Background
Objectives
Methods
Eligibility criteria
Search strategy
Study selection
Data collection process and data items
Summarizing outcome measures
Summary effects measures calculation
Assessment of risk bias
Results
Study selection
Study characteristics
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 %) |
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 |
---|---|---|---|---|
Fell 2008 [23] | Objective: Evaluate the impaired-driving demonstration projects conduced in 7 states. | Indicators relative to surrounding states | Compared to surrounding states, Georgia, Tennessee, Indiana, Michigan had statistically significant decreases in the Ratio, whereas in some States (Louisiana, Texas), there were increases in the Ratio. | 12–18 months |
CITS | Ratio: ratio of drinking drivers (BAC > =0.01) to nondrinking drivers (BAC = 0.00) in fatal crashes | |||
2000–2003 | ||||
7 selected states in the US (Georgia, Louisiana, Pennsylvania, Tennessee, Texas, Indiana, and Michigan) | Use of paid media (+/− earned media): | |||
Georgia, Louisiana, Tennessee, Texas, Indiana, Michigan | VMT: alcohol-related fatalities (driver or pedestrian total BAC > 0.01) per 100 million | |||
Sobriety checkpoints: | ||||
VMT | ||||
Comparator (within-state comparison: Georgia, Tennessee, Michigan; neighboring states: selected nearby states, pooled; the rest of the nation, pooled). | Georgia, Louisiana, Pennsylvania, Tennessee, Indiana | Georgia: | ||
Saturation patrols: | ||||
Louisiana, Tennessee, Indiana, Michigan | ||||
Community education/partnership: | ||||
Pennsylvania, Michigan | ||||
Ratio: −14 % (p < 0.05), VMT −5 % | ||||
Louisiana: | ||||
Ratio: 1 %, VMT15% (p < 0.05) | ||||
Pennsylvania: | ||||
Ratio: −9 %, VMT: −2 % | ||||
Tennessee: | ||||
Ratio: −11 %(p < 0.035), VMT: 1 % | ||||
Indiana: | ||||
Ratio: −13 %(p < 0.018), VMT: −20 % (p < 0.002) | ||||
Michigan: | ||||
Ratio: −14 % (p < 0.07), VMT −18 % (p < 0.003) | ||||
Texas: | ||||
Ratio: 3 %, VMT: 5 % | ||||
Zwicker 2007a [24] | Objective: Evaluate the effect of the National Highway Traffic Safety Administration impaired driving high-visibility enforcement model in 2002 in West Virginia | Alcohol-related fatalities in targeted counties: reduction of 0.99 lives each month. - 24 % (p = 0.01) | Alcohol-related fatalities in targeted counties: − 24 % (p = 0.012) | 18 months |
CITS | ||||
2000–2004, monthly | ||||
Alcohol-related fatalities in targeted countries for men 21–34yo: reduction of 0.09 lives per month (p = 0.79) | ||||
Intervention period: July 2003- Dec 2004 | ||||
Comparison period: Jan 2000- June 2003 | Mass Media: | |||
Paid media (TV) | ||||
Intervention site: 6 counties in West Virginia | Enforcement: | Statewide alcohol-related fatality trend: reduction of 1.6 fatalities per month (p = 0.20) | ||
Sobriety checkpoints, saturation patrols | ||||
Comparator site: 49 non-targeted counties | ||||
Zwicker 2007b [25] | Objective: Evaluate Connecticut’s statewide impaired-driving publicity and enforcement campaign | The overall alcohol-related fatality trend for the State: | Net change in alcohol-related fatalities in the state: −36.4 % | 18 months |
CITS | ||||
Jan 2000- Dec 2004, monthly | Estimated reduction of 2.604 lives each month (p = 0.01) for the 18 mo. following the beginning of the campaign (Net change: lives saved during 18 mo., 36.4 % decrease) | |||
Net change in alcohol-related fatalities among men 21–34 years old: −29.7 % | ||||
Intervention phase: July 2003- Dec 2004, Comparison phase: Jan 2000- June 2003 | Mass media: | |||
Paid and earned media targeting men 18–34 years old | ||||
Enforcement: | ||||
Intervention site: Connecticut, USA | Sobriety checkpoint | The alcohol-related fatality trend for fatalities involving men 21 to 34 years old: | ||
Estimated reduction in the number of fatalities by 1.568 lives each month for the 18 mo. following the beginning of the campaign (p < 0.03) compared to 0.16 lives per month saved in contiguous counties (Net change: 25 lives saved during 18months, 29.7 %) | ||||
