EFFECTIVENESS OF STRATEGIES FOR PREVENTING DUI RECIDIVISM

Release Date:  December 4, 1998

PA NUMBER:  PAS-99-023

P.T.

National Institute on Alcohol Abuse and Alcoholism
National Highway Traffic Safety Administration, Department of Transportation
Center for Substance Abuse Treatment, SAMHSA

Application Receipt Date: March 18, 1999; standard receipt dates thereafter

PURPOSE

The purpose of this program announcement is to stimulate research that addresses
the problem of recidivism among people convicted of drinking and driving
offenses.  This includes individuals who are apprehended for driving under the
influence (DUI), driving while intoxicated (DWI), or related offenses such as
driving after suspension for a DUI and violation of zero tolerance laws, and are
either convicted or otherwise sanctioned for such illegal behavior.  Applicants
who respond to this program announcement are encouraged to develop research
applications that design, develop, implement, and/or test interventions that have
the potential of preventing or reducing DUI recidivism.  Such interventions may
be investigator initiated and implemented in collaboration with appropriate
members of judicial, administrative, and policy-making bodies specifically to
test or compare their efficacy in preventing or reducing DUI recidivism. 
Alternatively, the interventions to be studied may occur naturally in society as
laws, regulations, policies, and practices implemented by legally constituted
bodies and may be tested for their effectiveness by researchers who use the
established methodologies of studying "natural experiments."

Over the past 15 years, there has been a marked decrease in alcohol-related
fatalities and in alcohol-impaired driving among the U.S. driving population as
a whole.  Research indicates that these reductions have resulted in part from the
adoption and implementation of several laws by all or many States.  These legal
changes include raising the minimum legal drinking age to 21 by all States,
implementing administrative license revocation, increasing the severity and
expanding the types of sanctions for convicted DUI offenders, and reducing
legally acceptable BAC levels to .08 for drinking drivers.  However, much remains
to be learned about the relative effectiveness of specific sanctions, singly and
in combination, for violators of the aforementioned new laws.  Of particular
concern is how to deal most effectively with persons with multiple DUI offenses. 
The goal of this program announcement is to expand research in this domain as a
means of building a firmer knowledge base to assist judges, prosecutors, and
other decision makers in making choices among the various options available to
them in sanctioning DUI offenders.

HEALTHY PEOPLE 2000

The Public Health Service (PHS) is committed to achieving the health promotion
and disease prevention objectives of "Healthy People 2000," a PHS-led national
activity for setting priority areas.  This program announcement is related to the
priority areas of alcohol abuse reduction and alcoholism treatment.  Potential
applicants may obtain a copy of "Healthy People 2000" (Full Report: Stock No.
017-001-00474-0 or Summary Report:  Stock No.017-001-00473-1) through the
Superintendent of Documents, Government Printing Office, Washington, DC
20402-9325 (Telephone: 202-512-1800).

ELIGIBILITY

Applications may be submitted by domestic and foreign, for-profit and non-profit,
public and private organizations, such as universities, colleges, hospitals,
laboratories, units of State and local governments, and eligible agencies of the
Federal Government.  Racial/ethnic minority individuals, women, and persons with
disabilities are encouraged to apply as Principal Investigators.

MECHANISM OF SUPPORT

This research support may be obtained through applications for a regular research
project grant (R01), small grant (R03), or exploratory/developmental grants
(R21).  R21 grants are limited to up to 2 years for up to $100,000 for direct
costs per year.  Applicants for Exploratory/Developmental Grants will need to
cite the program announcement for Secondary Analysis of Existing Health Services
Data Sets (PA-97-066) in addition to this program announcement in their
application.  Applicants may also submit Investigator-Initiated Interactive
Research Project Grants (IRPG) under this program announcement.  Interactive
Research Project Grants require the coordinated submission of related regular
research project grant applications from investigators who wish to collaborate
on research.  Further information on the IRPG mechanism is may be obtained in PA-
96-001, which is available on the internet at http://www.nih.gov/grants/guide/pa-
files/PA-96-001.html.

