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Motor Vehicle Injury – Alcohol-Impaired Driving: School-Based Programs – Instructional Programs


What the CPSTF Found

About The Systematic Review

The CPSTF finding is based on evidence from a systematic review of nine studies (search period through December 2002).

The review was conducted on behalf of the CPSTF by scientists from CDC’s Division of Unintentional Injury Prevention with input from a team of specialists in systematic review methods and experts in research, practice, and policy related to motor vehicle injury prevention.

Summary of Results

More details about study results are available in the published evidence review pdf icon [PDF - 258 KB].

The systematic review included nine studies.

Self-reported drinking and driving (5 studies) and riding with drinking drivers (4 studies) both decreased.

Summary of Economic Evidence

An economic review of this intervention did not find any relevant studies.


The broader literature evaluating school-based programs to prevent substance abuse suggests instructional programs are likely to be most effective in reducing RDD and other relevant outcomes if they include resistance and other skill training and require student interaction.

Evidence Gaps

CPSTF identified several areas that have limited information. Additional research and evaluation could help answer the following questions and fill remaining gaps in the evidence base. (What are evidence gaps?)

  • To what extent are the outcomes of school-based education programs dependent on the following?
    • Content, delivery method, and the perceived status of the person delivering the intervention
    • Characteristics of the students
  • What effect do interventions have on alcohol-related traffic violations and crashes?
  • Are interventions cost-effective?
  • How consistent are objective outcome measures with self-reported outcomes?
  • How can studies reduce attrition to increase power and validity?

Study Characteristics

  • Most of the studies used before-and-after comparisons or time series designs with a concurrent comparison group.
  • The total number of students included in analyses ranged from 60 to more than 4600, with a median size of 853.
  • Nearly all of the studies targeted junior or senior high school students; five included multiple grades. The median grade targeted was the 10th grade.
  • Follow-up periods ranged from 1 to 84 months, though most studies had follow-up periods of 6 months or less.
  • Attrition provided one of the greatest threats to the validity of these studies, particularly those involving relatively long follow-up periods. Attrition ranged from zero for very short-term follow-ups to nearly two thirds of the baseline sample.
  • The content and level of interaction varied considerably across the instructional programs reviewed.
    • Three studies evaluated programs with informational or affective content that involved didactic presentations
    • Six studies provided information and focused on skills development (e.g., refusal skills, life skills) or reducing risk-taking behavior.
  • Many of the evaluated programs involved considerable student interactivity (e.g., discussion, feedback, role playing, planning activities).