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A QUESTION OF PRIORITIES — THE MAN OR THE METHOD?

A QUESTION OF PRIORITIES — THE MAN OR THE METHOD? COMMUNITY HEALTH STUDIES VOLUME IV, NUMBER 3, 1980 Anne Raymond Department of Community Medicine, St. Vincent’s Hospital, Fitzroy, Victoria A person whose drinking is causing trouble, and they are usually a private matter, less threatening to who continues to drink in the same way, will have the community at large. Nor do they kill people at the more trouble. rate of hundreds per year as does drinking driving. A statement of the obvious, perhaps, yet the relationship between the drinking and the trouble is St. Vincent’s Course not necessarily seen by the drinker. To him the trouble The Department of Community Medicine at St. is that the wife nags, the boss is cranky, the police are Vincent’s Hospital (Melbourne) decided to use out to get him, or he’s just unlucky. drink-driving convictions in young drivers as an When the luckless one is picked up for a opportunity to explain to them the risks of excessive drink-driving offence, his story usually starts with drinking, not only as it affects driving, but also as it “they said I was speeding” or “I was allegedly affects physical health and social relationships. weaving across the road”, or “I didn’t do anything With the co-operation of a few magistrates, a wrong, I just forgot to turn on the headlights”. It was program was established which has now been running “stiff I got caught”. If he managed tocatch himself by for 5 years. The first of its kind in Australia, it was hitting another vehicle or a pole, his answer to the started on a small scale as a pilot program, and has question “What happened‘?” almost invariably begins gradually increased in size and seemingly in effective- “It wasn’t my fault”. Again, he was just unlucky. The ness. It differs from similar overseas programs such as parked car he hit shouldn’t have been there. Such those in Phoenix, Arizona, United States of America dazzling displays of reasoning are one of the hallmarks and Alberta, Canada, in that it operates outside the of the drinker who is getting into trouble because of his court system and is not associated with law enforce- habit. ment authorities. Two other important differences are If one accepts that drink-driving crashes and that it is restricted to drivers under 26 years old, and convictions are not bad luck but alcohol-related works with them in small groups with a maximum of trouble, they can be seen as warning signals of a 15 in a group. The vast majority of drivers taking part damaging pattern of drinking, developing or already in the program are male, although the number of established. An opportunity exists, through hospitals females is gradually increasing. About I in 100 is and courts, to explain these warning signs to the female. The male predominance reflects the situation person at risk. If he has convinced himself that it was in the drink-driving population at large in which about “bad luck” that produced his predicament, there is no 98 per cent of apprehended drivers are male. reason for him to look carefully at what drinking is doing to his life, or to think about changing his drinking habits. He’ll just keep a more careful look out Aim and Structure for the police next time so they won’t catch him again. The aim of the course is to help drivers Working on this system of reasoning, I in 3 drivers understand more clearly the risks associated with convicted of a drink-driving offence will be recon- excessive drinking, especially when this is combined victed, and I in 7 will be convicted 3 times or more. with driving. The method which we use is to present to Some, of course, don’t survive to be reconvicted - drivers different views of the drink-driving problem, they go straight to the morgue. covering such aspects as: If one is looking for ways of preventing a the effect of alcohol on driving performance, hazardous drinking pattern from getting worse, a the association of raised blood alcohol level with drink-driving conviction provides an opportunity for raised crash risk, early intervention. Other troubles arising from drink-driving laws and penalties, and the factual drinking such as domestic difficulties or trouble at information on which these are based, work do not provide the same opportunity because how the Breathalyzer operates, RAYMOND 299 COMMUNITY HEALTH STUDIES physical effects of alcohol in the short and long becomes necessary, we decided to set up the St. term, and how one can become dependent, Vincent’s program within the existing framework. experiences and histories of people who have This allowed more flexibility and minimized red tape. become dependent and how they have learned to It also allowed the program to be tested for manage their problem. effectiveness before any attempt is made to build it The course consists of 4 two-hour sessions held into the system by means of legislation. There seemed one evening per week. The group leader takes the first little point in changing legislation if we could not show session and a doctor, a Breathalyzer operator and that the program was having a positive effect. young members of Alcoholics Anonymous speak to Operating within the existing system, which in the group in other sessions. At the end of the course a Victoria includes mandatory periods of disqualifica- certificate of attendance is given to the driver. No