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Woodall WG, Buller D, Saltz R, Martinez L. Professional Development to Improve Responsible Beverage Service Training: Formative Research Results and Protocol for a Randomized Controlled Trial. JMIR Res Protoc 2024; 13:e49680. [PMID: 38265847 PMCID: PMC10851124 DOI: 10.2196/49680] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2023] [Revised: 11/15/2023] [Accepted: 11/23/2023] [Indexed: 01/25/2024] Open
Abstract
BACKGROUND Improved interventions are needed to reduce the rate of driving while intoxicated. Responsible beverage service (RBS) training has reduced service to intoxicated patrons in licensed premises in several studies. Its efficacy might be improved by increasing the proper application and continued use of RBS with a professional development program in the 3 to 5 years between the required RBS retraining. OBJECTIVE This study aims to develop and evaluate a professional development component for an RBS training that aims to improve the effectiveness of the web-based training alone. METHODS In a 2-phase project, we are creating a professional development component for alcohol servers after completing an RBS training. The first phase involved formative research on the feasibility, acceptability, and potential effectiveness of components. Semistructured interviews with owners and managers of licensed establishments and focus groups and a survey with alcohol servers in New Mexico and Washington State examined support for RBS and the need for ongoing professional development to support RBS. A prototype of a professional development component, WayToServe Plus, was produced for delivery in social media posts on advanced RBS skills, support from experienced servers, professionalism, and basic management training. The prototype was evaluated in a usability survey and a field pilot study with alcohol servers in California, New Mexico, and Washington State. The second phase of the project will include full production of the professional development component. It will be delivered in Facebook private groups over 12 months and evaluated with a sample of licensed premises (ie, bars and restaurants) in California, New Mexico, and Washington State (n=180) in a 2-group randomized field trial (WayToServe training only vs WayToServe training and WayToServe Plus). Licensed establishments will be assessed for refusal of sales to apparently intoxicated pseudopatrons at baseline and 12 months after the intervention commences. RESULTS Although owners and managers (n=10) and alcohol servers (n=43) were favorable toward RBS, they endorsed the need for ongoing support for RBS for servers and identified topics of interest. A prototype with 50 posts was successfully created. Servers felt that it was highly usable and appropriate for themselves and the premises in the usability survey (n=20) and field pilot test (n=110), with 85% (17/20) and 78% (46/59), respectively, saying they would use it. Servers receiving the professional development component had higher self-efficacy (d=0.30) and response efficacy (d=0.38) for RBS compared with untreated controls. CONCLUSIONS Owners, managers, and servers believed that an ongoing professional development component on RBS would benefit servers and licensed premises. Servers were interested in using such a program, a large majority engaged with the prototype, and servers receiving it improved on theoretic mediators of RBS. Thus, the professional development component may improve RBS training. TRIAL REGISTRATION ClinicalTrials.gov NCT05779774; http://tinyurl.com/4mw6d2vk. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/49680.
