Health, safety, self-regulation and the older driver: It's not just a matter of age

Problem

The purpose of this research was to examine the impact of age and health on patterns of driving and self-regulation among older adults who still drive.

Method

This analysis presents the results of a nationwide survey of drivers who are 50 + (N = 3,824, 53.11% response rate), focusing on questions about the impact of their self-reported health on attitudes toward and self-regulation of driving.

Results

The data indicate that as age increases, so too does reported self-regulation of driving, increasing sharply among those ages 70 and older. The data also indicate that respondent's reported confidence in driving and their enjoyment of driving decline as they age. Health status bears a significant relationship with all three of these variables, positively related to confidence in driving skills and to enjoyment in driving, but negatively related to self-regulation reports. As self-reported health declines, respondent's report engages in greater voluntary restrictions of their driving.

Discussion

All too often, the driving decision is linked primarily to chronological age. Analysis done here indicates that age alone is not the best indicator of self-regulation and how older adults change their driving behaviors.

Summary

This research presents the results of a nationwide survey of 50+ drivers and their self-reported driving, self-regulation behaviors, and health status. Strong support was found for the argument that chronological age is not an adequate measure of self-regulating behaviors and driver safety among those 50+. In particular, it was found that a person's health status and the interaction between age and health are essential considerations in the decisions around self-regulation and driving. People tend to self-regulate more with age, but the effect becomes much more pronounced as health status declines.

Impact on industry

In the coming years, if older adults can't get to where they want to go and continue to be viable consumers in our national fabric, all industries will eventually suffer. Transportation is a key component to the nation's social contract with older individuals and their families.     

Enhancing older driver safety: A driving survey and evaluation of the CarFit program

Objective

To evaluate CarFit, an educational program designed to promote optimal alignment of driver with vehicle.

Methods

A driving activity survey was sent to 727 randomly selected participants living in retirement communities. Drivers (n = 195) were assigned randomly to CarFit intervention (n = 83, M age = 78.1) or Comparison (n = 112, M age = 79.6) groups. After 6 months, participants completed a post-test of driving activity and CarFit recommendations.

Results

Nonconsenting drivers were older and participated in fewer driving activities. CarFit participation was moderate (71%) with 86% of the participants receiving recommendations. 60% followed the recommendations at the 6-month re-evaluation). The CarFit (67.6%) and Comparison (59.3%) groups reported at least one type of self-regulation of driving activity at baseline. There was no significant change in the driving behaviors at the six-month follow-up.

Conclusion

CarFit was able to detect addressable opportunities that may contribute to the safety of older drivers.

Impact on industry

CarFit recommendations may need stronger reinforcement in order to be enacted by a participant.     

On-road and simulated driving: concurrent and discriminant validation

Introduction

A converging pair of studies investigated the validity of a simulator for measuring driving performance/skill.

Study 1

A concurrent validity study compared novice driver performance during an on-road driving test with their performance on a comparable simulated driving test.

Results

Results showed a reasonable degree of concordance in terms of the distribution of driving errors on-road and errors on the simulator. Moreover, there was a significant relationship between the two when driver performance was rank ordered according to errors, further establishing the relative validity of the simulator. However, specific driving errors on the two tasks were not closely related suggesting that absolute validity could not be established and that overall performance is needed to establish the level of skill.

Study 2

A discriminant validity study compared driving performance on the simulator across three groups of drivers who differ in their level of experience - a group of true beginners who had no driving experience, a group of novice drivers who had completed driver education and had a learner's permit, and a group of fully licensed, experienced drivers.

Results

The findings showed significant differences among the groups in the expected direction -- the various measures of driving errors showed that beginners performed worse than novice drivers and that experienced drivers had the fewest errors. Collectively, the results of the concurrent and discriminant validity studies support the use of the simulator as a valid measure of driving performance for research purposes.