Potential applicants for Exploratory/Developmental Grants may obtain copies of
the specific announcements from the NIAAA Home Page at http://www.niaaa.nih.gov
or from the Office of Scientific Affairs, NIAAA, 6000 Executive Boulevard, Suite
409, MSC 7003, Bethesda, MD 20892-7003, telephone: 301-443-4375 or FAX
301-443-6077.  Further information on grant mechanisms and areas of research
interest may be obtained from program staff listed under INQUIRIES.

FUNDS AVAILABLE

At least $1,300,000 in total costs will be available for three to five awards in
the first year of awards. This level of support is dependent on receipt of 
applications of high scientific merit.  The usual policies governing grants
administration and management, including facilities and administrative costs,
will apply.  Funding beyond the first and subsequent years of the grant will be
contingent upon satisfactory progress during the preceding years and availability
of funds.  The earliest possible award date is September 30, 1999.

RESEARCH OBJECTIVES

Background

In spite of the decreasing prevalence of DUI, it remains a major alcohol-related
problem in the United States and the leading cause of death for persons between
the ages of 1 and 24.  The extent of the problem is illustrated by the following
data:

o  Of the 41,967 persons killed in traffic crashes in 1997, 16,189 (39 percent)
died in alcohol-related crashes. This translates into one alcohol-related death
every 32 minutes during 1997.

o  An additional 327,000 persons (about 10 percent of all those injured in
crashes) received their injuries in alcohol-related crashes.

o  At some point in their lives, three in every 10 Americans will be involved in
an alcohol-related crash.

o  About 1.5 million people were arrested in 1996 for driving under the influence
(DUI) or driving while intoxicated (DWI).

Drunk driving recidivism rates are high: approximately one-third of drivers
arrested or convicted of DWI each year are repeat offenders.  A 1994 study
published in the New England Journal of Medicine concluded that drivers involved
in alcohol-related fatal crashes were eight times more likely to have had DWI
convictions in the previous 5 years than drivers randomly selected from the
general population of licensed drivers.  The National Highway Traffic Safety
Administration (NHTSA) indicates that in 1996, about one in six drivers with
positive BAC levels who died in traffic crashes had been convicted of driving
while intoxicated during the three previous years.  And a 1995 California study
suggests that 44 percent of drivers convicted of DUI in that State are
reconvicted of DUI within 10 years.

The magnitude of the DUI recidivism problem prompted NHTSA and NIAAA to
collaborate in sponsoring a series of working groups of judges, prosecutors, and
alcohol researchers to discuss what is known about effective prevention and
treatment interventions for DUI offenders and to develop two guides for judges,
prosecutors, and other relevant administrators to help them confront the problem
of DUI offenders.  A Guide to Sentencing DUI Offenders, published in 1996 by the
Department of Transportation (DOT HS 808 365), discusses the sentencing process,
factors influencing risk for recidivism, specific sanctions and remedies,
rehabilitation options for offenders sentenced to treatment, compliance and
reporting, and research needs.  The second guide, Sentencing and Dispositions of
Youth DUI and Other Alcohol Offenses, (referred to below as the Youth Guide) is
currently in press and focuses on youthful offenders.  Because all States have
adopted laws making age 21 the minimum legal drinking age, sales to and purchase,
possession, and consumption of alcohol by minors usually are illegal (although
laws and specific penalties vary among the States).  For that reason, the Youth
Guide has a broader focus of interest including laws and sanctions directed at
alcohol-related offenses by persons under age 21, including DUI.

Preparing the guides has made abundantly clear to NIAAA and NHTSA that the
existing knowledge base regarding the effectiveness of specific sanctions for DUI
offenders provides limited guidance for judges and other decision makers who
daily must choose among the available options.  For that reason, these two
agencies, as well as the Center for Substance Abuse Treatment (CSAT), which
served in an advisory role in the preparation of the Guides and which has a
strong interest in the effectiveness of interventions with DUI offenders, are
jointly inviting the research community to propose new studies that can help
address the fundamental unanswered questions about the outcomes and effectiveness
of various sanctions singly and in combination, and which populations and under
what conditions the interventions are most effective.

Applicants should justify their choice of interventions for study based on
relevant theories of behavior change for individuals and, where possible, on
existing data suggesting positive intervention effects.  Applicants should
explain why the chosen intervention should be expected to prevent DUI recidivism. 
Applicants also may propose small-scale feasibility or pilot studies as a prelude
to later designing more complex intervention research.

