A randomized trial to evaluate the effectiveness of an individual, education-based safe transport program for drivers aged 75 years and older

BMC Public Health

Rebecca Ivers⁴  Serigne Lo³  Anita Bundy¹  Soufiane Boufous⁵  Elizabeth Clarke²  Julie Brown⁶  Kristy Coxon⁴  Lisa Keay⁷ 

[1] Faculty of Health Sciences, University of Sydney, PO Box 170, Lidcombe, NSW, 2041, Australia;Kolling Institute, Building 6 Level 10, RNS Hospital, St Leonards, NSW, 2065, Australia;The George Institute for Global Health, PO Box M201, Missenden Rd, Camperdown, NSW, 2050, Australia;Sydney School of Public Health, The University of Sydney, Paramatta Rd, Sydney, NSW, 2006, Australia;Transport and Road Safety (TARS) Research, Level 1, Main old building, The University of New South Wales Sydney, Sydney, NSW, 2052, Australia;University of New South Wales, Sydney, Australia;Sydney Medical School, The University of Sydney, Paramatta Rd, Sydney, NSW, 2006, Australia

关键词: Education;    Road traffic injury;    Safety;    Mobility;    Participation;    Naturalistic driving;    Ageing;    Driving;   

Others  :  1162573
DOI  :  10.1186/1471-2458-13-106

 received in 2012-12-20, accepted in 2013-02-01,  发布年份 2013

【 摘 要 】

Background

There are concerns over safety of older drivers due to increased crash involvement and vulnerability to injury. However, loss of driving privileges can dramatically reduce independence and quality of life for older members of the community. The aim of this trial is to examine the effectiveness of a safe transport program for drivers aged 75 years and older at reducing driving exposure but maintaining mobility.

Methods and design

A randomised trial will be conducted, involving 380 drivers aged 75 years and older, resident in urban and semi-rural areas of North-West Sydney. The intervention is an education program based on the Knowledge Enhances Your Safety (KEYS) program, adapted for the Australian context. Driving experience will be measured objectively using an in-vehicle monitoring device which includes a global positioning system (GPS) to assess driving exposure and an accelerometer to detect rapid deceleration events. Participation will be assessed using the Keele Assessment of Participation (KAP). Data will be analysed on an intention-to-treat basis; the primary outcomes include driving exposure, rapid deceleration events and scores for KAP. Secondary outcomes include self-reported measures of driving, socialisation, uptake of alternative forms of transport, depressive symptoms and mood. A detailed process evaluation will be conducted, including examination of the delivery of the program and uptake of alternative forms of transport. A subgroup analysis is planned for drivers with reduced function as characterized by established cut-off scores on the Drivesafe assessment tool.

Discussion

This randomised trial is powered to provide an objective assessment of the efficacy of an individually tailored education and alternative transportation program to promote safety of older drivers but maintain mobility. Trial registration: Australian New Zealand Clinical Trials Registry ACTRN12612000543886.