tion for drivers convicted of drink-driving offences, information about individuals is given to any outside meant that the course could not be used as a “soft authority. Our job is to inform the drivers, not the option” in sentencing. The driver could not escape the courts or police. Drivers are given this assurance at the consequences of his behaviour by making the gesture start of the course. of attending the course. In many cases the driver is delayed in getting his licence back because the magistrate requires him to attend before his licence is In setting up a course and a method of evaluation, restored when his disqualification is up. Many drivers there is a basic conflict of interest between the regard this as an added penalty. Hostility apparent at methodologist and the drivers. The methodologist the start of the course in these cases is almost would like to set up a controlled scientific experiment invariably dissipated before the end. in which drivers are randomly assigned to various In our planning stages the “soft option” or types of program, and results compared. Drivers may “diversionary” method of referral was discussed and regard any sort of program as an added penalty. They discarded because it could not be used within the feel that they have “paid their penalty, learned their existing legislation. With experience behind us, we lesson and it won’t happen again”, therefore there is would not contemplate changing to this system even if no need for them to attend a course. Calling it an it could be easily implemented. It seems an important “education” course or a “rehabilitation” course adds part of the learning process for drivers to experience to their resentment. Who wants to be rehabilitated or the consequences of their behaviour, rather than to educated? All the driver wants is to get his licence avoid them by manipulation of the system. back. Anyhow, his only problem is that he was A decision must also be made as to what, if any, unlucky. information should be given to authorities such as It is essential that this conflict of interest be courts and police. We decided that it would be resolved, consciously, in the early stages of planning impossible to gain the trust of the drivers if they because the priority of interest which is established thought we would be reporting on them to the courts. It will influence almost every aspect of the program. was decided that no information about individuals Which takes precedence - the man or the method of would be given to any outside body. The only assessment? Those who are running the program must identifiable information that goes out is a certificate be quite clear in their own minds whether they are given to the driver at the end of the course saying that trying to do something to the driver, (that is he has attended four sessions. The magistrate must rehabilitate him or change his behaviour) or whether decide whether or not the driver should be relicensed. they are trying to do somethingfor him (that is make He has to make this decision for all drivers applying available information which may enable him to see his for restoration of their licences, whether or not they behaviour from a different viewpoint and perhaps to have attended the course. Again, this reflects the make wiser decisions in the future). decision to operate within the existing system of At St. Vincent’s we were convinced from the legislation and court procedure. We make no attempt start that we would have to place the drivers’ interests to influence the magistrate’s decision; and we make no first, and then work out a method of evaluation. Our promise to the driver that he will be relicensed. view was that if the drivers felt that the course was being run for the benefit of authorities or researchers, Evaluation In planning a method of evaluating the effective- it would not succeed. Research methodology would have to be adapted to the needs of the drivers, rather ness of the course, the conflict of interest between the than the reverse. We have had no reason to regret this driver and the scientist comes to the fore. From a decision. scientific point of view it would be. nice to run a tightly Another basic decision which must be made in controlled experiment where drivers in each group are the planning stages is whether the program is to subjected to the same input of information and tested operate, initially, within the existing system of before and after to see how much has been retained. It conviction and sentencing in the courts or whether would also be nice to be able to contact the driver at changes in legislation are required. intervals after completion of the course to find out how As legislative changes tend to be slow and he is getting on and whether his drinking andor cumbersome and are not easy to alter if further change driving habits have altered. COMMUNITY HEALTH STUDIES RAYMOND If the drivers’ interests are given priority over were 25 years or under in this sample were checked in those of the scientist, this tightly controlled methodol- Motor Registration Branch records in 1977, giving a ogy becomes impossible. While the same basic 10 year follow-up of their traffic conviction records. information may be presented to each group, the style The second control group was selected from of presentation and the emphasis will vary consider- Breathanalysis Squad records for the month of ably according to the needs of the