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Affiliation(s)
| | | | - Robert Saltz
- Prevention Research Center, Pacific Institute for Research and Evaluation, Berkeley, CA, United States
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Dougherty DM, Moon TJ, Liang Y, Roache JD, Lamb RJ, Mathias CW, Wasserman AM, Wood EE, Hill-Kapturczak N. Effectiveness of contingency management using transdermal alcohol monitoring to reduce heavy drinking among driving while intoxicated (DWI) arrestees: A randomized controlled trial. Alcohol Clin Exp Res (Hoboken) 2023; 47:1989-2001. [PMID: 37864527 DOI: 10.1111/acer.15180] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/27/2022] [Revised: 08/18/2023] [Accepted: 08/22/2023] [Indexed: 10/23/2023]
Abstract
BACKGROUND Driving while intoxicated (DWI) is a serious public health problem. However, treatment for DWI arrestees is not readily available. This study examines the effectiveness of a contingency management (CM) procedure using transdermal alcohol concentration (TAC) monitoring to reduce drinking among DWI arrestees. METHOD The study participants were 216 DWI arrestees under pretrial and included both Mandated participants undergoing court-ordered TAC monitoring and Non-Mandated participants wearing a study-provided TAC monitor. Participants were randomly assigned to either a CM (Mandated = 35; Non-Mandated = 74) or a Control condition (Mandated = 37; Non-Mandated = 70) and completed the 8-week intervention. CM participants received $50/week for not exceeding a TAC of 0.02 g/dL during the previous week. Payments to Controls were yoked to the CM group. RESULTS Among Non-Mandated participants, the probability of meeting the contingency was higher and remained stable (about 65%) over time in the CM group, whereas the probability was lower and declined in the Control group, widening the gaps in the probability between the study conditions (16.7%-24.1% greater in the CM group from visit 4 to 8, all p < 0.05). Among Mandated participants, the probability was not significantly different between conditions (p = 0.06-0.95). Furthermore, among Non-Mandated participants, the percentage of heavy drinking days remained low (9.16%-11.37%) in the CM group, whereas it was greater and increased over time (17.43%-26.59%) in the Control group. In Mandated participants, no significant differences in percent heavy drinking days were observed between conditions (p = 0.07-0.10). CONCLUSION We found that contingency effects on alcohol use are more pronounced among frequent and heavy alcohol users, i.e., Non-Mandated DWI arrestees. However, for individuals whose drinking was already suppressed by existing contingencies (i.e., court-mandated TAC monitoring), our CM procedure did not produce additional reductions in drinking.
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Affiliation(s)
| | - Tae-Joon Moon
- Department of Health, Behavior, and Society, University of Texas School of Public Health San Antonio, San Antonio, Texas, USA
- Department of Psychiatry and Behavioral Sciences, University of Texas Health Science Center at San Antonio, San Antonio, Texas, USA
| | - Yuanyuan Liang
- Department of Epidemiology and Public Health, University of Maryland, Baltimore County, Baltimore, Maryland, USA
| | - John D Roache
- Department of Psychiatry and Behavioral Sciences, University of Texas Health Science Center at San Antonio, San Antonio, Texas, USA
| | - Richard J Lamb
- Department of Psychiatry and Behavioral Sciences, University of Texas Health Science Center at San Antonio, San Antonio, Texas, USA
| | - Charles W Mathias
- Department of Psychiatry and Behavioral Sciences, University of Texas Health Science Center at San Antonio, San Antonio, Texas, USA
- School of Nursing, University of Texas Health Science Center at San Antonio, San Antonio, Texas, USA
| | | | - Erin E Wood
- Department of Psychology, University of Illinois at Urbana-Champaign, Urbana, Illinois, USA
| | - Nathalie Hill-Kapturczak
- Department of Psychiatry and Behavioral Sciences, University of Texas Health Science Center at San Antonio, San Antonio, Texas, USA
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Romosz AM, Scherer M, Voas RB, Romano E, Nochajski TH, Taylor EP, Brogdale MR, Manning AR. Understanding non-installers of the ignition interlock device: A qualitative analysis. Drug Alcohol Rev 2021; 40:1083-1091. [PMID: 33768663 DOI: 10.1111/dar.13275] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2020] [Revised: 02/01/2021] [Accepted: 02/09/2021] [Indexed: 11/28/2022]
Abstract
INTRODUCTION Literature notes the efficacious use of alcohol ignition interlock devices (IID) in reducing rates of drinking and driving while installed on the vehicle. Some drivers who are convicted of driving while intoxicated (DWI) elect to have their license suspended/revoked instead of installing the device. These individuals represent a high-risk subsample of drivers, yet limited literature has addressed this concern. The current study seeks to fill this gap using qualitative interviews addressing: (i) why do non-installers make the choice to not install a mandated IID; and (ii) how are non-installers managing without the IID? METHODS The study utilises the Managing Heavy Drinkers study of drivers in Erie County, New York, USA. Participants were purposively sampled from a group of non-installers (n = 6; four females, two males) who completed semi-structured interviews. Constructed grounded theory was used to develop a theoretical understanding of participant's experiences. RESULTS To understand why participants elect not to install the IID, thematic analysis revealed: alleviating constraints, predominantly the financial burdens associated with an IID, and institutional mistrust. Additionally, data revealed that participants are managing without the IID by mitigating apprehension. This included driving cautiously to avoid detection and utilising alternative transportation. DISCUSSION AND CONCLUSIONS This study furthers understanding of why drivers convicted of a DWI elect not to install an IID. Future research should seek to identify barriers to IID installation. This work provides evidence for establishing institutional protocols that ensure drivers convicted of a DWI receive consistent and correct information about the IID process.
