Health Interventions with Interlock Users: Effective?

描述(申请人提供)：酒精点火联锁，防止酒后驾驶司机启动车辆，已被证明在减少被判酒后驾车(酒后驾车)的个人的累犯率方面非常有效。这一证据引发了一种强烈的全国性趋势，即各州制定立法，要求对所有酒后驾车违规者实行互锁。然而，这种立法的效力是有限的，因为联锁装置只有在罪犯的车辆上安装时才有效(通常为6个月至2年)，但酒后驾车违法者通常在更长的时间内--最高可达7年--继续对公众构成高于平均水平的风险。需要制定一些计划，旨在延长互锁装置的效力，使其超出犯罪者的车辆使用期限。有一些证据表明，简短的教育计划和加强对联锁性能的监测可以减少解除联锁后的再犯率。该应用程序提出了一项研究，涵盖了佛罗里达州4万名酒后驾车罪犯的10年数据，该研究为联锁用户实施了一项干预计划，旨在减少他们在卸载后的累犯率。该计划遵循的是一种医学模式，在这种模式下，干预的需要是通过连锁呼气测试的表现而不是筛查访谈来客观地确定的。此外，根据日益增长的需要，通过增加治疗水平，分阶段实施干预措施。该计划实施了三种类型的干预--教育、监测和治疗--有一些证据表明，这些干预措施减少了连锁犯罪者的再犯罪率。在可以确定干预措施的好处的情况下，成本效益估计 将为所分析的样品开发，如果在其他州应用，将为预期效益开发。 公共卫生相关性：互锁装置通过防止被判酒后驾驶的司机启动车辆来拯救生命，但一旦从车辆上移除互锁装置，它们就不会对违法者卷入与酒精有关的撞车事故的风险产生任何影响。这项研究旨在确定简短的教育计划、更严格的监控或酒精治疗计划是否可以改变这些司机的行为，以便在联锁期间展示的更安全的行为在从违法者的车辆上移走后继续存在。

DESCRIPTION (provided by applicant): Alcohol-ignition interlocks, which prevent a drinking driver from starting the vehicle, have been demonstrated to be very effective in reducing the recidivism of individuals convicted of driving under the influence (DUI). That evidence has initiated a strong national trend for states to enact legislation requiring interlocks for all DUI offenders. The effectiveness of such legislation is limited, however, because interlocks are only effective while installed on the offender's vehicle (typically 6 months to 2 years), yet DUI offenders generally continue to be an above-average risk to the public for a much longer-up to 7 years. Programs targeted at extending the effectiveness of interlocks beyond the period they are on the offender's vehicle are needed. There is some evidence that brief educational programs and increasing the intensity of the monitoring of interlock performance can reduce recidivism following the removal of the interlock. This application proposes a study covering 10 years of data on 40,000 DUI offenders in Florida, which has implemented an intervention program for interlock users designed to reduce their recidivism following deinstallaton. That program follows a medical model where the need for intervention is determined objectively by interlock breath-test performance rather than by screening interviews. Furthermore, the intervention is applied in stages by increasing the level of treatment provided as an increasing need is demonstrated. The program implements the three types of intervention-education, monitoring, and treatment-for which there is some evidence that they reduce the recidivism of interlock offenders. Where benefits of the interventions can be identified, cost-benefit estimates will be developed for the sample analyzed and for the expected benefit if applied in other states. PUBLIC HEALTH RELEVANCE: Interlocks save lives by preventing convicted drinking drivers from starting their vehicles, but once the interlock is removed from the vehicle, they have no effect on the risk that the offender will be involved in an alcohol-related crash. This study is designed to determine whether brief educational programs, stricter monitoring, or alcohol treatment programs can change the behavior of these drivers so that the safer behavior demonstrated during the time on the interlock continues after its removal from offenders' vehicles.