BACKGROUND: Researchers and practitioners interested in developing online health interventions most often rely on Web-based and print resources to guide them through the process of online intervention development. Although useful for understanding many aspects of best practices for website development, missing from these resources are concrete examples of experiences in online intervention development for health apps from the perspective of those conducting online health interventions. OBJECTIVE: This study aims to serve as a series of case studies in the development of online health interventions to provide insights for researchers and practitioners who are considering technology-based interventional or programmatic approaches. METHODS: A convenience sample of six study coordinators and five principal investigators at a large, US-based land grant university were interviewed about the process of developing online interventions in the areas of alcohol policy, adolescent health, medication adherence, and human immunodeficiency virus prevention in transgender persons and in men who have sex with men. Participants were asked questions that broadly addressed each of the four phases of the User-Centered Design Process Map from the US Department of Health and Human Services' Research-Based Web Design & Usability Guidelines. Interviews were audio recorded and transcribed. Qualitative codes were developed using line-by-line open coding for all transcripts, and all transcripts were coded independently by at least 2 authors. Differences among coders were resolved with discussion. RESULTS: We identified the following seven themes: (1) hire a strong (or at least the right) research team, (2) take time to plan before beginning the design process, (3) recognize that vendors and researchers have differing values, objectives, and language, (4) develop a detailed contract, (5) document all decisions and development activities, (6) use a content management system, and (7) allow extra time for testing and debugging your intervention. Each of these areas is discussed in detail, with supporting quotations from principal investigators and study coordinators. CONCLUSIONS: The values held by members of each participating organization involved in the development of the online intervention or program, as well as the objectives that are trying to be met with the website, must be considered. These defined values and objectives should prompt an open and explicit discussion about the scope of work, budget, and other needs from the perspectives of each organization. Because of the complexity of developing online interventions, researchers and practitioners should become familiar with the process and how it may differ from the development and implementation of in-person interventions or programs. To assist with this, the intervention team should consider expanding the team to include experts in computer science or learning technologies, as well as taking advantage of institutional resources that will be needed for successful completion of the project. Finally, we describe the tradeoff between funds available for online intervention or program development and the complexity of the project.

Erickson, D., Rutledge, P., Lenk, K., Nelson, T., Jones-Webb, R., & Toomey, T. (2015). Patterns of alcohol policy enforcement activities among local law enforcement agencies: A latent class analysis. The International Journal Of Alcohol And Drug Research, 4(2), 103-111. doi:http://dx.doi.org/10.7895/ijadr.v4i2.204Aims: We assessed levels and patterns of alcohol policy enforcement activities among U.S. local law enforcement agencies.Design/Setting/Participants: We conducted a cross-sectional survey of a representative sample of 1,631 local law enforcementagencies across the 50 states.Measures/Methods: We assessed 29 alcohol policy enforcement activities within each of five enforcement domains—underagealcohol possession/consumption, underage alcohol provision, underage alcohol sales, impaired driving, and overservice ofalcohol—and conducted a series of latent class analyses to identify unique classes or patterns of enforcement activity for eachdomain.Findings: We identified three to four unique enforcement activity classes for each of the enforcement domains. In four of thedomains, we identified a Uniformly Low class (i.e., little or no enforcement) and a Uniformly High enforcement activity class(i.e., relatively high levels of enforcement), with one or two middle classes where some but not all activities were conducted.The underage provision domain had a Uniformly Low class but not a Uniformly High class. The Uniformly Low class was themost prevalent class in three domains: underage provision (58%), underage sales (61%), and overservice (79%). In contrast, lessthan a quarter of agencies were in Uniformly High classes.Conclusions: We identified qualitatively distinct patterns of enforcement activity, with a large proportion of agencies in classescharacterized by little or no enforcement and fewer agencies in high enforcement classes. An important next step is to determineif these patterns are associated with rates of alcohol use and alcohol-related injury and mortality.

OBJECTIVE: Underage alcohol compliance checks conducted by law enforcement agencies can reduce the likelihood of illegal alcohol sales at checked alcohol establishments, and theory suggests that an alcohol establishment that is checked may warn nearby establishments that compliance checks are being conducted in the area. In this study, we examined whether the effects of compliance checks diffuse to neighboring establishments. METHOD: We used data from the Complying with the Minimum Drinking Age trial, which included more than 2,000 compliance checks conducted at more than 900 alcohol establishments. The primary outcome was the sale of alcohol to a pseudo-underage buyer without the need for age identification. A multilevel logistic regression was used to model the effect of a compliance check at each establishment as well as the effect of compliance checks at neighboring establishments within 500 m (stratified into four equal-radius concentric rings), after buyer, license, establishment, and community-level variables were controlled for. RESULTS: We observed a decrease in the likelihood of establishments selling alcohol to underage youth after they had been checked by law enforcement, but these effects quickly decayed over time. Establishments that had a close neighbor (within 125 m) checked in the past 90 days were also less likely to sell alcohol to young-appearing buyers. The spatial effect of compliance checks on other establishments decayed rapidly with increasing distance. CONCLUSIONS: Results confirm the hypothesis that the effects of police compliance checks do spill over to neighboring establishments. These findings have implications for the development of an optimal schedule of police compliance checks.

