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Lima ACP, Maximiano-Barreto MA, Martins TCR, Luchesi BM. Factors associated with poor health literacy in older adults: A systematic review. Geriatr Nurs 2024; 55:242-254. [PMID: 38070263 DOI: 10.1016/j.gerinurse.2023.11.016] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2023] [Revised: 11/24/2023] [Accepted: 11/27/2023] [Indexed: 02/06/2024]
Abstract
OBJECTIVES To identify factors associated with poor health literacy in older adults. METHODS A systematic literature review was conducted, employing the descriptors "Aged" and "Health Literacy". PROSPERO - CRD 42022350140. RESULTS Out of 23,500 articles screened, 176 were selected. Several factors associated with poor health literacy in older adults were identified, such as sociodemographic (e.g., advanced age, low educational level, non-white population, and others), social (e.g., poor family/social support, loneliness, social isolation, few social activities, and others), economic (e.g., lower income and/or lower socioeconomic status) and health aspects (e.g., poor health, chronic conditions, mental health challenges, hospitalizations, frailty, physical inactivity, cognitive impairment, and others). CONCLUSIONS The factors associated with poor health literacy in older adults identified in this review could contribute to future research, support interventions to improve health literacy, and assist professionals in planning educational activities and public policies.
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Affiliation(s)
- Ana Caroline Pinto Lima
- Campus de Três Lagoas, Programa de Pós-Graduação em Enfermagem, Federal University of Mato Grosso do Sul, Três Lagoas, MS, Brazil
| | | | - Tatiana Carvalho Reis Martins
- Campus de Três Lagoas, Programa de Pós-Graduação em Enfermagem, Federal University of Mato Grosso do Sul, Três Lagoas, MS, Brazil; Instituto Integrado de Saúde, Federal University of Mato Grosso do Sul, Campo Grande, MS, Brazil
| | - Bruna Moretti Luchesi
- Campus de Três Lagoas, Programa de Pós-Graduação em Enfermagem, Federal University of Mato Grosso do Sul, Três Lagoas, MS, Brazil; Research Group on Mental Health, Cognition and Aging, Federal University of São Carlos, São Carlos, SP, Brazil.
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Liang D, Lau N, Antin JF. Modeling of older adults' driving exposure and avoidance using objective driving data in a naturalistic driving study. ACCIDENT; ANALYSIS AND PREVENTION 2022; 174:106728. [PMID: 35689967 DOI: 10.1016/j.aap.2022.106728] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/27/2021] [Revised: 05/13/2022] [Accepted: 05/31/2022] [Indexed: 06/15/2023]
Abstract
Older adults in the United States rely heavily on driving their own vehicles to commute to work, shop for groceries, and access public services. To effectively help older adults maintain mobility and independence,we need to better understand how thecognitive, visual functioning, and health declines influence their tendency to self-restrict their driving. The objective of this study is to develop a causal model to examine the effects of age, gender, household status (specifically living alone), physical, cognitive, visual abilities, and health status on older adults' driving mobility in terms of driving exposure and avoidance. Driving exposure was measured by actual driving data, whereas driving avoidance was assessed by both self-report data and actual driving exposure to challenging situations. Structural equation modeling was used to analyze data collectedin the Second Strategic Highway Research Program Naturalistic Driving Study for establishing relationships between the selected factors and mobility. The structural equation model included a total of794 participants aged 65 and over (367 or 46.22%femalesand 427 or 53.78% males). Results indicate that poorer health is associated with less driving exposure; deteriorating cognitive and physical capabilities are associated with more self-reported driving avoidance and less actual driving in challenging situations; visual function is associated with self-reported avoidance; living alone is associated with higher driving exposure in general as well as in challenging situations; self-reported driving avoidance of challenging situations has a negative association with actual driving in those same situations. The final model could be applied to predict older adults' mobility changes according to their age, gender, household status, as well as their visual, physical, cognitive and health status.
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Affiliation(s)
- Dan Liang
- Grado Department of Industrial and Systems Engineering, Virginia Tech, Blacksburg, VA 24060, United States.
| | - Nathan Lau
- Grado Department of Industrial and Systems Engineering, Virginia Tech, Blacksburg, VA 24060, United States.
| | - Jonathan F Antin
- Virginia Tech Transportation Institute, Blacksburg, VA 24060, United States.
