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Table 1 Studies included based on eligibility criteria: studies with no increases in enforcement activities or with statistical models to account for those increases

From: A systematic review: effectiveness of mass media campaigns for reducing alcohol-impaired driving and alcohol-related crashes

Author, Year (study period) Objective, Design, Evaluation setting Intervention Details: Scope (national, state, community) Message theme (tagline) Delivery method Cost Other details Results/Other Information Summary value Follow-up period
Whittam 2006 [18] Objective: Assess the potential impact of public-service assessments on young drivers between the ages of 16 and 19 years All crashes among 16–19 year olds Net change in serious-injury crashes among 16–19 year olds: 18.3 % decrease 4.5 months
 CITS, 1994–1999
 Intervention period: Aug 15–Dec 31, 1996 (excluding Oct)
Intervention site:
 Intervention sites: Kingsport, Johnson City, and Bristol, Tennessee • 21.6 % reduction during the intervention period (p < 0.05)
 Comparator sites: Hamilton County
Mass media: Paid television and radio announcements, billboard display Comparator site:
• 3.2 % increase in crashes (p = 0.61)
Net difference:
• 24.8 %
Serious-injury crashes among 16–19 year olds
Intervention site:
• 16.4 % decrease (p = 0.19)
Comparator site:
• 1.9 % increase (p = 0.17)
Net difference: 18.3 %
Murry 1993 [19] Objective: Evaluate an anti-drinking and driving advertising campaign targeting 15–24 year olds. Nighttime fatal and incapacitating accidents for 15–24 yo males and females (intervention site: −7.14 %, comparator: +11.8 %, p = 0.06) Net change −18.9 % (p = 0.05) 6 months
 Jan 1983–Sept 1987, monthly CITS
 Intervention: Wichita, Kansas, USA
 Comparator: Omaha, Nebraska, USA Mass media: 6-month paid media schedule using television, radio, newspapers, and billboards
Newstead 1995 [20] Objective: Evaluate various safety measures implemented starting Sept 1989 in Victoria, Australia. Contribution of drink-driving publicity in reducing nighttime serious casualty crashes: approximately 14 % (average of 1990–1992) Reduction of nighttime serious casualty crashes in Victoria from 1990 to 1992 was 14 % 3 years
 1983–1992
 ITS
 Intervention: Victoria, Australia
 Comparator: None
Mass Media:
TV advertising, Dec 1989 to Dec 1992, radio, press, outdoor advertising, Sky Channel and cinema Statistically significant in Victoria (p < 0.05), but not in Melbourne crashes (p = 0.07)
Enforcement: Random breath testing, lowering of freeway speed limit, speed cameras
Tay 2002 [21] Objective: Evaluate New Zealand’s Supplementary Road Safety Package initiated by Land Transport Safety Authority in 1995 Estimated impact of the advertising campaign on the number of fatal crashes using regression model: Estimated impact of advertising campaign on the number of fatal crashing has no impact on the target population (male 15–34 years old) 2 years
 ITS, 1988–1996 (108 observations)
 Intervention site: New Zealand
 Comparator site: None
• Male drivers between 35 and 54: 29.91 % decrease
• Female drivers between 15 and 24: 40.21 %
• Female drivers between 25 and 34: 70.04 %
Media campaign: TV, mainly targeting
• No impact on young male drivers (15–34)
18–24 year olds
Enforcement: Estimated impact of the program before and after implementation of the campaign:
Speed cameras, advanced speed detectors, compulsory breath testing
• Male drivers: −32.9 % (15–24yo) to +4.7 % (55 years and older)
Female drivers: −56.8 % (25–34 %) to −26.7 % (55 years and older)
Jones 2005 [22] Objective: Evaluate “Smart Roads” program in Pueblo, Colorado aimed at drivers aged 21–34. Nighttime injury crashes decreased by 39 % in the intervention counties, whereas it increased by 3.3 % in the control counties (p < 0.0001) Nighttime single-vehicle crashes: net change 28.8 % 4 years
 Before: 1998 to 1999
 After: 2000 to 2001
 CBA
 Intervention group: Pueblo county (intervention site) plus eight other low-population surrounding counties Mass media:
Television, radio, and newspaper advertisements, billboards, bumper stickers, bus station banners, other collaterals) Nighttime single-vehicle crashes decreased by 24.8 % in the intervention counties, whereas there was a 4.0 % increase in the control counties (p = 0.01)
 Comparison: all other counties in Colorado Workplace initiative education program.
