Reducing Alcohol-Impaired Driving: School-Based 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 is sufficient evidence to recommend as effective school-based instructional programs for reducing riding with drinking drivers. However, there is insufficient evidence to determine the effectiveness of these programs for reducing drinking and driving. Despite some evidence of beneficial effects on the outcomes of interest, there is also insufficient evidence to determine the effectiveness of peer organizations and social norming campaigns, due to the small number of available studies.

Despite considerable progress over the past decade in the development of school-based programs to reduce drinking and driving and riding with drinking drivers, further refinement is needed to improve their effectiveness and to develop sound principles to guide program development. Future studies should strive to improve our understanding of the extent to which outcomes of school-based education programs are dependent on content, delivery method, and the perceived status of the person delivering the intervention. To address the potential for lack of effectiveness or potential harms in some subpopulations, such efforts should also evaluate the extent to which effectiveness varies by recipient characteristics. Future studies should also be designed with the goal of evaluating evidence on alcohol-related traffic violations and crashes. Finally, programs should compile and publish cost data so that the cost-effectiveness of various approaches can be assessed.

Several common problems among evaluations of school-based programs need to be addressed in future studies. First, the majority of such evaluations have relied on self-report information to assess effectiveness. Although questionnaires regarding alcohol use, driving after drinking, and riding with alcohol-impaired drivers can provide valuable information, they may be subject to systematic biases that could distort the results of outcome evaluations. Thus, to the extent possible, subjective data should be supplemented with objective information to safeguard against potential biases. Attrition from pre-test to post-test to follow-up measurement periods has also been a consistent problem in the studies reviewed. Depending on the length of the follow-up period, half or more of the original subjects can be lost to attrition, reducing the power and potentially the validity of studies. Such problems should be anticipated and addressed to the extent possible in designing studies to address the gaps identified in these reviews.

Evidence Review

Elder RW, Nichols JL, Shults RA, et al. Effectiveness of school-based programs for reducing drinking and driving and driving and riding with drinking drivers: a systematic review. [PDF - 259KB] Am J Prev Med 2005;28(5S):288-304.