Mississippi s DUI Offender Intervention: 40 Years of Programming and Research

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1 Journal of Offender Rehabilitation, 52: , 2013 Copyright Taylor & Francis Group, LLC ISSN: print/ online DOI: / Mississippi s DUI Offender Intervention: 40 Years of Programming and Research ANGELA A. ROBERTSON and SHEENA GARDNER Social Science Research Center, Mississippi State University, Starkville, Mississippi, USA XIAOHE XU Department of Sociology, University of Texas at San Antonio, San Antonio, Texas, USA GUANGQING CHI and D. LEE MCCLUSKEY Social Science Research Center, Mississippi State University, Starkville, Mississippi, USA The Mississippi Alcohol Safety Education Program (MASEP) is a court-mandated driving under the influence (DUI) intervention for persons convicted of DUI. This study describes the evolution of the curriculum, evaluates the effectiveness of MASEP in reducing recidivism, and examines whether recent program revisions have led to improvements in reducing recidivism. Findings indicate that between 2005 and 2009 individuals who completed MASEP had significantly lower recidivism rates at 12-months follow-up compared to those who did not complete or did not enroll in MASEP, and that the most recent curriculum is more effective in reducing recidivism than its predecessor. KEYWORDS DUI intervention, impaired driving, offender rehabilitation, recidivism, substance abuse Driving under the influence (DUI) of alcohol or other drugs is a serious public safety concern. Alcohol-related motor vehicle accidents in the United States are estimated to cost more than $37 billion dollars annually (National Address correspondence to Angela A. Robertson, Social Science Research Center, Mississippi State University, 1 Research Blvd., Suite 103, Starkville, MS 39759, USA. angela.robertson@ssrc.msstate.edu 138

2 Mississippi s DUI Offender Intervention 139 Highway Traffic Safety Administration, 2012). In 2010, 31% of highway deaths were attributed to alcohol and more than 10,000 people died in alcoholrelated traffic accidents (National Highway Traffic Safety Administration, 2011). Driving under the influence of drugs is also part of the DUI problem. Of the fatally injured drivers that were tested for prescription medications and illegal drugs in 2009, 18% tested positive for one or more drugs that can impair driving (National Highway Traffic Safety Administration, 2010). In order to prevent further loss of life, it is imperative that effective interventions are implemented to reduce alcohol and drug impaired driving. Efforts to reduce DUI have led to improvements; however, the problem remains a significant public safety issue (Shults et al., 2001; Williams, 2006). According to the Substance Abuse and Mental Health Services Administration, an estimated 13.2% of persons ages 16 or older have driven under the influence of alcohol in the past year, 4.3% have driven under the influence of drugs in the past year, and 21.9% have driven under the influence of both alcohol and drugs concurrently (Substance Abuse and Mental Health Services Administration, 2010). All U.S. states employ legal sanctions, such as jail time, driver s license suspension, and fines as countermeasures to impaired driving, and also provide DUI-intervention programs to reduce future impaired driving. These strategies are linked to lower alcohol-related fatalities and reductions in DUI (Cavaiola & Wuth, 2002; Nochajski & Stasiewicz, 2006; Sweedler et al., 2004). Despite the positive impact of these various strategies, research demonstrates that the effectiveness of intervention programs in reducing recidivism among convicted DUI offenders varies considerably (Dill & Wells-Parker, 2006; Nochajski & Stasiewicz, 2006). As a result, about one third of first time offenders will repeat the offense (Simon, 1992; Voas & Fisher, 2001). In order to continue to lower alcohol-related fatalities and DUI recidivism, it is necessary to repeatedly assess the efficacy of DUI intervention programs, and to disseminate findings in order to improve program curricula. The purpose of this study is two-fold. First, we describe the characteristics and components of the Mississippi Alcohol Safety Education Program (MASEP), the DUI intervention program used in the state of Mississippi, and explain how the MASEP curriculum has evolved over the past 40 years. Second, we evaluate the effectiveness of MASEP in reducing DUI recidivism in court-mandated individuals between 2005 and 2009, and compare the relative effectiveness of the two most recent versions of the program. MASEP MASEP is a statewide statutorily mandated DUI intervention for persons convicted of a first offense DUI. In addition to being court ordered to attend and complete the program, DUI offenders pay fines of $250 to $1,000 and lose their driving privileges. The offender s driver s license is suspended for a

