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) 是主要的公共健康危害。在美国，2008 年有 13,846 人因酗酒驾驶而死亡（国家公路交通安全管理局 (NHTSA)，2009a）。新墨西哥州交通部 (DoT) 报告称，仅 2007 年新墨西哥州的酒后驾车总成本就超过 10 亿美元（NM DoT，2008 年）。在新墨西哥州，43% 的酒驾违法者是惯犯。这是不可接受的。具体来说，需要采取更多措施防止初犯成为累犯。该提案旨在开发一种新的网络应用程序，该应用程序可以持续提供有效的干预措施，从而有可能减少这些罪犯的酗酒情况。然而，目前向罪犯提供实证支持的干预措施面临着重大挑战。首先，尽管有证据表明短暂的动机干预可以减少罪犯的酗酒，但只有一小部分酒后驾车罪犯被转诊接受治疗。其次，对于那些转介治疗的人来说，通过药物滥用咨询师提供此类干预措施面临着重大挑战：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培训的临床医生往往会随着时间的推移“偏离”方案； 3) 药物滥用项目咨询师的年平均流动率为 50%（McLellan 等人，2003 年）。这种人员流动意味着为员工提供经验支持方案培训的项目通常需要培训新的顾问，而项目很少得到成本补偿。这样，培训就成为一项偶然的活动。因此，咨询师可能没有机会接受培训，而且如果接受过培训，随着时间的推移，他们往往会“偏离”经验支持的方案。该提案提供了一种替代方案。我们建议开发一个网络应用程序，可以持续提供干预措施，有可能减少这些罪犯的酗酒情况。饮酒量的减少将降低他们未来酒后驾车、与酒精相关的车祸、受伤和死亡的风险。利用“可教学的时刻”，该计划将把两种经验支持的简短动机干预措施（一种针对年轻人，一种针对老年人）和一种以禁欲为导向的认知行为干预纳入一个名为“右转”的单一新计划中。该提案有两个创新点：1）基于网络且适合年龄的BMI，专为犯罪者量身定制，并在继续时考虑到他们在犯罪结束时做出改变的意愿； 2) 认知行为、以禁欲为导向的网络应用程序，帮助他们实现并保持清醒。第二阶段提出的研发是为了完成该计划的开发，为 BMI 增加一个后续组件，并为计划管理员添加一个“后台”模块，其中包括广泛的结果报告功能。该计划的有效性将在一项随机临床试验中进行评估，并进行 3 个月的随访。