Planning for a Nondriving Future: Behaviors and Beliefs among Middle-Aged and Older Drivers

Harmon, Annie C.; Babulal, Ganesh M.; Vivoda, Jonathon M.; Zikmund‐Fisher, Brian J.; Carr, David B.

doi:10.3390/geriatrics3020019

Cited by 26 publications

(19 citation statements)

References 14 publications

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“…As the majority of older adults are not planning for mobility changes that may come with age (Harmon et al, 2018), the precontemplation stage of the Transtheoretical Stages Model (Glanz) was used to design questions to measure attitudes. This stage is characterized as unaware and older adults in this stage may not be thinking about their mobility or protecting it, may not be motivated, and may not be confident that they know what to do.…”

Section: Methodsmentioning

confidence: 99%

“…Older adults might be reluctant to discuss or think about mobility issues due to the loss of independence associated with driving reductions and falls (Ambrose et al, 2013;Oxley & Charlton, 2009). However, in one study, older adults believed that planning for changes that might come with age could result in better future mobility outcomes (Harmon et al, 2018). Older adults who make the decision to stop driving on their own or with help were more satisfied with their mobility than those who had the decision made for them (Oxley & Charlton, 2009).…”

Section: Introductionmentioning

confidence: 99%

“…Older adults who make the decision to stop driving on their own or with help were more satisfied with their mobility than those who had the decision made for them (Oxley & Charlton, 2009). While over half of middleaged and older adults have not planned for driving cessation, more than 80% agreed that planning would help them to meet their transportation needs if they stop driving (Harmon et al, 2018). Planning can include using evidence-based interventions to reduce aging-associated risk factors (e.g., increasing medication use, decreasing muscle strength) that potentially reduce mobility (Dellinger et al, 2001;Gillespie et al, 2012).…”

Section: Introductionmentioning

confidence: 99%

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Older Adults’ Attitudes About Future Mobility Changes and the Usefulness of Mobility Assessment Materials

2020

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Objectives: To understand older adults’ attitudes about future mobility and usefulness of mobility assessment materials. Methods: Data came from a telephone survey of 1,000 older adults aged 60–74 years. After answering baseline questions, respondents received mobility assessment materials, then completed follow-up interviews. Respondents were asked about future mobility challenges. During baseline and follow-up, subjects were asked four questions about their mobility as they aged which measured thinking about mobility, thinking about protecting mobility, confidence in protecting mobility, and motivation to protect mobility. Differences in percent of respondents’ attitudes between baseline and follow-up and 95% confidence intervals were calculated. Results: Driving (42%) was the most commonly reported challenge. Significant increases from baseline to follow-up in thinking about mobility (25%), thinking about protecting mobility (39%), and confidence in protecting mobility (29%) were reported. Discussion: Brief mobility assessment materials can encourage older adults to consider future mobility. Planning for changes can prolong safe mobility.

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Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Older Adults’ Attitudes About Future Mobility Changes and the Usefulness of Mobility Assessment Materials

2020

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“…There are 44 million licensed drivers aged ≥65 years in the United States (CDC 2020 ) and driving remains the primary mode of transportation for older Americans (Choi et al 2012 ). Driving is linked to individual well-being and driving cessation can negatively impact older adults independence and mental health (Chihuri et al 2016 ; Edwards et al 2009 ; Foley et al 2002 ; Harmon et al 2018 ). Identifying ways to support older drivers to stay on the road safely and maintain independence and community involvement is a national priority (Classen et al 2007 ; NHTSA 2010 ; NHTSA 1999 ).…”