3 140 A. A. Robertson et al. minimum of 90 days and remains suspended until the individual completes MASEP. The program is one of only a few statewide programs in the United States operated by a single agency, Mississippi State University, and, to our knowledge, is the only DUI intervention in the nation operating under the auspices of a university. MASEP consists of two interrelated units. The MASEP Operations Unit interfaces with the judicial system and manages 51 schools in 41 locations throughout the state. The MASEP Research & Development Unit conducts research on DUI recidivism as well as the characteristics, risk behaviors, and service needs of DUI offenders. Study findings are then used to revise the curriculum to improve program effectiveness and to increase public safety. History of MASEP and Program Evaluation Research The original MASEP curriculum was modeled after the first DUI program developed in the United States, the Phoenix Program. The Phoenix Program model was developed in 1966 and provided education on drinking and driving and also made referrals to alcohol treatment (Stewart & Malfetti, 1970). Beginning in 1971, the U. S. Department of Transportation encouraged each state to establish driver education schools for DUI offenders as part of a highway safety program (Cavaiola & Wuth, 2002). As the pioneer in DUI intervention programming, the Phoenix Program served as a blueprint for programs across the country, including MASEP, which was implemented in MASEP CURRICULUM: 1972 EDITION MASEP began with two pilot sites. At that time individuals who participated in the program included those ordered to attend MASEP based on the discretion of the court, as well as those individuals with a blood alcohol concentration (BAC) of.15 or higher who voluntarily attended the program to reduce their license suspension time. MASEP was designed as a four week, 10 hour program that used lectures and films to teach participants facts about the effects of alcohol on health and driving, and information on problem drinking and alcoholism. The original MASEP program did not identify participants with substance use disorders. Within a few years, enrollment grew and 18 schools were established across the state. In 1981, several changes occurred. MASEP began to serve only those offenders who were classified as first-time DUI offenders (it was possible to have multiple first DUI offenses if the arrests occurred more than five years apart). Up to that point, MASEP accepted all referrals regardless of the number of prior DUI convictions. In addition, the state legislature changed the law so that a BAC of.10 or higher resulted in mandatory referral to MASEP. The first evaluation of MASEP was conducted between 1975 and This study aimed to measure the relative effectiveness of probation in

4 Mississippi s DUI Offender Intervention 141 reducing DUI recidivism when compared with other interventions (Landrum et al., 1982). Over 5,000 DUI offenders were randomly assigned to one of the following conditions: (a) 1 year of probation which consisted of monthly supervision meetings, (b) an intervention of either 8 weeks of structured group therapy or participation in MASEP, (c) probation plus intervention, or (d) a no-treatment control. Because research suggested that educational programs for DUI offenders were more effective for social drinkers (Ellinsgstad & Springer, 1976), participants assigned to the intervention condition were separated into two groups based on alcohol problem severity and DUI recidivism risk screening scores. Offenders who were classified as problem drinkers/high risk for DUI recidivism received group therapy, while those classified as nonproblem drinkers/low risk for DUI rearrest received MASEP. The results of the study were discouraging. While the combined probation and intervention condition appeared to reduce DUI recidivism, neither of the other interventions were shown to be effective. There was no statistically significant difference in 2-year recidivism rates of offenders assigned to MASEP when compared with those assigned to the no-treatment control group (Landrum et al., 1982). Findings from this study along with other research demonstrating the ineffectiveness of lecture-oriented DUI schools (Ellinsgstad & Springer, 1976; Jones & Joscelyn, 1978) clearly demonstrated the need to drastically change the MASEP curriculum in order to improve program effectiveness. MASEP CURRICULUM: 1989 EDITION In March 1987, the Mississippi Governor s Highway Safety Program provided necessary funding to revise the MASEP curriculum and program format. The second edition of MASEP was the same length and duration as the earlier curriculum and continued to provide factual information on the effects of alcohol on health and driving. It differed from the original version because it incorporated group process techniques to foster open communication and active participation among all program participants. The curriculum also included guided group discussions, in-class exercises, and homework assignments designed to encourage participants to systematically examine their alcohol use and its negative impact on their lives. Participants were encouraged to think about the ways in which they could avoid future DUI arrests. The new program also developed a procedure to assess problem drinking among participants, and to provide feedback concerning the severity of their alcohol-related problems (Snow et al., 1989). The new curriculum also encouraged individuals in need to seek substance abuse treatment by offering a directory of available treatment services. The second edition of the MASEP curriculum was implemented statewide in 1989, and researchers evaluated the effectiveness of the program again in 1992 (Snow, 1996). This study compared the DUI recidivism rates of