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Bahrampouri S, Khankeh HR, Hosseini SA, Mehmandar M, Ebadi A. Components of driving competency measurement in the elderly: A scoping review. Med J Islam Repub Iran 2021; 35:2. [PMID: 33996653 PMCID: PMC8111623 DOI: 10.47176/mjiri.35.2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2020] [Indexed: 11/28/2022] Open
Abstract
Background: Iran will face the "aging Tsunami" phenomenon by the 2040s. Therefore, paying attention to the elderly's driving to maintain and promote their independence and quality of life on the one hand and paying attention to the dangers of driving by the elderly for road safety will be important. The purpose of this research was to determine the components of driving competency in the elderly.
Methods: The research has employed a scoping review. To this end, searches of scientific databases were conducted using keywords between 1990 and 2019. The process of selecting the documentation was-based on the PRISMA chart.
Results: In the first phase, 2769 records were found, and finally, 37 records met the inclusion criteria set for this study. The results indicated that 18 components were extracted that were classified into seven main categories including cognitive, sensory, motor, mental functions, and medications, diseases, and driving history.
Conclusion: Sensory, motor, and cognitive abilities are the most important components of elderly safe driving. Therefore, as age increases, chronic disease, multiple drug use, and subsequent problems increase. This can affect the ability to drive safely and can cause traffic injuries. Therefore, it is recommended to use the results of this research to design a suitable tool and model for assessing driving competency in the elderly.
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Affiliation(s)
- Saiedeh Bahrampouri
- Health in Emergency and Disaster Research Center, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Hamid Reza Khankeh
- Health in Emergency and Disaster Research Center, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Seyed Ali Hosseini
- Health in Emergency and Disaster Research Center, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | | | - Abbas Ebadi
- Behavioral Sciences Research Center, Life Style, Baqiyatallah University of Medical Sciences, Tehran, Iran.,Nursing Faculty, Baqiyatallah University of Medical Sciences, Tehran, Iran
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Fukuda Y, Ando S, Saito M. Risk awareness, medication adherence, and driving behavior as determined by the provision of drug information to patients. PATIENT EDUCATION AND COUNSELING 2020; 103:1574-1580. [PMID: 32173213 DOI: 10.1016/j.pec.2020.02.037] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/22/2019] [Revised: 02/24/2020] [Accepted: 02/27/2020] [Indexed: 06/10/2023]
Abstract
OBJECTIVE The study identifies appropriate risk expressions by healthcare professionals in communicating the risks of driving-impairing medicine to patients, gauging changed patient behavior, preventing traffic accidents due to drugs, and improving drug adherence. METHODS An online questionnaire survey was conducted on participants' perception of driving-related risks, and risk awareness, as well as reports of healthcare professionals' expressions and warning messages regarding driving-impairing drugs. RESULTS Approximately 80 % of participants were aware of the effects of pharmaceutical drugs on driving ability, and 50 % responded that they had received an explanation from their respective health professionals. As reported by participants, although healthcare professionals typically used more indirect expressions, direct warning messages were associated with high-risk awareness. CONCLUSION The content of the explanatory sentences and debriefing influenced risk perception among participants. Direct expressions were more desirable for appropriate risk perception by participants. Providing information from healthcare professional about the degree of risks and patients' determining their influence on driving behavior based on risk perception was necessary to clarify the predictors of driving behavior. PRACTICE IMPLICATIONS Health professionals should be aware that their warning messages could have a significant impact on patients' risk perception and driving behavior.
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Affiliation(s)
- Yasue Fukuda
- Suzuka University of Medical Science, 3500-3 Minami-tamagaki, Suzuka, Mie, 513-8670, Japan.
| | - Shuji Ando
- Department of Information and Computer Technology, Tokyo University of Science, 6-3-1 Niijuku, Katsushika-ku, Tokyo, 125-8585, Japan.
| | - Moemi Saito
- Faculty of Pharma-Science, Teikyo University, 2-11-1 Kaga, Itabashi-ku, Tokyo, 174-8605, Japan.