group. Questions November 1973. A consecutive series of all drivers 25 and misunderstandings differ from one group to the or under who were convicted as a result of the breath next. While one group may accept without question test, who had a metropolitan address and whose that alcohol impairs driving performance, they will records could be found at the Motor Registration want to argue about the accuracy of the Breathalyzer. Branch have been followed up for a five year period. The next group may be just the opposite. It is Drivers from both samples who attended the drivers’ impossible to deal satisfactorily with both situations if course were excluded from the control groups. the format is to be rigidly controlled. A constantly All drivers who booked to attend the course have changing array of visiting speakers as we have at St. been followed up at the Motor Registration Branch. Vincent’s precludes strict uniformity of presentation. Updating records of “course drivers” and controls to the end of 1978 involved a hand search of close to In the interests of science it would be nice to 2,000 drivers’ records. Comparison of reconviction collect by means of questionnaires a lot of data which rates of course drivers and controls is being carried out could be analysed to show whether changes had using a Life Table method that has been modified to occurred in knowledge and attitude of the drivers. allow for more than one reconviction to be taken into However, filling in questionnaires is of no interest or account. benefit to the driver, therefore is a waste of his time A study of the time between the first and second especially as the total time available for each group is drink-driving conviction in those who had two only eight hours. Time spent on activities which the convictions before attending the course, and those in drivers regard as pointless must be limited. For those the control groups, shows that the highest risk of who are semi-literate or illiterate, the task of reconviction occurs within 6 months of the first. and answering questionnaires can be quite threatening. that 80 per cent of reconvictions occur within 3 years Illiteracy is a very real problem among drivers of the first. It would seem, therefore, that if course attending these courses. drivers show a lower rate of reconviction than the Added to these difficulties with paperwork, there controls in the three years following the course, there is the suspicion among many of the drivers that, in is strong evidence to suggest that the course is having a spite of assurances to the contrary, in some way the worthwhile effect. Detailed analysis of results is still information will be used against them. They may not underway but indications are that the reconviction rate believe that it does not go to outside authorities. This is lower over this critical 3 year period amongst those suspicion limits to some degree the questions which who have done the course. can be asked. For instance, it is unlikely that accurate information about use of drugs other than alcohol or Drawbacks and Difficulties tobacco could be obtained. The same would apply to One of the drawbacks of this method of questions about driving while disqualified. While evaluation is that it counts only the “failures” - drivers may discuss these activities in the group, it is those who are reconvicted for a drink-driving offence. unlikely that they would record the information on It is an indirect and somewhat insensitive method of paper. assessing changes in drinking and/or driving be- Given these problems in evaluating the program, haviour. However, if course drivers show a lower two types of assessment have been used. One which is reconviction rate on the road, it may be that they have immediate and unscientific, is to ask the drivers at the had fewer alcohol-related problems in other areas of end of the course what they thought of it. The second, their lives also. In other words, the benefit may be more scientific but slower in providing feedback, is to even greater than is reflected by their driving records. compare the reconviction records of course drivers While the wider benefit cannot be measured, with those of control groups who did not attend. We anecdotal evidence suggests it exists. have used both methods of monitoring effectiveness. A limited attempt was made to contact drivers a The response of drivers completing the course year after they completed the course. About 15-20 per has, with few exceptions, been very favourable. Had it cent of the letters were returned “address unknown”. not been, it is unlikely that we would have persevered Further attempts did not seem warranted as only two with it long enough to test results by the more drivers actually replied. Problems of literacy again scientific method. arise in this type of follow-up. While there may be more ideal methods of Comparison with Controls evaluation, theoretically, what must be done is what is Two control groups have been used for compari- possible, given the limitations of one pair of hands and son. One is a sample of drivers selected for an earlier a shoestring budget. (Staff for the drivers’ course study of breathalyzed drivers. It consists of drivers consists of one full-time co-ordinator and one breathalyzed in Melbourne in 1967. The drivers who part-time group leader). RAYMOND 30 1 COMMUNITY HEALTH STUDIES No matter how carefully one tries to control the Conclusion