Driving Outside the Wire: Examining Factors Impacting Veterans’ Postdeployment Driving

Abstract

Combat Veterans (CVs) deployed to Iraq or Afghanistan experience driving difficulty, based on medical conditions and/or deployment exposures, elevating their risk of motor vehicle crash-related injury or death. To address grounded theory rigor and incorporate constructs such as the Person Environment Occupation Performance model, we revised the Hannold et al. (2013) conceptual framework. We conducted two focus groups with seven CVs. Conceptual framework revisions were based on an iterative process and thematic analysis. We elicited CVs’ perspectives on deployment training, driving pre- and postdeployment, strategies, and intervention preferences. Personal, environmental, and task factors underpinned CVs’ driving. Participants described triggers (e.g., stressful stimuli), use of environmental (e.g., car controls) or personal (e.g., avoiding traffic) strategies, and outcomes of appropriate or risky driving. Findings illustrated CVs’ driving difficulty and informed development of a Veteran-centric driving intervention. Improving driving fitness has implications for Veterans’ participation and community integration.

Application of the Person–Environment–Occupation–Performance Model: A Scoping Review

“…The 2015 PEOP Model was incorporated in several articles. A revised model was proposed to convey the influence of person, environment, and occupation factors on veterans’ post deployment driving ( Winter et al, 2020 ). A modified image of the model illustrated a pathway to guide practitioners in using social prescribing programs for individuals who experience loneliness ( Johansson et al, 2021 ).…”

“…This emphasis on performance enabled investigators to explore performance as a distinct entity for the occupations chosen for study. Research methods included observations, interviews, focus groups, surveys, and objective measures to describe the performance aspects of occupations and influencing factors (e.g., Maher et al, 2018 ; McGregor & Unsworth, 2021 ; Winter et al, 2020 ). Some articles also examined participation in valued family, community, and societal roles (e.g., Dorsey et al, 2017 ; Skinner et al, 2022 ; Wolf et al, 2016 ), but the distinction between performance and participation constructs appears to need further development.…”

“…Physical accessibility of the built environment (Hwang et al, 2016) Sensory complexity of environment (Kersten et al, 2020) Physical characteristics of public bathrooms (McGregor & Unsworth, 2021) Play areas within the home environment(Sood et al, 2014) Presence and behavior of other drivers(Winter et al, 2020) Assistive technology…”

Meeting the Needs of Rural Veterans: A Qualitative Evaluation of Whole Health Coaches’ Expanded Services and Support during COVID-19

“…Prior to COVID-19, the primary strategies used by coaches to introduce Veterans to WH relied on face-to-face, in-person interactions. Although the VA has long been at the vanguard of developing and implementing tele-based delivery of healthcare services to Veterans [ 53 , 54 , 55 , 56 , 57 , 58 , 59 , 60 , 61 ], WH coaches had not formerly relied on telehealth approaches and had to pivot quickly to incorporate various technologies and resources into their daily work with Veterans, representing a substantial shift for the WH initiative.…”

“…Veteran mental health is longstanding primary concern within the VHA [ 56 ]. Research efforts around the utilization of mental health services by rural Veterans [ 57 ], for conditions such as depression, anxiety, and PTSD, are ongoing, as are the development of clinical programs [ 58 , 59 , 60 , 61 ]. This concern underpinned our WH coaches’ extraordinary efforts in increasing their social support of the Veteran patients, which was intended to bolster Veterans’ ability to cope with stressors brought on by pandemic.…”