Impact on industry

These findings support the use of a driving simulator as a valid measure of driving performance for research purposes. Future research should continue to examine validity between on-road driving performance and performance on a driving simulator and the use of simulated driving tests in the evaluation of driver education/training programs.     

Increasing self-awareness among older drivers: The role of self-screening

Introduction

Self-screening by older drivers has shown considerable promise for increasing self-awareness about functional abilities associated with safe driving. The purpose of this study was to improve upon existing self-screening instruments by focusing entirely on “health concerns” that affect driving - that is, the symptoms that people experience due to medical conditions and the medications used to treat them - rather than the medical conditions or medications themselves.

Method

A computer-based, easy-to-use self-screening instrument for older drivers was developed to provide individualized feedback intended to increase self-awareness about declines in driving-related abilities, as well as suggestions for behavioral changes or safety tips to maintain safe driving, further evaluation from a physician/health professional, and vehicle modifications to help compensate for driving-related declines.

Results

This paper describes the development of the self-screening instrument and summarizes findings relative to increasing self-awareness among older drivers. This research represents an important first step in improving self-awareness among older drivers through self-screening.     

Older driver retraining: An updated systematic review of evidence of effectiveness

Problem and Objective

The number of older drivers who might benefit from driver retraining is growing. A previous review on the effectiveness of older driver retraining included intervention studies up to 2004. The objective was to perform an updated systematic review of the effectiveness of older driver retraining for improving driving-related skills and reducing crash rates.

Method

Articles published from 2004-2008 were grouped according to the intervention provided and outcome studied. Randomized clinical trials (RCTs) were appraised using the Physiotherapy Evidence Database (PEDro) Scale and scored for quality according to their internal validity. Each intervention's effectiveness was then rated and assigned a level of evidence by combining pre- and post- 2004 findings.

Results

Three RCTs and one matched-pairs cohort design met the inclusion criteria. There is strong evidence (Level 1a) that education combined with on-road training improves driving performance and moderate evidence (Level 1b) that it improves knowledge. There is moderate evidence (Level 1b) that physical retraining improves driving performance. There is moderate evidence (Level 1b) that an educational intervention curriculum alone is not effective in reducing crashes.

Summary

The updated evidence on the effectiveness of retraining aimed at older drivers is sufficiently encouraging to merit assertive health promotion actions regarding intervention and program planning.

Impact on Industry

These positive findings warrant a comprehensive plan that has both behavioral and monetary incentives encouraging older driver participation in programs aimed at driver safety.     

Self-assessed driver competence among novice drivers - a comparison of driving test candidate assessments and examiner assessments in a Dutch and Finnish sample

Problem

This study examined novice drivers’ overconfidence by comparing their self-assessed driver competence with the assessments made by driving examiners.

Method

A Finnish (n = 2,739) and a Dutch sample (n = 239) of drivers license candidates assessed their driver competence in six areas and took the driving test.

Result and Discussion

In contrast to previous studies where drivers have assessed their skill in comparison to the average driver, a smaller proportion overestimated and a larger proportion made realistic self-assessments of their driver competence in the present study, where self-assessments were compared with examiner assessments. Between 40% and 50% of the candidates in both samples made realistic assessments and 30% to 40% overestimated their competence. The proportion of overestimation was greater in the Dutch than in the Finnish sample, which might be explained by greater possibilities for practicing self-assessment in the Finnish driver education system. Similar to other self-assessment studies that indicate that incompetence is related to overestimation, a larger proportion of candidates that failed the test overestimated their skill compared to those who passed. In contrast to other studies, males did not overestimate their skills more than females, and younger driver candidates were not more overconfident than older drivers.

Impact on traffic safety

Although a great proportion of the candidates made a realistic assessment of their own driver competence, overestimation is still a problem that needs to be dealt with. To improve the accuracy of novice drivers’ self-assessment, methods for self-assessment training should be developed and implemented in the driver licensing process.     

Preferred modes of travel among older adults: What factors affect the choice to walk instead of drive?

