Motor Vehicle Injury – Alcohol-Impaired Driving: Multicomponent

Interventions with Community Mobilization

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 What the CPSTF Found
 Supporting Materials
 Considerations for Implementation

Summary of CPSTF Finding

The Community Preventive Services Task Force (CPSTF) recommends the use of
multicomponent interventions with community mobilization on the basis of strong evidence of
their effectiveness in reducing alcohol-impaired driving.

Intervention

Multicomponent interventions to reduce alcohol-impaired driving can include any or all of a

number of components, such as sobriety checkpoints, training in responsible beverage service,
education and awareness-raising efforts, and limiting access to alcohol. Interventions that
qualified for this review:

1. Implemented multiple programs and/or policies in multiple settings to effect the community
environment to reduce alcohol-impaired driving, and
2. Included participation of active community coalitions or task forces in their design or execution
(community mobilization)

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Intervention

Publicized sobriety checkpoint programs are a form of high visibility enforcement where law
enforcement officers stop drivers systematically to assess whether they are alcohol-impaired.
Media efforts are critical to publicize programs. The program goal is to reduce alcohol-impaired
driving by increasing the public's perceived risk of arrest while also arresting alcohol-impaired
drivers identified at checkpoints.

There are two types of sobriety checkpoints:

  Selective Breath Testing (SBT) - police must have reason to suspect that a stopped driver
is intoxicated before a breath test can be requested. SBT is used in the United States.
 Random Breath Testing (RBT) – all stopped drivers are given breath tests for blood
alcohol concentration (BAC) levels. RBT is used in Australia and several European
countries.

Health Communication and Social Marketing: Campaigns That Include

Mass Media and Health-Related Product Distribution

Based on strong evidence of effectiveness for producing intended behavior

changes, the Community Preventive Services Task Force (CPSTF) recommends
health communication campaigns that use multiple channels, one of which must
be mass media, combined with the distribution of free or reduced-price health-
related products (defined above). Intervention

This review evaluates the effectiveness of interventions that combine two components to
increase the appropriate, repeated use of evidence-based, health-related products:

1. A health communication campaign that uses messages to increase awareness of, demand
for, and appropriate use of the product. The messages must be delivered through multiple
channels, one of which must be mass media, to provide multiple opportunities for
exposure; and

Health communication campaigns apply integrated strategies to deliver messages designed,

directly or indirectly, to influence health behaviors of target audiences. Messages are
communicated through various channels that can be categorized as:

 Mass media (e.g., television, radio, billboards)

 Small media (e.g., brochures, posters)
 Social media (e.g., Facebook©, Twitter©, web logs)
 Interpersonal communication (e.g., one-on-one or group education)

Alcohol – Excessive Consumption: Responsible Beverage Service

Training
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 What the CPSTF Found
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Summary of CPSTF Finding

The Community Preventive Services Task Force finds insufficient evidence to determine the
effectiveness of responsible beverage service (RBS) training programs for reducing excessive
alcohol consumption and related harms at the community level.

Although reviewed studies generally showed positive results for the measured outcomes, these
results primarily came from academic research studies that evaluated programs focused on
individual establishments and were implemented under favorable conditions (e.g., intensive
training programs, short follow-up times). Because of these limitations, further evidence is
necessary to assess the public health impact of sustainable, community-wide RBS training
programs.

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Intervention

Responsible beverage service (RBS) training programs give owners, managers, and staff of
establishments that serve alcohol knowledge and skills to help them serve alcohol responsibly
and fulfill the legal requirements of alcohol service.

Training programs for managers and owners most often provide guidance on implementation of
service policies and practices. Training programs for servers focus on knowledge and skills that
enhance their ability to prevent excessive alcohol consumption among patrons and minimize
harms from excessive drinking that has already occurred.