5 142 A. A. Robertson et al. participants who completed the program as ordered (i.e., in 4 consecutive weeks) with those who did not enroll. Overall, 19.6% of DUI offenders were rearrested within 24 months of their court ordered referral date to MASEP. Results indicated that those who completed MASEP had a significantly lower DUI recidivism rate than those who did not enroll in the program (17.0% versus 23.1%). Recidivism rates at 36 months mirrored those found at 24 months. The overall recidivism rate was 25.9%, and participants who completed the program recidivated at a significantly lower rate (22.7%) than those who did not enroll (29.9%). Although the impact size of 6% to 7% (the difference between the recidivism rates of those who completed the program as intended and those who did not enroll) seems small, these results were consistent with other studies examining the effectiveness of DUI interventions (Wells-Parker & Bangert-Drowns, 1995). MASEP CURRICULUM: 2000 EDITION The program was revised again in September The third edition of the MASEP curriculum differed from the previous edition in several ways. First, the duration of the program was increased from 10 to 12 hours. Second, greater emphasis was placed on the development of a DUI avoidance plan. Participants were given more opportunities to revise their plans after discussing the plan s strengths and weaknesses with other group members. Another major difference between the 1989 and 2000 versions of MASEP involved the provision of feedback based upon an assessment conducted in the first session. In the 1989 version, participants were given a brief feedback report that included their BAC level at the time of arrest, their score on the Mortimer-Filkins Questionnaire (Mortimer, Filkins, & Lower, 1971), and a description of what the measures meant. The feedback process was improved by allotting significantly more time during the third session, so that feedback reports could be discussed, and the connection between these indicators and future risk of drinking and driving could be thoroughly explained. A third evaluation of the effectiveness of MASEP in reducing DUI recidivism was conducted with offenders mandated to the program from 1996 through 2004 (Robertson, Gardner, Xu, & Costello, 2009). The study compared 3-year recidivism rates of individuals based on program completion status and program edition. Individuals were sorted into one of three categories based on their completion status: those who completed the program within three months (completers), those who enrolled but did not complete the program or those who took more than three months to complete the program (noncompleters), and those who did not enroll (DNE). Participants were also grouped according to program version, those receiving the 1989 version and those receiving the 2000 version of the curriculum. Results of the study indicated that those who completed the program had significantly lower 3-year recidivism rates (21.1%) than noncompleters