Introduction

There are many factors that influence older adults' travel choices. This paper explores the associations between mode of travel choice for a short trip and older adults' personal characteristics.

Methods

This study included 406 drivers over the age of 64 who were enrolled in a large integrated health plan in the United States between 1991 and 2001. Bivariate analyses and generalized linear modeling were used to examine associations between choosing to walk or drive and respondents' self-reported general health, physical and functional abilities, and confidence in walking and driving.

Results

Having more confidence in their ability to walk versus drive increased an older adult's likelihood of walking to make a short trip by about 20% (PR = 1.22; 95% CI: 1.06-1.40), and walking for exercise increased the likelihood by about 50% (PR = 1.53; 95% CI = 1.22-1.91). Reporting fair or poor health decreased the likelihood of walking, as did cutting down on the amount of driving due to a physical problem.

Discussion

Factors affecting a person's decision to walk for exercise may not be the same as those that influence their decision to walk as a mode of travel. It is important to understand the barriers to walking for exercise and walking for travel to develop strategies to help older adults meet both their exercise and mobility needs. Impact on Industry: Increasing walking over driving among older adults may require programs that increase confidence in walking and encourage walking for exercise.     

A comparison of web-based and telephone surveys for assessing traffic safety concerns, beliefs, and behaviors

Introduction

The purpose of this investigation was to compare the results of a web-based and a telephone interview survey measuring driver concerns about a variety of traffic safety issues, their beliefs, and specific driving behaviors.

Method

State-wide, annual random digit-dial telephone surveys and web-based surveys were conducted in Maryland. A total of 1,700 drivers were surveyed by telephone and 6,806 took a web survey.

Results

Telephone respondents were more likely to be female and older. Web respondents were more likely to be white and not Latino/Hispanic. After controlling for demographic differences, telephone survey respondents were more likely to be concerned about traffic safety. They were more likely to believe that sobriety checkpoints reduce drunk driving (OR = 2.18, 95% CI 1.94, 2.45), they would be ticketed for not wearing a seat belt (OR = 1.26, 95% CI 1.12, 1.43), and they would be stopped by the police if they drove after drinking too much (OR = 1.17, 95% CI 1.03, 1.32). They were less likely to report a variety of risky behaviors including using a cell phone while driving (OR = .54, 95% CI .48, .61) and driving 10+ mph over the speed limit (OR = .81, 95% CI .72, .91), but were more likely to report having been ticketed for a moving violation in the last month (OR = 2.22, 95% CI 1.70, 2.90). Suggestions are offered for overcoming potential sources of sampling bias.

Impact on Industry

Web-based surveys produce substantially different results than random-digit-dial telephone surveys, when used for public assessments of traffic safety concerns and behaviors.     

Dissociation between driving performance and drivers' subjective estimates of performance and workload in dual-task conditions

Introduction

The current study measured how concurrent driving and in-vehicle activities of different levels of engagement varied in terms of performance and subjective estimates of demand and performance.

Method

In this test track study, 41 younger and older drivers completed a series of cognitive tasks while driving an instrumented vehicle. One task involved an engaging guessing game where drivers tried to guess the identity of an object. The other task involved a simple mental arithmetic task.

Results

We observed some dissociation between drivers' performance and their subjective reports. For instance, drivers tended to estimate their performance as better for the more engaging guessing task than the arithmetic task, though their performance was actually worse. At the same time, subjective estimates of workload across the two tasks did not vary in the dual-task condition even though they did in the single-task baseline conditions, suggesting that drivers failed to account for the added demands in dual-task situations.

Conclusions

We discuss the implications of these findings for driver safety.

Impact on Industry

Crashes due to distraction can carry tremendous costs for employers, in terms of injury, disability, and loss of potentially productive work years, whether these crashes occur on or off the job.     

