An evaluation of the roadwise review: a mixed methods approach

The combined effects of on-road and simulator training with feedback on older drivers' on-road performance: Evidence from a randomized controlled trial

OBJECTIVE

A number of training programs that seek to improve driving performance among older drivers are available accompanied by a growing interest in their effectiveness. The purpose of the present investigation was to examine the combined effect of (1) basic in-class training (BT); (2) on-road training with individualized feedback (OR); and (3) training on a driving simulator (S).

METHODS

Using a randomized controlled trial study design, 78 older drivers were randomly assigned to one of 3 groups (BT, BT + OR, or BT + OR + S). All participants completed a pre- and postintervention on-road driving evaluation on a standardized route. The driving evaluations were recorded using video and Global Positioning System (GPS) equipment and were scored by a blind assessor.

RESULTS

The results indicated a significant reduction of approximately 30% in overall number of driving errors/omissions among participants in the BT + OR and the BT + OR + S groups in comparison to participants in the BT group.

CONCLUSIONS

This study adds to the mounting evidence demonstrating the effectiveness of individualized driver training in improving safe driving among older adults.

Self-rated confidence and on-road driving performance among older adults: Autoévaluation de la confiance et de la performance au volant chez les personnes âgées

BACKGROUND.

Driver confidence can be measured through concepts such as driving frequency, situational avoidance, and self-perceptions. However, it is not clear how well confidence aligns with actual driving performance.

PURPOSE.

We examined the relationship between subjective measures of confidence in driving ability and on-road performance.

METHOD.

We report findings from two studies. The first compared scores from the Older and Wiser Driver Questionnaire to an on-road driving evaluation. The second looked at the Day and Night Driving Comfort Scales and Driving Habits and Intentions Questionnaire in relation to an on-road driving evaluation.

FINDINGS.

No measures of confidence in driving ability were related to on-road driving performance.

IMPLICATIONS.

Confidence in driving ability bears little relationship to on-road performance. Future research should examine approaches to foster a better match between self-assessments and actual abilities among drivers.

Biopsychosocial Risk Factors for Driving Cessation

Objective: This study aims to identify social, psychological, and biomedical risk factors for current and future driving cessation in older adults. Method: Data from six waves (1998-2008) of the Health and Retirement Study (HRS) were pooled. Participants aged 65 and above were included in the study ( N = 17,349). Results: Multivariate logistic regression models to identify risk factors for current and future driving cessation were consistent (age, gender, education, race, marital status, income, cognitive function, limits in activities of daily living and instrumental activities of daily living, vision, health, diabetes, stroke, arthritis, and hip fracture). Only one variable, falls, was associated with future driving cessation (odds ratio [OR] = 0.92; confidence interval [CI] = [0.85, 1.0]), but not current driving cessation. Discussion: Older age, female gender, and minority race were risk factors for current and future cessation. Adults with arthritis were more likely to keep driving compared with those without arthritis.

Implementation of a community-based mature driver screening and referral program: A feasibility study

We tested the feasibility of implementing a community mature driver screening and referral program utilizing the Roadwise Review screening instrument. We recruited a convenience sample of 151 mature drivers (age 65 and over) at six community senior centers in suburban Connecticut. A 30 item survey collected demographic information, driving history, and self-reported vision, physical fitness, and attention problems. Participants completed a 30min computer screening program that assessed 8 areas associated with driving ability. Referrals were provided to participants with identified impairments. A post survey measured program satisfaction; a two week follow-up determined intent to address impairments. Among the problems/issues reported: reading highway/street signs or seeing other vehicles at night (25%), trouble looking over shoulder when changing lanes (18%), avoidance of night driving (22%) or in unfamiliar places (31%). Screening found mild impairments in 86% of participants and 52% with serious impairments. Referrals were given to 75%; at follow-up, 74% reported intent to complete referrals. Most participants (94%) would recommend the program to family/friends. In conclusion, this study was feasible to implement and identified driving impairments among mature drivers. Most participants intended follow-up with driving recommendations and program satisfaction was high.