6 Mississippi s DUI Offender Intervention 143 (35.8%), and DNEs (29.5%). Using Cox proportional hazards regression and controlling for gender, age, race, educational attainment, and prior DUI history, program completers had a significantly lower hazard of subsequent DUI arrest than those that did not enroll (hazard ratio = 0.71). Furthermore, Cox regression results suggested that the third edition of the MASEP curriculum was more effective than the previous, as recidivism was 16% higher for participants enrolled in the 1989 version than those enrolled in the 2000 version. MASEP CURRICULUM: 2008 EDITION Ongoing research indicated shifts in the demographics, substance use patterns, and treatment needs of DUI offender population that might influence participant engagement and program effectiveness. First, the proportion of females increased from 13% in 1992 to almost 19% in 2008 (Robertson, Liew, & Gardner, 2011). Because current research indicates that drinking norms, the effects of alcohol on health, and the factors that motivate behavioral change differ for women and men (Holmila & Raitasalo, 2005; Nolen-Hoeksema, 2004; Wells-Parker, Popkin, & Ashley, 1996), the changing composition of MASEP participants suggests the need to incorporate gender-specific information into the curriculum. Second, there was indirect evidence of an increase in drug impaired driving. The proportion of court orders with reported BAC significantly decreased from 77.5% in 1992 to 31.3% in Missing data on BAC can result from BAC test refusal, failure of the referring court to record BAC on the court order form, or drug impaired driving. Questions about the extent of drug impaired driving prompted the collection of information from MASEP participants about their substance use on the day of arrest. Anonymous surveys were collected from 419 MASEP participants between February 26, 2007 and March 3, Some respondents (11.7%) denied any substance use on the day of their arrest; 60.6% reported alcohol use only, 4.1% reported the use of another drug (primarily marijuana) and 23.6% reported poly-drug use on the day of their arrest. These findings clearly indicated the need to include measures of drug use in the assessment and feedback process and to incorporate information on the effects of drugs on driving and health into the MASEP curriculum. Another change observed over time was an increase in psychological distress among people enrolled in the program. Depressed mood and negative affect has been shown to be related to temptation to drink and to drinking and driving (Dill et al., 2007). Scores from subscales of the Mortimer-Filkins Questionnaire (MFQ) revealed that the proportion of participants with high scores on the depression scale increased from 24.6% in 1992 to 28.1% in The proportion of participants with high levels of anxiety also increased over the same time period from 18.8% to 23.8%. The increase in the

7 144 A. A. Robertson et al. proportion of MASEP participants reporting high levels of anxiety and depression indicated that psychological distress and mental health issues should be addressed. In recognition of the changing characteristics and needs of DUI offenders in Mississippi, the program was once again revised. The revised curriculum was implemented statewide in 2008 and continues to be used to date. The MASEP curriculum was modified to provide gender-specific substance abuse information and assessment feedback. Program components were also changed to address the use of drugs other than alcohol and poly-drug use such as the mixing of alcohol with prescription medications. Many of the changes were based on recommendations from the Center for Substance Abuse Treatment (Center for Substance Abuse Treatment, 1999) and included the incorporation of evidence-based substance abuse intervention practices such as the theoretical Model of Change (Prochaska & Velicer, 1997). The 2008 edition of the program teaches participants about the stages of change, and participants are given information and advice on the change process. Another addition to the DUI intervention was problem solving and critical thinking skills training. Participants are encouraged to use these skills when creating their DUI avoidance plan and resolving problems in other areas of their lives. Perhaps the most significant change to the program was the complete overhaul of the assessment and feedback process. A new assessment instrument was developed, pilot tested, and implemented to better measure alcohol and drug use and related problems. The new assessment contains the following validated measures: (a) Alcohol Use Disorders Identification Test (AUDIT; Babor, Higgins-Biddle, Saunders, & Monteiro, 2001), (b) Research Institute on Addictions Self-Inventory (RIASI; Nochajski & Wieczorek, 1998), (c) Short Inventory of Alcohol and Other Drug Consequences (InDUC; Miller, Tonigan, & Longabaugh, 1995), and (d) the Center for Epidemiological Studies-Depression Scale (CES-D 10-item; Andersen, Malmgren, Carter, & Patrick, 1994). Information from the new assessment provides MASEP participants with personalized feedback designed to increase their motivation to change drinking and drug use behaviors (Sobell et al., 1996; Squires & Hester, 2004), identify any mental health issues participants may be experiencing, and inform participants about their odds of getting another DUI if no behavioral changes are made. Since its establishment in 1972, MASEP has undergone numerous changes for the purpose of improving the program s effectiveness in reducing recidivism among first-time DUI offenders. In an effort to constantly improve the program, MASEP researchers have regularly reviewed the DUI recidivism literature, conducted empirical studies of the program s effectiveness on reducing recidivism, and, when necessary, revised the MASEP curriculum to incorporate new strategies and techniques grounded in evidence-based research. The present study continues in this tradition by measuring the

