title: Alcohol use and abuse among rural Zimbabwean adults: a test of a community-level intervention.
abstract: BACKGROUND
  Understanding what factors contribute to alcohol abuse in resource-poor countries is important given its adverse health consequences. Past research shows that social peers influence substance abuse, suggesting that the social environment may be an effective target for reducing alcohol abuse across a population. This study investigates the determinants of alcohol use and abuse in rural Zimbabwe and tests a community popular opinion leader (CPOL) community-based intervention partly directed at reducing alcohol abuse.
  
  
  METHODS
  Tests were conducted on the impact of the CPOL intervention on alcohol use patterns across communities in rural Zimbabwe over three waves from 2003 to 2007, including community- and individual-level tests using data based on in-person interviews of adult men and women (ages 18-30; N=5543). Data were analyzed using paired-sample t-tests, as well as logistic and ordinary least-squares regression with random effects.
  
  
  RESULTS
  Higher drinking (any use, more frequent use, greater quantity, and/or frequent drunkenness) was generally associated with being male, older, not married, more highly educated, of Shona ethnicity, away from home frequently, employed, having no religious affiliation, or living in areas with a higher crude death rate or lower population density. Over the study period, significant declines in alcohol use and abuse were found in intervention and control sites at relatively equal levels.
  
  
  CONCLUSIONS
  Although no support was found for the effectiveness of the CPOL study in reducing alcohol abuse, Zimbabwe is similar to other countries in the impact of socio-demographic and cultural factors on alcohol use and abuse.
authors.affiliation: Battelle Memorial Institute, Centers for Public Health Research and Evaluation, 1100 Dexter Avenue North, Suite 400, Seattle, WA 98109-3598, USA. cubbinsl@battelle.org
authors.forename: Lisa A
authors.initials: LA
authors.lastname: Cubbins
authors.forename: Danuta
authors.initials: D
authors.lastname: Kasprzyk
authors.forename: Daniel
authors.initials: D
authors.lastname: Montano
authors.forename: Lucy P
authors.initials: LP
authors.lastname: Jordan
authors.forename: Godfrey
authors.initials: G
authors.lastname: Woelk
mesh_terms: D000293:Adolescent; D000328:Adult; D000428:Alcohol Drinking / Q000453:epidemiology* / Q000517:prevention & control; D000435:Alcoholic Intoxication / Q000453:epidemiology* / Q000517:prevention & control; D000437:Alcoholism / Q000453:epidemiology* / Q000517:prevention & control; D005260:Female; D006801:Humans; D008297:Male; D012307:Risk Factors; D012424:Rural Population; D015030:Zimbabwe / Q000453:epidemiology