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Affiliation(s)
- Ann M Romosz
- Pacific Institute of Research and Evaluation, Calverton, USA.,Department of Business Psychology, The Chicago School of Professional Psychology, Washington, USA
| | - Michael Scherer
- Pacific Institute of Research and Evaluation, Calverton, USA.,Department of Clinical Psychology, The Chicago School of Professional Psychology, Washington, USA
| | - Robert B Voas
- Pacific Institute of Research and Evaluation, Calverton, USA
| | - Eduardo Romano
- Pacific Institute of Research and Evaluation, Calverton, USA
| | - Thomas H Nochajski
- School of Social Work, University at Buffalo, The State University of New York, Buffalo, USA
| | - Eileen P Taylor
- Pacific Institute of Research and Evaluation, Calverton, USA
| | - Meg R Brogdale
- Department of Business Psychology, The Chicago School of Professional Psychology, Washington, USA
| | - Amy R Manning
- Pacific Institute of Research and Evaluation, Calverton, USA.,School of Social Work, University at Buffalo, The State University of New York, Buffalo, USA.,Department of Social Work, Buffalo State College, Buffalo, USA
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Huang CY, Chou SE, Su WT, Liu HT, Hsieh TM, Hsu SY, Hsieh HY, Hsieh CH. Effect of Lowering the Blood Alcohol Concentration Limit to 0.03 Among Hospitalized Trauma Patients in Southern Taiwan: A Cross-Sectional Analysis. Risk Manag Healthc Policy 2020; 13:571-581. [PMID: 32607025 PMCID: PMC7305841 DOI: 10.2147/rmhp.s250734] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2020] [Accepted: 05/20/2020] [Indexed: 11/28/2022] Open
Abstract
Background In June 2013, the legal blood alcohol concentration (BAC) limit for driving was lowered from 0.05 to 0.03 mg/mL in Taiwan. Thus, this study aimed to assess the epidemiological changes in terms of drinking among drivers in southern Taiwan before and after the law was imposed. Methods Only patients who had undergone the BAC test at the emergency room were included in the study. The patients during the study period before (n = 2735) and after (n = 2413) the implementation of the law were selected for comparison. Drunk patients were defined as those who had a BAC ≥0.005 and were considered as driving under the influence (DUI) of alcohol. Meanwhile, driving while intoxicated (DWI) was defined as a BAC ≥0.05, which was the level adopted in the new law. Results Since the BAC limit lowered to 0.03, the number of DUI patients significantly decreased from 340 (12.4%) to 171 (7.1%), and that of DWI patients significantly reduced from 273 (10.0%) to 146 (6.1%) based on the alcohol test. In addition, after the implementation of the law, the number of associated injuries did not significantly decrease from that before the law was implemented in patients involved in alcohol-related crashes. Conclusion After lowering the legal BAC limit from 0.05 to 0.03, responsiveness to the change in law was observed among the studied population. However, such responsiveness may not be observed in some citizens who may need special interventions to help reduce their behavior of drinking and driving.