8 Mississippi s DUI Offender Intervention 145 effectiveness of the program as a whole and examining whether the most recent program revisions have led to improvements in reducing DUI recidivism among MASEP participants. METHODS Participants This study examined DUI recidivism rates among individuals court-mandated to attend MASEP between 2005 and The data for this study were compiled from three different administrative data sources: driving citation records from the state between 2004 and 2010, MASEP administrative records, and assessment data collected from participants during the first session of the program. All three data sources were linked through driver s license and/or social security numbers, to create a comprehensive DUI recidivism data set. Between 2005 and 2009 there were 81,315 cases in the MASEP administrative records. After removing duplicate entries and cases without driver s license or social security numbers from the administrative data, the remaining cases were linked with the citation records via driver s license numbers. Unfortunately, this process only yielded a matching rate of 27.9% (22,727 records). There are several reasons for such a low matching rate. First, the quality of the data reported on court order/referral forms was poor. Because the forms were completed by hand instead of electronically, there is no mechanism for identifying and correcting administrative forms with incomplete or inaccurate data. Second, in cases where there were multiple referrals and/or arrests occurring within a short period of time, it was difficult to identify which arrest led to the court-mandated participation in MASEP, thus decreasing the matching rate. To complete the data merger, information from the assessment was linked. Assessment data were collected from all individuals who enrolled in the program and attended the first session. At that time, additional demographic information such as education was collected and individuals drug and alcohol problems were assessed. Measures DEMOGRAPHICS Demographic variables serving as statistical controls in the study included race (African American, White, and other; dummy-coded with White as the reference), age (15 88 years), sex (male and female; dummy-coded with female as the reference), and education (less than high school, high school, college, and postgraduate).

9 146 A. A. Robertson et al. DUI RECIDIVISM DUI recidivism was defined differently depending on whether the participant enrolled in MASEP. Participants who enrolled in the course were counted as having recidivated if they had another DUI arrest after the date in which they enrolled in the course. Participants who never enrolled in the course were considered to have recidivated if they had a DUI arrest anytime after their first guilty DUI conviction. PRIOR DUI ARRESTS Prior DUI arrests were also defined differently depending on whether the participant enrolled in MASEP. Participants who enrolled in the course were flagged as having a prior arrest(s) if they had a DUI arrest prior to the date in which they enrolled in the course. Among participants who never enrolled, any arrests that occurred before the date of their first guilty DUI conviction were considered prior arrests. PROGRAM COMPLETION Individuals court mandated to MASEP were grouped into one of three categories: timely completers, noncompleters, and nonenrollees. Individuals who enroll and complete the program within three months of the court referral were considered completers. Individuals were classified as noncompleters if they dropped out of the program before completing all four sessions or if they attended classes so inconsistently that it took more than 3 months to complete the program. The last group, nonenrollers, was composed of individuals who were court-ordered to attend MASEP but never enrolled in the program. PROGRAM VERSION Over the study period, two different curricula were used. Participants who attended classes prior to October 2008 received the 2000 version of the program. Participants who enrolled in MASEP after that date received the 2008 version of the MASEP curriculum. PROBLEM SEVERITY Indicators of problem severity were collected from the assessment form completed by participants during the first session of the MASEP program. Depending on the program version, harmful involvement with alcohol was measured by either the MFQ or the AUDIT. The MFQ measure used in the 2000 program version identifies high-risk drinkers through a 58-item questionnaire (Anderson, Snow, & Wells-Parker, 2000). MFQ scores were

