In the years spanning 1997 to 2006 (the latter being the most recent year for which data are available), there were more alcohol-related fatal crashes in 2006 (17,749) than in any of the other years.1 Also in 2006, 4,434 pedestrians (14 or older) were killed in drunk driving incidents, and there are many more injuries each year related to drinking and driving. Clearly, drinking and driving remains a devastating problem in the United States. However, with a range of programs used for universal prevention in schools and recidivism prevention (or intervention) through the courts, it is often difficult to choose the best strategy to combat the problem.
Two major types of strategies for decreasing impaired driving are law-based and attitude-based strategies. Law-based strategies typically focus on imposing harsher punishments or increasing the perceived likelihood of getting caught (such as through use of sobriety checkpoints). Attitude-based strategies attempt to change the person's perceived acceptance of impaired driving by emphasizing the potential of harm to self (such as through shock videos) or others (such as through victim impact panels or VIPs).
Ultimately, law- and attitude-based strategies can be used together to decrease overall rates of impaired driving. Of course, the selection of most law-based strategies is done through the legislative process, while attitude-based strategies tend to be chosen by individuals within a system, such as educators, counselors, and interventionists. Choosing an effective attitude-based strategy is particularly difficult because the majority of programs aimed at impaired driving have very little well-controlled research to inform those working in the field. One reason for this lack of research is that it is difficult to assess programs' effectiveness.
Universal prevention in schools
Shock videos are commonly used in driver's education programs. However, few studies have examined their effectiveness. With the wide use of prevention attempts, it would be valuable for educators and counselors to evaluate how successful shock videos are at changing attitudes.
One of the few studies of its kind examined the effectiveness of a shock video that was already being used in a driver's education class in a high school.2 In the study, 106 students were randomly divided into two groups that watched either an impaired driving prevention video (“Sentenced for Life,” produced in 1988) or a control video unrelated to drinking and driving. Only the shock video group had a significant decrease in rationalizations for drinking and driving, lenient attitudes toward drinking and driving, and perceived likelihood of future impaired driving. However, this study looked only at a short-term attitude change (same day) and did not examine actual behavior change.
Clearly, more research needs to be done with shock videos, and this study was fairly easy to do for a few reasons. First, it measured the effectiveness of a program already in place. Second, it used the Behaviors and Attitudes Drinking and Driving Scale (BADDS; SASSI Research Institute)3, which is a brief self-report questionnaire with good reliability and validity.4 Finally, the control group was able to watch the shock video later that same week.
As another example, Fatal Vision goggles alter one's perceptual field to mimic some of the effects of being intoxicated (such as loss of coordination), and they have been used in countless high schools and universities as a tool to prevent drunk driving. Students wear these goggles while completing sobriety tests (including walking on a straight line), and these exercises are often paired with a video involving one or more stories recounting fatal impaired driving accidents. When we scoured the research in 2001, however, we could not find a single study that investigated the devices' effectiveness.
We decided to put them to the test in the first study on Fatal Vision goggles.5 The study results showed that a group of students who wore the goggles during the program had a greater decrease in drinking and driving rationalizations and reported likelihood of future impaired driving than did those in a control group. However, we measured only the attitude change on the same day of the study.
In a second study on Fatal Vision goggles, we found that the attitude change on the BADDS was not sustained one month following the program.6 Additionally, there was not a significant decrease in self-reported impaired driving at one-month follow-up. Thus, while our research to date is somewhat discouraging, more research needs to be conducted with Fatal Vision goggles to determine if there is added value in including them as part of a comprehensive prevention approach.
Court efforts to prevent recidivism
Prevention and intervention targeting attitude change with adults charged with DWI also deserves examination. Victim impact panels have been used frequently, with the panels typically consisting of several people who have experienced devastating effects from impaired driving (such as losing a family member).