Motor Vehicle Injury Alcohol-Impaired Driving: School-Based Programs Instructional Programs
Findings and Recommendations
The Community Preventive Services Task Force (CPSTF) recommends school-based instructional programs to reduce riding with alcohol-impaired drivers. The CPSTF finds insufficient evidence to determine whether these programs reduce alcohol-impaired driving or alcohol-related crashes.
The full CPSTF Finding and Rationale Statement and supporting documents for Reducing Alcohol-Impaired Driving: School-Based Programs, Instructional Programs are available in The Community Guide Collection on CDC Stacks.
Intervention
School-based instructional programs to reduce alcohol-impaired driving can address the problems of drunk driving (DD) and riding with drunk drivers (RDD) alone or have a broader focus on addressing alcohol or other substance use.
About The Systematic Review
The CPSTF finding is based on evidence from a systematic review of nine studies (search period through December 2002).
Study Characteristics
- Most of the studies used before-and-after comparisons or time series designs with a concurrent comparison group.
- The total number of students included in analyses ranged from 60 to more than 4,600, with a median size of 853.
- Nearly all of the studies targeted junior or senior high school students; five included multiple grades. The median grade targeted was the 10th grade.
- Follow-up periods ranged from 1 to 84 months, though most studies had follow-up periods of 6 months or less.
- Attrition provided one of the greatest threats to the validity of these studies, particularly those involving relatively long follow-up periods. Attrition ranged from zero for very short-term follow-ups to nearly two thirds of the baseline sample.
- The content and level of interaction varied considerably across the instructional programs reviewed.
- Three studies evaluated programs with informational or affective content that involved didactic presentations
- Six studies provided information and focused on skills development (e.g., refusal skills, life skills) or reducing risk-taking behavior.
- Many of the evaluated programs involved considerable student interactivity (e.g., discussion, feedback, role playing, planning activities).
Summary of Results
The systematic review included nine studies.
- Self-reported drinking and driving (5 studies) and riding with drinking drivers (4 studies) both decreased.
Summary of Economic Evidence
An economic review of this intervention did not find any relevant studies.
Applicability
The broader literature evaluating school-based programs to prevent substance abuse suggests instructional programs are likely to be most effective in reducing RDD and other relevant outcomes if they include resistance and other skill training and require student interaction.
Evidence Gaps
- To what extent are the outcomes of school-based education programs dependent on the following?
- Content, delivery method, and the perceived status of the person delivering the intervention
- Characteristics of the students
- What effect do interventions have on alcohol-related traffic violations and crashes?
- Are interventions cost-effective?
- How consistent are objective outcome measures with self-reported outcomes?
- How can studies reduce attrition to increase power and validity?
Implementation Considerations and Resources
- School-based interventions should be part of a larger community effort.
- A universal approach that targets all students may offer greater potential to positively influence the school social environment and societal norms than a tailored approach that targets high-risk individuals. All the included studies used a universal approach.
Crosswalks
Healthy People 2030 includes the following objectives related to this CPSTF recommendation.