Possible Interventions for Study

In the field of alcohol-problem prevention research, a popular way of
conceptualizing interventions is to distinguish between universal, selective, and
indicated approaches in terms of certain characteristics of the target group. 
This typology takes into account the breadth of the target group, its risk of
having the disorder or problem of concern, and the benefit/cost ratio of
committing resources to its prevention in that particular target group. 
Universal approaches target entire populations or subpopulations without regard
to risk; selective strategies target subgroups known to be at higher than average
risk; and indicated interventions target persons with individual risk factors
that require more immediate intervention.

Since the objective of this research endeavor is to prevent DUI recidivism, the
critical target population is that group of people who have already been arrested
or apprehended for committing DUI, and the proposed interventions must show
promise of preventing (or reducing) their drinking, their driving, or the
combination of these behaviors.  The risk of recidivism varies across the
heterogeneous DUI offender population, depending on such factors as the frequency
of driving after drinking, number of prior DUI offenses, and the offender's age,
sex, ethnicity, and history of alcohol-related problems.  Specific subpopulations
may be the focus of a proposed study.  Of particular interest are persistent DUI
offenders who pose an especially difficult problem for both public safety and the
courts, and thus are a highly desirable focus of proposed research to reduce
recidivism.

Several factors known to facilitate reduction of recidivism across the spectrum
of DUI offenders also should be considered, including consistency, certainty, and
coordination of sanctions.  In addition, it is important that such legally
prescribed policies as mandated screening for alcohol and other drug problems and
other mandatory sanctions be fully and consistently implemented; that sanctions
be made increasingly severe for repeat offenders; that courts, evaluators,
probation officers, and treatment providers be integrated into a coordinated
system to ensure compliance with the sentence, since failure to address non-
compliance greatly undermines the effectiveness of a sanction and the authority
of the court.

Sanctions imposed on DUI offenders may have several objectives.  They
simultaneously seek to 1) protect the road-using public, 2) hold the offender
accountable to the victim and/or the community, and 3) provide education and/or
treatment to the offender through a combination of retribution, general and
specific deterrence, incapacitation, rehabilitation, and restorative justice. 
Thus, a combination of sanctions often is needed to achieve these goals.  It is
important to note, however, that the goal of this program of research is to
measure the effectiveness of sanctions on recidivism.  For this reason,
investigators should not focus on the general deterrent effect on the driving
public of the countermeasure being studied.  However, sanctions that are very
effective in reducing recidivism may also have a general deterrent effect if they
are highly publicized.

A number of specific intervention options identified in the Guide to Sentencing
DUI Offenders and the Youth Guide might be rigorously evaluated with various
populations in a jurisdiction in which they currently are being used. 
Alternatively, the sanctions may be deliberately implemented so as to facilitate
systematic evaluation in jurisdictions where they are not currently being used.
Many of the sanctions identified in the guides have been assessed only with adult
populations or have included such small samples of youth that their effectiveness
with this population has not been determined.

Offender Sanctions

Offenders most frequently are sentenced to jail terms (including weekend
detention), probation (with a wide range of conditions of probation), fines, and
court-mandated license suspension/revocation. Each of these sanctions may vary
widely in length or amount, as well as the conditions of supervision and may be
the subject of assessment under specific conditions or with particular
subpopulations.

o  Based on studies available through 1995, the Guide to Sentencing DUI Offenders
concludes that jail may be effective as a general deterrent, but it appears to
be no more effective as a specific deterrent for reducing DUI recidivism than
other sanctions, and it is far more costly.  Moreover, mandatory jail sentences
may so overload the court and correctional system that the implementation of jail
sentences actually is curtailed.  Nevertheless, incarceration may be the most
appropriate and/or effective sanction with certain offenders.

o  Weekend interventions programs provide opportunities to assess the offender's
alcohol and other drug problems, permit individualized treatment plans, and allow
offenders to remain on the job.  One study suggests that repeat offenders in such
programs have lower recidivism rates than those sentenced to jail or given
suspended sentences and fines.  However, more research is needed.