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Affiliation(s)
- Chun-Ying Huang
- Department of Trauma Surgery, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University and College of Medicine, Kaohsiung 83301, Taiwan
| | - Sheng-En Chou
- Department of Trauma Surgery, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University and College of Medicine, Kaohsiung 83301, Taiwan
| | - Wei-Ti Su
- Department of Trauma Surgery, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University and College of Medicine, Kaohsiung 83301, Taiwan
| | - Hang-Tsung Liu
- Department of Trauma Surgery, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University and College of Medicine, Kaohsiung 83301, Taiwan
| | - Ting-Min Hsieh
- Department of Trauma Surgery, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University and College of Medicine, Kaohsiung 83301, Taiwan
| | - Shiun-Yuan Hsu
- Department of Trauma Surgery, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University and College of Medicine, Kaohsiung 83301, Taiwan
| | - Hsiao-Yun Hsieh
- Department of Plastic Surgery, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University and College of Medicine, Kaohsiung 83301, Taiwan
| | - Ching-Hua Hsieh
- Department of Plastic Surgery, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University and College of Medicine, Kaohsiung 83301, Taiwan
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Merrell E, Johnson B. A proposal for an alcohol purchase license. Am J Drug Alcohol Abuse 2019; 46:143-148. [PMID: 31689140 DOI: 10.1080/00952990.2019.1676432] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/04/2019] [Revised: 09/25/2019] [Accepted: 09/30/2019] [Indexed: 06/10/2023]
Abstract
Background: Recent advances in technology have allowed for innovative targeting of high-risk alcohol users.Objectives: We propose the implementation of an alcohol purchase license linked to a state agency managed database, or so-called Banned Drinker Register (BDR).Methods: Individuals who are unable to drink safely will be identified by a well-founded criterion and their ability to purchase alcohol proscribed. A state agency will be responsible for maintaining the BDR and compiling mandated reports from hospitals, courts, police and child protective agencies of alcohol-related dangerous behavior, adjudicating reports with the input of those involved in these events, and determining which individuals will not be allowed to purchase alcohol. Outlets of alcohol sales will then be required to assess customers for eligibility of alcohol purchase using an electronic card reader (as used for age verification). Individuals wanting to protect themselves from drinking may also self-request to be placed on the BDR.Results: Overall, the convenience/access for persons who injure themselves with alcohol and others with intoxicated behavior would be reduced. Opportunities for cost savings would come from a decrease in yearly incarcerations, a reduction in preventable traffic accidents and property damage requiring state municipal intervention, a decreased cost to offending individuals by preventing increased insurance rates, loss of jobs to incarceration and loss of potential future wages, and the possibility of preventing long term medical complications of chronic alcohol use and its toll on the health care system.Conclusions: Health benefits will include increased public safety and awareness about drinking consequences and reduced alcohol-related morbidity and mortality.
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Affiliation(s)
- Eric Merrell
- Department of Psychiatry, SUNY Upstate Medical University, Syracuse, NY, USA
| | - Brian Johnson
- Department of Psychiatry, SUNY Upstate Medical University, Syracuse, NY, USA
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Mathias CW, Moon TJ, Karns-Wright TE, Hill-Kapturczak N, Roache JD, Mullen J, Dougherty DM. Estimating resource utilization demands in implementing statewide screening, brief intervention, and referral to treatment for alcohol-impaired drivers. Traffic Inj Prev 2019; 20:15-22. [PMID: 30715916 PMCID: PMC6445674 DOI: 10.1080/15389588.2018.1528500] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/04/2018] [Revised: 09/20/2018] [Accepted: 09/21/2018] [Indexed: 06/09/2023]
Abstract
OBJECTIVES The Alcohol Use Disorders Identification Test (AUDIT) is used to assess the level of alcohol use/misuse and to inform the intensity of intervention delivered within screening, brief intervention, and referral to treatment (SBIRT) programs. Policy initiatives are recommending delivery of SBIRT within health care settings to reduce alcohol misuse and prevent alcohol-impaired driving. Recent reports are considering extending delivery of SBIRT to criminal justice settings. One consideration in implementing SBIRT delivery is the question of resource utilization; the amount of effort required in delivering the 4 different intensities of intervention in SBIRT: Alcohol education, simple advice, brief counseling and continued monitoring, and brief counseling and referral to specialist (from least to most intense in terms of delivery time, the skill level of the provider, and personnel resources). METHODS In order to inform expectations about intervention intensity, this article describes the AUDIT scores from 982 adults recently arrested for alcohol-impaired driving. The distribution of scores is extrapolated to state rates for individuals arrested for alcohol-impaired driving by intervention level. RESULTS Though alcohol education was the most common intervention category, about one quarter of the sample scored in a range corresponding with the more intensive interventions using the brief counseling, continued monitoring for ongoing alcohol use, and/or referral to specialist for diagnostic evaluation and treatment. CONCLUSIONS This article provides local distribution of AUDIT scores and state estimates for the number of individuals scoring in each level of risk (AUDIT risk zone) and corresponding intervention type. Routine criminal justice practice is well positioned to deliver alcohol screening, education, simple advice, and continued alcohol monitoring, making delivery of SBIRT feasible for the majority of alcohol-impaired drivers. Challenges to implementing the full range of SBIRT services include resource demands of brief counseling, identifying the appropriate providers within a criminal justice context, and availability of community providers for referral to diagnostic and specialty care. Solutions may vary by state due to differences in population density and incidence rates of alcohol-impaired driving.
