Phase II year
2013
(last award dollars: 2015)
Driving while intoxicated (DWI) is a major public health hazard. In the U.S. there were 13,846 deaths in 2008 caused by alcohol-impaired drivers (National Highway Traffic Safety Administration (NHTSA), 2009a). The New Mexico Dept. of Transportation (DoT) reported the total DWI cost to New Mexico in 2007 alone was over one billion dollars (NM DoT, 2008). In New Mexico, 43% of DWI offenders are repeat offenders. This is unacceptable. Specifically, more needs to be done to prevent first-time offenders from becoming recidivists. This proposal is to develop a new web application that could consistently deliver an effective intervention that has the potential to reduce heavy drinking in these offenders. Currently, however, there are significant challenges to delivering empirically supported interventions to offenders. First, only a small proportion of DWI offenders are referred for treatment, despite evidence that brief motivational interventions reduce heavy drinking in offenders. Second, for those referred to treatment, providing such interventions through substance abuse counselors faces significant challenges: 1) Many substance abuse counselors are not trained in empirically supported protocols; 2) clinicians who are trained in empirically supported interventions tend to "drift" from protocols over time; and 3) there is an average annual turn-over rate of 50% in counselors in substance abuse programs (McLellan et al., 2003). This turnover means that programs that provide training for staff in empirically supported protocols often need to train new counselors, and programs are rarely compensated for the cost. Training then becomes an occasional event. As a result, counselors may not have the opportunity to be trained, and if trained, tend to "drift" from empirically supported protocols ove time. This proposal provides an alternative. We propose to develop a web application that could consistently deliver an intervention that has the potential to reduce heavy drinking in these offenders. This reduction in drinking would reduce their risk for future DWIs, alcohol-related crashes, injuries, and death. Taking advantage of a "teachable moment," the program will incorporate two empirically supported brief motivational interventions (one for younger and one for older adults) and an abstinence-oriented, cognitive behavioral intervention into a single, new program called Right Turns. There are two innovations in this proposal: 1) A web-based and age-appropriate BMI that is tailored to offenders and that takes their readiness to change at the end of it into account when segueing to; 2) a cognitive behavioral, abstinence-oriented web application to help them achieve and maintain sobriety. The R&D proposed in Phase II is to complete the development of the program, adding a follow-up component to the BMIs and a "back office" module for program administrators that include extensive outcome report functions. The program's effectiveness will then be evaluated in a randomized clinical trial with a 3 month follow-up.
Public Health Relevance Statement: Public Health Relevance: Drunk driving is a major public health hazard that caused 13,846 deaths in the U.S. in 2008. If this program proves to be effective, it could become a reliably delivered, empirically supported intervention to reduce recidivism in first-time DWI offenders. Reducing the drinking, alcohol- related problems and drunk driving in this population would benefit the individuals, their families, and their communities.
NIH Spending Category: Alcoholism; Behavioral and Social Science; Clinical Research; Clinical Trials; Prevention; Substance Abuse; Violence Research
Project Terms: Abstinence; Accounting; Administrator; Age; alcohol related problem; Alcohols; Back; base; Behavioral; Boxing; brief motivational intervention; Cessation of life; Clinical; Cognitive; Cognitive Therapy; Communities; cost; Data Analyses; Data Reporting; Development; drinking; Driving While Intoxicated; Drunk driving; effective intervention; Elderly; Electronic Mail; Event; Face; Family; Feedback; follow-up; Future; Goals; Health Hazards; Heavy Drinking; Individual; Injury; innovation; Internet; Intervention; Knowledge Base (Computer); Letters; New Mexico; offender; Online Systems; Outcome; Participant; Pharmaceutical Preparations; Phase; Pilot Projects; Population; prevent; probation; Professional counselor; Program Development; Program Effectiveness; programs; Progress Reports; Protocols documentation; prototype; Provider; public health medicine (field); public health relevance; Randomized Clinical Trials; Readiness; recidivism; Recruitment Activity; repeat offender; Reporting; Research; research and development; Risk; Safety; sobriety; Structure; Substance abuse problem; System; Text; Time; TimeLine; tool; trafficking; Training; Transportation; Work