Comparator site: 3 neighboring states | ||||
Lacey 2008 [26] | Objective: Evaluate NHTSA Checkpoint Strikeforce program done July-December of each year, 2002–2004. | Alcohol-related fatal crashes in the intervention sites: −7.1 % relative to the nation as a whole (p = 0.119). In one State, West Virginia, the reduction was 16.7 % (p = 0.02) when compared to the Nation as a whole. | Alcohol-related fatal crashes: −7.1 % | 3 years |
CITS | ||||
1991–2004, annually | ||||
Intervention sites: Delaware, Maryland, Pennsylvania, Virginia, West Virginia, District of Columbia | Mass Media: | |||
Paid and earned media. “Checkpoint Strikeforce. You Drink & Drive. You Lose.” | ||||
Comparator: entire nation | Enforcement: | |||
Checkpoints. BAC measurements (Maryland, Delaware, and Virginia) | ||||
Agent 2002 [27] | Objective: Document | Number in 2002 compared to the average of the previous three years | Alcohol/drug related crashes: −9 % | 4 years (13 days per year) |
ITS | the results of the “You Drink& Drive. | |||
Before intervention: 13 days around Labor day in1999–2001 | You Lose” campaign. | 1. The number of crashes in which alcohol and/or drugs were listed as a contributing factor or the driver was noted to be suspected of drinking: −9 % (not statistically significant) | Number of injuries and fatalities resulting from alcohol/drug related crashes: −5 % | |
Enforcement: | ||||
Checkpoints and saturated enforcement activity | ||||
Intervention: 13 days around Labor day in 2002 | Mass media: | |||
Paid media: broadcast and cable television, radio (from 15 to 30 Aug, 2002), and outdoor billboards (15 Aug–15 Sep, 2002) | ||||
Intervention site: Kentucky, USA | ||||
2. The number of injuries and fatalities resulting from these crashes: −5 % | ||||
Comparator: none | ||||
Solomon 2008 [28] | Objective: Evaluate the effect of the National 2006 Labor Day holiday campaign, “Drunk Driving. Over the Limit. Under Arrest.” Targeting age group 18 to 34 years old | 1. The total number of alcohol-related fatalities: 17,602 in 2006 compared to 17,590 in 2005 (0.07 %). | The total number of alcohol-related fatalities: 0.07 % increase (2005–2006) | 4 months (Sep-Dec 2006) |
ITS | ||||
Intervention period: 3 weekends leading up to and around the Labor Day holiday period in 2006 | ||||
2. The number of motor vehicle fatalities for male drivers (BAC 0.01 or higher) age 18 to 34: decreased from 5782 to 5654 (−2.21 %) | ||||
Mass Media: | ||||
1. Earned media (Aug 7- Sep 10) | ||||
Intervention: 2006 | 2. Paid media (Aug 16–20; 23–27; Aug 30- Sep 3) | |||
3. The number of motor vehicle fatalities for male drivers (BAC 0.08 or higher) age 18 to 34: decreased from 4996 to 4872 (−2.48 %) | ||||
Comparaison: 2005 | ||||
Enforcement: | ||||
Intervention site: USA (nationwide) | Sobriety checkpoints, saturation patrols | |||
Comparator site: none | ||||
Beck 2009 [31] | Objective: Evaluate | Net change in three-year averages before and during campaign in Maryland: | Alcohol-related total | 6 years |
crashes: 2.2 % | ||||
CITS | the effect of the Checkpoint Strikeforce campaign | Total alcohol-related fatalities: 14.7 % | ||
Before intervention: 1999–2001, Intervention: 2002–2004 | Mass Media: | ● Alcohol-related total crashes: 2.2 % | Alcohol fatalities as a percentage of total fatalities: Net change 3 % | |
Paid and earned media | ● Alcohol-related injury crashes: −4.7 % | |||
Enforcement: | ● Alcohol-related fatality crashes: −2.7 % | |||
Intervention site: Maryland (Pennsylvania, Delaware, West Virginia, Virginia, District of Columbia) | Sobriety checkpoints | |||
● Total alcohol-related fatalities: 14.7 % | ||||
● Alcohol-related injured drivers: −3.8 % | ||||
Comparator sites: Minnesota, Oregon, and Washington | ||||
Miller 2004 [30] | Objective: Evaluation of three incremental CBT program approaches | Mass media is estimated to have decreased in nighttime fatal or serious crashes decreased by 13.9 % (90 % CI = −26.1 to −0.1) nationally | Nighttime fatal or serious crashes: −13.9 % | 10 years |
ITS | ||||