Evaluating impaired drivers confidence and intention to "(Please) drink responsibly"

Introduction

Currently, alcohol industry-sponsored advertisements subsume traditional designated driver and don't drink and drive messages within responsible drinking campaigns. Yet, to date, there remains a dearth of literature specifically examining the attitudinal beliefs impaired drivers attach to the responsible drinking message.

Objective

This investigation sought to examine the responsible drinking attitudes and beliefs of impaired drivers, specifically examining their confidence and intention to drink responsibly the next time they consumed alcohol.

Methods

A random sample of 729 students attending a large, public Texas university completed a web-based administration of the Characteristic of Responsible Drinking Survey (CHORDS).

Results

Participants in this sample who had driven while impaired by alcohol exhibited significantly less confidence in refraining from drinking and driving and reported significantly lower intentions to designate a driver, take a taxi, or use a safe-ride program the next time they consumed alcohol. Additionally, they also reported less confidence, and lower intentions, to ensure their blood alcohol concentrations remained below the legal limit (0.08%) the next time they consumed alcohol.

Conclusions

Drivers who had driven while impaired significantly differed in their confidence and intention to drink responsibly the next time they consumed alcohol. Logistic regression results indicate that by increasing one's confidence in responsible drinking, and increasing their intention to drink responsibly, the likelihood of impaired driving can be decreased.

Impact on industry

Results from this investigation demonstrate one’s responsible drinking attitudinal beliefs accounts for a significant amount of the variance associated with one’s alcohol-related behaviors. Thus, further research should examine and establish how individuals conceptualize and practice responsible drinking.     

Risks older drivers pose to themselves and to other road users

Problem

Studies have shown that older drivers have high death rates and lower rates of involvement in crashes that kill others; but most studies have not considered drivers' responsibility for their crashes, and many have considered only one particular measure of risk.

Method

This study examines risks that drivers of various ages pose to themselves and to others on per-driver, per-trip, and per-mile bases, taking responsibility for crashes into account, using United States fatal crash data from 1999 through 2003 and travel estimates from 2001.

Results

Relative to other age groups, drivers aged 85 and older face the highest risk of their own death, whereas teens pose the greatest risk to passengers, occupants of other vehicles, and non-motorists.

Discussion

The oldest drivers pose more risk to other road users than middle-aged drivers do; the degree of their excess risk depends strongly upon how risk is measured.

Impact on industry

These results demonstrate the importance of keeping clear the meaning and implications of various risk measures.     

Predicting driver drowsiness using vehicle measures: Recent insights and future challenges

Introduction

Driver drowsiness is a significant contributing factor to road crashes. One approach to tackling this issue is to develop technological countermeasures for detecting driver drowsiness, so that a driver can be warned before a crash occurs.

Method

The goal of this review is to assess, given the current state of knowledge, whether vehicle measures can be used to reliably predict drowsiness in real time.

Results

Several behavioral experiments have shown that drowsiness can have a serious impact on driving performance in controlled, experimental settings. However, most of those studies have investigated simple functions of performance (such as standard deviation of lane position) and results are often reported as averages across drivers, and across time.

Conclusions

Further research is necessary to examine more complex functions, as well as individual differences between drivers.

Impact on Industry

A successful countermeasure for predicting driver drowsiness will probably require the setting of multiple criteria, and the use of multiple measures.     

Road safety in China: Analysis of current challenges

Introduction

China has the world's largest population, and is the second largest automobile market. China's economy is booming, resulting in a rapid increase in both the road infrastructure and access to private vehicles. Along with economic growth, the ownership of motorized vehicles has almost quadrupled in the past 10 years, from 42.2 million in 1997 to 159.7 million in 2007. However, at the same time, China also has a very high number of road fatalities compared to other countries, with about 100,000 reported fatalities each year.

Method

This study analyzes the Chinese road-fatality situation to identify areas in which the total harm caused by crashes can be substantially and readily reduced. It provides a comprehensive analysis of the current road-fatality situation in China using conventional indices and the likely future trends.

