Evaluating South Dakota's 24/7 Sobriety Program

描述(由申请人提供)：酒精的使用，特别是在刑事司法系统中的使用，给个人和社会带来了巨大的成本。政策制定者正在想方设法减轻酒精对公共健康和安全的威胁，尽管预算压力迫使他们考虑将有酒精问题的低级罪犯留在社区，而不是监禁。由于有500多万人处于社区监督之下，即使这一群体的酒精消费略有减少，也可以改善公共健康和公共安全。这项研究对南达科他州的一项大规模创新计划提出了严格的评估，该计划受到了极大的关注，是在社区矫正环境中减少酒精消费的成功方法。南达科他州的全天候戒酒计划(24/7)要求罪犯每天接受两次酒精测试。那些检测呈阳性或漏检的人将面临立即但短暂的监禁。自2005年以来，已有超过13,000名参与者，我们的计算表明，在所有22-40岁的男性中，参与率至少为5%。虽然全天候被吹捧为国家模式，并正在其他州被考虑和采用，但没有经过同行审查的科学证据表明其有效性或成本效益。我们建议的全天候评估在方法、数据获取和范围方面都是创新的。准实验方法是在没有随机分配的情况下评估大规模实施的必要方法，这种方法利用了跨县和跨罪犯类型的24/7交错实施。特别获得参与者和非参与者的数据，以及关于社区中与酒精有关的伤害的更广泛的事故水平数据，也加强了这项评估。具体目标是：目标1：记录24/7全天候跨县和跨罪犯类型的实施和利用情况。目标2：在参与者中确定24/7计划违规的预测因素。目的3：评估全天候参与对个体水平累犯结果的影响。目的4：评估全天候工作对健康和社会结果的影响，包括与酒精有关的交通事故、住院、逮捕和举报的犯罪。目标5：将全天候酒精测试的成本和收益货币化。这项研究的目标是为南达科他州内外的政策制定者和利益相关者提供关于全天候酒精测试有效性和成本效益的严格证据，为正在进行的关于如何有效利用酒精测试来减少酒精滥用及其后果的政策辩论提供信息。这一信息至关重要，因为财政紧张的州寻求减少监禁，并有效地管理社区中有酒精问题的人，同时保护公共健康和安全。 与公共健康相关：政策制定者正在寻找方法来减轻酒精对公共健康和安全的威胁，尽管预算压力迫使他们考虑将更多有酒精问题的低级罪犯留在社区，而不是监禁。南达科他州的全天候戒酒计划被吹捧为全国典范，并已在其他州得到考虑和采用，尽管没有同行评议的评估来证明其有效性或成本效益。这项拟议的研究将为政策制定者和其他利益相关者提供对这一创新计划的严格准实验评估，为正在进行的关于如何有效利用酒精测试来减少酒精滥用及其后果的政策辩论提供信息。

DESCRIPTION (provided by applicant): Alcohol use, particularly among those in the criminal justice system, imposes tremendous costs on individuals and society. Policymakers are searching for ways to mitigate the threat alcohol poses to public health and safety even as budgetary pressures force them to consider keeping low-level offenders with alcohol problems in the community rather than incarcerated. With more than 5 million individuals under community supervision, even small reductions in alcohol consumption among this population can improve public health and public safety. This study proposes a rigorous evaluation of a large-scale and innovative program in South Dakota that has received significant attention as a successful approach to reducing alcohol consumption in community corrections settings. South Dakota's 24/7 Sobriety Program (24/7) requires that offenders submit to breathalyzer tests twice per day. Those testing positive or missing a test face an immediate, but brief, jail term. Since 2005 there have been more than 13,000 participants and our calculations suggest participation rates of at least 5% among all males aged 22-40. While 24/7 is touted as a national model and is being considered and adopted in other states, there is no peer-reviewed scientific evidence of its effectiveness or cost-effectiveness. Our proposed evaluation of 24/7 is innovative in its methods, access to data, and scope. The quasi- experimental approach, which exploits the staggered implementation of 24/7 across counties and offender types, is necessary to evaluate the large-scale implementation in the absence of random assignment. The evaluation is also strengthened by exceptional access to data on participants and non-participants and by the broader incident-level data on alcohol-related harms in the community. The specific aims are: Aim 1: Document the implementation and utilization of 24/7 across counties and offender types. Aim 2: Identify predictors of 24/7 program violations among participants. Aim 3: Estimate the effect of 24/7 participation on individual-level recidivism outcomes. Aim 4: Estimate the effect of 24/7 on health and social outcomes including alcohol-related traffic accidents, hospital admissions, arrests, and reported crimes. Aim 5: Monetize the costs and benefits of 24/7. The goal of this study is to provide policymakers and stakeholders within and beyond South Dakota with rigorous evidence regarding 24/7's effectiveness and cost-effectiveness to inform the ongoing policy debate about how to effectively use alcohol testing to reduce alcohol misuse and its consequences. This information is critical as fiscally-constrained states seek to reduce incarceration and effectively manage those with alcohol problems in the community while safeguarding public health and safety. PUBLIC HEALTH RELEVANCE: Policymakers are searching for ways to mitigate the threat alcohol poses to public health and safety even as budgetary pressures force them to consider keeping more low-level offenders with alcohol problems in the community rather than incarcerated. South Dakota's 24/7 Sobriety Program is touted as a national model and is already being considered and adopted in other states, despite the fact that there is no peer-reviewed evaluation demonstrating its effectiveness or cost-effectiveness. The proposed study will provide policymakers and other stakeholders with a rigorous quasi-experimental evaluation of this innovative program to inform the ongoing policy debate about how to effectively use alcohol testing to reduce alcohol misuse and its consequences.