Intervention (CBT): 1993~ | ||||
Intervention (media): 1995~ | Mass Media: National anti-drunk-driving campaign with hard-hitting messages | |||
Intervention (CBT enhancement): 1996~ | ||||
Intervention sites: New Zealand (CBT enhancement in Northern Police Region) | Enforcement: CBT checkpoints, (Northern Region) highly visible CBT through booze busses | |||
NHTSA 2007 [32] | Objective: Evaluation of the effect on the | Total declines in yearly average of fatal crashes for alcohol-impaired drivers from 2002 to 2005 were slightly greater for the non-SES, as compared with the SES (a 5 % drop in non-SES compared to a 2 % decline in SES, net decline: 3 %). | Net decline in yearly average of fatal crashes for alcohol-impaired drivers: −3 % | 5 years |
CITS | National Impaired Driving Crackdown Campaign targeting men 21 to 34 years old | |||
Before: 2001 and 2002 | ||||
After: 2004 and 2005 | ||||
Intervention sites: 13 Strategic Evaluation States (SES) (Alaska, Arizona, California, Florida, Georgia, Louisiana, Mississippi, Montana, New Mexico, Ohio, Pennsylvania, Texas, West Virginia) | Mass Media: paid and earned media (done nationwide). Additional advertising done in | |||
In the target group of 18–34 year-old-male drivers, the decline was greater in non-SES compared to SES (8.7 % in non-SES and 3.8 % in SES). | ||||
SES. | ||||
Comparator sites: non-SES | Enforcement: Sobriety checkpoints or saturation patrols in SES | |||
Suriyawongpaisal 2002 [33] | Objective: Evaluate the campaign against drink-driving and enforcement efforts | Percentage of the traffic injury victims who were drivers with illegal BAC (0.05 or more): 14.6 % increase in 9 months (p = 0.20) | Percentage of the traffic injury victims who were drivers with illegal BAC (0.05 or more): 14.6 % increase | 9 months (assessed in alternating months) |
ITS | ||||
March-Nov 2002, alternating months | Mass Media: | |||
Intervention sites: 4 of the 21 public hospitals in Bangkok, Thailand | ||||
Comparator site: None | ||||
Active public education program at national scale (roadside posters; bumper; radio and TV programs or spots; public announcements; press reports), 1997 | ||||
Enforcements: | ||||
Highly visible sobriety check points, 1999 |
Study design
Participants
Settings
Interventions
Comparator
Quality measures and risk of bias
ITS | Intervention independent of other changes | Shape of the intervention effect pre-specified | Intervention unlikely to affect data collection | Knowledge of the allocated interventions adequately prevented during the study | Incomplete outcome data adequately addressed | Study free from selective outcome reporting | Study free from other risks of bias |
---|---|---|---|---|---|---|---|
Whittam 2006 [18] | Low risk (ARIMA model used and had comparator site) | Low risk | Low risk | Low risk | Low risk | High risk (crash data only for 16–19 year olds) | Low risk (has comparator site, using ARIMA model) |
Good quality study | |||||||
Murry 1993 [19] | Low risk (authors state that data were transformed to isolate the experimental effect from any extraneous influences) | Low risk | Low risk | Low risk | Low risk | High risk (using proxy indicator, using certain age group only) | Low risk (using comparator site, using model) |
Good quality study | |||||||
Newstead 1995 [20] | Low risk (regression model used to account for other factors) | Low risk | Low risk | Low risk | Low risk | Unclear risk (using proxy indicator) | Low risk (using regression model, but no comparator site) |
Good quality study | |||||||
Tay 2002 [21] | Low risk (used regression models to exclude other factors) | Low risk | Low risk | Low risk | Unclear risk (States that some inconsistencies may exist in the reporting as done by local police) | Unclear risk (used proxy measures) | Low risk |
Good quality study | |||||||
Fell 2008 [23] | High risk (other enforcement measures took place) | Low risk | Low risk | Low risk | Low risk | Low risk | Low risk |
Intermediate quality study | |||||||
