RAND Corporation, Santa Monica, California.
NORC at the University of Chicago, Chicago, Illinois.
Alcohol Clin Exp Res. 2019 Oct;43(10):2222-2231. doi: 10.1111/acer.14161. Epub 2019 Aug 31.
Driving under the influence (DUI) programs are a unique setting to reduce disparities in treatment access to those who may not otherwise access treatment. Providing evidence-based therapy in these programs may help prevent DUI recidivism.
We conducted a randomized clinical trial of 312 participants enrolled in 1 of 3 DUI programs in California. Participants were 21 and older with a first-time DUI offense who screened positive for at-risk drinking in the past year. Participants were randomly assigned to a 12-session manualized cognitive behavioral therapy (CBT) or usual care (UC) group and then surveyed 4 and 10 months later. We conducted intent-to-treat analyses to test the hypothesis that participants receiving CBT would report reduced impaired driving, alcohol consumption (drinks per week, abstinence, and binge drinking), and alcohol-related negative consequences. We also explored whether race/ethnicity and gender moderated CBT findings.
Participants were 72.3% male and 51.7% Hispanic, with an average age of 33.2 (SD = 12.4). Relative to UC, participants receiving CBT had lower odds of driving after drinking at the 4- and 10-month follow-ups compared to participants receiving UC (odds ratio [OR] = 0.37, p = 0.032, and OR = 0.29, p = 0.065, respectively). This intervention effect was more pronounced for females at 10-month follow-up. The remaining 4 outcomes did not significantly differ between UC versus CBT at 4- and 10-month follow-ups. Participants in both UC and CBT reported significant within-group reductions in 2 of 5 outcomes, binge drinking and alcohol-related consequences, at 10-month follow-up (p < 0.001).
In the short-term, individuals receiving CBT reported significantly lower rates of repeated DUI than individuals receiving UC, which may suggest that learning cognitive behavioral strategies to prevent impaired driving may be useful in achieving short-term reductions in impaired driving.
在影响驾驶（DUI）项目中，是减少那些可能无法接受治疗的人获得治疗机会差异的独特环境。在这些项目中提供基于证据的治疗可能有助于预防 DUI 再犯。
我们对加利福尼亚州的 3 个 DUI 项目中的 312 名参与者进行了一项随机临床试验。参与者年龄在 21 岁及以上，首次 DUI 犯罪，过去一年筛查出有高危饮酒行为。参与者被随机分配到 12 节手动认知行为疗法（CBT）或常规护理（UC）组，然后在 4 个月和 10 个月后进行调查。我们进行了意向治疗分析，以检验以下假设：接受 CBT 的参与者报告减少了驾驶障碍、饮酒量（每周饮酒量、戒酒和狂饮）以及与酒精相关的不良后果。我们还探讨了种族/民族和性别是否调节了 CBT 结果。
参与者中 72.3%为男性，51.7%为西班牙裔，平均年龄为 33.2 岁（SD=12.4）。与 UC 相比，接受 CBT 的参与者在 4 个月和 10 个月的随访中酒后驾车的可能性较低，与接受 UC 的参与者相比（优势比[OR]为 0.37，p=0.032，OR 为 0.29，p=0.065）。与接受 UC 的参与者相比，女性在 10 个月的随访中这种干预效果更为明显。在 4 个月和 10 个月的随访中，UC 与 CBT 之间的其余 4 个结果没有显著差异。在 10 个月的随访中，UC 和 CBT 组的参与者在 5 个结果中的 2 个结果（狂饮和与酒精相关的后果）显著减少（p<0.001）。
短期内，接受 CBT 的个体报告的重复 DUI 率明显低于接受 UC 的个体，这表明学习预防驾驶障碍的认知行为策略可能有助于在短期内减少驾驶障碍。
