This renewal extends our work during the last award period and seeks to translate these findings to the criminal justice system. Our accomplishments include: (a) developing methods for processing transdermal alcohol concentration data that yield clinically-meaningful quantification of drinking; (b) demonstrating contingency management can be successfully implemented using transdermal alcohol monitors and that contingency management can produce sustained reductions in heavy drinking in non-treatment-seeking problematic drinkers; and (c) establishing collaborations within the judicial system. Specifically, we propose to implement this contingency management program as an adjunctive intervention for driving while intoxicated (DWI) offenders who are mandated to transdermal alcohol monitoring and the majority of whom continue to misuse alcohol despite court prohibition while awaiting trial (pretrial period). Contingency Management and Control groups will experience 8-weeks of intervention (or sham) and 12-months follow-up for alcohol use. During the course of the study, we will examine how constructs from the Theory of Planned Behavior relate to observed drinking outcomes. Our primary aims are: to determine whether contingency management reduces drinking among DWI offenders court-ordered to undergo transdermal alcohol monitoring; to evaluate the extent to which reductions in drinking among DWI offenders assigned to the Contingency Management group are sustained during follow-up; how outcomes relate to constructs identified in the Theory of Planned Behavior (Attitudes, Social Norms, Behavioral Control and Intentions); and determine the costs, benefits, and net benefits of this program on the criminal justice system. The results of this study will inform the eventual integration of contingency management into traditional judicial approaches. Lastly, exploratory analyses will: (a) examine how study participation relates to outcomes tracked by the criminal justice system; and (b) test for impact of psychiatric or other substance use comorbidity; and (c) characterize the impact of alcohol use on participants' lives.
Public Health Significance: Driving while intoxicated offenders, largely ignored by the research community, pose a significant risk to themselves and society. The results of this study will inform the development of interventions aimed at this unique population of risky drinkers. The proposed study will also provide fundamental information on how specific behavioral processes relate to individual differences in the ability to reduce alcohol consumption and inform us about how differences in these behavioral processes might be leveraged to affect better and more cost-effective outcomes within the criminal justice system.
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