The objective of this project was to create a valid and effective Web-based self-screening instrument to provide older drivers with individualized information to help them make better decisions about driving. The project was intended to improve upon existing self-screening instruments by focusing on health concerns – that is, the symptoms people experience due to medical conditions, medications used to treat them, and the general aging process – rather than the medical conditions or medications themselves. This approach allows for a much more comprehensive self-screening than has been possible previously. By linking the severity of health concerns to their effects on critical driving skills, the instrument provides five types of individualized feedback including general awareness, self-awareness, and recommendations for behavioural changes, further evaluation, and vehicle modifications. Development of the self-screening instrument was based on an extensive review of the literature and conduct of an expert panel and focus groups. The evaluation portion of the study involved obtaining feedback from 68 older adult participants about the usefulness of the self-screening instrument and their intentions to make changes as a result of completing it. The validation portion of the activity involved statistically comparing participants’ results from the self-screening instrument to results from an on-road driving assessment and a series of clinical tests to evaluate cognitive, visual, and psychomotor abilities. Both the clinical evaluation and on-road driving assessment were administered through a driving assessment program operated by the University of Michigan and managed by an occupational therapist. More than three-fourths of subjects indicated that the self-screening instrument made them more aware of how declines in driving-related abilities can affect driving and more than 90% thought the information provided by the instrument served as a useful reminder of things they already knew. More than one-third of subjects discovered a change in themselves of which they were previously unaware. Large percentages of subjects reported plans to engage in behaviours to maintain safe driving with 42% planning to change how they drive; 33% planning to take a driving refresher course; and 53% planning to talk with a doctor. More than three-fourths reported they would use the instrument again in the future; more than 90% would recommend it to older family members and friends; and 94% thought it would serve as a useful way to discuss driving concerns with family members. Overall, subjects’ scores on the self-screening instrument were significantly correlated with the clinical evaluation scores and on-road driving performance scores. In conclusion, the SAFER Driving: Enhanced Driving Decisions Workbook appears to be a useful and valid self-screening instrument for older adult drivers. The tool is free and in the public domain at http://um-saferdriver.org. (Author/publisher)
Abstract