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Brad S. Krevor, Ph.D, Heller Graduate SchoolBrandeis UniversityMarch 30, 2005
The Integrated Responsible Retailing Systems Project
A new model to reduce the sale of age-restricted products to underage customers
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Background
Attorney General Consumer Protection Initiative:
4 Regional meetings (1999)
National CDC-sponsored meeting (March 2000)
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Background
Report on Best Practices for RR
Commissioned by Center for Substance Abuse Prevention (CSAP)
Diverse Report Committee
Review of evidence
Alcohol enforcement
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Background
Innovations of CSAP Report: • Completed a systematic review of components of RR
• Identified the critical nature of management systems
• Role of public agencies: enforce and assist licensees identify and implement Best Practices for RR
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Background
Paradox of enforcement:Enforcement is sine qua non of compliance…
… but public agencies have inadequate resources to inspection frequently
“Educate into compliance”: … but not when turnover rates > enforcement frequency
Wagenaar study (2005)
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Background
Paradox of enforcement:
Deterrent effect is undermined by uncertainty of how to avoid risk:
Policies do not translate into consistent clerk (or manager) performance
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Background
EAV Study for Miller Brewing Company:
Clerk is important determinant of whether the store is found to be compliant (EAV study)
TobaccoInspections
Baseline 1Compliance
Baseline 2Compliance
CompliantB1 & B2
Florida 81% 86% 66%
Iowa 43% 51% 33%
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Clerk characteristics: • Little or no loyalty to job or employer
• Aversion to confrontation
• Personal use of alcohol and tobacco, now or as
minor, may affect age-verification behavior
• Willful collusion
Impact of tight labor market and limited hiring pool
Background
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Integrated Responsible Retailing Model
a continuous system supported by the efforts of retailers, agencies, and other public and private stakeholders
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Protocols for age verification/ sales declination
Point-of-sales aids:
Signage
Specialty calendars
ID scanning
Hiring, Supervision,
Training
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A “Community Policing” model employs a “problem-solving” approach to underage access and use.
Identify and address actual sources of age-restricted products in the community
An involved, concerned community is decisive in motivating public agencies, which in turn can engage—and assist—retailers.
“Retailers as Active Partners”
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Responsible Retailing
Policies
• Laws and Regulations
• Enforcement protocols
• Penalties
• Funding
What Policies will encourage adoption of effective RR practices?
Public PolicyPublic Policy
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Background
2003 RR Forum 1st priority recommendation:Demonstrate and evaluate the integrated RR systems model.
Project partners:Alabama Alcohol Beverage Control Board
Iowa Division on Alcoholic Beverages
Missouri Dept. of Alcohol and Tobacco Enforcement
New Mexico Alcohol and Gaming Division
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Developing an operational model
1. Health care analogue: implementing clinical guide-lines in medical practice sites.
Example: In a1991 study, 60% of tobacco users reported that their primary care physician had not advised them to quit. What factors impede the adoption of clinical guidelines (1996) for treating tobacco dependence.
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Developing an operational model
Why primary care physicians don’t adopt guidelines: Unfamiliarity Time constraints: too busy Inability to overcome inertia of prior practice Doubts regarding effectiveness Doubts regarding self-efficacy (for tobacco) Aversion to confrontation
[note similarity to explanations for not checking IDs]
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Developing an operational model
Why primary care physicians do adopt guidelines:
Training (mixed results) Feedback on peer performance
Brandeis—Harvard study (1999): absence of resources and mechanisms is impediment.
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Developing an operational model
Assisting medical practice sites to implement clinical guidelines:
Planning Guide for Primary Care Practice Sites [and for Pre-Natal Care Practice Sites]
Promulgated by State of Vermont health department
Local hospital / health dept. provides medical sites with training and counseling
[Similar delivery system designs in Massachusetts, New Mexico, Oregon et al.]
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Developing an operational model
2. Business analogue for implementing Best Practices:
ExxonMobil Assurance of Voluntary Compliancea. Adoption of many Best Practices in CSAP Report
b. Continual monitoring
c. Remedial response to age-verification failures
d. Company-wide commitment
Transparency
How would one replicate the ExxonMobil model at the level of community?