Section: Introductionmentioning

confidence: 99%

The Advancing Understanding of Transportation Options (AUTO) study: design and methods of a multi-center study of decision aid for older drivers

et al. 2021

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Background Decision-making about when to stop driving for older adults involves assessment of driving risk, availability of support or resources, and strong emotions about loss of independence. Although the risk of being involved in a fatal crash increases with age, driving cessation can negatively impact an older adult’s health and well-being. Decision aids can enhance the decision-making process by increasing knowledge of the risks and benefits of driving cessation and improve decision quality. The impact of decision aids regarding driving cessation for older adults is unknown. Methods The Advancing Understanding of Transportation Options (AUTO) study is a multi-site, two-armed randomized controlled trial that will test the impact of a decision aid on older adults’ decisions about changes in driving behaviors and cessation. AUTO will enroll 300 drivers age ≥ 70 years with a study partner (identified by each driver); the dyads will be randomized into two groups (n = 150/group). The decision aid group will view the web-based decision aid created by Healthwise at baseline and the control group will review information about driving that does not include evidence-based elements on risks and benefits and values clarification about driving decisions. The AUTO trial will compare the effect of the decision aid, versus control, on a) immediate decision quality (measured by the Decisional Conflict Scale; primary outcome); b) longitudinal psychosocial outcomes at 12 and 24 months (secondary outcomes); and c) longitudinal driving behaviors (including reduction or cessation) at 12 and 24 months (secondary outcomes). Planned stratified analyses will examine the effects in subgroups defined by cognitive function, decisional capacity, and readiness to stop driving. Discussion The AUTO study is the first large-scale randomized trial of a driving decision aid for older adults. Results from this study will directly inform clinical practice about how best to support older adults in decision-making about driving. Trial registration ClinicalTrials.gov: NCT04141891. Registered on October 28, 2019. Located at https://clinicaltrials.gov/ct2/show/NCT04141891

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“…By the year 2050, this number of licensed drivers over the age of 65 years old is expected rise to 89 million in the United States ( 2 ). This said, driving remains critical to older drivers in maintaining both their physical mobility and mental health ( 3 ).…”

mentioning

confidence: 99%

Measuring the Applicability of Intersection-Based Older Driver Training Programs

Schneider¹,

Hajiseyedjavadi

Tainter

et al. 2020

Transportation Research Record: Journal of the Transportation R

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Older drivers remain overrepresented in intersection crashes. Previous evidence suggests that the primary reason for this lies with their lack of scanning for potential threat vehicles while entering stop-controlled intersections. More so, secondary glances prove critical when the conditions obscure potential threat vehicles while approaching the intersection. Currently, simulator-based older driver training programs have proven effective in increasing the frequency of secondary glances taken by older drivers up to 2 years following the training. However, both the need for a full-scale driving simulator and participant dropout rates because of simulator sickness within training programs continue to limit the applicability of these alternatives. This study used a series of micro-scenarios to train older drivers in secondary glances, thus reducing the potential for participant dropouts resulting from simulator sickness. In addition, driver immersion levels varied across multiple training platforms, ranging from low to medium. A total of 91 participants between 67 and 86 years old were assigned to one of five groups. Three groups were provided active, secondary glance training on a driving simulator (one on a low immersion simulator and two on medium immersion simulators), a fourth group was provided passive training using a PowerPoint presentation, and the last group was a control with no training. Following training, all participants were evaluated in their personal vehicles while wearing head-mounted cameras. The medium immersion group resulted in the highest percentage of secondary glances (82%), whereas the control group resulted in the lowest percentage (42%). The results provide evidence to suggest that the training programs using micro-scenarios in medium and low immersion simulators can increase the frequency of secondary glances without having high dropout rates caused by simulator sickness.

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Planning for a Nondriving Future: Behaviors and Beliefs among Middle-Aged and Older Drivers

Cited by 26 publications

References 14 publications

Older Adults’ Attitudes About Future Mobility Changes and the Usefulness of Mobility Assessment Materials

Older Adults’ Attitudes About Future Mobility Changes and the Usefulness of Mobility Assessment Materials

The Advancing Understanding of Transportation Options (AUTO) study: design and methods of a multi-center study of decision aid for older drivers

Measuring the Applicability of Intersection-Based Older Driver Training Programs

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