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Affiliation(s)
- Charles W. Mathias
- Department of Psychiatry The University of Texas Health Science Center at San Antonio San Antonio, TX
- Center for Research to Advance Community Health (ReACH) The University of Texas Health Science Center at San Antonio San Antonio, TX
| | - Tae-Joon Moon
- Department of Psychiatry The University of Texas Health Science Center at San Antonio San Antonio, TX
| | - Tara E. Karns-Wright
- Department of Psychiatry The University of Texas Health Science Center at San Antonio San Antonio, TX
| | - Nathalie Hill-Kapturczak
- Department of Psychiatry The University of Texas Health Science Center at San Antonio San Antonio, TX
| | - John D. Roache
- Department of Psychiatry The University of Texas Health Science Center at San Antonio San Antonio, TX
- Institute for Integration of Medicine and Science The University of Texas Health Science Center at San Antonio San Antonio, TX
- Department of Pharmacology The University of Texas Health Science Center at San Antonio San Antonio, TX
| | | | - Donald M. Dougherty
- Department of Psychiatry The University of Texas Health Science Center at San Antonio San Antonio, TX
- Institute for Integration of Medicine and Science The University of Texas Health Science Center at San Antonio San Antonio, TX
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Fell JC, Tanenbaum E, Chelluri D. Evaluation of a combination of community initiatives to reduce driving while intoxicated and other alcohol-related harms. Traffic Inj Prev 2018; 19:S176-S179. [PMID: 29584485 DOI: 10.1080/15389588.2018.1426904] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
OBJECTIVES In 2013, the community of Redlands, California, created an initiative using evidence-based strategies to deter driving under the influence (DUI), underage drinking and driving, public intoxication, and alcohol-related calls for service. The initiative, called "Responsible Redlands," included adopting a social host and a deemed approved local ordinance, using minor-decoy and shoulder-tap operations, increasing sobriety checkpoints and saturation patrols, conducting responsible beverage service (RBS) training, using identification (ID) scanners to spot false IDs, and a publicity campaign to urge neighbors to report loud drinking parties. The objectives of this study were to determine whether the initiatives were carried out as planned and to assess any impacts that may have occurred due to the combination of initiatives. METHODS Data from the Redlands Police Department were used to assess the process evaluation. The Statistical Analysis System (SAS) was used to create contingency tables to compare before (2007-2012) and after (2013-2014) the intervention start date and to conduct time-series analyses and calculate chi-squared test statistics on five outcome measures: DUI arrests, underage drinking violations, public intoxication violations, alcohol calls for service, and place of last drink (POLD) data from alcohol violators. Data sources were from the Redlands Police Department: DUI arrests for drivers under age 21 years and drivers age 21 or older; alcohol-related calls for service; public intoxication citations; and place of last drink surveys. Comparable data from control communities in California were not available at the time of the analyses. RESULTS Responsible Redlands Initiatives appeared to be carried out as planned. There was a statistically significant decrease in DUI arrests for drivers 21 and older from preintervention to postintervention (p < .001), in alcohol-related calls for service (p < .001), in loud music calls for service (p = .06), and in public intoxication citations (p < .001). There were decreases in underage drinking violations and in DUIs for under age 21 drivers, but the numbers were too small for chi-squared statistical tests. CONCLUSIONS "Responsible Redlands" interventions were associated with several significant decreases in outcome measures from preintervention to postintervention. Communities that consider these initiatives in combination (social host and deemed approved ordinances; minor-decoy and shoulder-tap operations; DUI checkpoints and saturation patrols; RBS training; use of ID scanners and a public information campaign to report loud drinking parties) can expect to experience potential decreases in alcohol-related harm.