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Personal and Clinical Factors Associated with Older Drivers' Self-Awareness of Driving Performance. Can J Aging 2020; 40:82-96. [PMID: 32089137 DOI: 10.1017/s071498082000001x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Most older adults perceive themselves as good drivers; however, their perception may not be accurate, and could negatively affect their driving safety. This study examined the accuracy of older drivers' self-awareness of driving ability in their everyday driving environment by determining the concordance between the perceived (assessed by the Perceived Driving Ability [PDA] questionnaire) and actual (assessed by electronic Driving Observation Schedule [eDOS]) driving performance. One hundred and eight older drivers (male: 67.6%; age: mean = 80.6 years, standard deviation [SD] = 4.9 years) who participated in the study were classified into three groups: underestimation (19%), accurate estimation (29%), and overestimation (53%). Using the demographic and clinical functioning information collected in the Candrive annual assessments, an ordinal regression showed that two factors were related to the accuracy of self-awareness: older drivers with better visuo-motor processing speed measured by the Trail Making Test (TMT)-A and fewer self-reported comorbid conditions tended to overestimate their driving ability, and vice versa.
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Molnar L, Eby D, Vivoda J, Bogard S, Zakraksek J, St. Louis R, Zanier N, Ryan L, LeBlanc D, Smith J, Yung R, Nyquist L, DiGuiseppi C, Li G, Mielenz T, Strogatz D. The effects of demographics, functioning, and perceptions on the relationship between self-reported and objective measures of driving exposure and patterns among older adults. TRANSPORTATION RESEARCH. PART F, TRAFFIC PSYCHOLOGY AND BEHAVIOUR 2018; 54:367-377. [PMID: 30337834 PMCID: PMC6190922 DOI: 10.1016/j.trf.2018.02.026] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
The exploratory study reported here was intended to examine: how strongly subjectively reported driving avoidance behaviors (commonly referred to as self-regulation) and exposure were related to their objectively measured counterparts and whether it depended on the specific behavior; the extent to which gender and age play a role in the association between subjectively reported driving avoidance behaviors and exposure and their objectively measured counterparts; and the extent to which demographics, health and functioning, driving-related perceptions, and cognition influence the association between subjective and objective driving avoidance behaviors overall. The study used data from the Longitudinal Research on Aging Drivers (LongROAD) study, a multisite, prospective cohort study designed to generate empirical data for understanding the role of medical, behavioral, environmental, and technological factors in driving safety during the process of aging. Objective driving measures were derived from GPS/datalogger data from 2131 LongROAD participants' vehicles. The corresponding subjective measures came from a comprehensive questionnaire administered to participants at baseline that asked them to report on their driving exposure, patterns, and other aspects of driving. Several other variables used in the analyses came from the comprehensive questionnaire and an inperson clinical assessment administered to participants at baseline. A series of simple linear and logistic models were fitted to examine the relationship between the subjective and objective driving measures of interest, and a multivariable analysis was conducted to examine the potential role of selected factors in the relationship between objective and subjective driving avoidance behaviors. Results of the models are presented and overall findings are discussed within the context of the existing research literature.