【 授权许可】

   
2013 Keay et al.; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

【 参考文献 】

• [1]Lyman S, Ferguson SA, Braver ER, Williams AF: Older driver involvements in police reported crashes and fatal crashes: trends and projections. Inj Prev 2002, 8(2):116-120.
• [2]Ramke J, Palagyi A, du Toit R, Brian G: Stated and actual willingness to pay for spectacles in Timor-Leste. Ophthalmic Epidemiol 2009, 16(4):224-230.
• [3]De Coster C, Dik N, Bellan L: Health care utilization for injury in cataract surgery patients. Can J Ophthalmol 2007, 42(4):567-572.
• [4]Williams AF, Shabanova VI: Responsibility of drivers, by age and gender, for motor-vehicle crash deaths. J Safety Res 2003, 34(5):527-531.
• [5]Crash data and rates for Age-Sex Groups of drivers. 1996. http://www.nhtsa.gov/people/injury/research/809-050pdf.pdf webcite
• [6]Dickerson AE, Molnar LJ, Eby DW, Adler G, Bedard M, Berg-Weger M, Classen S, Foley D, Horowitz A, Kerschner H, et al.: Transportation and aging: a research agenda for advancing safe mobility. Gerontologist 2007, 47(5):578-590.
• [7]Boufous S, Finch C, Hayen A, Williamson A: The impact of environmental, vehicle and driver characteristics on injury severity in older drivers hospitalized as a result of a traffic crash. J Safety Res 2008, 39(1):65-72.
• [8]Mayhew DR, Simpson HM, Ferguson SA: Collisions involving senior drivers: high-risk conditions and locations. Traffic Inj Prev 2006, 7(2):117-124.
• [9]Baldock MRJ, Thompson JP, Mathias JL: Self-regulation of driving behaviour among older drivers: Findings from a five year follow-up. 2008, 470-478. [2008 Australasian Road Safety Research, Policing and Education Conference. Adelaide, Australia: University of Adelaide;]
• [10]Fildes B, Pronk PN, Langford J, Hull M, Frith B, Anderson R: Model licence re-assessment procedure for older and disabled drivers. Sydney, Australia: Austroads Inc; 2000.
• [11]Staplin L, Gish KW, Wagner EK: MaryPODS revisited: updated crash analysis and implications for screening program implementation. J Safety Res 2003, 34(4):389-397.
• [12]Langford J: Usefulness of off-road screening tests to licensing authorities when assessing older driver fitness to drive. Traffic Inj Prev 2008, 9(4):328-335.
• [13]Leproust S, Lagarde E, Salmi LR: Risks and advantages of detecting individuals unfit to drive: a Markov decision analysis. J Gen Intern Med 2008, 23(11):1796-1803.
• [14]Foley DJ, Heimovitz HK, Guralnik JM, Brock DB: Driving life expectancy of persons aged 70 years and older in the United States. Am J Public Health 2002, 92(8):1284-1289.
• [15]Freeman EE, Munoz B, Turano KA, West SK: Measures of visual function and time to driving cessation in older adults. Optom Vis Sci 2005, 82(8):765-773.
• [16]Charlton J, Oxley J, Scully J, Koppel S, Congiu M, Muir C, Fildes B: Self-regulatory driving practices of older drivers in the Australian Capital Territories and New South Wales.. Melbourne, Australia: Monash University Accident Research Center; 2006.
• [17]Gallo JJ, Rebok GW, Lesikar SE: The driving habits of adults aged 60 years and older. J Am Geriatr Soc 1999, 47(3):335-341.
• [18]Molnar LJ, Eby DW: The relationship between self-regulation and driving-related abilities in older drivers: an exploratory study. Traffic Inj Prev 2008, 9(4):314-319.
• [19]Ball K, Owsley C, Stalvey B, Roenker DL, Sloane ME, Graves M: Driving avoidance and functional impairment in older drivers. Accid Anal Prev 1998, 30(3):313-322.
• [20]Brabyn JA, Schneck ME, Lott LA, Haegerstrom-Portnoy G: Night driving self-restriction: vision function and gender differences. Optom Vis Sci 2005, 82(8):755-764.
