Smartphone Help for DWI Offenders and Their Families: A B-SMART App

描述(由申请人提供)：酒后驾车(DWI)在美国仍然是一个重要的、可预防的发病率和死亡率来源。为了减少美国的酒后驾车事故，已经尝试了各种制裁和干预措施，包括加强酒后驾车执法力度、更严格的酒后驾车法律、负责任的酒精饮料服务培训和酒精治疗。点火联锁装置(IID)要求司机向安装在汽车上的酒精测试器单元吹气，以建立清醒状态，从而减少安装时的酒驾。IID的使用已经变得很普遍：美国大多数州现在要求被判有罪的酒后驾车者在某种形式的定罪后在车内安装IID。然而，研究已经确凿地表明，一旦酒后驾车罪犯的IID被移除，酒后驾车累犯率就会恢复到与没有安装IID的罪犯相当的水平。这表明，只要安装了IID，IID就有效，但在安装期限之后不会提供任何效果。然而，IID确实有效地提供了在安装时停止酒驾的方法。本文建议进行系统开发(第一阶段)和随机疗效试验(第二阶段)，旨在延长酒后驾驶戒烟最初由IID提供的干预措施。B-SMART将是一款智能手机应用程序，将通过提供应对技能、沟通技能和帮助避免酒后驾车的策略，让酒后驾车罪犯的相关家庭成员(CFM)参与进来。这种干预的独特之处在于，家庭成员参与支持酒后驾车犯罪者不酒后驾车，并使用智能手机技术使这一支持立即、可获得和传播。干预的内容将基于由联合调查员McCrady开发的针对酒精使用障碍患者的经验性验证的夫妇治疗，并转化为智能手机平台。该项目的第一阶段将涉及B-SMART的系统和迭代开发，采用：1)专家咨询委员会，2)社区咨询委员会，以及3)由CFM和DWI违规者组成的迭代开发、多媒体和可用性焦点小组和访谈。B-SMART的具体里程碑和交付成果预计将在第一阶段完成。该项目未来的第二阶段将包括完成B-SMART，以及B-SMART的随机疗效试验，以检查其对各种与酒精相关的依赖变量的影响，包括DWI再抑制。如果B-SMART被证明影响酒后驾车和酒后驾车再次被捕，政府、社区和治疗实体以及酒后驾车犯罪者的家属将拥有一个重要和可获得的工具，进一步减少酒后驾车造成的社会、健康和经济后果。

DESCRIPTION (provided by applicant): Driving while intoxicated (DWI) remains a substantial and preventable source of morbidity and mortality in the United States. A variety of sanctions and interventions have been attempted to reduce DWI in the U.S., including enhanced DWI enforcement efforts, stricter drunk driving laws, responsible alcohol beverage service training, and alcohol treatment. The Ignition Interlock Device (IID), which requires a driver to blow into a breathalyzer unit installed in an automobile to establish sobriety, reduces drunk driving while installed. The use of IIDs has become widespread: most states in the U.S. now require convicted drunk drivers to install an IID in their cars upon some form of conviction. However, research has conclusively shown that once the IIDs are removed from DWI offenders' cars, DWI recidivism levels return to those comparable to offenders who did not have an IID installed. This indicates that IIDs are effective as long as they are installed, but do not provide any effect beyond the installation period. IIDs do, however, effectively provide a cessation of drunk driving while installed. Proposed here is the systematic development (in Phase I) and randomized efficacy trial of (in Phase II) an intervention designed to extend the drunken driving cessation initially provided by an IID. B-SMART will be a smartphone app that will involve the Concerned Family Member (CFM) of DWI offenders by providing coping skills, communication skills, and strategies to help avoid DWI. Unique to this intervention are the involvement of family members in supporting the DWI offender to not drink and drive, and the use of smartphone technology to make that support immediate, accessible, and diffusible. The content of the intervention will be based on empirically validated couples therapy for those with Alcohol Use Disorders developed by co-Investigator McCrady, translated to a smartphone platform. Phase I of this project will involve the systematic and iterative development of B-SMART, employing: 1) an Expert Advisory Board, 2) a Community Advisory Board, and 3) iterative development, multimedia, and usability focus groups and interviews comprised of CFM and DWI offenders. Specific milestones and deliverables for B-SMART are projected for Phase I. A future Phase II of the project will involve the completion of B-SMART, and a randomized efficacy trial of B-SMART that examines its impact on a variety of alcohol-related dependent variables, including DWI re-arrest. Should B-SMART be demonstrated to impact DWI and DWI re-arrest, government, community, and therapeutic entities, along with families of DWI offenders, will have an important and accessible tool to further reduce the social, health and economic consequences of DWI.