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.     

Structural equation model analysis for the evaluation of overall driving performance: A driving simulator study focusing on driver distraction

Objective: The present research relies on 2 main objectives. The first is to investigate whether latent model analysis through a structural equation model can be implemented on driving simulator data in order to define an unobserved driving performance variable. Subsequently, the second objective is to investigate and quantify the effect of several risk factors including distraction sources, driver characteristics, and road and traffic environment on the overall driving performance and not in independent driving performance measures.

Methods: For the scope of the present research, 95 participants from all age groups were asked to drive under different types of distraction (conversation with passenger, cell phone use) in urban and rural road environments with low and high traffic volume in a driving simulator experiment. Then, in the framework of the statistical analysis, a correlation table is presented investigating any of a broad class of statistical relationships between driving simulator measures and a structural equation model is developed in which overall driving performance is estimated as a latent variable based on several individual driving simulator measures.

Results: Results confirm the suitability of the structural equation model and indicate that the selection of the specific performance measures that define overall performance should be guided by a rule of representativeness between the selected variables. Moreover, results indicate that conversation with the passenger was not found to have a statistically significant effect, indicating that drivers do not change their performance while conversing with a passenger compared to undistracted driving. On the other hand, results support the hypothesis that cell phone use has a negative effect on driving performance. Furthermore, regarding driver characteristics, age, gender, and experience all have a significant effect on driving performance, indicating that driver-related characteristics play the most crucial role in overall driving performance.

Conclusions: The findings of this study allow a new approach to the investigation of driving behavior in driving simulator experiments and in general. By the successful implementation of the structural equation model, driving behavior can be assessed in terms of overall performance and not through individual performance measures, which allows an important scientific step forward from piecemeal analyses to a sound combined analysis of the interrelationship between several risk factors and overall driving performance.     

Validation of the propensity for angry driving scale

Problem: This study examined the validity of the Propensity for Angry Driving Scale (PADS; DePasquale, J. P., Geller, E. S., Clarke, S. W., and Littleton, L. C. (2001). Measuring road rage: Development of the Propensity for Angry Driving Scale. Journal of Safety Research, 32, 1–16) in predicting aggressive driving. Method: The PADS and the Driving Anger Scale (DAS; Deffenbacher, J. L., Oetting, E. R., and Lynch, R. S. (1994). Development of a driving anger scale. Psychological reports, 74, 83–91.) were administered to 232 college student volunteers with measures of aggressive and risky driving. Results: Convergent and discriminant validity of the PADS were supported through relationships among measures of similar constructs. The PADS significantly (p<.05) predicted moving tickets, minor accidents, aggressive driving, risky driving, and maladaptive driving anger expression, above and beyond gender, miles driven per week, and trait anger. Discussion: Findings suggest that the PADS is a useful predictor of aggressive driving and has some advantages over the DAS. Impact on Industry: The PADS is an effective predictor of aggressive driving that complements established measures like the DAS and provides researchers with another valuable tool for the assessment of aggressive driving.     

Improving older driver knowledge and self-awareness through self-assessment: the driving decisions workbook

PURPOSE: This study aims to assess whether the Driving Decisions Workbook, a self-assessment instrument for older drivers, increased self-awareness and general knowledge. This study also assessed perceptions regarding its usefulness, particularly as a tool for facilitating discussions within families of older drivers. A secondary purpose of the study was to determine if problems identified by drivers in the workbook related to problems they had with actual driving. DESIGN AND METHODS: The Driving Decisions Workbook was administered along with a questionnaire and a road test. A convenience sample of 99 licensed drivers aged 65 and above was used. RESULTS: After completing the workbook, about three fourths of the participants reported being more aware of changes that could affect driving. Fourteen percent reported that they had discovered a change in themselves of which they had not been previously aware. All respondents found the workbook to be at least a little useful and thought the workbook could help facilitate family discussions. Workbook responses were positively correlated with overall road test scores. Significant correlations were also noted between the road test and a majority of workbook subsection responses. IMPLICATIONS: This study indicates that the workbook may be a useful first-tier assessment instrument and educational tool for the older driver. It may encourage an older driver to drive more safely and/or to seek clinical assessment, and help in facilitating discussions about driving within their families.     

Making sense of invulnerability at work—a qualitative study of police drivers

This paper reports a qualitative study of 54 police drivers who were interviewed about their views on police driver training, driving strategies and their accident involvement. Study of the transcribed interviews indicated that officers constructed narratives of themselves as being highly aware of hazards presented by other road users and they used a variety of discursive devices to minimise their own culpability and attribute risk elsewhere. Rather than maintaining a straightforward ‘illusion of invulnerability’ they were formulating a ‘topography of risk’ in which they were responding to hazards presented by suspects or other road users. Their meticulously detailed accounts of the circumstances surrounding accidents serve to place them as knowledgeable and impartial participants and create a sense of expertise and authority. Training initiatives could profitably seek to challenge this ‘topography of risk’ and sense of authority so that drivers more fully appreciate the hazard they may present to themselves and the public.     