• [21]Campbell MK, Bush TL, Hale WE: Medical conditions associated with driving cessation in community-dwelling, ambulatory elders. J Gerontol 1993, 48(4):S230-S234.
• [22]Freund B, Szinovacz M: Effects of cognition on driving involvement among the oldest old: variations by gender and alternative transportation opportunities. Gerontologist 2002, 42(5):621-633.
• [23]Okonkwo OC, Crowe M, Wadley VG, Ball K: Visual attention and self-regulation of driving among older adults. Int Psychogeriatr 2007, 1–12:1-12.
• [24]Anstey KJ, Windsor TD, Luszcz MA, Andrews GR: Predicting driving cessation over 5 years in older adults: psychological well-being and cognitive competence are stronger predictors than physical health. J Am Geriatr Soc 2006, 54(1):121-126.
• [25]Marottoli RA, Ostfeld AM, Merrill SS, Perlman GD, Foley DJ, Cooney LM Jr: Driving cessation and changes in mileage driven among elderly individuals. J Gerontol 1993, 48(5):S255-S260.
• [26]Gilhotra JS, Mitchell P, Ivers R, Cumming RG: Impaired vision and other factors associated with driving cessation in the elderly: the Blue Mountains Eye Study. Clin Experiment Ophthalmol 2001, 29(3):104-107.
• [27]Classen S, Lopez ED, Winter S, Awadzi KD, Ferree N, Garvan CW: Population-based health promotion perspective for older driver safety: conceptual framework to intervention plan. Clin Interv Aging 2007, 2(4):677-693.
• [28]Keay L, Munoz B, Turano KA, Hassan SE, Munro CA, Duncan DD, Baldwin K, Jasti S, Gower EW, West SK: Visual and cognitive deficits predict stopping or restricting driving: the Salisbury Eye Evaluation Driving Study (SEEDS). Invest Ophthalmol Vis Sci 2009, 50(1):107-113.
• [29]Campbell MK, Elbourne DR, Altman DG, Group C: CONSORT statement: extension to cluster randomised trials. BMJ 2004, 328(7441):702-708.
• [30]Australian Bureau of Statistics: Population Aging in New South Wales. Canberra: Commonwealth of Australia; 2008.
• [31]Pfiefer E: A short portable mental status questionnaire for the assessment of organic brain deficit in elderly patients. J Am Geriatr Soc 1975, 23(10):433.
• [32]Groll DL, To T, Bombardier C, Wright JG: The development of a comorbidity index with physical function as the outcome. J Clin Epidemiol 2005, 58(6):595-602.
• [33]Yesavage JA, Brink TL, Rose TL, Lum O, Huang V, Adey M, Leirer VO: Development and validation of a geriatric depression screening scale: a preliminary report. J Psychiatr Res 1982, 17(1):37-49.
• [34]Watson D, Clark LA, Tellegen A: Development and validation of brief measures of positive and negative affect: the PANAS scales. J Pers Soc Psychol 1988, 54(6):1063-1070.
• [35]Dougherty BE, Flom RE, Bullimore MA: An evaluation of the Mars Letter Contrast Sensitivity Test. Optom Vis Sci 2005, 82(11):970-975.
• [36]Owsley C, Stalvey BT, Wells J, Sloane ME, McGwin G Jr: Visual risk factors for crash involvement in older drivers with cataract. Arch Ophthalmol 2001, 119(6):881-887.
• [37]Mathias JL, Lucas LK: Cognitive predictors of unsafe driving in older drivers: a meta-analysis. Int Psychogeriatr 2009, 21(4):637-653.
• [38]Betz ME, Fisher J: The Trail-making Test B and driver screening in the emergency department. Traffic Inj Prev 2009, 10(5):415-420.
• [39]Edwards JD, Leonard KM, Lunsman M, Dodson J, Bradley S, Myers CA, Hubble B: Acceptability and validity of older driver screening with the DrivingHealth Inventory. Accid Anal Prev 2008, 40(3):1157-1163.
• [40]Bowie CR, Harvey PD: Administration and interpretation of the Trail Making Test. Nat Protoc 2006, 1(5):2277-2281.