o  Detention in facilities dedicated to DUI offenders incapacitates high-risk
offenders for various lengths of time and may offer opportunities for
rehabilitation services, but research on the impact of detention combined with
treatment programs is very limited.

o  Probation is not a single program or strategy; rather, the conditions of
probation vary widely.  Moreover, there is little data on the effectiveness of
particular programs of varying length and scope as conditions of probation. 
Research might explore the short and longer-term outcomes with DUI offenders of
each of the following sanctions or combinations of them as a condition of
probation: intensive probation, home detention, electronic monitoring, license
or vehicle restrictions, fines and/or community service, and attendance at victim
impact panels or at Alcoholics Anonymous.  For example, a NHTSA study found that
recidivism rates one year after sentencing were 33 percent lower for the
experimental subjects sentenced to home detention and electronic monitoring (6
percent) than for those of individuals in a control group (4 percent). However,
the effectiveness of most other conditions of probation, both through the
probationary period and beyond it, and the extent of compliance with these
conditions, have not been carefully assessed.

o  Since offenders often fail to comply with all the terms of their sentence,
investigators may explore the costs and benefits of implementing various
mechanisms to increase compliance with sanctions. These might compare scheduled
meetings with the sentencing judge; increased phone monitoring by probation
officers, and brief incarceration for even minor infractions.

o  Based on findings that suggest drug courts have been effective in reducing the
recidivism rates of drug offenders, it would be useful to test and evaluate the
drug court model with DUI offenders.

Administrative Licensing Actions

The courts share responsibility for managing DUI offenders with State departments
of motor vehicles (DMVs).  DMV agencies maintain critical records and have
administrative power to suspend a driver's license and vehicle registration and
to determine when a suspended offender is eligible for reinstatement.  Although
administrative license suspension (ALS) and revocation (ALR) are civil actions,
they have been found to be among the most effective in reducing DUI recidivism. 
In contrast, judicial license suspension is a post-conviction action ordered by
the court.

o  Studies of administrative license suspension clearly indicate that it is
effective in reducing DUI recidivism and the risk of crash involvement among
drinking drivers.  Optimal suspension periods appear to be between 12 and 18
months, but suspension periods tend to be shorter, in part, because it is
believed that suspension has a negative impact on a driver's employment and
family welfare.  Although some research suggests that job loss is not a major
problem, it continues to be a significant factor in persuading courts not to
impose license restrictions as a sanction.  The length and impact of this
sanction merits further rigorous study.

o  Researchers might assess the effectiveness of various civil remedies or court-
based sanctions for driving after suspension, which is a serious offense that
occurs frequently, but appears to be addressed inconsistently.

Vehicle-related Sanctions

Several recent studies suggest that efforts to reduce illegal driving by
convicted alcohol-impaired drivers through vehicle impoundment, license plate
impoundment and tagging, and/or use of alcohol ignition interlocks may all be
effective, both during and after the sanction period.  While there is a growing
body of research on ignition interlocks, research on other vehicle restrictions
is limited; thus, investigators might usefully explore the effectiveness of other
vehicle sanctions during and after the sanction period.

o  Recent data on the effectiveness of vehicle impoundment suggests that
recidivism and crashes can be reduced for suspended license offenders. Data on
vehicle forfeiture are limited and might be further studied, particularly the
conditions under which this intervention can be effective.  For example, whether
forfeiture is equally effective with all groups of offenders and the optimal
duration of different vehicle-related sanctions are unclear.

o  Vehicle tagging (the placement of a sticker over portions of the license plate
indicating that the owner has a suspended driver's license) appeared to reduce
traffic violations and crashes when it was implemented in Oregon.  Further
examination of this administrative approach would be valuable.

