Publicized sobriety checkpoint programs: a community guide systematic review.

CONTEXT: Publicized sobriety checkpoint programs deter alcohol-impaired driving by stopping drivers systematically to assess their alcohol impairment. Sobriety checkpoints were recommended in 2001 by the Community Preventive Services Task Force for reducing alcohol-impaired driving, based on strong evidence of effectiveness. Since the 2001 review, attention to alcohol-impaired driving as a U.S. public health problem has decreased. This systematic review was conducted to determine if available evidence supports the effectiveness of publicized sobriety checkpoint programs in reducing alcohol-impaired driving, given the current context. The economic costs and benefits of the intervention were also assessed. EVIDENCE ACQUISITION: This review focused on studies that evaluated the effects of publicized sobriety checkpoint programs on alcohol-involved crash fatalities. Using Community Guide methods, a systematic search was conducted for studies published between July 2000 and March 2012 that assessed the effectiveness of publicized sobriety checkpoint programs. EVIDENCE SYNTHESIS: Fourteen evaluations of selective breath testing and one of random breath testing checkpoints met the inclusion criteria for the systematic review, conducted in 2012. Ten evaluations assessed the effects of publicized sobriety checkpoint programs on alcohol-involved crash fatalities, finding a median reduction of 8.9% in this crash type (interquartile interval=-16.5%, -3.5%). Five economic evaluations showed benefit-cost ratios ranging from 2:1 to 57:1. CONCLUSIONS: The number of studies, magnitude of effect, and consistency of findings indicate strong evidence of the effectiveness of publicized sobriety checkpoint programs in reducing alcohol-involved crash fatalities. Economic evidence shows that these programs also have the potential for substantial cost savings.

Moving toward the eradication of syphilis.

This study analyzed syphilis incidence among active duty U.S. Sailors and Marines and explored opportunities and strategies for the Department of the Navy to contribute to the achievement of the National Syphilis Elimination Plan. From 1987 through 1999, there were 1,886 cases of syphilis among active duty members reported to the Navy Environmental Health Center. Most were male (90%), younger than 30 years (81%), and black (64%). Most were diagnosed within the continental United States (79%). Incidence rates of primary and secondary syphilis per 100,000 among the active duty force declined steadily, from 37 in 1990 to 3 in 1999. Strategies suggested to further reduce syphilis among active duty members include the following: (1) Navy Medicine adoption and tracking of the national target of < 0.4 cases per 100,000 by 2005; (2) expand training of medical professionals in client-centered prevention counseling; (3) include affected populations in the design of interventions; (4) conduct outcome evaluations of educational interventions; (5) examine condom access policies; and (6) evaluate the current syphilis surveillance system.