• [41]Richardson ED, Marottoli RA: Visual attention and driving behaviors among community-living older persons. J Gerontol A Biol Med Sci 2003, 58(9):M832-M836.
• [42]Freund B, Colgrove LA: Error specific restrictions for older drivers: Promoting continued independence and public safety. Accid Anal Prev 2008, 40(1):97-103.
• [43]Adrian J, Postal V, Moessinger M, Rascle N, Charles A: Personality traits and executive functions related to on-road driving performance among older drivers. Accid Anal Prev 2011, 43(5):1652-1659.
• [44]Andrews EC, Westerman SJ: Age differences in simulated driving performance: Compensatory processes. Accid Anal Prev 2012, 45(2):660-668.
• [45]Hassan SE, Turano KA, Munoz B, Munro C, Bandeen-Roche K, West SK: Cognitive and vision loss affects the topography of the attentional visual field. Invest Ophthalmol Vis Sci 2008, 49(10):4672-4678.
• [46]West SK, Hahn DV, Baldwin KC, Duncan DD, Munoz BE, Turano KA, Hassan SE, Munro CA, Bandeen-Roche K: Older Drivers and Failure to Stop at Red Lights. J Gerontol A Biol Sci Med Sci 2009, 65(2):179-183.
• [47]Ball K, Owsley C, Sloane ME, Roenker DL, Bruni JR: Visual attention problems as a predictor of vehicle crashes in older drivers. Invest Ophthalmol Vis Sci 1993, 34(11):3110-3123.
• [48]Kay LG, Bundy AC, Clemson L: Awareness of driving ability in senior drivers with neurological conditions. Am J Occup Ther 2009, 63(2):146-150.
• [49]Kay LG, Bundy A, Clemson L: Validity, reliability and predictive accuracy of the Driving Awareness Questionnaire. Disabil Rehabil 2009, 31(13):1074-1082.
• [50]Harris PA, Taylor R, Thielke R, Payne J, Gonzalez N, Conde JG: Research electronic data capture (REDCap) - A metadata-driven methodology and workflow process for providing translational research informatics support. J Biomed Inform 2009, 42(2):377-381.
• [51]Korner-Bitensky N, Kua A, von Zweck C, Van Benthem K: Older driver retraining: an updated systematic review of evidence of effectiveness. J Safety Res 2009, 40(2):105-111.
• [52]Marottoli RA, Ness PH, Araujo KL, Iannone LP, Acampora D, Charpentier P, Peduzzi P: A randomized trial of an education program to enhance older driver performance. J Gerontol A Biol Med Sci 2007, 62(10):1113-1119.
• [53]Stalvey BT, Owsley C: The development and efficacy of a theory-based educational curriculum to promote self-regulation among high-risk older drivers. Health PromotPract 2003, 4(2):109-119.
• [54]van Ranst E, Silverstein NM, Gottlieb AS: Promoting safe and comfortable driving for elders. Stud Health Technol Inform 2005, 118:231-243.
• [55]Owsley C, McGwin G Jr, Phillips JM, McNeal SF, Stalvey BT: Impact of an educational program on the safety of high-risk, visually impaired, older drivers. Am J Prev Med 2004, 26(3):222-229.
• [56]Owsley C, Stalvey BT, Phillips JM: The efficacy of an educational intervention in promoting self-regulation among high-risk older drivers. Accid Anal Prev 2003, 35(3):393-400.
• [57]Weinstein ND, Sandman PM: A model of the precaution adoption process: Evidence from home radon testing. Health Psychol 1992, 11(3):170-180.
• [58]Weinstein ND, Sandman PM, Blalock SJ: The precaution adoption process model. In Health behavior and health education: Theory, research and practice. 4th edition. Edited by Glanz K, Rimer BK, Viswanath K. San Francisco: Jossey-Bass; 2008:123-148.
• [59]Rogers JC, Holm MB: The occupational therapy process. In Willard and Spackman's occupational therapy. 11th edition. Edited by Crepeau EB, Cohn ES, Schell BAB. Philadelphia: Lippincott Williams and Wilkins; 2009:478-518.