Treatment and Rehabilitation Options

The research literature on the treatment of alcoholism is largely silent on the
specific treatment needs and most effective approaches for the subcategory of
persons who enter the treatment system as a result of a court order following
apprehension and/or conviction for DUI.  It is unknown, for example, whether
treatment programs found to have been effective with voluntary patients  (e.g.,
cognitive behavioral therapy) also are effective with those ordered by the court
to enter them.  A meta-analysis of 225 intervention/treatment programs for DUI
offenders (including educational programs and well as self-help, outpatient, and
inpatient treatment programs), indicated that such programs could reduce
recidivism by 7 to 9 percent.  For many first offenders, the shock of being
arrested and exposure to offender education classes may have been sufficient to
deter further DUI.  Nevertheless, the content, format, and number of educational
materials probably varied widely and was not rigorously assessed.  Since
recidivists tend to exhibit higher rates of alcoholism and more alcohol-related
problems than first-time DUI offenders, treatment interventions in a criminal
justice setting with the recidivist population also merit further examination. 
Other treatment-related research questions include how to sustain abstinence and
prevent relapse with various groups of DUI offenders following treatment 
interventions.

o  Educational programs may include didactic lectures on the medical and legal
consequences of drinking or DUI, discussions that more actively involve
offenders, and/or video presentations. One study found that for non-alcoholic DUI
offenders, education reduced recidivism somewhat more than did fines alone.  It
is unclear, however, what program content is most effective and what period of
involvement is most effective in reducing recidivism.

o  Data on treatment effectiveness is limited but suggests that recidivism may
be reduced among DUI problem drinkers if they are required to participate for at
least a year in an intensive treatment program that involves weekly therapy
sessions and bi-weekly individual interviews with either a therapist or probation
officer.  Project MATCH found that alcohol dependent (but not necessarily DUI
offender) clients treated in both inpatient and outpatient sites were equally
likely to reduce their drinking in response to three treatments (cognitive-
behavioral therapy, motivational enhancement therapy, and twelve-step
facilitation).  The effectiveness of these treatment regimes under conditions of
court coercion with the DUI offender population might be usefully explored.

o  Research findings are mixed, and further study is needed concerning the
effectiveness of diversion programs where prosecution is deferred while the
offenders undergo long-term treatment.  Similarly, studies might be undertaken
that test the effects of deferred prosecution following informal probation and
community service, or other such conditions.

o  Alcoholics Anonymous (AA) is the most popular self-help group for alcoholics. 
However, it is not clear how AA can be used most effectively as an intervention
strategy for DUI offenders.

An additional challenge to the court and to researchers is how to integrate the
three sanction areas-- license suspension, alcohol education and treatment, and
punitive sanctions such as jail -- that currently are used to manage DUI
offenders.  Combining treatment with incarceration or brief interventions with
court processing and screening, for example, may be occurring and should be
evaluated.

Specific Issues for Youth-Focused Research

In the absence of tested adolescent-specific interventions, many of the sanctions
identified above (whether age-appropriate or not) have been applied to youthful
DUI offenders as well as adults but have not been rigorously evaluated with a
youthful population. In addition, there is a need to develop and test
interventions specifically tailored to the developmental and social needs of
adolescents.  These may be novel approaches (as long as theoretically or
empirically justified), or investigators may modify common adult interventions
to make them age-appropriate.  Researchers should note, however, that there are
special challenges and research issues that arise in addressing youthful DUI
offenders.  Some are related to the fact that their special age status permits
many alcohol-related cases involving youth to be handled by the juvenile court. 
It is not known, for example, whether the court to which a youth's alcohol-
related offense is referred (traffic, juvenile, criminal or family court) results
in different sanctions and whether these, in turn, result in different compliance
and recidivism rates.  Other questions are related to the implementation and
outcomes of special laws that apply only to youth.  These include zero tolerance
laws requiring that they have no measurable BAC level when driving or risk loss
of driving privileges.  Further uncertainties revolve around the role and
responsibility of parents for minor children and how best to involve them in the
sanctioning process.

o  There are now more than 280 teen courts operating in 31 States.  These are
designed to hold offenders accountable for their actions while freeing court
dockets.  Individual programs have conducted internal evaluations of their
effectiveness, but there has been no standardized overall evaluation of teen
courts.

o  License suspension and revocation may be particularly effective among youth
since the driver's license is an especially prized possession among them. 
Studies of license actions among youth might usefully explore the optimum period
of license suspension and revocation among young people, which may differ from
that of adults due to zero tolerance laws.

o  The evidence is mixed regarding the effects of community service on recidivism
or crashes among adult DUI offenders.  It has not been evaluated among youthful
offenders but may be particularly appropriate as a form of restorative justice
for youth given their limited ability to pay financial restitution and lower
likelihood of need for alcohol treatment.  Other forms of restorative justice
that merit further systematic evaluation particularly among youth include victim-
offender mediation, attendance at victim impact panels, and emergency department
visitation.

o  The potential involvement of parents in the youth sanctioning process and the
effects of their involvement merit study.  For example, does their attendance at
court proceedings, in parenting skills classes, or in restitution programs with
their children reduce the recidivism of youthful offenders?