10 Mississippi s DUI Offender Intervention 147 used to categorize participants into groups based on their likelihood of having a drinking problem: a score of 12 or less indicates no evidence of problem drinking; 12 to 15 suggests that the individual may have an alcohol problem; 16 to 23 indicates that a participant may have a drinking problem; and 24 or higher offers strong evidence that an individual is harmfully involved with alcohol. For this study, MFQ scores were categorized into two groups, those with a low alcohol problem severity (MFQ score 23) and those with a high alcohol problem severity (MFQ score 24). The implementation of a revised MASEP curriculum in 2008 was accompanied by a change in the measure of alcohol problem severity. The AUDIT was developed by the World Health Organization and has proven to be both a highly reliable and valid measure of alcohol problems (Babor et al., 2001). There are three AUDIT score categories that indicate an individual s degree of alcohol abuse. For this study, participants with high levels of alcohol problems (AUDIT score 16) were distinguished from those that that had low or moderate levels of alcohol problems (AUDIT score 15). The final measure of alcohol problem severity was dummy-coded with low problem severity serving as the reference. Analytic Strategy All missing values were imputed using the Multiple Imputation procedure in Stata (Stata, 2009). Because of the large number of missing values in respondents education, 25 datasets were generated and pooled for multivariate statistical modeling (M = 25). As a result, all regression coefficients that will be interpreted in the following section represent average effects of covariates on DUI recidivism. As suggested by prior studies, the Cox proportion hazards model was used to estimate the effects of covariates on DUI recidivism (Robertson et al., 2009). The Cox regression model assumes that the hazard rate of DUI recidivism for the jth participant in the current dataset is h(t/x j ) = h 0 (t) exp(x j β x ), where β x represents the regression coefficients that will be estimated from the data, and h 0 (t) is the unestimated baseline hazard (Cleves, 2008). One of the advantages of this hazard modeling framework is that it makes no assumptions about the shape of the hazard over time. Two Cox regression models were fit to the data. Model 1 estimated the effects of the program completion status on the hazard of DUI recidivism for the entire sample, while Model 2 assessed the effectiveness of the MASEP programs on the hazard of DUI recidivism for the subsample of participants who completed the MASEP curriculum. In both models typical sociodemographic characteristics such as sex, age, and educational attainment were statistically controlled. The following section reports the major findings from these two Cox regression models.

11 148 A. A. Robertson et al. RESULTS Characteristics of DUI Offenders Descriptive statistics for all variables in the Cox regression models are reported in Table 1. The majority of DUI offenders were male (80.7%) and Caucasian (57.2%). The average age of the sample was 36 years. Over half (57.1%) of the individuals court referred to MASEP enrolled and completed the program; a small percent (4.2%) enrolled but did not complete the program; and the remainder (35.3%) never enrolled in MASEP despite being court ordered to do so. Most of the offenders (60.1%) were referred to MASEP when the 2000 edition of the curriculum was in use. Approximately one fifth (19.1%) of DUI offenders had a history of DUI prior to the DUI conviction that resulted in court referral to MASEP. Educational attainment and alcohol problem severity was obtained from individuals who enrolled in the program and completed the assessment. Among MASEP participants, 23.6% did TABLE 1 Characteristics of DUI Offenders (N = 22,727) Characteristics n % M SD Program completion status Completers 12, Noncompleters Nonenrollers 8, Sex Male 18, Female 4, Race White 13, Black 9, Other Unknown Age <=36 12, >=37 10, Unknown Prior DUI 4, Program version 2000 edition 13, edition 9, High Alcohol Problem Severity 3, Education Less than high school 3, High school 4, College Unknown Note. Measures of alcohol problem severity and education were obtained from the assessment form completed during the first session of the MASEP program. As a result, this information is unavailable for individuals who never enrolled in the program.

