The crash reduction effectiveness of a network-wide traffic police deployment system. The effect of drinking and driving interventions on alcohol-involved traffic crashes within a comprehensive community trial. Deterring the drinking driver: the Stockton experience. Effectiveness of brief interventions after alcohol-related vehicular injury: A randomized controlled trial. Increased police enforcement: effects on speed. Changing perceptions of riskiness in drinking, drugs, and driving: an emergency department-based alcohol and substance abuse prevention program. Reducing alcohol-impaired driving in Massachusetts: the Saving Lives Program. Brief intervention in alcohol-positive traffic casualties: is it worth the effort? A randomized trial of a DWI intervention program for first offenders: intervention outcomes and interactions with antisocial personality disorder among a primarily American-Indian sample.
Random Road Watch (RRW) is a traffic policing program in operation in Queensland, Australia. It differs from conventional traffic policing in that an explicit resource management technique is used which randomly schedules low levels of police enforcement in a manner intended to provide long-term, widespread coverage of a road network and hence maximise road safety benefits. Implementation of the program studied in Queensland covered 55% of total crashes within the state. This study aimed to measure the crash effects of the RRW program in Queensland. A quasi-experimental study design was used for the evaluation incorporating Poisson regression statistical analysis techniques. Analysis of the effects of the Queensland RRW program on crash frequency has shown the program to be effective overall. Estimated program effects were largest on fatal crashes, with an estimated reduction of 31%. Estimated aggregate program crash effects reduced with crash severity and increased with time after program introduction. Crash reductions in the third year after program introduction translated into savings, at state level, of some 12% of the state's crashes of all severities and some 15% of the state's fatal road crashes. Overall, the program produced a significant 11% reduction in total crashes in areas outside of metropolitan Brisbane. The opportunity-cost benefit/cost ratio for the program was estimated to be 55:1. The Drinking and Driving Component, one of five elements of the Community Trials Project, involved the implementation of a special drink driving countermeasure in the three experimental communities, one in Northern California, one in Southern California and another in South Carolina. This intensified enforcement of driving under the influence (DUI) was designed to deter potential drinking drivers by increasing their perception of the risk of being arrested leading to a reduction in the consumption of alcohol before driving. See component detailed description in Voas (1997, this issue). The evaluation found that media advocacy training and technical assistance resulted in increased DUI news coverage and that additional police officer hours for DUI enforcement, greater use of breathalyzer equipment, increased officer training and more checkpoints produced increased DUI enforcement. The combined effects of increased DUI news coverage and DUI enforcement yielded increased public perceived risk of arrest and subsequently less drinking and driving. Overall the evaluation found that alcohol-involved traffic crashes were reduced as a result of this component in the experimental communities as contrasted with the matched comparison communities. The effectiveness of drunk driving enforcement patrols is generally assumed. However, few adequate evaluations are available in the traffic safety literature. The U.S. Department of Transportation funded a special program in Stockton, a city with a population of 120,000 in the central valley of California, to test the effectiveness of special drunk driving patrols on weekend evenings, applied within a setting in which no other major alcohol safety programs were present. The objective of this effort was to determine the effectiveness of a "traditional" approach to enforcing driving while impaired (DWI) laws; one in which innovative procedures such as sobriety checkpoints were not used. The results indicated that nighttime collisions in Stockton were reduced during the three and a half year period of the special enforcement program. Because 40% of motor vehicle fatalities in the United States are alcohol-related, interventions delivered by trauma clinicians targeted to reduce drinking are of particular importance to public health. The objective of this study was to test the effectiveness of hospital-based brief intervention strategies to reduce alcohol consumption and other health-related outcomes in the year after an alcohol-related vehicular injury. Brief interventions are clinically based strategies including assessment and direct feedback about drinking alcohol, goal setting, behavioral modification techniques, and the use of a self-help manual.
                The study was a randomized controlled trial of two types of brief intervention with a 12-month follow-up. Participants with alcohol-related vehicular injury who were admitted to Level I trauma centers were eligible for enrollment. Enrolled participants were randomized to a control, simple advice, or brief counseling condition. Primary outcome variables were alcohol consumption (standard drinks/month, binges/month), adverse driving events (driving citations, traffic crashes), and changes in health status (hospital and emergency department admissions).
                The study enrolled 187 participants at baseline and retained 100 across 12 months. Participants had a significant decrease in alcohol consumption and traffic citations at 12 months as compared with baseline. Mean standard drinks/month declined from 56.80 (SD 63.89) at baseline to 32.10 (SD 53.20) at 12 months. Mean binges/month declined from 5.79 (SD 6.98) at baseline to 3.21 (SD 6.17) at 12 months. There were no differences in alcohol consumption, adverse driving events, or health status by condition.