methodology, there are always elements of the system In planning, running and evaluating a program which are beyond control. For example, magistrates such as the course for young drinking drivers at St. differ in their practices of refemng drivers to the Vincent’s, we believe there must be one over-riding course. Some refer all under 26 year old drinking principle - the interests of drivers must take drivers coming through the courts as a matter of precedence over the interests of methodologists. The routine. Others refer those whom they consider at high man comes before the method. We are dealing with risk of committing further offences. Where magis- people who have got into trouble because of their trates are using their discretion as opposed to routine drinking on at least one occasion, not subjects in an referral, it is certain that the “hard” cases are the ones experiment. sent to the course, not those considered to have low If the drink-driving problem is to be reduced (it risk of re-offending. will never be “solved”) it must be approached from the point of view of the drivers who constitute the Even if magistrates were to use a uniform method problem. Drivers are people, not things, and do not of referral according to strict scientific methods, there readily conform to rigid and strictly controlled would still be the problem of self-referral. If a driver is research methods. Nor do magistrates. sufficiently motivated to enrol for the course of his There will always be a gap between the ideal own volition, strict methodology would exclude him. program and the possible. One can attempt to narrow This would be contradictory to the long term aim of the the gap but it must be kept in mind that drinking- program which is to foster responsible behaviour in driving is not a statistical problem, it is a human drinking and driving. problem and can only be dealt with in human terms. Another example of factors which cannot be There may be a greater chance of success for a controlled by the researcher are changes in legislation, program which explores what is possible in the real asoccurred in Victoria in December 1978. Fortunately life situation, and devises a method of assessing this happened at the end of the year and will not results, rather than in one which attempts to impose a influence results in the period under observation. “sophisticated research design” on the real world. RAYMOND COMMUNITY HEALTH STUDIES http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Australian and New Zealand Journal of Public Health Wiley

A QUESTION OF PRIORITIES — THE MAN OR THE METHOD?

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Wiley
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"Copyright © 1980 Wiley Subscription Services, Inc., A Wiley Company"
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1326-0200
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1753-6405
DOI
10.1111/j.1753-6405.1980.tb00722.x
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Abstract

COMMUNITY HEALTH STUDIES VOLUME IV, NUMBER 3, 1980 Anne Raymond Department of Community Medicine, St. Vincent’s Hospital, Fitzroy, Victoria A person whose drinking is causing trouble, and they are usually a private matter, less threatening to who continues to drink in the same way, will have the community at large. Nor do they kill people at the more trouble. rate of hundreds per year as does drinking driving. A statement of the obvious, perhaps, yet the relationship between the drinking and the trouble is St. Vincent’s Course not necessarily seen by the drinker. To him the trouble The Department of Community Medicine at St. is that the wife nags, the boss is cranky, the police are Vincent’s Hospital (Melbourne) decided to use out to get him, or he’s just unlucky. drink-driving convictions in young drivers as an When the luckless one is picked up for a opportunity to explain to them the risks of excessive drink-driving offence, his story usually starts with drinking, not only as it affects driving, but also as it “they said I was speeding” or “I was allegedly affects physical health and social relationships. weaving across the road”, or “I didn’t do anything With the co-operation of a few magistrates, a wrong, I just forgot to turn on the headlights”. It was program was established which has now been running “stiff I got caught”. If he managed tocatch himself by for 5 years. The first of its kind in Australia, it was hitting another vehicle or a pole, his answer to the started on a small scale as a pilot program, and has question “What happened‘?” almost invariably begins gradually increased in size and seemingly in effective- “It wasn’t my fault”. Again, he was just unlucky. The ness. It differs from similar overseas programs such as parked car he hit shouldn’t have been there. Such those in Phoenix, Arizona, United States of America dazzling displays of reasoning are one of the hallmarks and Alberta, Canada, in that it operates outside the of the drinker who is getting into trouble because of his court system and is not associated with law enforce- habit. ment authorities. Two other important differences are If one accepts that drink-driving crashes and that it is restricted to drivers under 26 years old, and convictions are not bad luck but alcohol-related works with them in small groups with a maximum of trouble, they can be seen as warning signals of a 15 in a group. The vast majority of