Estimating the Effect of 24/7 Sobriety on Morbidity and Mortality in North Dakota

估计 24/7 清醒对北达科他州发病率和死亡率的影响

• 批准号: 10018458
• 负责人: Nancy Nicosia
• 金额: $ 39.76万
• 依托单位: RAND CORPORATION
• 依托单位国家: 美国
• 财政年份: 2019
• 资助国家: 美国
• 起止时间: 2019-09-15 至 2022-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10018458
• 关键词: Alcohol consumption; Alcohols; Automobile Driving; Biological; Breath Tests; Breathalyzer Tests; Cause of Death; Centers for Disease Control and Prevention (U.S.); Communities; County; Crime; Criminal Justice; Data; Dependence; Disease; Domestic Violence; Driving While Intoxicated; Drunk driving; Emergency department visit; Evaluation; Exhibits; Face; Funding; Goals; Health; Heavy Drinking; Hospital Mortality; Hospitalization; Intervention; Intoxication; Jail; Life Style; Link; Measures; Methods; Modeling; Montana; Morbidity - disease rate; Mothers; Motor Vehicles; National Institute on Alcohol Abuse and Alcoholism; North Dakota; Organ; Outcome; Participant; Persons; Policies; Population; Public Health; Public Policy; Published Comment; Research Personnel; Safety; Societies; South Dakota; Test Result; Testing; Tissues; Transportation; Universities; Variant; Work; adverse outcome; alcohol consequences; alcohol monitoring; alcohol testing; alcohol violation; attributable mortality; cost; drinking; experience; experimental study; high risk population; impaired driving performance; improved; innovation; male; mortality; offender; prevent; problem drinker; programs; sobriety; successful intervention; trend

PROJECT SUMMARY Alcohol has been linked to morbidity and mortality resulting from intoxication, dependence and the biological consequences of alcohol use on organs and tissue. The relationship between alcohol and disease is especially concerning among those who exhibit heavy drinking episodes. The CDC estimates that 80,000 deaths are attributable to excessive alcohol use in the U.S. annually, making alcohol use the third-leading lifestyle-related cause of death. Alcohol use is particularly problematic among criminal justice populations as are alcohol-related adverse consequences such as mortality. While the issues have been well-documented, efforts thus far to identify strategies that effectively reduce alcohol-related harms have produced mixed results. The mixed results may be explained, in part, by the extent to which these interventions target those drinkers most likely to experience or impose harms and the extent to which the interventions successfully reduce drinking. The goal of this project is to determine whether North Dakota's 24/7 Sobriety Program for criminal justice offenders reduced morbidity and mortality in counties that implemented the program. North Dakota's 24/7 Sobriety Program (hereafter, ND 24/7) applies the concept of frequent alcohol testing in combination with swift, certain but modest sanctions for alcohol violations to offenders living in the community. Participants must submit to breathalyzer tests twice per day or wear continuous alcohol monitoring bracelets. Those testing positive or missing a test face an immediate, but brief, jail term. The program's primary goal is to reduce heavy drinking among this population and the criminal justice consequences of their alcohol use (e.g. repeat DUI). Although they have not yet been studied rigorously, the effects of the program are likely to extend to other alcohol-related outcomes – with morbidity and mortality being among the most costly. Exploiting variation in the timing of the program's implementation across ND counties, we will employ quasi-experimental methods to determine whether the program influenced emergency room visits, hospital admissions and mortality. We will also assess whether implementation features (e.g. testing, exposure) influence outcomes. We will then use these findings to construct a measure of the program's benefits. The study's goal is to provide policymakers and other stakeholders with rigorous analyses of the program. The proposed study is innovative in its focus on the health- and mortality-related consequences of a targeted intervention to reduce the adverse consequences associated with alcohol use among those likely to impose the greatest costs on themselves and society. The proposed study team is uniquely qualified to conduct this study. They are currently evaluating ND 24/7's effects on DUI. And their NIAAA-funded evaluation of South Dakota's 24/7 Sobriety Project indicated that the South Dakota program reduced heavy drinking and, consequently, repeat drunk driving arrests, domestic violence arrests, and traffic crashes among young males.

项目摘要 酒精与因中毒、依赖和酗酒而导致的发病率和死亡率有关。 酒精使用对器官和组织的生物学后果。酒精和疾病之间的关系 尤其是那些表现出大量饮酒的人。疾病控制中心估计， 在美国，每年有200人死于过度饮酒，这使得饮酒成为美国第三大死亡原因。 与生活方式有关的死因酗酒在刑事司法人员中尤其成问题， 与酒精有关的不良后果，如死亡。虽然这些问题已经有了很好的记录， 迄今为止，为确定有效减少酒精相关危害的战略所做的努力产生了好坏参半的结果。 这些干预措施针对饮酒者的程度可能部分解释了这种好坏参半的结果 最有可能经历或造成伤害的人，以及干预措施成功减少伤害的程度 喝酒该项目的目标是确定北达科他州的24/7清醒计划是否为犯罪 司法罪犯在实施该方案的县中降低了发病率和死亡率。 北达科他州的24/7清醒计划（以下简称ND 24/7）适用于频繁饮酒的概念 对居住在美国的违法者进行快速、确定但适度的酒精违规制裁， 社区参与者必须每天接受两次酒精测试，或持续饮酒 监控手环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。的 该计划的主要目标是减少这一人群中的大量饮酒和刑事司法 酒精使用的后果（例如重复DUI）。虽然还没有被严格研究， 该计划的影响可能会扩展到其他与酒精相关的结果-发病率和死亡率 是最昂贵的。利用ND中计划实施时间的变化 县，我们将采用准实验方法，以确定该计划是否影响 急诊室就诊、住院和死亡率。我们还将评估实施情况， 特征（例如测试、暴露）影响结果。然后，我们将使用这些发现来构建一个衡量标准， 该计划的好处。 这项研究的目标是为决策者和其他利益攸关方提供对 程序.拟议的研究是创新的，其重点是健康和死亡相关的后果， 有针对性的干预措施，以减少那些可能 给自己和社会带来最大的代价。拟议的研究小组是唯一有资格进行 本研究他们目前正在评估ND 24/7对DUI的影响。以及他们由NIAAA资助的 南达科他州的24/7清醒项目表明，南达科他州计划减少了大量饮酒， 因此，青年男子多次因酒后驾车、家庭暴力和交通事故被捕。