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Affiliation(s)
- James C Fell
- a National Opinion Research Center (NORC) at the University of Chicago , Bethesda , Maryland
| | - Erin Tanenbaum
- a National Opinion Research Center (NORC) at the University of Chicago , Bethesda , Maryland
| | - Devi Chelluri
- a National Opinion Research Center (NORC) at the University of Chicago , Bethesda , Maryland
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Mullen J, Ryan SR, Mathias CW, Dougherty DM. Feasibility of a computer-assisted alcohol screening, brief intervention and referral to treatment program for DWI offenders. Addict Sci Clin Pract 2015; 10:25. [PMID: 26553284 PMCID: PMC4640391 DOI: 10.1186/s13722-015-0046-1] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2015] [Accepted: 10/28/2015] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Alcohol use patterns that are hazardous for one's health is prevalent among DWI (driving while intoxicated) offenders and is a key predictor of recidivism. The aim of this program evaluation was to determine the feasibility and usability of implementing a computer-assisted screening, brief intervention and referral to treatment (SBIRT) program for DWI offenders to enable the identification of those in need of treatment services soon after arrest. Our treatment program consisted of a web-based, self-guided screening tool for assessing alcohol use patterns and generating a personalized feedback report that is then used to deliver a brief motivational intervention and if needed, a referral to treatment. METHODS Between August and November 2014, all DWI offenders attending orientation for pre-trial supervision were assessed for eligibility. Of the 129 eligible offenders, 53.5 percent enrolled and the first 50 were asked to complete a usability and satisfaction questionnaire. RESULTS The results demonstrated that the majority of those screened reported at-risk alcohol use patterns requiring referral to treatment. Clients reported high ratings of usability and satisfaction with the screening tool and personalized feedback report, which did not significantly differ depending on alcohol use patterns. There were relatively few technical difficulties, and the majority of clients reported high levels of satisfaction with the overall SBIRT program. CONCLUSION Results of this program evaluation suggest that computer-assisted SBIRT may be successfully implemented within the criminal justice system to DWI offenders soon after arrest; however, further research is required to examine its effects on treatment utilization and recidivism.
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Affiliation(s)
- Jillian Mullen
- Psychiatry Department, The University of Texas Health Science Center at San Antonio, NRLC MC 7793, 7703 Floyd Curl Drive, San Antonio, TX, 78229-3900, USA.
| | - Stacy R Ryan
- Psychiatry Department, The University of Texas Health Science Center at San Antonio, NRLC MC 7793, 7703 Floyd Curl Drive, San Antonio, TX, 78229-3900, USA.
| | - Charles W Mathias
- Psychiatry Department, The University of Texas Health Science Center at San Antonio, NRLC MC 7793, 7703 Floyd Curl Drive, San Antonio, TX, 78229-3900, USA.
| | - Donald M Dougherty
- Psychiatry Department, The University of Texas Health Science Center at San Antonio, NRLC MC 7793, 7703 Floyd Curl Drive, San Antonio, TX, 78229-3900, USA.
