Motor Vehicle-Related Injury Prevention: Reducing Alcohol-Impaired Driving

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.

Identified Research Gaps

Results from the Community Guide review indicate that sufficient or strong evidence exists that the effectiveness of the five interventions reviewed reduces alcohol impaired driving. However, important issues related to the effectiveness of these interventions require further research.

General Questions

• How do interventions to reduce alcohol-impaired driving interact with each other (e.g., 0.08% BAC laws and administrative license revocation)?
• What effects do these interventions have on long-term changes in social norms about drinking and driving?

Laws

• How do variations in enforcement levels influence the effectiveness of laws to reduce alcohol-impaired driving?
• What are the independent effects of publicity on the effectiveness of laws to reduce alcohol-impaired driving?
• Does public compliance with new laws change in a predictable manner over time?

Sobriety Checkpoints

• Does the use of passive alcohol sensors at sobriety checkpoints improve their deterrent effects?
• Are the deterrent effects of sobriety checkpoints diminished if warning signs are posted that allow drivers to avoid the checkpoints?
• How do various configurations of sobriety checkpoints (e.g., intermittent blitzes vs. continuous, weekend nights vs. random time periods, number of officers per checkpoint) affect deterrence?
• What level of enforcement and publicity about sobriety checkpoints is necessary to maintain effectiveness over time?

Server Intervention Training

• Are server intervention training programs delivered community-wide effective at decreasing alcohol-impaired driving and alcohol-related crashes?
• What essential content areas should be included in all server intervention training programs?
• What effect does the method by which training is delivered (e.g., videotapes, lectures, role-playing) have on the effectiveness of server training programs?
• How do mandatory vs. voluntary server training programs differ with respect to:
  • Management support for program goals?
  • Level of participation in training programs?
  • Overall effectiveness for decreasing patron BACs and drinking and driving?
• What specific management policies and practices are necessary to get the maximum benefits from server intervention training?
• What is the long-term effect of server intervention training programs? Are “booster sessions” required to maintain effectiveness?
• What effect does server intervention training have on alcohol sales, overall revenues, and tips?

Applicability

Questions remain about possible differences in the effectiveness of each intervention for specific settings and subgroups. For example:

• Are these interventions equally effective in rural and urban settings?
• Are these interventions equally effective when applied to populations with different baseline levels of alcohol-impaired driving?
• Does targeting publicity efforts to specific subpopulations (e.g., young drivers, ethnic minorities, men) improve the effectiveness of interventions to reduce alcohol-impaired driving?

Other Positive or Negative Effects

Few other positive and negative effects were reported in this body of literature. Further research about the following questions would be useful:

• What proportion of youths charged with violating zero tolerance laws had BAC levels elevated enough to warrant a more serious drinking-driving offense?
• Do interventions to reduce alcohol-impaired driving reduce other forms of alcohol-related injury?

Economic Evaluations

Little economic evaluation information was available. Research is warranted to answer the basic economic questions:

• What are the cost-benefit, cost utility, and cost-effectiveness of interventions to reduce alcohol impaired driving?

Barriers to Implementation

Several of the interventions reviewed face barriers to effective implementation. Research into the following areas may help to overcome these barriers:

• What role can community coalitions play in removing barriers to implementing interventions designed to prevent alcohol-impaired driving?
• What are the most effective means of disseminating research findings about effectiveness to groups that want to implement interventions?
• What forms of incentives (e.g., insurance discounts) are most helpful for increasing management and owner support for server intervention training?
• How can the costs of interventions to prevent alcohol-impaired driving be shared or subsidized?
• What situational and environmental influences help or hinder the implementation of server intervention training?

Evidence Review

Shults RA, Elder RW, Sleet DA, et al. Reviews of evidence regarding interventions to reduce alcohol-impaired driving. [PDF - 2.30MB] Am J Prev Med 2001;21(4S):66-88.