Driving performance while using cell phones: an observational study

INTRODUCTION: Through spontaneous driving observations, this study sought to examine the impact of using a hands-free cell phone while driving on speed and safe gap keeping behaviors. The study also examined the association between the measure of disturbance created by using a cell phone and the driver's awareness of the disturbance. METHOD: Twenty-three male adults were observed while driving for an hour and a half each; drivers were unaware of being observed. During the session, each of the participants received a phone call, initiated by an associate of the observer. The experiment was divided into two periods during which the experimental parameters were monitored: 10 minutes during conversation on a cell phone and 10 minutes of non-conversation on a hands-free cell phone. After the experiment, the driver was questioned concerning the extent to which his/her driving was disturbed by the cell phone conversation. RESULTS: T-test for matched samples revealed that the gaps between the drivers' cars and those in front of them diminished when drivers were engaged in the cell phone conversations. Repeated measures ANOVA revealed that drivers that had short conversations did not change their speed, while drivers who were engaged in long (over 16 minutes) conversations drove faster. No effect of drivers' awareness toward cell phone-related disturbance on actual driving behavior monitored in the present study was found.     

Young driver risk in relation to parents' retrospective driving record

PROBLEM: Parents are an important potential influence on the driving safety of their children. This study examined the relationship of parental driving record on male and female offspring's at-fault collision risk. METHOD: Drivers aged 16-21 on the date of full licensure were selected from driver records and a matching process was used to identify putative parents in two-parent households. Poisson regression models were developed to predict at-fault collisions of male and female youth in the three years following full licensure from parents' at-fault collisions, speeding offenses, and other moving offenses in the four years prior to children's licensure. One set of models examined the relative risk associated with increasing numbers of maternal and paternal at-fault collisions and offenses. Other models examined the joint versus separate maternal and parental contributions. RESULTS: Controlling for region of residence, both mothers' and fathers' at-fault collisions were associated with an increased risk in both male and female youth at-fault collisions. Mothers' and fathers' speeding offenses were also associated with increased relative risk of at-fault collisions for both sons and daughters, while fathers' other moving offenses increased collision risk for sons but not daughters. DISCUSSION: Further research is required to identify how parental driving risk is transmitted to children. IMPACT ON INDUSTRY: (a) Parents of young children should be informed of their role in influencing their children's future driving risk; (b) The results identify risk factors that could be of interest to licensing authorities and the insurance industry.     

Longitudinal examination of underage drinking and subsequent drinking and risky driving

INTRODUCTION: Alcohol use, alcohol misuse, and risky driving from adolescence into young adulthood were compared by drinking onset age. METHODS: Surveys were administered in Grades 5/6, 6/7, 7/8, 10, 12, and at approximately age 23. Participants were placed into Drinking Onset groups based on self-reported alcohol use frequency on the adolescent surveys. Driving records were examined in three age periods: under 21, 21-25, and 26+. RESULTS: The earliest drinking initiators reported higher alcohol use and misuse on each survey, and were more likely to have risky driving offenses before age 21 and to have alcohol driving offenses in all three age periods. DISCUSSION: The earliest drinking initiators engaged in risky drinking behavior and risky driving behavior that was consistently higher than those with later drinking initiation, beginning in adolescence and persisting well into young adulthood.     

Parents' views of teen driving risks, the role of parents, and how they plan to manage the risks

PROBLEM: There is limited information about how parents view teen driving risks and intend to handle these risks during the licensing process, and how they will respond to graduated licensing provisions. METHODS: Parents in Connecticut were interviewed when their teens got their learner's permit. The survey was undertaken when the state did not have a midnight restriction or a passenger restriction. RESULTS: Generally, parents were well aware of teen driving risks, thought parents should be thoroughly involved in the licensing process, and plan to be active participants themselves. DISCUSSION: Parents were concerned about the risk of driving after midnight and already restrict that behavior. However, parents do not seem to see or understand the risks of having even one teen passenger in the vehicle. IMPACT ON INDUSTRY: The views and existing practices of parents need to be taken into account in deciding on the provisions of graduated licensing legislation and how to best ensure acceptance and compliance.     

Factors associated with driving under the influence of alcohol

Objective: This study examined the risk factors of driving under the influence of alcohol (DUI) among drivers of specific vehicle categories (DSC). On the basis of this research, the variables related to DUI and involvement in traffic crashes were defined. The analysis was conducted for car drivers, bicyclists, motorcyclists, bus drivers, and truck drivers.

Method: The research sample included drivers involved in traffic crashes on the territory of Serbia in 2016 (60,666). Two types of analyses were conducted in this study. Logistic regression established the correlation between DUI and DSC and the The Technique for Order of Preference by Similarity to Ideal Solution (Multi-criteria decision making) method was applied to consider the scoring and explore the potential for the prevalence of DUI on the basis of 2 data sets (DUI and non DUI).

Results: The study results showed that driver error and male drivers were the 2 most significant risk factors for DUI, with the highest scores and potential for prevalence. The nonuse of restraint systems, driver experience, and driver age are the factors with a significant prediction of involvement in an accident and an insignificant prediction of DUI.

Conclusions: Following the development of the logistic prediction models for DUI drivers, testing of the model was conducted for 3 control driver groups: Car, motorcycle, and bicycle. The prediction model with a probability greater than 50% showed that 77% of car drivers were under the influence of alcohol. Similarly, the prediction percentage for motorcyclists and bicyclists amounted to 71 and 67%, respectively. The recommendation of the study is that drivers whose DUI probability is above 50% should be potentially suspected of DUI. The results of this study can help to understand the problem of DUI among specific driver categories and detect DUI drivers, with the aim of creating successful traffic safety policy.