OBJECTIVE: The purpose of this study was to assess the status and integration of college systems to address student alcohol use. METHOD: We conducted a survey of college leaders (campus administrators, healthcare directors, and enforcement directors) among 569 4-year colleges in the United States. We measured strategies across five key system components: policy, enforcement, education, screening, and intervention/treatment. We used latent class analyses to identify classes of colleges based on their alcohol systems. RESULTS: We identified three classes of colleges. Thirty-four percent of colleges were in a class that was characterized as having the most strategies relative to the other colleges, including high probabilities for having one of the three policy strategies, both enforcement strategies, two of the three screening strategies, and both intervention strategies. Class 2 colleges were similar to Class 1 colleges but had very low probabilities of having the intervention strategies. Thirty percent of the colleges were in Class 3; these colleges had a low probability of having any of the strategies except two of the three policy strategies. CONCLUSIONS: Many of the colleges had implemented strategies to address student alcohol use across multiple system components, although no class of colleges had implemented all of the identified strategies in each of the five components. Many colleges failed to use complementary strategies, such as having screening but no treatment or intervention services. More research is needed to assess whether class membership is associated with rates of student alcohol use and related problems.

OBJECTIVE: To evaluate whether the adoption of a local clean indoor air (CIA) policy in St. Paul, Minnesota, was associated with changes in alcohol-related crimes outside on-premises alcohol-licensed businesses. DESIGN: The enactment of a comprehensive CIA policy on 31 March 2006 was used as the intervention time point in an interrupted time-series analysis to assess changes in weekly crime frequency prior to the policy enactment compared with the period after the policy was established (n=261 weeks). SETTING: St. Paul, Minnesota, USA. SUBJECTS: On-premise alcohol-licensed business addresses were collected from St. Paul, Minnesota, for the period of January 2003 to December 2007, and geocoded. A 500-foot (152.4 m) buffer was drawn around each business. MAIN OUTCOME MEASURES: Alcohol-related crime (ie, arrest) data were obtained from the St. Paul Police Department; crimes had been geocoded by the police department. They were aggregated by week to include only those crimes that occurred within the drawn buffer. Relevant types of crimes included serious (eg, aggravated assaults, homicide, robbery, rape and theft) and less serious (eg, lesser assault, fighting, noise violations, public drunkenness/lewdness or other liquor law violations) crimes. RESULTS: Within a buffer of 500 foot of alcohol-licensed businesses, 23 978 serious alcohol-related crimes and 49 560 less serious alcohol-related crimes occurred over 5 years. Using interrupted time-series analyses to compare the weekly alcohol-related crime frequency in proximity with the bars and restaurants, we found no significant change in either type of crime associated with the local comprehensive CIA policy (p=0.13) after adjustment for seasonal differences and overall crime frequencies. CONCLUSIONS: Evidence from this study suggests that alcohol-related crimes were not significantly affected by a local comprehensive CIA policy that banned smoking in public workplaces in St. Paul, Minnesota.

OBJECTIVE: We examined the associations between the density of alcohol establishments and five types of nonviolent crime across urban neighborhoods. METHOD: Data from the city of Minneapolis, MN, in 2009 were aggregated and analyzed at the neighborhood level. We examined the association between alcohol establishment density and five categories of nonviolent crime: vandalism, nuisance crime, public alcohol consumption, driving while intoxicated, and underage alcohol possession/consumption. A Bayesian approach was used for model estimation accounting for spatial auto-correlation and controlling for relevant neighborhood demographics. Models were estimated for total alcohol establishment density and then separately for off-premise establishments (e.g., liquor and convenience stores) and on-premise establishments (e.g., bars and restaurants). RESULTS: We found positive associations between density and each crime category. The association was strongest for public consumption and weakest for vandalism. We estimated that a 3.3%-10.9% increase across crime categories would result from a 20% increase in neighborhood establishment density. Similar results were seen for on- and off-premise establishments, although the strength of the associations was lower for off-premise density. CONCLUSIONS: Our results indicate that communities should consider the potential increase in nonviolent crime associated with an increase in the number of alcohol establishments within neighborhoods.