Culturally Sensitive Counseling, in and out of Jail, Shows Promise in Navajo Area
Investigators at the University of New Mexico (UNM) studied the effectiveness of the San Juan County DWI Facility to deter drunken driving in San Juan County, N.M.
The study evaluated the facility as a sentencing option for first-time offenders, as well as the effect of adding a Victim Impact Panel (VIP), where offenders hear about the experience of victims of someone else's, or their own, drinking and driving.
San Juan County had the highest frequency of DWI (driving while intoxicated) offenses in the state and had the second-highest rate of alcohol-related vehicle fatalities in the United States.
The San Juan County DWI facility, which was started in 1994, incarcerates offenders for 28 days. During that time, offenders participate in various assessment and treatment activities, and they then enter a two-month aftercare period of regular alcohol intervention components. Many elements of the program have been modified to be culturally sensitive to the 70 percent Navajo client population.
- An analyses of traffic safety data strongly indicated that the program deterred further drinking and driving. For those who were not part of the treatment group, the probability of being rearrested was significantly greater; the magnitude of difference was approximately 18 percent.
- Results from the pretest and the follow-up posttests show that the SJC-DWI program also changed participants' perceptions about drinking and driving and their future intentions concerning it.
- The Victim Impact Panel component did not contribute to the overall impact of the program. Among program participants, there were no differences between VIP and non-VIP groups.
The Robert Wood Johnson Foundation (RWJF) provided a grant of $50,000 to support this work from October 1996 to March 1999.
San Juan County, N.M., had the second-highest rate of alcohol-related vehicle fatalities in the United States, according to the National Institute on Alcohol Abuse and Alcoholism (1991), and ranked first among counties in New Mexico for frequency of DWI offenses and aggravated DWI offenses; 1993 estimates of the economic costs of DWI crashes in the county were more than $80 million (San Juan County is also the site of "New Mexico Fighting Back," a site in RWJF's Fighting Back® national program to support community-wide efforts to reduce alcohol and drug abuse; its Fighting Back initiative was folded into another RWJF program, Healthy Nations®, which works with Native American tribes to combat alcohol and substance abuse).
In order to address this problem, in 1994 the county instituted the San Juan County DWI Facility program, with several treatment components that are aimed at deterring first-time DWI offenders from subsequent drinking and driving. The facility incarcerates offenders for 28 days in a facility with a variety of assessment and treatment activities (employed offenders have the option of day work-release).
Once released from the program, offenders go into a two-month aftercare period, where they regularly participate in alcohol intervention components. Many of these components including counseling and Alcoholics Anonymous meetings, are modified to be culturally sensitive to the client population, which is 70 percent Navajo.
The program also added a weekly sweat lodge and talking circle, unique to the cultural orientation of the program, and a Victims Impact Panel (VIP). Patterned after Mothers Against Drunk Driving (MADD) VIPs, the San Juan County program, requires offenders to attend a session in which victims of someone else's, or their own, drinking and driving describe their experience. The VIP includes at least one Navajo presenter.
As early preliminary data indicated that SJC-DWI had a positive impact, RWJF funded the University of New Mexico's Center of Alcoholism, Substance Abuse, and Addictions to thoroughly evaluate:
- The effectiveness of the San Juan County DWI program.
- The program as a sentencing option for first-time offenders.
- The impact of VIP as a program component.
To examine the impact of the program, project researchers studied traffic safety records, including the number of alcohol-related driving offenses and crash data, for all of those people arrested for DWI from August 1, 1994 (the inception of the program), through March 31, 2001.
Researchers obtained the information from the Division of Government Research at the University of New Mexico, the organization that analyses data for the N.M. Department of Traffic Safety. They obtained additional driving arrest information from the National Law Enforcement Telecommunications System, a privately maintained file that law enforcement officials use to make rapid checks of arrest and conviction records of suspects. The outcome measure of interest was the time of subsequent arrest following the completion of the treatment program.
Using a randomized factorial design, researchers recruited project participants from first-time DWI offenders, age 18 or older, who were just entering the county-DWI facility. They randomly assigned participants to one of two groups: 57 people took part in the standard DWI program, and 55 people took part in the standard program with the addition of the VIP component.
The project assessed participants at the time of their entrance into the program (pretest), just prior to their detention release (posttest), and at two months after their release (post-release). The staff administered the assessment measures, and center staff mailed a two-month follow-up questionnaire to the 112 participants. (As an incentive, upon sending in the completed questionnaire, each participant received $50.)
Intake measures included demographic information and quantity/frequency of alcohol use. Two-month follow-up measures included quantity/frequency of alcohol use and attendance at VIP panels. All 112 participants completed the intake assessment packet, and 94 (83 percent) completed the two-month interview. Project staff also statistically examined traffic safety data for the study cohort participants in order to measure longer-term change.
- The analyses of traffic safety data for San Juan County-DWI participants strongly indicated that the program deterred further drinking and driving. For those who were not part of the treatment group, the probability of being rearrested was significantly greater; the magnitude of difference was approximately 18 percent. While the data do not establish cause and effect, according to the principal investigator, they are strongly suggestive of SJC-DWI program impact.
- Results from the pretest and the follow-up posttests show that the SJC-DWI program also changed participants' perceptions about drinking and driving and their future intentions concerning it. The program contained program-related social-cognitive variables including:
- It is not a big deal to drink and drive.
- I often drink and drive.
- Sometimes, without even thinking about it, I just get in the car and drive somewhere after drinking.
- It is hard to avoid drinking and driving.
- Religion is not at all important to me in helping me with everyday life.
- Sometimes I have to drive somewhere even after I have been drinking.
Pretests indicated moderate levels of disagreement with the statements, while the two-month follow-up mean values indicated strong disagreement with the statements.
- The VIP component did not contribute to the overall impact of the program. Among program participants, there were no differences between VIP and non-VIP groups. However, the length of the VIPs was small (two to three hours) compared with the larger anti-DWI components (approximately 200 hours). Thus, this finding may in part be due to the strong effects of the larger program, which tended to swamp the effects of the VIPs.
An article by project staff on the effect of the MADD VIP presentations appeared in the Journal of Studies on Alcohol.
AFTER THE GRANT
Using data from this project, the grantee organization obtained funding from the National Institute on Alcohol Abuse and Alcoholism for a long-range study to provide definitive data on the program's effects. RWJF also funded dissemination to primary care physicians (see Grant Results on ID# 029466) and to pediatricians, obstetricians/gynecologists, female physicians, nurses, and cardio pulmonary specialists (see Grant Results on all of these grants).
GRANT DETAILS & CONTACT INFORMATION
Evaluation of a Drunk-driving Prevention Program for First-time Offenders
The University of New Mexico (UNM) (Albuquerque, NM)
Dates: October 1996 to March 1999
W. Gill Woodall, Ph.D.
(Current as of date of this report; as provided by grantee organization; not verified by RWJF; items not available from RWJF.)
Kunitz S, Woodall WG, Zhao H, Wheeler D, Lillis R, and Rogers EM. "Re-arrest Rates After Incarceration for DWI: A Comparative Study in a Southwestern County." American Journal of Public Health, 92(11): 18261831, 2002. Abstract available online.
Polacsek M, Rogers EM, Woodall WG, Delaney H, Wheeler D, and Rao N. "MADD Victim Impact Panels and Stages-of-Change in Drunk-Driving Prevention." Journal of Studies on Alcohol, 62(3): 344350, 2001. Abstract available online.
Report prepared by: Janet Spencer King
Reviewed by: Kelsey Menehan
Reviewed by: Molly McKaughan
Program Officer: James R. Knickman