Epperlein 1987 [29] Objective: Evaluate the effect of crackdown on drinking drivers in Arizona Impact estimates of the anti-drunk-driving publicity campaigns of March, 1982 Nighttime fatal crashes (net change): −16.2 % 22 months
 March 1972-Dec 1983 ITS
 Intervention site: Arizona, USA Mass media: • Nighttime fatal crashes −26.8 % (pre-intervention mean/month. 724)
Television, print, and radio advertisements, billboards, posters, bumper stickers (March 1982)
 Comparator site: None (daytime crashes and crashes with no identified drinking drivers used for comparison)
• Daytime fatal crashes −10.6 % (pre-intervention mean/month. 1633)
Enforcement:
Stricter DWI legislation Increasing the minimum drinking age (August 1982)
Net change: −16.2 %
• Drinking drivers in crashes −14.0 % (pre-intervention mean/month. 1036)
• Non-drinking drivers in crashes −0.8 % (pre-intervention mean/month. 11345)
Net change: 13.2 %
Zampetti 2013 [34] Objective: To verify the effect of intensive vs. basic road safety education programs on the incidence and severity of nonfatal road injuries (NFRTI) The number of NFRTI Difference in incidence of NFRTI in the basic site: −0.04 % (p = 0.05) 5 years
 Before: Jun–Aug 2003 • Before: 907,
 After: Jun–Aug 2008 After: 755
 CBA Incidence of injuries in the basic campaigns (8 municipalities)
 Intervention period: 2003–2008
 Intervention sites: 20 municipalities in the Local Health Authority 1 (LHA1) area in Campania, Italy Publicity campaigns: Billposting on public transport, bus stops, train stations, in bars and meeting places. Dispatch of brochures, pamphlets, and posters • Difference in incidence of injuries −0.4 per 1,000 (2003 (before) 1.1, 2008 (after) 0.7)
 No comparator site
Mass media: press conferences, articles in local papers, radio/television interviews, and the LHA1 web site • Incidence of injuries in the intensive campaigns (12 municipalities)
Sites for intensified approach (12 out of 20 municipalities): • Difference −0.5 per 1,000; p < 0.001
School campaigns and community conferences, 1-day conference at the end of school year
Worden 1975 (Elder) [35] Objective: Evaluate Vermont public education campaign on alcohol and highway safety The proportion of “high-risk” male drivers (those who report consuming three or more drinks at least once a week) above 0.05 g/dL BAC: Drivers above 0.05 g/dL BAC: −158 % 24 months
 May 1972–May 1974
 CBA
 Intervention site: Vermont Mass media: Radio, TV, drive-in theater spots. Fatal crashes: 0 %
 Comparison site: counties with no intervention • At mid-campaign (May, 1973) decreased 37 % from a baseline of 10 of 48 drivers to 9 of 69 (95 % CI: −72 % ~ +42 %; net change = −158 %)
Enforcement: Stayed high throughout the study period
• Immediately following the campaign (May, 1974) decreased 67 % (95 % CI: −88 % ~ −7 %; net change −111 %)
The proportion of had-been-drinking to total fatal crashes decreased 6 % from a baseline of 9 of 20 to 8 of 19 (95 % CI: −54 % ~ +91 %; net change 0 %)
*Very small sample sizes
Cameron 1998 (Elder) [36] Objective: Evaluation of the first two years of the New Zealand Supplementary Road Safety Package that was introduced in 1995/1996 (supplements CBT and speed camera programs introduced in 1993) In 1996–1997, campaign estimated to result in: Injury crashes 24 months
 Jan 1990–June 1997, quarterly Arm 1 (Urban): −7 %
 CITS
 Intervention: New Zealand (crashes during high alcohol consumption hours) • A 33 % decrease in urban high alcohol hour serious injury crashes (95 % CI: −40 % ~ −25 %; net change = −7 %) Arm 2 (Rural): −18 %
 Comparator: New Zealand (crashes during low alcohol consumption hours)
Mass media: primarily TV advertising campaigns • A 32 % decrease in rural high alcohol hour serious injury crashes (95 % CI: −41 % ~ −22 %; net change = −18 %)
Enforcement: Sobriety checkpoint
In 1995–1996, campaign estimated to result in:
• A 16 % decrease in urban high alcohol hour serious injury crashes (95 % CI: −24 ~ −6 %; net change = −2 %)
A 6 % decrease in rural high alcohol hour serious injury crashes (95 % CI: −18 % ~ −7 %; net change = −5 %)
  1. BAC Blood Alcohol Concentration, CBA Controlled Before-After, CBT Compulsory Breath Testing, CI Confidence Interval, CITS Controlled Interrupted Time Series, DWI Driving While Intoxicated, ITS Interrupted Time Series, LHA Local Health Authority, NFRTI Nonfatal Road Injuries, NHTSA National Highway Traffic Safety Administration, TV, Television, USA United States of America