• [60]Meredith L, Brown J, Clarke E, Coxon K, Boufous S, Ivers RQ, Keay L: Validation of an in-vehicle monitoring device for measuring driving exposure and deceleration events. Sydney: Conference Proceedings of the Australasian College of Road Safety; 2012.
• [61]Greaves S, Fifer S, Ellison R, Zhang Y, Germanos G: Development of a GPS/GPRS Prompted-Recall Solution for Longitudinal Drivng Behaviour Studies. Melbourne, Australia: 30th Australian Transport Research Forum; 2007.
• [62]Dingus TA, Klauer SG, Neale VL, Petersen A, Lee SE, Sudweeks J, Perez MA, Hankey J, Ramsey D, Gupta S, et al.: The 100-Car Naturalistic Driving Study, Phase II – Results of the 100-Car Field Experiment. Virginia: National Highway Transport Safety Administration; 2006.
• [63]Owsley C, Stalvey B, Wells J, Sloane ME: Older drivers and cataract: driving habits and crash risk. J Gerontol A Biol Med Sci 1999, 54(4):M203-M211.
• [64]Sullivan KA, Smith SS, Horswill MS, Lurie-Beck JK: Older adults' safety perceptions of driving situations: towards a new driving self-regulation scale. Accid Anal Prev 2011, 43(3):1003-1009.
• [65]Yesavage JA, Brink TL, Rose TL, Lum O, Huang V, Adey M, Leirer VO: Development and validation of a geriatric depression screening scale: a preliminary report. J Psychiatr Res 1982, 17(1):37-49.
• [66]Wilkie R, Peat G, Thomas E, Hooper H, Croft PR: The Keele Assessment of Participation: a new instrument to measure participation restriction in population studies. Combined qualitative and quantitative examination of its psychometric properties. Qual Life Res 2005, 14(8):1889-1899.
• [67]Wood JM, Anstey KJ, Kerr GK, Lacherez PF, Lord S: A Multidomain Approach for Predicting Older Driver Safety Under In-Traffic Road Conditions. J Am Geriatr Soc 2008.
• [68]Niele VL, Dingus TA, Klauer SG, Sudweeks J, Goodman M: An overview of the 100-car naturalistic study and findings. Washington, USA: National HIghway Traffic Safety Administration; 2009. [Paper Number 05–0400]
• [69]Bellg AJ: Enhancing Treatment Fidelity in Health Behavior Change Studies: Best Practices and Recommendations From the NIH Behavior Change Consortium. Health Psychol 2004, 23(5):443-451.
• [70]Oakley A, Strange V, Bonell C, Allen E, Stephenson J: Process evaluation in randomised controlled trials of complex interventions. BMJ 2006, 332(7538):413-416.
• [71]Saunders RP, Evans MH, Joshi P: Developing a Process-Evaluation Plan for Assessing Health Promotion Program Implementation: A How-To Guide. Health Promot Pract 2005, 6(2):134-147.
• [72]Broekhuizen K, Althuizen E, van Poppel MNM, Donker M, van Mechelen W: From Theory to Practice: Intervention Fidelity in a Randomized Controlled Trial Aiming to Optimize Weight Development During Pregnancy. Health Promot Pract 2012, 13(6):816-825.
• [73]Hawe P, Shiell A, Riley T: Complex interventions: how “out of control” can a randomised controlled trial be? BMJ 2004, 328(7455):1561-1563.
• [74]Craig P, Dieppe P, Macintyre S, Michie S, Nazareth I, Petticrew M: Developing and evaluating complex interventions: the new Medical Research Council guidance. BMJ 2008, 337:a1655.
• [75]Linnan L, Steckler A: Process evaluation for public health interventions and research: An overview. In Process evaluation for public health interventions and research. Edited by Steckler A, Linnan L. San Francisco, CA, US: Jossey-Bass; 2002:1-24.
• [76]Kua A, Korner-Bitensky N, Desrosiers J, Man-Son-Hing M, Marshall S: Older driver retraining: a systematic review of evidence of effectiveness. J Safety Res 2007, 38(1):81-90.