The effectiveness of Motivational Interviewing in secondary and tertiary prevention of alcohol-impaired driving: A systematic review of the documentation
Alcohol use is linked to approximately 30 % of all fatal traffic crashes. In many jurisdictions, evaluation and treatment programs for offenders are in place to reduce alcohol misuse and recidivism. Due to its brevity, Motivational Interviewing (MI) has captured the attention of the clinical community. This systematic review of the scientific literature examines the effectiveness of MI for secondary and tertiary prevention of driving while impaired by alcohol (DWI) in offenders and in drivers recruited from hospital settings following a traffic crash – with a specific focus directed at young drivers. Search of CINAHL, MEDLINE, PsychINFO and PubMed databases covering the 1983−2014 period identified 11 studies that described randomization to experimental and control groups. Bias in results was examined using the Cochrane Collaboration protocol. Meta-analysis was not appropriate given significant disparities between studies. Despite the limited number of studies (n = 6), the findings were judged promising for effectiveness in MI among recidivists and patients seen in hospital settings with alcohol problems. Four of these studies were evaluated to possess moderate or little methodological bias. Results were mixed in studies (n = 5) with young offenders and first-time DWI offenders in which problem alcohol use was not a recruitment inclusion criterion. Only one of these studies possessed little methodological bias. Additional randomized controlled trials conducted and reported according to the Consolidated Standards of Reporting Trials (CONSORT) Statement are needed to establish MI’s effectiveness in secondary and tertiary prevention of DWI in young drivers and first-time offenders. Confirmation is needed for its effectiveness in recidivists and injured patients recruited from hospital settings.