drivers taking part damaging pattern of drinking, developing or already in the program are male, although the number of established. An opportunity exists, through hospitals females is gradually increasing. About I in 100 is and courts, to explain these warning signs to the female. The male predominance reflects the situation person at risk. If he has convinced himself that it was in the drink-driving population at large in which about “bad luck” that produced his predicament, there is no 98 per cent of apprehended drivers are male. reason for him to look carefully at what drinking is doing to his life, or to think about changing his drinking habits. He’ll just keep a more careful look out Aim and Structure for the police next time so they won’t catch him again. The aim of the course is to help drivers Working on this system of reasoning, I in 3 drivers understand more clearly the risks associated with convicted of a drink-driving offence will be recon- excessive drinking, especially when this is combined victed, and I in 7 will be convicted 3 times or more. with driving. The method which we use is to present to Some, of course, don’t survive to be reconvicted - drivers different views of the drink-driving problem, they go straight to the morgue. covering such aspects as: If one is looking for ways of preventing a the effect of alcohol on driving performance, hazardous drinking pattern from getting worse, a the association of raised blood alcohol level with drink-driving conviction provides an opportunity for raised crash risk, early intervention. Other troubles arising from drink-driving laws and penalties, and the factual drinking such as domestic difficulties or trouble at information on which these are based, work do not provide the same opportunity because how the Breathalyzer operates, RAYMOND 299 COMMUNITY HEALTH STUDIES physical effects of alcohol in the short and long becomes necessary, we decided to set up the St. term, and how one can become dependent, Vincent’s program within the existing framework. experiences and histories of people who have This allowed more flexibility and minimized red tape. become dependent and how they have learned to It also allowed the program to be tested for manage their problem. effectiveness before any attempt is made to build it The course consists of 4 two-hour sessions held into the system by means of legislation. There seemed one evening per week. The group leader takes the first little point in changing legislation if we could not show session and a doctor, a Breathalyzer operator and that the program was having a positive effect. young members of Alcoholics Anonymous speak to Operating within the existing system, which in the group in other sessions. At the end of the course a Victoria includes mandatory periods of disqualifica- certificate of attendance is given to the driver. No tion for drivers convicted of drink-driving offences, information about individuals is given to any outside meant that the course could not be used as a “soft authority. Our job is to inform the drivers, not the option” in sentencing. The driver could not escape the courts or police. Drivers are given this assurance at the consequences of his behaviour by making the gesture start of the course. of attending the course. In many cases the driver is delayed in getting his licence back because the magistrate requires him to attend before his licence is In setting up a course and a method of evaluation, restored when his disqualification is up. Many drivers there is a basic conflict of interest between the regard this as an added penalty. Hostility apparent at methodologist and the drivers. The methodologist the start of the course in these cases is almost would like to set up a controlled scientific experiment invariably dissipated before the end. in which drivers are randomly assigned to various In our planning stages the “soft option” or types of program, and results compared. Drivers may “diversionary” method of referral was discussed and regard any sort of program as an added penalty. They discarded because it could not be used within the feel that they have “paid their penalty, learned their existing legislation. With experience behind us, we lesson and it won’t happen again”, therefore there is would not contemplate changing to this system even if no need for them to attend a course. Calling it an it could be easily implemented. It seems an important “education” course or a “rehabilitation” course adds part of the learning process for drivers to experience to their resentment. Who wants to be rehabilitated or the consequences of their behaviour, rather than to educated? All the driver wants is to get his licence avoid them by manipulation of the system. back. Anyhow, his only problem is that he was A decision must also be made as to what, if any, unlucky. information should be given to authorities such as It is essential that this conflict of interest be courts and police. We decided that it would be resolved, consciously, in the early stages of planning impossible to gain the trust of the drivers if they because the priority of interest which is established thought we would be reporting on them to the courts. It will influence almost every aspect of the program. was decided that no information about individuals Which takes precedence - the man or the method of would be given to any outside body. The only assessment? Those who are running