12 Mississippi s DUI Offender Intervention 149 not complete high school, 33.2% graduated from high school or obtained a GED, and 38% attended or completed college. A quarter of MASEP participants were classified as problem drinkers based on MFQ or AUDIT scores. Recidivism Rates Recidivism rates by program completion status and program version are reported in Table 2. In bivariate analyses, the overall recidivism rate at 12 months was 12.4% and 22.1% at 36 months. Compared to those who did not complete or did not enroll in MASEP, offenders who completed the program had significantly lower DUI recidivism at 12 months (χ 2 = , df = 4) and at 36 months (χ 2 = , df = 2). While individuals who completed the 2008 version of MASEP had a lower recidivism rate of 9.1% compared to a rate of 10.1% for participants who completed the 2000 version, the difference was not statistically significant (χ 2 = 3.21, df = 1). Multivariate Analyses of DUI Recidivism Rates A full Cox regression model predicting DUI recidivism on the basis of gender, age, race, educational attainment, prior DUI and program completion showed that each of these variables was statistically significant (Model 1, Table 3). The results indicated that enrolling in MASEP, whether completed or not, significantly reduces the hazard of DUI recidivism. While enrolling but not completing the program reduces the hazard of DUI recidivism by 88%, completing the program further reduces the hazard by another 2% (a total of 90%) as compared to those who did not enroll. In addition, other covariates serving as statistical controls were also statistically significant. More TABLE 2 Recidivism Rates by Program Completion and Program Version Recidivism within 12 months a Recidivism within 36 months b % χ 2 % χ 2 Program completion *** *** Completers Noncompleters Nonenrollers Program version edition edition 9.1 a Recidivism is defined as being arrested for another DUI within 12 months after the date of enrollment in MASEP or for those who did not enroll, being arrested for DUI again within 12 months of the date of their first guilty DUI conviction. b We cannot calculate 36 month recidivism rates by program version because none of the participants who completed the 2008 version of the program have been at risk for subsequent arrest for 36 months. ***p <.001.

13 TABLE 3 Cox Regressions to Predict Hazard of DUI Recidivism in Mississippi Model 1 (N = 22,727) Model 2 (N = 12,975) Coefficient SE Hazard ratio Coefficient SE Hazard ratio Program completion status Completion 2.315*** (0.047) Noncompletion 2.098*** (0.075) Nonenrollment (reference) Program version: ** (0.047) edition (reference) Male 0.397*** (0.040) *** (0.055) Female (reference) Age 0.009*** (0.001) *** (0.001) Race Black 0.056* (0.029) (0.041) Others 0.500*** (0.108) ** (0.138) White (reference) Educational attainment 0.210*** (0.026) *** (0.026) Prior DUI offenses 0.344*** (0.031) *** (0.045) High alcohol problem severity 0.415*** (0.044) *p <.05. **p <.01. ***p <