                Whether the reductions in alcohol consumption and traffic citations were a result of the crash, hospitalization for injury, screening for alcohol use, or combination of these factors is difficult to determine. Further work is needed to understand the mechanisms involved in reductions of health-related outcomes and the role of brief intervention in this population. Results of a field experiment in which a 35-km long stretch of road was subjected to an increase in police enforcement--mostly as stationary speed controls--are presented. A group of police officers was invited to plan and perform the enforcement based on their own experience and ideas. The level of enforcement reached a daily average of nine hours throughout an enforcement period of six weeks. Speed measurements were done in 60 and 80 km/h speed-limit zones before, during and after enforcement withdrawal, and were compared to another stretch of road. Average speeds were reduced by 0.9-4.8 km/h in both speed-limit zones and for all times of day. For some time intervals, the average speed and the percentage of speeding drivers were reduced for several weeks of the after-period, demonstrating a time-halo effect of eight weeks at most. The percentage of speeding drivers was reduced in both speed-limit zones for all hours of the day except the morning rush hours 6.00-9.00 A.M. It is suggested that commuting drivers in the morning rush hours are most resistant to speed reduction. These results were statistically significant at alpha = 0.01. For the last three years, the University of New Mexico School of Medicine/Division of Emergency Medicine has sponsored an Alcohol and Substance Abuse Prevention Program (ASAP). The program's objectives were to expose youth to the "real-life" social and medical consequences of alcohol and substance abuse through visits and interviews with patients and their families at the University of New Mexico Emergency Department and Trauma Center. A pretest, post-test, and eight-month follow-up evaluation design was used to assess the program's effects. Questionnaires were administered to randomly selected experimental and control groups of seventh grade students (n = 27). Repeated-measures analysis of variance detected a significant experimental/control condition x time crossover interaction effect for stated perception of riskiness, F (2, 31) = 3.20, P = .049. The data indicated that, over time, the experimental group perceived the riskiness of driving under the influence of drugs or alcohol to be greater, while the control group perceived such behavior to be less risky. The purpose of this study ws to assess whether a community program begun in March 1988 that organized multiple city departments and private citizens could reduce alcohol-impaired driving, related driving risks, and traffic deaths and injuries.
                Trends in fatal crashes and injuries per 100 crashes were compared in Saving Lives Program cities and the rest of Massachusetts from March 1984 through February 1993. In annual roadside surveys conducted at randomly selected locations, safety belt use among occupants of 54577 vehicles and travel speeds of 118442 vehicles were observed. Four statewide telephone surveys (n = 15188) monitored self-reported driving after drinking.
                In program cities relative to the rest of Massachusetts during the 5 program years in comparison with the previous 5 years, fatal crashes declined 25%, from 178 to 120, and fatal crashes involving alcohol decreased 42%, from 69 to 36. Visible injuries per 100 crashes declined 5%, from 21.1 to 16.6. The proportions of vehicles observed speeding and teenagers who drove after drinking were cut in half.
                Interventions organized by multiple city departments and private citizens can reduce driving after drinking, related driving risks, and traffic deaths and injuries. This study aimed at testing the effectiveness of a brief motivational intervention (BI) compared with a minimal intervention (MI) for reducing alcohol consumption in adult, alcohol-positive traffic casualties.
                Patients were recruited at the emergency room of a trauma hospital and screened for alcohol by a qualitative saliva test (positive from a blood alcohol concentration of 0.02 g/l). Positive patients (13.3%) who accepted entering the study were randomly allocated into BI and MI. Baseline assessment was the same for all patients. Blind telephone follow-ups were performed at months 3, 6, and 12, and results were analysed by protocol and by intention-to-treat analysis.
                After 1 year of follow-up, 67% of the patients had reduced their consumption, the percentage of heavy drinkers had dropped by 47%, and 62% of baseline AUDIT-C positive patients (hazardous drinkers) had become negative. Binge drinking dropped significantly (P < 0.05). Results at month 12 were in line with the previous ones.
                The effectiveness of BI compared with MI has not been verified, but a significant reduction in consumption has been observed in the whole sample, without significant differences by type of intervention. The persistence and dimension of changes suggest a real effect of both interventions, although the lack of a pure control group does not allow definitive conclusions. Traffic casualties are in a teachable moments to benefit from easy and cheap interventions. Randomized trial evidence on the effectiveness of incarceration and treatment of first-time driving while intoxicated (DWI) offenders who are primarily American Indian has yet to be reported in the literature on DWI prevention. Further, research has confirmed the association of antisocial personality disorder (ASPD) with problems with alcohol including DWI.
                A randomized clinical trial was conducted, in conjunction with 28 days of incarceration, of a treatment program incorporating motivational interviewing principles for first-time DWI offenders. The sample of 305 offenders including 52 diagnosed as ASPD by the Diagnostic Interview Schedule were assessed before assignment to conditions and at 6, 12, and 24 months after discharge. Self-reported frequency of drinking and driving as well as various measures of drinking over the preceding 90 days were available at all assessments for 244 participants. Further, DWI rearrest data for 274 participants were available for analysis.
                Participants randomized to receive the first offender incarceration and treatment program reported greater reductions in alcohol consumption from baseline levels when compared with participants who were only incarcerated. Antisocial personality disorder participants reported heavier and more frequent drinking but showed significantly greater declines in drinking from intake to posttreatment assessments. Further, the treatment resulted in larger effects relative to the control on ASPD than non-ASPD participants.
                Nonconfrontational treatment may significantly enhance outcomes for DWI offenders with ASPD when delivered in an incarcerated setting, and in the present study, such effects were found in a primarily American-Indian sample.
Studies examining increased police patrol programs were generally consistent in reporting beneficial effects on traffic crashes and fatalities, but study quality and reporting were often poor. Methodological limitations included inadequate sample size, dissimilar baseline measures, contamination, and inadequate data analysis. Thus existing evidence, although supportive, does not firmly establish whether increased police patrols, implemented with or without other intervention elements, reduce the adverse consequences of alcohol-impaired driving.