Methodological Issues and Outcome Measures

To assess the efficacy of interventions and the effectiveness of intervention
programs for DUI offenders, researchers may propose experimental or quasi-
experimental study designs, as well as  secondary analyses of existing data sets
that permit tests of the effectiveness of sanctions but where the data have not
been fully or appropriately exploited.  The selection of interventions for
testing should be theory-driven whenever possible.  Formal theories postulating
mechanisms of change from a particular intervention may be drawn from
multidisciplinary sources such as the behavioral, biomedical, developmental,
and/or social sciences.  For example, Jessor's problem behavior theory, Bandura's
social learning theory and Prochaska and DeClemente's stages of change theory may
be useful.

Research to establish the efficacy of an intervention must include appropriate
comparison groups.  The single most powerful procedure available to provide
unbiased comparison groups is the random assignment of subjects to experimental
and control conditions. While courts have often opposed randomization as
antithetical to individualized sentencing, many judges appreciate the need for
randomization and its justice were the alternative sentences appear to be of
equivalent severity and their relative effectiveness is unknown.  Similarly, a
proposed intervention that cannot be assigned to all eligible offenders due to
resource limitations may use randomization to offer all eligible offenders an
equal opportunity to enter the program or obtain the treatment.

Proposals that use quasi-experimental designs, including natural experiments that
use time-series analyses, are also welcome.  Whatever the chosen methodological
design and analysis plan, they must be justified in terms of their
appropriateness for the task at hand.  Applicants must defend their choice of
methods in terms of their scientific credibility, but pragmatic considerations
may also be relevant.  For example, randomization may not be acceptable to
authorities in the particular judicial system in which the proposed study will
take place; or the law may mandate that a new naturally occurring intervention
that the applicant proposes to evaluate must be universally applied, forcing the
investigator to seek appropriate controls elsewhere.  Where randomization is
proposed, applicants must be able to justify "treatment indifference" from an
ethical perspective -- i.e., that the intervention to be tested has not been
proven to be superior (or inferior) to the alternative intervention(s). 
Otherwise, it may be unethical to propose randomization.

Researchers also should address potential problems of (a) self selection and (b)
sample attrition, as well as assure (c) sufficient statistical power to detect
differences in intervention efficacy or effectiveness when they really exist. 
Even where the principal investigator has strong methodological skills, it may
be advisable to include among the research team an expert in study design and/or
statistics.

Since the purpose of this program announcement is to stimulate research on
interventions to prevent or reduce DUI recidivism, outcome measures (or
endpoints) must be relevant to this objective.  Direct evidence of recidivism may
include alcohol-related crashes, and reconvictions, rearrests, or new citations
for DUI.  Because offender self-reports of violations would in many instances
constitute an admission of illegal behavior that could lead to additional
sanctions, self reports are likely to produce biased and unreliable data.  If
used as an outcome measure, they should be augmented with corroborative
information from collaterals or archival data.

With respect to reducing DUI recidivism and alcohol-involved traffic crashes,
mediating and moderating variables may affect the outcome.  Both program inputs
(e.g., more intense monitoring) and program outputs (e.g., increased perception
of the risk of sanctions for drinking and driving) may contribute to such
intermediate changes as reduced drinking or modified driving behaviors.  In
creating intervention programs, researchers need to identify and model the
anticipated mediating and moderating factors that are likely to contribute to
intermediate and more distal changes in the outcome measures.  Such factors may
include dispositional and personality characteristics (e.g., sensation-seeking),
offender perceptions of risk of apprehension for violating the sanction and
actual enforcement mechanisms, and integrity of the delivery of the intervention
(e.g., whether the education program is delivered as described by the provider). 
While the DUI outcome is the ultimate measure of program effectiveness,
explanatory models of the change process, measures of program implementation and
integrity, and data identifying the sociodemographic and personality
characteristics of the study population are essential elements in the cumulative
process of understanding program success or failure and linkages between the
intervention processes and their outcomes.

