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

描述（由申请人提供）：醉酒驾驶（DWI）仍然是美国发病率和死亡率的重要和可预防的来源。在美国，已经尝试了各种制裁和干预措施来减少DWI，包括加强DWI执法力度，更严格的酒后驾驶法律，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量装置吹气，以建立清醒状态，这减少了安装后的酒后驾驶。IID的使用已经变得很普遍：美国大多数州现在都要求被定罪的酒驾司机在某种形式的定罪后在车上安装IID。然而，研究最终表明，一旦从酒后驾车违法者的汽车上取下IID，酒后驾车的再犯水平就会恢复到与没有安装IID的违法者相当的水平。这表明iid在安装期间是有效的，但在安装期间之后不提供任何效果。然而，iid在安装后确实有效地阻止了酒后驾驶。本文建议对一种干预措施进行系统开发（一期）和随机疗效试验（二期），该干预措施旨在延长最初由IID提供的酒驾停止时间。B-SMART将是一个智能手机应用程序，通过提供应对技巧、沟通技巧和策略来帮助避免酒驾违者。这种干预的独特之处在于家庭成员的参与，以支持酒后驾车的违规者，并使用智能手机技术使这种支持立即，可访问和传播。干预的内容将基于经验验证的夫妻治疗酒精使用障碍由共同调查员McCrady开发，翻译成智能手机平台。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的具体里程碑和可交付成果预计将在第一阶段进行。项目的未来第二阶段将包括完成B-SMART，以及B-SMART的随机疗效试验，该试验将检查其对各种酒精相关的因变量的影响，包括酒后驾车再逮捕。如果B-SMART被证明对酒后驾车和酒后驾车再逮捕有影响，政府、社区和治疗机构以及酒后驾车罪犯的家庭将拥有一个重要的和可获得的工具，以进一步减少酒后驾车的社会、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.