Zwicker 2007a [24] | High risk (enforcement also took place) | Low risk | Low risk | Low risk | Low risk | Low risk | Low risk (used ARIMA model and applied parameters to model periodic fluctuations in the crash rates) |
Intermediate quality study | |||||||
Zwicker 2007b [25] | High risk (enforcement also took place) | Low risk | Low risk | Low risk | Low risk | Low risk | Low risk (contiguous county data were used to remove factors that may have obscured the effect of the campaign on the trend) |
Intermediate quality study | |||||||
Lacey 2008 [26] | High risk (law enforcement activities also took place) | Low risk | Low risk | Low risk | Low risk | Low risk | Low risk (ARIMA model used) |
Intermediate quality study | |||||||
Epperlein 1987 [29] | Unclear risk (no comparator site, but daytime crashes used to account for other changes) | Low risk | Low risk | Low risk | Low risk | Unclear risk (using proxy indicator) | High risk, not using model |
Low quality | |||||||
Miller 2004 [30] | High risk (media campaign done together with other enforcements, though model was used to look at each interventions) | Low risk | Low risk | Low risk | Low risk | Unclear risk (using proxy indicator, fatal nighttime crashes) | High risk (ARIMA model was used, but evaluation of mixed approaches in different areas over different period) |
Low quality study | |||||||
Agent 2002 [27] | High risk (enforcement activities also took place as part of the campaign) | Low risk | Low risk | Low risk | Low risk | Unclear risk (documentation of alcohol use is dependent on the reporting officer) | High risk (no model used) |
Low quality study | |||||||
Solomon 2008 [28] | High risk (enforcement measures also in place) | Low risk | Low risk | Low risk | Low risk | Low risk | High risk (Only looking at changes in absolute numbers, no application of models, no comparator site) |
Low quality study | |||||||
Beck 2009 [31] | High risk (enforcement also took place) | High risk (point of analysis not clear) | Low risk | Low risk | Low risk | Low risk | High risk (only looking at the absolute number of alcohol-related crashes, not using any models or accounting for rates in comparator sites) |
Low quality study | |||||||
NHTSA 2007 [32] | High risk (enforcement also took place) | Low risk | Low risk | Low risk | Low risk | Low risk | High risk (compared with non-intervention sites, but no model used. Unclear if other factors accounted for) |
Low quality study | |||||||
Suriyawongpaisal 2002 [33] | High risk (enforcement measures also used) | High risk (point of analysis is not the point of intervention, and not clearly stated why the data points were selected) | Low risk | High risk (hospital staff of the study sites were not blinded, and could have affected how they collected data) | High risk (not sure what proportion of cases were missed in each period, data collection dependent on hospitals enrolled) | Unclear risk | High risk (the study did not account for other changes that could have affected the outcome) |
Low quality study |
CBA | Allocation sequence generation | Allocation adequately concealed | Baseline outcome measurements similar | Baseline characteristics similar | Incomplete outcome data adequately addressed | Knowledge of the allocated interventions adequately prevented | Study adequately protected against contamination | Study fee from selective outcome reporting | Study free from other risks of bias |
---|---|---|---|---|---|---|---|---|---|
Jones 2005 [22] | High risk | High risk | Low risk | Unclear | Unclear | Low risk | Unclear risk (selected Pueblo and surrounding counties as intervention sites, but possibility of contamination remains) | Unclear risk (using surrogate indicator) | Unclear risk (not sure if it has accounted for other changes during before/after) |
Intermediate quality study | |||||||||
Zampetti 2013 [34] | High risk | High risk | Low risk | Unclear | Unclear | Low risk | Unclear (due to nature of intervention) | Unclear (using proxy indicator) | High risk (has not taken into account other changes during study period) |
Low quality study |