The complexity of the problem and difficulties in establishing new programs for
study suggest that some investigators may prefer to design feasibility studies. 
These might address such issues as how best to operationalize interventions for
use in specific real-world legal or jurisdictional environments; the feasibility,
costs, and relative effectiveness of having different types of individuals in a
community (e.g., professionals, paraprofessionals, or community-based volunteers
who receive special training) perform offender screening or act as probation
officers; or constructing or adapting protocols for use among culturally diverse
or youthful populations.

Given the complex nature of the specific research problem and the desirability
of implementing a true experimental design if possible, collaborative efforts
between researchers and justice system practitioners are strongly encouraged. 
For example, researchers with expertise in alcohol treatment, criminal justice,
and traffic safety research may wish to collaborate with criminal justice system
practitioners including judges, treatment providers, and/or probation department
personnel to maximize the competence of the study team investigating different
aspects of the common topic.

INCLUSION OF WOMEN AND MINORITIES IN RESEARCH INVOLVING HUMAN SUBJECTS

It is the policy of the NIH that women and members of minority groups and their
subpopulations must be included in all NIH supported biomedical and behavioral
research projects involving human subjects, unless a clear and compelling
rationale and justification is provided that inclusion is inappropriate with
respect to the health of the subjects or the purpose of the research.  This
policy results from the NIH Revitalization Act of 1993 (Section 492B of Public
Law 103-43).

All investigators proposing research involving human subjects should read the
"NIH Guidelines for Inclusion of Women and Minorities as Subjects in Clinical
Research," which have been published in the Federal Register of March 20, 1994
(FR 59 14508-14513) and in the NIH Guide for Grants and Contracts, Volume 23,
Number 11, March 18, 1994.

Investigators also may obtain copies of the policy from the program staff listed
under INQUIRIES.  Program staff may also provide additional relevant information
concerning the policy.

INCLUSION OF CHILDREN AS PARTICIPANTS IN RESEARCH INVOLVING HUMAN SUBJECTS

It is the policy of NIH that children (e.g., individuals under the age of 21)
must be included in all human subjects research, conducted or supported by the
NIH, unless there are scientific and ethical reasons not to include them. This
policy applies to all initial (Type 1) applications submitted for receipt dates
after October 1, 1998.

All investigators proposing research involving human subjects should read the
"NIH Policy and Guidelines on the Inclusion of Children as Participants in
research Involving Human Subjects" that was published in the NIH Guide for Grants
and Contracts, March 6, 1998, and is available a the following URL address:
http://www.nih.gov./grants/guide/notice-files/not98-024.html

Investigators also may obtain copies of these policies from the program staff
listed under INQUIRIES.  Program staff may also provide additional relevant
information concerning the policy.

APPLICATION PROCEDURES

Applications are to be submitted on the grant application form PHS 398 (rev.
4/98) and will be accepted on March 18, 1999 and on the standard application
receipt dates each year thereafter.  Application kits are available at most
institutional offices of sponsored research and may be obtained from the Division
of Extramural Outreach and Information Resources, National Institutes of Health,
6701 Rockledge Drive, MSC 7710, Bethesda, MD 20892-7910, telephone 301-710-0267,
Email: grantsinfo@nih.gov.

The title and number of the program announcement must be typed on line 2 of the
face page of the application form and the YES box must be marked.

The completed original application and five legible copies must be sent or
delivered to:

CENTER FOR SCIENTIFIC REVIEW
NATIONAL INSTITUTES OF HEALTH
6701 ROCKLEDGE DRIVE, ROOM 1040 - MSC 7710
BETHESDA, MD  20892-7710
BETHESDA, MD  20817 (for express/courier service)

REVIEW CONSIDERATIONS

Applications that are complete will be evaluated for scientific and technical
merit by an appropriate peer review group convened in accordance with the
standard NIH peer review procedures.  As part of the initial merit review, all
applications will receive a written critique and undergo a process in which only
those applications deemed to have the highest scientific merit, generally the top
half of the applications under review, will be discussed, assigned a priority
score, and receive a second level review by the appropriate national advisory
council.