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Mullen J, Ryan SR, Mathias CW, Dougherty DM. Treatment Needs of Driving While Intoxicated Offenders: The Need for a Multimodal Approach to Treatment. Traffic Inj Prev 2015; 16:637-44. [PMID: 25664371 PMCID: PMC4481140 DOI: 10.1080/15389588.2015.1013189] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/06/2014] [Accepted: 01/25/2015] [Indexed: 05/10/2023]
Abstract
OBJECTIVE This study aimed to characterize and compare the treatment needs of adults with driving while intoxicated (DWI) offenders recruited from a correctional residential treatment facility and the community to provide recommendations for treatment development. METHOD A total of 119 adults (59 residential, 60 community) with at least one DWI offense were administered clinical diagnostic interviews to assess substance use disorders and completed a battery of questionnaires assessing demographic characteristics, legal history, psychiatric diagnoses, medical diagnoses, and health care utilization. RESULTS Almost all (96.6%) DWI offenders met clinical diagnostic criteria for an alcohol use disorder, approximately half of the sample also met diagnostic criteria for comorbid substance use disorders, and a substantial proportion also reported psychiatric and medical comorbidities. However, a high percentage were not receiving treatment for these issues, most likely as a result of having limited access to care, because the majority of participants had no current health insurance (64.45%) or primary care physician (74.0%). The residential sample had more extensive criminal histories compared to the community sample but was generally representative of the community in terms of their clinical characteristics. For instance, the groups did not differ in rates of substance use, psychiatric and medical health diagnoses, or the treatment of such issues, with the exception of alcohol abuse treatment. CONCLUSIONS DWI offenders represent a clinical population with high levels of complex and competing treatment needs that are not currently being met. Our findings demonstrate the need for standardized screening of DWI offenders and call for the development of a multimodal treatment approach in efforts to reduce recidivism.
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Affiliation(s)
- Jillian Mullen
- a Department of Psychiatry , The University of Texas Health Science Center at San Antonio , San Antonio , Texas
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Lapham SC, Todd M. Do deterrence and social-control theories predict driving after drinking 15 years after a DWI conviction? Accid Anal Prev 2012; 45:142-151. [PMID: 22269495 PMCID: PMC3323116 DOI: 10.1016/j.aap.2011.12.005] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/14/2011] [Revised: 12/08/2011] [Accepted: 12/13/2011] [Indexed: 05/31/2023]
Abstract
OBJECTIVE This study investigates the utility of deterrence and social-control theories for prospective prediction of driving-while-impaired (DWI) outcomes of first-time DWI offenders. METHOD The sample consisted of a subset of 544 convicted first-time DWI offenders (N=337 females) who were interviewed 5 and 15 years after referral to a Screening Program in Bernalillo County, New Mexico. Variables collected at the 5-year (initial) interview were used in structural equation models to predict past 3-months, self-reported DWI at the 15-year follow-up (follow-up) interview. These variables represented domains defined by deterrence and social-control theories of DWI behavior, with one model corresponding to deterrence theory and one to social-control theory. RESULTS Both models fit the data. DWI jail time was positively related to perceived enforcement, which was negatively but not significantly related to self-reported DWI. Neither jail time for DWI nor perceived likelihood of arrest was linearly related to self-reported DWI at follow-up. Interactions between jail time and prior DWI behavior indicated relatively weaker associations between initial and 15-year DWI for those reporting more jail time. CONCLUSION Our prospective study demonstrated that for this convicted DWI offender cohort, classic formulations of deterrence and social-control theories did not account for DWI. However, results suggest that punishment may decrease the likelihood of DWI recidivism.
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Affiliation(s)
- Sandra C. Lapham
- Pacific Institute for Research and Evaluation, 612 Encino Place NE, Albuquerque, NM 87102, United States,
| | - Michael Todd
- Pacific Institute for Research and Evaluation, 1995 University Avenue, Suite 450, Berkeley, CA 94704, United States,
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Voas RB, Fell JC. Preventing impaired driving opportunities and problems. Alcohol Res Health 2011; 34:225-35. [PMID: 22330222 PMCID: PMC3629952] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Impaired driving remains a significant public health problem in the United States. Although impressive reductions in alcohol-related fatalities occurred between 1982 and 1997, during which all 50 States enacted the basic impaired-driving laws, progress has stagnated over the last decade. Substantial changes in the laws and policies or funding for the enforcement of the criminal offense of driving while intoxicated (DWI) are needed for further substantial progress in reducing alcohol-related crash injuries. However, research indicates that evidence-based laws in the 50 States and current best practices in DWI enforcement are not being fully adopted or used. It seems, however, that effective operations, such as the low-staff check points that are routinely applied in many communities, could be extended to many more police departments. In addition, several enforcement methods have been proposed but never fully tested.
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Affiliation(s)
- Robert B Voas
- Driving Center, Pacific Institute for Research and Evaluation, Calverton, Maryland
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