Research Papers

Individualized On-road training to enhance safe driving in seniors: A randomized controlled trial

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Date added June 30, 2016
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Category 2016 CARSP XXVI Halifax
Tags Research and Evaluation, Session 2B
Author/Auteur Erica Sawula
Stream/Volet Research and Evaluation

Slidedeck Presentation only (no paper submitted)

2B - Sawula

Abstract

Background/Context: In Canada, seniors’ driving exposure is rising. Therefore, senior driver safety is an area requiring considerable attention. However, while much attention has been devoted to identifying unsafe drivers, less research has examined approaches to enhance safe driving behavior in seniors.

Aims/Objectives: The objective of this study was to examine the effectiveness of driver training component combinations (i.e., on-road driving and simulator training) with individualized feedback, in order to determine which components are necessary in enhancing safe driving performance in older adult drivers.

Methods/Target Group: We used a randomized controlled trial (RCT) study design. Based on their age and sex, participants (65+, n=78) were block randomized to one of three driving training intervention groups: 1) Basic training (BT) group: received an in-class safe driving education component only; 2) On-road training (ORT) group: received both an in-class education component and on-road training component; 3) On-road and simulator training (ORT+S) group: received an in-class education component, an on-road training component, and a simulator training component.

Two sessions of individualized on-road instruction, based on the driving instructor review of the baseline videos, was given to participants in the ORT and ORT+S groups to target the main concern areas. The ORT+S group received an additional one-hour simulator training session.

The main outcome measure was the number of unsafe driving actions committed on a standardized on-road driving evaluation, captured by video and GPS technology, and scored by a blinded, independent rater, before and after receiving designated driving training interventions.

To analyze differences across the three study groups, we used an analysis of covariance (ANCOVA) with on-road driving evaluation post scores as the outcome variable and baseline on-road driving scores as the covariate."

Results/Activities: Mean baseline total on-road driving scores were similar for intervention groups, averaging 129.78 (SD=29.87) for the control group, 128.48 (SD=20.15) for the in-class plus on-road training group, and 127.73 (SD=24.24) for the in-class plus on-road plus simulator training group. The control group achieved an average reduction of 7.18 (95% CI [0.11, 14.26]) unsafe-driving actions; the in-class plus on-road training group and the in-class plus on-road plus simulator-training group achieved an average reduction of 41.64 (95% CI [26.21, 53.29]) and 38.69 (95% CI [22.20, 52.16]) unsafe-driving actions, respectively, especially regarding vehicle control (p=.010) and observation errors (p<.001).

Discussion/Deliverables: These results suggest that on-road training with a review of on-road driving evaluation videos and individualized feedback of on-road driving performance can improve on-road safe-driving performance in older adult drivers. The addition of simulator training with individualized feedback in the BT+OR+S group did not produce a greater reduction in unsafe-driving actions compared to the BT+OR group. One explanation for this result may be that a substantial number (n=13) of participants in the BT+OR+S group could not complete the simulated drive due to simulator sickness.

Conclusions: The findings demonstrate that achieving considerable improvements in older adults’ driving relies on on-road training and that individualized feedback supplementation should be the focus of more inquiry. Limitations and future research directions will also be discussed.

Erica Sawula