Review Criteria

The goals of NIH-supported research are to advance our understanding of
biological systems, improve the control of disease, and enhance health.  The
reviewers will comment on the following aspects of the application in their
written critiques in order to judge the likelihood that the proposed research
will have a substantial impact on the pursuit of these goals.  Each of these
criteria will be addressed and considered by the reviewers in assigning the
overall score, weighting them as appropriate for each application.  Note that the
application does not need to be strong in all categories to be judged likely to
have a major scientific impact and thus to deserve a high priority score.  For
example, an investigator may propose to carry out important work that by its
nature is not innovative but is essential to move a field forward.

Significance:  Does this study address an important problem?  If the aims of the
application are achieved, how will scientific knowledge be advanced?  What will
be the effect of these studies on the concepts or methods that drive this field?

Approach:  Are the conceptual framework, design, methods, and analyses adequately
developed, well-integrated, and appropriate to the aims of the project?  Does the
applicant acknowledge potential problem areas and consider alternative tactics?

Innovation:  Does the project employ novel concepts, approaches or methods?  Are
the aims original and innovative?  Does the project challenge existing paradigms
or develop new methodologies or technologies?

Investigator:  Is the investigator appropriately trained and well-suited to carry
out this work?  Is the work proposed appropriate to the experience level of the
principal investigator and other researchers (if any)?

Environment:  Does the scientific environment in which the work will be done
contribute to the probability of success?  Do the proposed experiments take
advantage of unique features of the scientific environment or employ useful
collaborative arrangements?  Is there evidence of institutional support?

Budget:  Is the requested budget and estimation of time to completion of the
project appropriate for the proposed research?

In addition, plans for the recruitment and retention of subjects will be
evaluated as will the adequacy of plans to include both genders, minorities and
their subgroups, and children as appropriate for the scientific goal of the
research.

The initial review group will also examine the provisions for the protection of
human subjects and the safety of the research environment.

AWARD CRITERIA

Applications will be considered for funding on the basis of the overall
scientific and technical merit of the application as determined by peer review,
programmatic needs and balance, and the availability of funds.

INQUIRIES

Inquiries concerning this program announcement are encouraged.  The opportunity
to clarify any issues or questions from potential applicants is welcome.

Inquiries regarding programmatic issues may be directed to:

Susan E. Martin, Ph.D.
Division of Clinical and Prevention Research
National Institute on Alcohol Abuse and Alcoholism
6000 Executive Boulevard MSC 7003
Bethesda, MD  20892-7003
Telephone:  (301) 443-8767
FAX:  (301) 443-8774
Email:  smartin@willco.niaaa.nih.gov

Direct inquiries regarding fiscal matters to:

Edward Ellis
Grants Management Branch
National Institute on Alcohol Abuse and Alcoholism
6000 Executive Boulevard MSC 7003
Bethesda, MD  20892-7003
Telephone:  (301) 443-4706
FAX:  (301) 443-3891
Email:  eellis@willco.niaaa.nih.gov

AUTHORITY AND REGULATIONS

This program is described in the Catalog of Federal Domestic Assistance, No.
93.273.  Awards are made under the authorization of the Public Health Service
Act, Sections 301 and 464H, and administered under the PHS policies and Federal
Regulations at Title 42 CFR Part 52 and 45 CFR Part 74 or 45 CFR Part 95, as
applicable.  This program is not subject to the intergovernmental review
requirements of Executive Order 12372 or Health Systems Agency Review.

The Public Health Service (PHS) strongly encourages all grant recipients to
provide a smoke-free workplace and promote the non-use of all tobacco products. 
In addition, Public Law 103-227, the Pro-Children Act of 1994, prohibits smoking
in certain facilities (or in some cases, any portion of a facility) in which
regular or routine education, library, day care, health care or early childhood
development services are provided to children. This is consistent with the PHS
mission to protect and advance the physical and mental health of the American
people.

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	Office of Extramural Research (OER)			National Institutes of Health (NIH) 9000 Rockville Pike Bethesda, Maryland 20892			Department of Health and Human Services (HHS)
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