Results

Four areas were identified in which countermeasures have the most potential to substantially reduce fatalities in China: pedestrians and other non-motorists, nighttime driving, vehicle passengers, and motorcycles.

Conclusion

While China faces unprecedented road safety issues, this report identifies major areas in which there are opportunities to greatly reduce total harm.     

Driving self-restriction in high-risk conditions: how do older drivers compare to others?

Introduction

Many older drivers self-restrict or avoid driving under high-risk conditions. Little is known about the onset of driving self-restrictions or how widespread self-restrictions are among drivers of all ages.

Methods

The Second Injury Control and Risk Survey (ICARIS-2) was a nationwide cross-sectional, list-assisted random-digit-dial telephone survey from 2001 to 2003. National prevalence estimates and weighted percentages of those reporting driving self-restrictions were calculated. Multivariable logistic regression was used to explore associations between specific self-restrictions and age group, adjusting for other personal characteristics.

Results

More than half of all drivers reported at least one driving self-restriction. The most commonly reported restriction was avoidance of driving in bad weather (47.5%), followed by at night (27.9%) and on highways or high-speed roads (19%). A greater percentage of young adult women (18-24 years) reported self-restricting in bad weather compared to women in other age groups, and the percentage of drivers self-restricting at night, in bad weather, and on highways or high-speed roads increased steeply after age 64. We found that women, those in low income groups, and those who had driven low annual mileage were more likely to self-restrict.

Conclusions

In addition to assessing self-restrictions among older drivers, a new finding from our study is that self-restrictions are also quite prevalent among younger age groups. Driving self-restrictions may be better understood as a spectrum across ages in which drivers’ reasons for restriction change.

Impact on industry

Future research on the ability of driving self-restrictions to reduce actual crash risk and prevent injuries is needed.     

The Long Beach/Fort Lauderdale relative risk study

Problem

The role of alcohol as a major factor in traffic crash causation has been firmly established. However, controversy remains as to the precise shape of the relative risk function and the BAC at which crash risk begins to increase.

Methods

This study used a case-control design in two locations: Long Beach, California, and Fort Lauderdale, Florida. Data were collected on 2,871 crashes of all severities and a matched control group of drivers selected from the same time, location, and direction of travel as the crash drivers. Of the 14,985 sample drivers, 81.3% of the crash drivers and 97.9% of the controls provided a valid BAC specimen.

Results

When adjusted for covariates and nonparticipation bias, increases in relative risk were observed at BACs of .04-.05, and the elevations in risk became very pronounced when BACs exceeded .10.

Discussion

The results provide strong support for .08 per se laws and for state policies that increase sanctions for BACs in excess of .15.

Impact on Industry

This study provides further precision on the deleterious effects of alcohol on driving and, by implication, on other complex tasks.     

Injury severity analysis of accidents involving young male drivers in Great Britain

Introduction

Young male drivers are over-represented in traffic accidents; they were involved in 14% of fatal accidents from 1991 to 2003 while holding only 8% of all drivers licenses in the UK. In this study, a subset of the UK national road accident data from 1991 to 2003 has been analyzed. The primary aim is to determine how to best use monetary and progressive resources to understand how road safety measures will reduce the severity of accidents involving young male drivers in both London and Great Britain.

Method

Ordered probit models were used to identify specific accident characteristics that increase the likelihood of one of three categorical outcomes of accident severity: slight, serious, or fatal.

Results

Characteristics found to lead to a higher likelihood of serious and fatal injuries are generally similar across Great Britain and London but are different from those predicted to lead to a higher likelihood of slight injuries. Those characteristics predicted to lead to serious and fatal injuries include driving in darkness, between Friday and Sunday, on roads with a speed limit of 60 mph, on single carriageways, overtaking, skidding, hitting an object off the carriageway, and when passing the site of a previous accident. Characteristics predicted to lead to slight injuries include driving in daylight, between Monday and Thursday, on roads with a speed limit of 30 mph or less, at a roundabout, waiting to move, and when an animal is on the carriageway.

