Reducing Alcohol-Impaired Driving: Designated Driver Promotion Programs

Research Gaps

What are Research Gaps?

Prior to and during the literature review and data analysis, the review team and the Community Preventive Services Task Force attempt to address the key questions of what interventions work, for whom, under what conditions, and at what cost. Lack of sufficient information often leaves one or more of these questions unanswered. The Community Guide refers to these as "research gaps." Research gaps can be pulled together in the form of a basic set of questions to inform a research agenda for those in the field. For this particular review the research gaps were framed as future directions.

Identified Research Gaps

Results from the Community Guide review indicate that there were too few empirical studies of sufficient quality and conflicting results to draw clear conclusions about effectiveness of the reviewed designated driver interventions.

Population-based campaigns to promote designated driver use require more research and evaluation to determine their effectiveness. Although the studies reviewed indicate that incentive programs to promote designated driver use may result in small increases in the number of self-identified designated drivers, much remains to be learned regarding the influence of such programs on the decision to use a designated driver, alcohol-impaired driving, and alcohol-related crashes.

Until we have stronger evidence regarding the effects of incentive programs on these variables, it will be difficult to determine their public health impact. Studies of the effects of incentive programs implemented in drinking establishments throughout a community would be ideal sources for such evidence. Well-controlled studies of this nature would be difficult and costly to develop, but the evaluation of existing community-based, designated driving programs would be very helpful in providing preliminary estimates of the public health benefits of designated driver incentive programs. For example, a planned evaluation of the Townsville Thuringowa Safe Communities designated driver program in North Queensland, Australia may begin to address questions related to program effects on alcohol-related crashes and driver BACs.

Future studies of designated driver programs conducted in individual drinking establishments should consider consistently collecting information on the number of drinking groups in the establishment during the observation period. This information would allow for comparisons across studies. Second, it would also be helpful if such studies were supplemented with qualitative evaluations that examined the effect of incentive programs on people’s choices about selecting a designated driver. For example, debriefing people who identified themselves as designated drivers could help answer the fundamental question of how many of these people were new designated drivers recruited by the incentive program, as opposed to those who would have acted as such even without the program, or would have used other safe transportation alternatives. Finally, if and when there are sufficient data on the effectiveness of designated driver programs, information on the cost-effectiveness of both the incentive and population-based campaigns would be helpful for program planning.

Evidence Review

Ditter SM, Elder RW, Shults RA, et al. Effectiveness of designated driver programs for reducing alcohol-impaired driving: a systematic review. [PDF - 146KB] Am J Prev Med 2005;28(5S):280-87.