Server training may address:

 Checking IDs
 Service practices that reduce the likelihood of excessive consumption
 Identifying and responding to early signs of excessive consumption (e.g., rapid consumption)
 Identifying intoxicated patrons and refusing service to them
 Intervening to prevent intoxicated patrons from driving

Motor Vehicle Injury – Alcohol-Impaired Driving: Ignition Interlocks

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 What the CPSTF Found
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Summary of CPSTF Finding

The Community Preventive Services Task Force (CPSTF) recommends the use of ignition
interlocks for people convicted of alcohol-impaired driving based on evidence that they reduce
re-arrest rates while the interlocks are installed.

Public health benefits of ignition interlock interventions are currently limited by the small
proportion of offenders who install interlocks in their vehicles. More widespread and sustained
use of interlocks among this population could have a greater impact on alcohol-related crashes.

Intervention

An ignition interlock is a device that can be installed in a motor vehicle to prevent a driver who
has a blood alcohol concentration (BAC) above a specified level (usually 0.02% to 0.04%) from
driving the vehicle. Interlocks are most often installed in vehicles of people who have been
convicted of alcohol-impaired driving to give them an opportunity to drive legally.

CPSTF Finding and Rationale Statement

Motor Vehicle Injury – Alcohol-Impaired Driving: Mass Media Campaigns

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 What the CPSTF Found
 Supporting Materials
 Considerations for Implementation

Summary of CPSTF Finding

The Community Preventive Services Task Force (CPSTF) recommends mass media campaigns
to reduce alcohol-impaired driving under certain conditions. These conditions include carefully
planned and well-executed campaigns; adequate audience exposure; and settings with ongoing
alcohol-impaired driving prevention activities.

Intervention

Mass media campaigns spread messages about the physical dangers and legal consequences of
drunk driving. They persuade people not to drink and drive and encourage them to keep other
drivers from doing so.
Motor Vehicle Injury – Alcohol-Impaired Driving: 0.08% Blood Alcohol
Concentration (BAC) Laws

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 What the CPSTF Found
 Supporting Materials
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Summary of CPSTF Finding

The Community Preventive Services Task Force (CPSTF) recommends 0.08% BAC laws to
reduce alcohol-related motor vehicle crash fatalities.

Intervention

These laws state that it is illegal for a driver’s blood alcohol concentration to exceed 0.08%.

CPSTF Finding and Rationale Statement

Read the CPSTF finding [PDF - 136 kB].

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Considerations for Implementation

The CPSTF recommendation and evidence from this review may be used to inform decisions
about maintaining 0.08% BAC laws. The following considerations are drawn from studies
included in the evidence review, the broader literature, and expert opinion.
  Engage partners throughout the process. Building support from the ground up can help
secure policies that reinforce healthy behaviors in the community.
 Demonstrate why the policy is important. Use Task Force findings and surveillance data
to show partners how policies have been effective.
 Educate stakeholders. Keep the media, community influencers, and policymakers
informed about BAC laws to help communicate messages that are accurate and timely.
o Keep messages brief and to the point. Use graphics, figures, or infographics to
clearly demonstrate how the intervention can improve health outcomes.
o Extend your communication reach by working through partners who have the
most credibility with key audiences.
 Pay attention to sustainability. Continue to conduct surveillance related to alcohol-
impaired driving and disseminate findings.

Motor Vehicle Injury – Alcohol-Impaired Driving: Maintaining Current

Minimum Legal Drinking Age (MLDA) Laws
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 What the CPSTF Found
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Summary of CPSTF Finding

The Community Preventive Services Task Force (CPSTF) recommends maintaining current
minimum legal drinking age laws to reduce alcohol-related crashes and associated injuries
among 18- to 20-year-old drivers.

Intervention

Minimum legal drinking age (MLDA) laws specify an age below which the purchase or public
consumption of alcoholic beverages is illegal. In the United States, the age in all states is 21
years.

CPSTF Finding and Rationale Statement

The following considerations are drawn from studies included in the evidence review, the
broader literature, and expert opinion.