Impact on Industry

These results aid the selection of policy options that are most likely to reduce the severity of accidents involving young male drivers.     

"The little squealer" or "the virtual guardian angel"? Young drivers' and their parents' perspective on using a driver monitoring technology and its implications for parent-young driver communication

Introduction

In-vehicle driving monitoring technologies have the potential to enable young drivers to learn from self-assessment. However, their use is largely dependent on parental involvement.

Method

A total of 79 interviews were conducted with young drivers and parents regarding this technology and its use. Most had the experience of having an in-vehicle data recorder installed in the vehicle driven by the young drivers. Parents and the young drivers expressed both appreciation as well as reservations about its potential as a means to enhance the driving safety of young drivers.

Results

A surprising finding was that some parents did not check the feedback and said they relied on the young driver to do so. Main concerns related to privacy, parent-young driver relationship, self-esteem and confidence, constructive use of the feedback data, and the limitations of the documentation that can be done by the technology.

Conclusions

Providing parents and young drivers with a support system and tools to discuss and utilize the feedback are underscored. Challenges include addressing the invasion of young drivers’ privacy and gender differences, and using the monitoring-capacity of the technology to enhance safe driving practices. Implications for programs to enhance communication and a dialogical approach between parents and young drivers are discussed.     

Is a hands-free phone safer than a handheld phone?

Introduction

Although it is becoming more and more accepted that driving while talking on a cell phone can be hazardous, most jurisdictions are making handheld phone use illegal while allowing hands-free phone use.

Methods

The scientific literature exploring the effects of these two types of cell phone use on driving and driving-related performance is reviewed here.

Results

Our review shows that talking on the phone, regardless of phone type, has negative impacts on performance especially in detecting and identifying events. Performance while using a hands-free phone was rarely found to be better than when using a handheld phone. Some studies found that drivers compensate for the deleterious effects of cell phone use when using a handheld phone but neglect to do so when using a hands-free phone.

Impact on Industry

Current research does not support the decision to allow hands-free phone use while driving.     

Are drivers' comparative risk judgments about speeding realistic?

Introduction

This study focused on comparative judgments about speeding risks among young drivers who have a high risk of being involved in a traffic accident.

Method

We examined (a) how these drivers assess their risk of sanctions and their risk of causing an automobile crash because of speeding in comparison to the estimated risks of other drivers, and (b) how realistic their comparative risk judgments are. We measured the relationship between the drivers' comparative risk judgments, self-reported speeding, and driving-related sensation-seeking. We hypothesized that (a) they would think they have less risk of sanctions and of causing a car accident than others, and (b) their comparative judgments of speeding risks would be linked to self-reported speeding and driving-related sensation-seeking. The study was based on a computerized questionnaire survey conducted with 3,002 young drivers (mean age = 22.3) administered by professional investigators.

Results

The results confirmed our hypotheses.

Impact on Industry

In order to improve the effectiveness of prevention measures and to evaluate the effect of them, road-safety interventions should take into account comparative risk judgments about the targeted risk behavior.     

Social norms of accompanied young children and observed crossing behaviors

Introduction

Social norms for accompanied young children and crossing behaviors were examined in two studies conducted in an Ultra-Orthodox Jewish community in Israel.

Method

In Study 1, road behaviors of young children crossing with and without accompaniment and older children were observed, and the actual social norm for accompanied school children younger than 9-years-old was examined. In Study 2, the perceived norm of accompaniment was tested by questionnaires.

Results

Young children who crossed without accompaniment exhibited poorer crossing skills compared to older children and to young children crossing with accompaniment. In the four locations observed, the actual accompaniment rate ranged between 15%-60%. The perceived social norm for child accompaniment was lower than the actual norm.

Conclusions

The discussion refers to both theoretical issues and their practical implications.