the program must identifiable information that goes out is a certificate be quite clear in their own minds whether they are given to the driver at the end of the course saying that trying to do something to the driver, (that is he has attended four sessions. The magistrate must rehabilitate him or change his behaviour) or whether decide whether or not the driver should be relicensed. they are trying to do somethingfor him (that is make He has to make this decision for all drivers applying available information which may enable him to see his for restoration of their licences, whether or not they behaviour from a different viewpoint and perhaps to have attended the course. Again, this reflects the make wiser decisions in the future). decision to operate within the existing system of At St. Vincent’s we were convinced from the legislation and court procedure. We make no attempt start that we would have to place the drivers’ interests to influence the magistrate’s decision; and we make no first, and then work out a method of evaluation. Our promise to the driver that he will be relicensed. view was that if the drivers felt that the course was being run for the benefit of authorities or researchers, Evaluation In planning a method of evaluating the effective- it would not succeed. Research methodology would have to be adapted to the needs of the drivers, rather ness of the course, the conflict of interest between the than the reverse. We have had no reason to regret this driver and the scientist comes to the fore. From a decision. scientific point of view it would be. nice to run a tightly Another basic decision which must be made in controlled experiment where drivers in each group are the planning stages is whether the program is to subjected to the same input of information and tested operate, initially, within the existing system of before and after to see how much has been retained. It conviction and sentencing in the courts or whether would also be nice to be able to contact the driver at changes in legislation are required. intervals after completion of the course to find out how As legislative changes tend to be slow and he is getting on and whether his drinking andor cumbersome and are not easy to alter if further change driving habits have altered. COMMUNITY HEALTH STUDIES RAYMOND If the drivers’ interests are given priority over were 25 years or under in this sample were checked in those of the scientist, this tightly controlled methodol- Motor Registration Branch records in 1977, giving a ogy becomes impossible. While the same basic 10 year follow-up of their traffic conviction records. information may be presented to each group, the style The second control group was selected from of presentation and the emphasis will vary consider- Breathanalysis Squad records for the month of ably according to the needs of the group. Questions November 1973. A consecutive series of all drivers 25 and misunderstandings differ from one group to the or under who were convicted as a result of the breath next. While one group may accept without question test, who had a metropolitan address and whose that alcohol impairs driving performance, they will records could be found at the Motor Registration want to argue about the accuracy of the Breathalyzer. Branch have been followed up for a five year period. The next group may be just the opposite. It is Drivers from both samples who attended the drivers’ impossible to deal satisfactorily with both situations if course were excluded from the control groups. the format is to be rigidly controlled. A constantly All drivers who booked to attend the course have changing array of visiting speakers as we have at St. been followed up at the Motor Registration Branch. Vincent’s precludes strict uniformity of presentation. Updating records of “course drivers” and controls to the end of 1978 involved a hand search of close to In the interests of science it would be nice to 2,000 drivers’ records. Comparison of reconviction collect by means of questionnaires a lot of data which rates of course drivers and controls is being carried out could be analysed to show whether changes had using a Life Table method that has been modified to occurred in knowledge and attitude of the drivers. allow for more than one reconviction to be taken into However, filling in questionnaires is of no interest or account. benefit to the driver, therefore is a waste of his time A study of the time between the first and second especially as the total time available for each group is drink-driving conviction in those who had two only eight hours. Time spent on activities which the convictions before attending the course, and those in drivers regard as pointless must be limited. For those the control groups, shows that the highest risk of who are semi-literate or illiterate, the task of reconviction occurs within 6 months of the first. and answering questionnaires can be quite threatening. that 80 per cent of reconvictions occur within 3 years Illiteracy is a very real problem among drivers of the first. It would seem, therefore, that if course attending these courses. drivers show a lower rate of reconviction than the Added to these difficulties with paperwork, there controls in the three years following the course, there is the suspicion among many of the drivers that, in is strong evidence to suggest that the course is having a spite of assurances to the contrary, in