14 Mississippi s DUI Offender Intervention 151 specifically, the hazard of DUI recidivism decreases as the individual s age and educational attainment increase. As expected, males were at higher risk of DUI recidivism than females, and whites were more likely to be DUI reoffenders than blacks and other racial/ethnical groups. Finally, a prior history of DUI offenses increased the hazard of DUI recidivism. Next, we examined differences in recidivism rates across program versions for individuals who completed MASEP. As can be seen from Model 2 in Table 3, two different versions of the MASEP programs had differential effects on the hazard of DUI recidivism. The Cox regression results indicated that the hazard of DUI recidivism was 12.3% lower for those who completed the 2008 program than those who completed the 2000/2005 program, suggesting that the 2008 program out-performs the 2000 program in reducing DUI recidivism. Also, having a substantial alcohol problem increased the hazard of DUI recidivism by 51%. The findings for control covariates resembled those from Model 1 except that there was no longer a significant difference between Blacks and Whites in DUI recidivism. DISCUSSION Established in 1972, the Mississippi Alcohol Safety Education Program celebrated its 40th anniversary in Throughout this time, MASEP researchers have evaluated the program s effectiveness and, as a result of study findings, undertaken numerous revisions in an effort to further reduce DUI recidivism among first-time DUI offenders. Over this period, the MASEP curriculum changed from a lecture-oriented educational program to one that encourages active participation among program participants. Additional changes to the program included the implementation of new assessment instruments, the provision of personalized feedback so participants may understand the severity of their alcohol-related problems, the inclusion of problem solving and critical thinking skills training, and revisions of curriculum material to reflect the changing demographics of MASEP participants. As in previous program evaluation studies, the current study examined the overall effectiveness of MASEP and explored whether the latest curriculum revision resulted in lower rates of DUI recidivism compared to the previous version. Findings indicated that individuals who completed MASEP had significantly lower recidivism rates at 12 months compared to those who did not complete or did not enroll in MASEP. Results also showed that the most recent curriculum implemented in 2008 is more effective in reducing recidivism than its predecessor. In addition to comparing rates of recidivism based on completion status and program version, the study identified participant characteristics that decrease one s likelihood to recidivate: enrollment in the program, being older, having a higher level of educational attainment, being female or a minority, and having no prior history of DUI offenses.

15 152 A. A. Robertson et al. Our study is not without limitations. First, rearrest is an imperfect measure of DUI as many impaired driving events go undetected (Peck, Arstein- Kerslake, & Helander, 1994). However, official reports of DUI recidivism are the most commonly used outcome measure in DUI intervention program evaluations. A second limitation is the low rate of matching of court referral records with DUI arrest records. Our matching process yielded a matching rate of 28% due in part to the quality of the data reported on court order/ referral forms. This problem is inherent in working with archival data and is not specific to Mississippi (Frost, Phillips, Tollefson, & Werstak, 2006). To address some of the data issues for future studies, MASEP researchers will work closely with the Mississippi Office of Highway Safety to obtain DUI citation records annually and merge these records with court referral and MASEP assessment datasets on an ongoing basis. Despite these limitations, the overall impact size of 6.6% to 7.7% (the difference between 12-month and 36-month recidivism rates of individuals not exposed to MASEP and those who completed the program) are similar to findings in other studies of DUI intervention effectiveness (Wells-Parker & Bangert-Drowns, 1995). MASEP researchers will continue evaluating the program to identify areas with room for improvement. One such area is an examination of the psychometric properties and the predictive validity of newly implemented assessment instruments. MASEP participants are given personalized feedback based on their answers to the assessment measures. Personalized feedback has been shown to reduce alcohol consumption among heavy drinkers (Agnostinelli, Brown, & Miller, 1995; Hester, Squires, & Delaney, 2005) and is an essential component of brief motivational interventions aimed at reducing problem drinking (Miller & Sanchez, 1994). The RIASI is one of the MASEP assessment measures. Although the RIASI is an assessment instrument used in DUI intervention programs in New York State and in Ontario, Canada, there have been few published studies of the RIASI (Nochajski, Miller, Augustino, & Kramer, 1995; Nochajski, Miller, & Wieczorek, 1995; Shuggi, Mann, Zalcman, Chipperfield, & Nochajski, 2006) and additional cross-validation research is needed (Anderson et al., 2000; Chang, Gregory, & Lapham, 2002). Researchers will check the psychometric properties of the RIASI with Mississippi DUI offenders, determine the accuracy of the RIASI in identifying recidivists, and make revisions to the assessment and feedback process if necessary. REFERENCES Agnostinelli, G., Brown, J. M., & Miller, W. R. (1995). Effects of normative feedback on consumption among heavy drinking college students. Journal of Drug Education, 25, Ander sen, E. M., Malmgren, J. A., Carter, W. B., & Patrick, D. L. (1994). Screening for depression in well older adults: Evaluation of a short form of the CES-D. American Journal of Preventative Medicine, 10,

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