research.
Participants
Adult; Female, Male
Setting
Community Wide, Reservation, Rural
Delivery
Individual, Face-to-Face
Clerks in convenience stores on or near reservations.
Participants were clerks in 13 convenience stores selling alcohol for off-site consumption on or around rural Southern California reservations. Research staff reported estimated demographic characteristics of the clerks. Estimated mean age of the 27 women and 24 men was 31 years; race/ethnicity of the clerks was not reported.
Staffing Needs
Community Member
Community members who appear underage; a different program staff to administer reward or reminder.
Credentials and level of education of those delivering the reward or reminder intervention were not specified. Background of program staff was not described, but volunteer decoys were community members.
Research Design
Pre-/post-intervention data
Developmental stage of research
A small pilot study demonstrated the feasibility of reducing alcohol sales to minors.
The intervention was tested a limited number of times in a small sample of stores, and there was no follow-up, indicating an early stage of development. Replication in additional stores and follow-up are needed to determine how long effects last.
Potential
This low-burden prevention intervention shows promise to be feasible, inexpensive, and transportable.
This is a simple, easily transported, relatively inexpensive, promising program to reduce Native youth access to alcohol. With community and Tribal leadership support, this intervention appears feasible and effective. Modifications may be required for communities where alcohol is sold differently, decoys are likely to be recognized, or underage access to alcohol is primarily through friends and family.
References
Moore RS, Roberts J, McGaffigan R, et al. Implementing a reward and reminder underage drinking prevention program in convenience stores near Southern California American Indian reservations. Am J Drug Alcohol Abuse. 2012;38(5):456-460. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3445436. https://doi.org/10.3109/00952990.2012.696758.
Lee JP, Moore RS, Roberts J, et al. Off-premise alcohol outlets on and around Tribal land: Risks for rural California Indian youth. J Ethn Subst Abuse. 2015;14(1):59-78. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4344917. https://doi.org/10.1080/15332640.2014.958643.
Moore RS, Gilder DA, Grube JW, et al. Prevention of underage drinking on California Indian reservations using individual- and community-level approaches. Am J Public Health. 2018;108(8):1035-1041. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6050833. https://doi.org/10.2105/ajph.2018.304447.
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