Evaluating South Dakota's 24/7 Sobriety Program

描述（由申请人提供）：酒精使用，特别是在刑事司法系统中，给个人和社会带来了巨大的成本。政策制定者正在寻找减轻酒精对公共健康和安全构成威胁的方法，尽管预算压力迫使他们考虑将有酒精问题的低级别罪犯留在社区而不是监禁。由于有500多万人处于社区监督之下，即使在这一人群中少量减少酒精消费也可以改善公共健康和公共安全。 这项研究提出了一个大规模的和创新的计划，在南达科他州，已收到显着的关注作为一个成功的方法，以减少酒精消费在社区矫正设置严格的评估。南达科他州的24/7清醒计划（24/7）要求罪犯每天接受两次酒精测试。那些检测呈阳性或错过检测的人将面临立即但短暂的监禁。自2005年以来，已有13 000多人参加，我们的计算表明，22-40岁的所有男性的参与率至少为5%。虽然24/7被吹捧为国家模式，并正在考虑和采用其他国家，没有同行审查的科学证据，其有效性或成本效益。 我们提出的24/7评估在方法、数据获取和范围方面都是创新的。准实验方法，利用交错实施24/7跨县和罪犯类型，是必要的，以评估在没有随机分配的大规模实施。此外，还特别提供了关于参与者和非参与者的数据，以及关于社区中与酒精有关的危害的更广泛的事件级数据，从而加强了评估。具体目标是：目标1：记录各县和罪犯类型24/7的实施和利用情况。 目标2：确定参与者中24/7计划违规的预测因素。 目标3：评估24/7参与对个人累犯结果的影响。 目标4：估计24/7对健康和社会结果的影响，包括与酒精有关的交通事故，住院，逮捕和报告的犯罪。 目标5：将24/7的成本和收益货币化。 这项研究的目标是为南达科他州内外的政策制定者和利益相关者提供关于24/7有效性和成本效益的严格证据，以告知正在进行的关于如何有效使用酒精测试以减少酒精滥用及其后果的政策辩论。这一信息至关重要，因为受酒精约束的州寻求减少监禁，有效管理社区中有酒精问题的人，同时保障公共健康和安全。 公共卫生相关性：决策者正在寻找减轻酒精对公共健康和安全构成威胁的方法，尽管预算压力迫使他们考虑将更多有酒精问题的低级罪犯留在社区，而不是监禁。南达科他州的24/7清醒计划被吹捧为一个全国性的模式，并已被其他州考虑和采用，尽管没有同行评审的评估证明其有效性或成本效益。这项拟议的研究将为政策制定者和其他利益相关者提供对这一创新计划的严格的准实验性评估，以告知正在进行的关于如何有效使用酒精测试以减少酒精滥用及其后果的政策辩论。

DESCRIPTION (provided by applicant): Alcohol use, particularly among those in the criminal justice system, imposes tremendous costs on individuals and society. Policymakers are searching for ways to mitigate the threat alcohol poses to public health and safety even as budgetary pressures force them to consider keeping low-level offenders with alcohol problems in the community rather than incarcerated. With more than 5 million individuals under community supervision, even small reductions in alcohol consumption among this population can improve public health and public safety. This study proposes a rigorous evaluation of a large-scale and innovative program in South Dakota that has received significant attention as a successful approach to reducing alcohol consumption in community corrections settings. South Dakota's 24/7 Sobriety Program (24/7) requires that offenders submit to breathalyzer tests twice per day. Those testing positive or missing a test face an immediate, but brief, jail term. Since 2005 there have been more than 13,000 participants and our calculations suggest participation rates of at least 5% among all males aged 22-40. While 24/7 is touted as a national model and is being considered and adopted in other states, there is no peer-reviewed scientific evidence of its effectiveness or cost-effectiveness. Our proposed evaluation of 24/7 is innovative in its methods, access to data, and scope. The quasi- experimental approach, which exploits the staggered implementation of 24/7 across counties and offender types, is necessary to evaluate the large-scale implementation in the absence of random assignment. The evaluation is also strengthened by exceptional access to data on participants and non-participants and by the broader incident-level data on alcohol-related harms in the community. The specific aims are: Aim 1: Document the implementation and utilization of 24/7 across counties and offender types. Aim 2: Identify predictors of 24/7 program violations among participants. Aim 3: Estimate the effect of 24/7 participation on individual-level recidivism outcomes. Aim 4: Estimate the effect of 24/7 on health and social outcomes including alcohol-related traffic accidents, hospital admissions, arrests, and reported crimes. Aim 5: Monetize the costs and benefits of 24/7. The goal of this study is to provide policymakers and stakeholders within and beyond South Dakota with rigorous evidence regarding 24/7's effectiveness and cost-effectiveness to inform the ongoing policy debate about how to effectively use alcohol testing to reduce alcohol misuse and its consequences. This information is critical as fiscally-constrained states seek to reduce incarceration and effectively manage those with alcohol problems in the community while safeguarding public health and safety. PUBLIC HEALTH RELEVANCE: Policymakers are searching for ways to mitigate the threat alcohol poses to public health and safety even as budgetary pressures force them to consider keeping more low-level offenders with alcohol problems in the community rather than incarcerated. South Dakota's 24/7 Sobriety Program is touted as a national model and is already being considered and adopted in other states, despite the fact that there is no peer-reviewed evaluation demonstrating its effectiveness or cost-effectiveness. The proposed study will provide policymakers and other stakeholders with a rigorous quasi-experimental evaluation of this innovative program to inform the ongoing policy debate about how to effectively use alcohol testing to reduce alcohol misuse and its consequences.