some way the worthwhile effect. Detailed analysis of results is still information will be used against them. They may not underway but indications are that the reconviction rate believe that it does not go to outside authorities. This is lower over this critical 3 year period amongst those suspicion limits to some degree the questions which who have done the course. can be asked. For instance, it is unlikely that accurate information about use of drugs other than alcohol or Drawbacks and Difficulties tobacco could be obtained. The same would apply to One of the drawbacks of this method of questions about driving while disqualified. While evaluation is that it counts only the “failures” - drivers may discuss these activities in the group, it is those who are reconvicted for a drink-driving offence. unlikely that they would record the information on It is an indirect and somewhat insensitive method of paper. assessing changes in drinking and/or driving be- Given these problems in evaluating the program, haviour. However, if course drivers show a lower two types of assessment have been used. One which is reconviction rate on the road, it may be that they have immediate and unscientific, is to ask the drivers at the had fewer alcohol-related problems in other areas of end of the course what they thought of it. The second, their lives also. In other words, the benefit may be more scientific but slower in providing feedback, is to even greater than is reflected by their driving records. compare the reconviction records of course drivers While the wider benefit cannot be measured, with those of control groups who did not attend. We anecdotal evidence suggests it exists. have used both methods of monitoring effectiveness. A limited attempt was made to contact drivers a The response of drivers completing the course year after they completed the course. About 15-20 per has, with few exceptions, been very favourable. Had it cent of the letters were returned “address unknown”. not been, it is unlikely that we would have persevered Further attempts did not seem warranted as only two with it long enough to test results by the more drivers actually replied. Problems of literacy again scientific method. arise in this type of follow-up. While there may be more ideal methods of Comparison with Controls evaluation, theoretically, what must be done is what is Two control groups have been used for compari- possible, given the limitations of one pair of hands and son. One is a sample of drivers selected for an earlier a shoestring budget. (Staff for the drivers’ course study of breathalyzed drivers. It consists of drivers consists of one full-time co-ordinator and one breathalyzed in Melbourne in 1967. The drivers who part-time group leader). RAYMOND 30 1 COMMUNITY HEALTH STUDIES No matter how carefully one tries to control the Conclusion methodology, there are always elements of the system In planning, running and evaluating a program which are beyond control. For example, magistrates such as the course for young drinking drivers at St. differ in their practices of refemng drivers to the Vincent’s, we believe there must be one over-riding course. Some refer all under 26 year old drinking principle - the interests of drivers must take drivers coming through the courts as a matter of precedence over the interests of methodologists. The routine. Others refer those whom they consider at high man comes before the method. We are dealing with risk of committing further offences. Where magis- people who have got into trouble because of their trates are using their discretion as opposed to routine drinking on at least one occasion, not subjects in an referral, it is certain that the “hard” cases are the ones experiment. sent to the course, not those considered to have low If the drink-driving problem is to be reduced (it risk of re-offending. will never be “solved”) it must be approached from the point of view of the drivers who constitute the Even if magistrates were to use a uniform method problem. Drivers are people, not things, and do not of referral according to strict scientific methods, there readily conform to rigid and strictly controlled would still be the problem of self-referral. If a driver is research methods. Nor do magistrates. sufficiently motivated to enrol for the course of his There will always be a gap between the ideal own volition, strict methodology would exclude him. program and the possible. One can attempt to narrow This would be contradictory to the long term aim of the the gap but it must be kept in mind that drinking- program which is to foster responsible behaviour in driving is not a statistical problem, it is a human drinking and driving. problem and can only be dealt with in human terms. Another example of factors which cannot be There may be a greater chance of success for a controlled by the researcher are changes in legislation, program which explores what is possible in the real asoccurred in Victoria in December 1978. Fortunately life situation, and devises a method of assessing this happened at the end of the year and will not results, rather than in one which attempts to impose a influence results in the period under observation. “sophisticated research design” on the real world. RAYMOND COMMUNITY HEALTH STUDIES

Journal

Australian and New Zealand Journal of Public Health – Wiley

Published: Jul 1, 1980

There are no references for this article.