 Engage partners throughout the process. Building support from the ground up can help
secure policies that reinforce healthy behaviors in the community.
 Demonstrate why the policy is important. Use CPSTF findings and recent surveillance
data to show partners how policies have been effective.
  Educate stakeholders. Keep the media, community influencers, and policymakers
informed about MLDA laws to help communicate messages that are accurate and timely.
o Keep messages brief and to the point. Use graphics, figures, or infographics to
clearly demonstrate how the intervention can improve health outcomes.
o Extend communication reach by working through partners who have the most
credibility with key audiences.
 Pay attention to sustainability. Continue to conduct surveillance related to alcohol-
impaired driving and disseminate findings.

Motor Vehicle Injury – Alcohol-Impaired Driving: Lower BAC Laws for

Young or Inexperienced Drivers

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 What the CPSTF Found
 Supporting Materials
 Considerations for Implementation

Summary of CPSTF Finding

The Community Preventive Services Task Force (CPSTF) recommends laws that establish a
lower illegal blood alcohol concentration (BAC) for young or inexperienced drivers than for
older or more experienced drivers based on evidence they reduce alcohol-related motor vehicle
crashes.

Intervention

In the United States, lower blood alcohol concentration (BAC) laws apply to all drivers under the
age of 21. Between states, the illegal BAC ranges from any detectable BAC to 0.02%.

In other countries, lower BAC laws apply to either newly licensed drivers or newly licensed
drivers under a specified age.

CPSTF Finding and Rationale Statement

Motor Vehicle Injury – Alcohol-Impaired Driving: Lower BAC Laws for

Young or Inexperienced Drivers
Tabs

 Snapshot(active tab)
 What the CPSTF Found
  Supporting Materials
 Considerations for Implementation

Summary of CPSTF Finding

The Community Preventive Services Task Force (CPSTF) recommends laws that establish a
lower illegal blood alcohol concentration (BAC) for young or inexperienced drivers than for
older or more experienced drivers based on evidence they reduce alcohol-related motor vehicle
crashes.

Intervention

In the United States, lower blood alcohol concentration (BAC) laws apply to all drivers under the
age of 21. Between states, the illegal BAC ranges from any detectable BAC to 0.02%.

In other countries, lower BAC laws apply to either newly licensed drivers or newly licensed
drivers under a specified age.

CPSTF Finding and Rationale Statement

Considerations for Implementation

The CPSTF recommendation and evidence from this review may be used to inform decisions
about maintaining lower BAC laws for young or inexperienced drivers. The following
considerations are drawn from studies included in the evidence review, the broader literature,
and expert opinion.

 Engage partners throughout the process. Building support from the ground up can help
secure policies that reinforce healthy behaviors in the community.
 Demonstrate why the policy is important. Use CPSTF findings and recent surveillance
data to show partners how policies have been effective.
 Educate stakeholders. Keep the media, community influencers, and policymakers
informed about lower BAC laws to help communicate messages that are accurate and
timely.
o Keep messages brief and to the point. Use graphics, figures, or infographics to
clearly demonstrate how the intervention can improve health outcomes.
o Extend your communication reach by working through partners who have the
most credibility with key audiences.
 Pay attention to sustainability. Continue to conduct surveillance related to alcohol-
impaired driving and disseminate findings.
 Lower BAC laws may be useful in populations other than young drivers. For example,
CDC recommends that states consider enacting lower BAC laws for all drivers who
transport children.
 Lower BAC laws can result in underage drinking drivers with high BACs receiving only
zero tolerance citations rather than being arrested for alcohol-impaired driving (as would
drinking drivers 21 years and older).
 Following are potential barriers to full enforcement of lower BAC laws:
o Because young people are less likely than adults to drink in bars, police patrols
that target bar neighborhoods are likely to miss underage drinking drivers.
o Officers may have difficulty identifying underage drinking drivers with low
BACs because they may not show obvious signs of impairment.
o Because of ambiguities, some state laws prohibit police officers from testing the
BAC of an underage driver unless there is probable cause to believe that the
driver’s BAC is above the legal limit for adults.