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RR Systems Project
Phase 1 (Sept 2003 – May 2005):
Focus upon Tier 1: Retail-level
Objective: Develop tools to assist retailers and implementation strategies
Study Sites: Birmingham, AL Springfield, MO Santa Fe, NM Des Moines, IA
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RR Systems Project
Assistance to retailers:
1. Develop “A Planning Tool for [Iowa] Retailers” a quality improvement tool to assess current practices identifies absent Best Practices Promoted and supported by state Regulatory /
Enforcement agency: R / E Agency is engine that drives the model
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RR Systems Project
Assistance to retailers:2. Monitoring / Feedback
Multiple inspections by young adults Reports to retailers on individual inspections
Feedback—not penalties
Will include inspections by pseudo-intoxicated
customers
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RR Systems Project
Experimental Design: Arm #1: use of Planning Tool for Retailers Arm #2: use of Mystery Shopper reports Arm #3; use of both PT and MS reports Arm #4: control stores
60-80 stores per community (36 in Santa Fe)
Mostly gas station / C-stores (some package stores)
Mostly chains
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RR Systems Project
What we’ve learned in Phase 1:
Experimental design undermined by:
1. Change for chain stores occurs through district supervisor / trainer, not through individual store manager
2. Some chains introduced changes following state RR Forum
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RR Systems Project
Lessons from Phase 1:
Planning Tool for … Retailers
Useful self-assessment tool, especially for chains
Could be more explicit
Could be more prescriptive
Focus groups will be held in spring 2005
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RR Systems Project
Lessons from Phase 1:
Mystery Shopper Reporting
“50 year-old native American woman”
Use of feedback (Missouri experience)
Expand to capture opportunity of “teachable moment”
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RR Systems Project
Lessons from Phase 1: Variability of retailers
Chains Owner-operated
high Number of employees low
“ Turnover “
“ Need for Systems “
“ Level of technology “
“ Explicit policies “
no Manager is change agent? yes
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RR Systems Project
Phase 2 (beginning May 2005):
Focus: Community context (2nd tier of model)
Objective: Employ community policing principles to identify actual sources of alcohol (both commercial and social) in the community
“If you were 100% successful . . .”
Expand intervention
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RR Systems Project
Phase 3 (2006?):
Objective: conduct a multi-state community trial to evaluate the effectiveness of the “enforcement + assistance” model at the level of county, with study arms that employ various implementation strategies (e.g. voluntary, compulsory for violators, incentives) to engage retailers.
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Questions raised by RR Systems Project
Q. #1: How do we raise the level of performance in individual stores?
Andy’s Liquorette
ExxonMobil
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Questions raised by RR Systems Project
Q. #2: How do we engage retailers to adopt and sustain RR Best Practices?
Voluntary adoption: Corporate leadership Increase enforcement Build capacity: Field of Dreams fallacy Adopt BPs to discharge citation Mandatory adoption Retailer Incentives
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Questions raised by RR Systems Project
Q. #2: Potential retailer incentives
Reduced license fees
Mitigation for future infractions
Affirmative Defense for future infractions
Curtailment of routine compliance checks
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Questions raised by RR Systems Project
Q. #2: Incentives to engage retailers are problematic
Objections of Regulatory / Enforcement agencies
Compare: Susan Curry study Treatment for TB Brazil: payments to parents for 16 million school
children
Public health outcomes vs. personal responsibility Good Policy may be counterintuitive
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Questions raised by RR Systems Project
Q. #3: How do we create the capacity to sustain an RR system at the level of state and community?
Beyond current resources of R/E agencies
What would it cost to provide training, mystery
shopper feedback, enforcement?
Which entities can provide the “assistance” in the
“enforcement + assistance” model?
How can public resources be best applied?
How can public resources be leveraged?
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Brad S. Krevor, Ph.D, Heller Graduate SchoolBrandeis UniversityMarch 30, 2005
The Integrated Responsible Retailing Systems Project