A web application to reduce heavy drinking in first-time DWI offenders

一个网络应用程序，可减少醉驾初犯者的酗酒情况

• 批准号: 8901728
• 负责人: Reid Kevin Hester
• 金额: $ 29.59万
• 依托单位: BEHAVIOR THERAPY ASSOCIATES, LLP
• 依托单位国家: 美国
• 财政年份: 2011
• 资助国家: 美国
• 起止时间: 2011-09-01 至 2016-09-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8901728
• 关键词: Abstinence; Accounting; Administrator; Age; Alcohols; Back; Behavioral; Boxing; Cessation of life; Clinical; Cognitive; Cognitive Therapy; Communities; Data Analyses; Data Reporting; Development; Driving While Intoxicated; Drunk driving; Elderly; Electronic Mail; Event; Face; Family; Feedback; Future; Goals; Health Hazards; Heavy Drinking; Individual; Injury; Internet; Intervention; Knowledge Base (Computer); Letters; New Mexico; Online Systems; Outcome; Participant; Pharmaceutical Preparations; Phase; Pilot Projects; Population; Professional counselor; Program Development; Program Effectiveness; Progress Reports; Protocols documentation; Provider; Public Health; Randomized Clinical Trials; Readiness; Recruitment Activity; Reporting; Research; Risk; Safety; Structure; Substance abuse problem; System; Text; Time; TimeLine; Training; Transportation; Work; alcohol related problem; base; brief motivational intervention; cost; drinking; effective intervention; follow-up; innovation; offender; prevent; probation; programs; prototype; public health relevance; recidivism; repeat offender; research and development; sobriety; tool; trafficking

DESCRIPTION (provided by applicant): Driving while intoxicated (DWI) is a major public health hazard. In the U.S. there were 13,846 deaths in 2008 caused by alcohol-impaired drivers (National Highway Traffic Safety Administration (NHTSA), 2009a). The New Mexico Dept. of Transportation (DoT) reported the total DWI cost to New Mexico in 2007 alone was over one billion dollars (NM DoT, 2008). In New Mexico, 43% of DWI offenders are repeat offenders. This is unacceptable. Specifically, more needs to be done to prevent first-time offenders from becoming recidivists. This proposal is to develop a new web application that could consistently deliver an effective intervention that has the potential to reduce heavy drinking in these offenders. Currently, however, there are significant challenges to delivering empirically supported interventions to offenders. First, only a small proportion of DWI offenders are referred for treatment, despite evidence that brief motivational interventions reduce heavy drinking in offenders. Second, for those referred to treatment, providing such interventions through substance abuse counselors faces significant challenges: 1) Many substance abuse counselors are not trained in empirically supported protocols; 2) clinicians who are trained in empirically supported interventions tend to "drift" from protocols over time; and 3) there is an average annual turn-over rate of 50% in counselors in substance abuse programs (McLellan et al., 2003). This turnover means that programs that provide training for staff in empirically supported protocols often need to train new counselors, and programs are rarely compensated for the cost. Training then becomes an occasional event. As a result, counselors may not have the opportunity to be trained, and if trained, tend to "drift" from empirically supported protocols ove time. This proposal provides an alternative. We propose to develop a web application that could consistently deliver an intervention that has the potential to reduce heavy drinking in these offenders. This reduction in drinking would reduce their risk for future DWIs, alcohol-related crashes, injuries, and death. Taking advantage of a "teachable moment," the program will incorporate two empirically supported brief motivational interventions (one for younger and one for older adults) and an abstinence-oriented, cognitive behavioral intervention into a single, new program called Right Turns. There are two innovations in this proposal: 1) A web-based and age-appropriate BMI that is tailored to offenders and that takes their readiness to change at the end of it into account when segueing to; 2) a cognitive behavioral, abstinence-oriented web application to help them achieve and maintain sobriety. The R&D proposed in Phase II is to complete the development of the program, adding a follow-up component to the BMIs and a "back office" module for program administrators that include extensive outcome report functions. The program's effectiveness will then be evaluated in a randomized clinical trial with a 3 month follow-up.

描述（由申请人提供）：醉酒驾驶（DWI）是一个重大的公共健康危害。在美国，2008年有13，846人死于酒精受损的司机（国家公路交通安全管理局（NHTSA），2009年a）。新墨西哥州警局交通部（DoT）报告称，仅2007年新墨西哥州的DWI总成本就超过10亿美元（NM DoT，2008）。在新墨西哥州，43%的DWI罪犯是惯犯。这是不可接受的。具体而言，需要做更多的工作来防止初犯者成为累犯。这项建议是开发一个新的网络应用程序，可以始终如一地提供有效的干预，有可能减少这些罪犯的大量饮酒。然而，目前，在向罪犯提供有经验支持的干预措施方面存在重大挑战。首先，只有一小部分的DWI罪犯被转介治疗，尽管有证据表明，简短的动机干预减少了大量饮酒的罪犯。第二，对于那些被转介到治疗的人，通过药物滥用咨询师提供这种干预面临着重大挑战：1）许多药物滥用咨询师没有接受过经验支持方案的培训; 2）接受过经验支持干预方案培训的临床医生往往会随着时间的推移而“偏离”方案;和3）在药物滥用项目中，顾问的平均年周转率为50%（McLellan等人，2003年）。这种人员流动意味着，为工作人员提供经验支持的方案培训的项目往往需要培训新的辅导员，而项目很少得到成本补偿。训练就变成了一个偶然的事件。因此，咨询师可能没有机会接受培训，即使接受培训，也往往随着时间的推移而偏离经验支持的协议。这一提议提供了一种替代办法。我们建议开发一个Web应用程序，可以始终如一地提供干预，有可能减少这些罪犯的大量饮酒。这种饮酒的减少将降低他们未来发生DWI、与酒精相关的撞车、受伤和死亡的风险。利用“可教的时刻”，该计划将把两个经验支持的简短动机干预（一个针对年轻人，一个针对老年人）和一个以禁欲为导向的认知行为干预纳入一个名为"右转“的新计划。这项提案有两个创新：1）一个基于网络的、适合年龄的BMI，为罪犯量身定制，并在结束时考虑到他们的改变意愿; 2）一个认知行为的、以禁欲为导向的网络应用程序，帮助他们实现和保持清醒。第二阶段提出的研发工作是完成该方案的开发，为BMI增加一个后续组成部分，并为方案管理员增加一个“后台”模块，其中包括广泛的成果报告功能。该计划的有效性将在一项为期3个月的随机临床试验中进行评估。