CARS Development History


Following the 2013 usability trials, a full implementation study was completed in 2015 among first offenders and repeat offenders in two Massachusetts-based DUI treatment programs. The randomized control trials (RCTs) assessed the usability of the comprehensive CARS instrument along with two shorter versions (i.e., screeners). Data analyses from these implementation trials validated the self-administered CARS screener, interviewer-administered CARS screener, and comprehensive CARS assessment as effective instruments for screening and assessing impaired drivers. The RCTs also found:
Continued evidence of co-morbidity in the repeat DUI population, particularly anxiety-related disorders.
Full CARS provides diagnostic information.
Screening results did not differ significantly by condition, with the exception of conduct disorder among DUI offenders in the self-administered trial setting.
CARS screener does a very good job of identifying substance use disorders.
Results from the self-administered screener do not differ fundamentally from those for the interviewer-administered screener.
In October 2015, Dr. Howard Shaffer, lead researcher and the Dr. Morris E. Chafetz Professor in Psychiatry in the Field of Behavioral Sciences at Harvard Medical School and Dr. Sarah Nelson, Associate Director of Research, Harvard Medical School, Division on Addiction, The Cambridge Health Alliance, presented the preliminary results of the implementation trials of the CARS tool to the National Highway Traffic Safety Administration (NHTSA) and the National Institute on Alcohol Abuse and Alcoholism (NIAAA). More recent results were presented at the National Association of Drug Court Professionals (NADCP) Training Conference in the summer of 2016:

Pilot Testing

In 2016, supported the implementation of CARS at six pilot sites across the country. The sites were chosen after a thorough selection process which sought to identify programs that represent a variety of different criminal justice models (e.g., DUI Courts, traditional probation, intensive supervision, etc.) and have an established history of utilizing innovative practices. Also of importance, the following sites offered an opportunity to implement CARS in both urban and rural locales:
IMPACT DWI Program (Milwaukee, WI)
Isanti County probation; Judge James Dehn (Cambridge, MN)
Lackawanna/Susquehanna Office of Drug and Alcohol Programs; Judge Michael Barrasse (Scranton, PA)
Laramie County DUI Court (Cheyenne, WY)
San Joaquin County Monitoring Court Program; Judge Richard Vlavianos (Stockton, CA)
South St. Louis County DWI Court and probation; Judge Shaun Floerke (Duluth, MN)
The information collected from the pilots has been instrumental in identifying ways to improve the efficiency of the CARS assessment and will inform the development of online training materials. A report that summarizes the experience of the pilot sites and provides CARS implementation recommendations will be available in March 2017.