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Affiliation(s)
- L.J. Molnar
- University of Michigan Transportation Research Institute, Ann Arbor, MI, United States
- Center for Advancing Transportation Leadership and Safety (ATLAS Center), Ann Arbor, MI, United States
| | - D.W. Eby
- University of Michigan Transportation Research Institute, Ann Arbor, MI, United States
- Center for Advancing Transportation Leadership and Safety (ATLAS Center), Ann Arbor, MI, United States
| | - J.M. Vivoda
- Miami University, Sociology and Gerontology, Oxford, OH, United States
| | - S.E. Bogard
- University of Michigan Transportation Research Institute, Ann Arbor, MI, United States
| | - J.S. Zakraksek
- University of Michigan Transportation Research Institute, Ann Arbor, MI, United States
- Center for Advancing Transportation Leadership and Safety (ATLAS Center), Ann Arbor, MI, United States
| | - R.M. St. Louis
- University of Michigan Transportation Research Institute, Ann Arbor, MI, United States
- Center for Advancing Transportation Leadership and Safety (ATLAS Center), Ann Arbor, MI, United States
- Monash University Accident Research Centre, Clayton, Australia
| | - N. Zanier
- University of Michigan Transportation Research Institute, Ann Arbor, MI, United States
- Center for Advancing Transportation Leadership and Safety (ATLAS Center), Ann Arbor, MI, United States
| | - L.H. Ryan
- Institute for Social Research, University of Michigan, Ann Arbor, MI, United States
| | - D. LeBlanc
- University of Michigan Transportation Research Institute, Ann Arbor, MI, United States
| | - J. Smith
- Institute for Social Research, University of Michigan, Ann Arbor, MI, United States
| | - R. Yung
- Institute of Gerontology, Division of Geriatric and Palliative Medicine, University of Michigan, Ann Arbor, MI, United States
| | - L. Nyquist
- Institute of Gerontology, Division of Geriatric and Palliative Medicine, University of Michigan, Ann Arbor, MI, United States
| | - C. DiGuiseppi
- Department of Epidemiology, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, CO, United States
| | - G. Li
- Department of Anesthesiology, Columbia University College of Physicians and Surgeons, New York, NY, United States
- Department of Epidemiology, Mailman School of Public Health, Columbia’s Injury Control Research Center, Columbia University, New York, NY, United States
| | - T.J. Mielenz
- Department of Epidemiology, Mailman School of Public Health, Columbia’s Injury Control Research Center, Columbia University, New York, NY, United States
| | - D. Strogatz
- Bassett Research Institute, Bassett Healthcare Network, Cooperstown, NY, United States
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Alonso F, Esteban C, Sanmartín J, Useche SA. Reported prevalence of health conditions that affect drivers. COGENT MEDICINE 2017. [DOI: 10.1080/2331205x.2017.1303920] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
Affiliation(s)
- Francisco Alonso
- DATS (Development and Advising in Traffic Safety) Research Group, INTRAS (Traffic and Road Safety Institute), University of Valencia, c/Serpis, 29, Valencia 46022, Spain
| | - Cristina Esteban
- DATS (Development and Advising in Traffic Safety) Research Group, INTRAS (Traffic and Road Safety Institute), University of Valencia, c/Serpis, 29, Valencia 46022, Spain
| | - Jaime Sanmartín
- METRAS Research Group (Measurement, Evaluation, Analysis, and Data Processing of Traffic Accidents and Road Safety), INTRAS (Traffic and Road Safety Institute), University of Valencia, c/Serpis, 29, Valencia 46022, Spain
| | - Sergio A. Useche
- DATS (Development and Advising in Traffic Safety) Research Group, INTRAS (Traffic and Road Safety Institute), University of Valencia, c/Serpis, 29, Valencia 46022, Spain
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Karthaus M, Falkenstein M. Functional Changes and Driving Performance in Older Drivers: Assessment and Interventions. Geriatrics (Basel) 2016; 1:geriatrics1020012. [PMID: 31022806 PMCID: PMC6371115 DOI: 10.3390/geriatrics1020012] [Citation(s) in RCA: 61] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2016] [Revised: 05/12/2016] [Accepted: 05/12/2016] [Indexed: 11/18/2022] Open
Abstract
With the increasing aging of the population, the number of older drivers is rising. Driving is a significant factor for quality of life and independence concerning social and working life. On the other hand, driving is a complex task involving visual, motor, and cognitive skills that experience age-related changes even in healthy aging. In this review we summarize different age-related functional changes with relevance for driving concerning sensory, motor, and cognitive functions. Since these functions have great interindividual variability, it is necessary to apply methods that help to identify older drivers with impaired driving abilities in order to take appropriate measures. We discuss three different methods to assess driving ability, namely the assessment of (i) functions relevant for driving; (ii) driving behavior in real traffic; and (iii) behavior in a driving simulator. We present different measures to improve mobility in older drivers, including information campaigns, design of traffic and car environment, instructions, functional training, and driving training in real traffic and in a driving simulator. Finally, we give some recommendations for assessing and improving the driving abilities of older drivers with multi-modal approaches being most promising for enhancing individual and public safety.
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Affiliation(s)
- Melanie Karthaus
- Leibniz Research Centre for Working Environment and Human Factors at TU Dortmund (IfADo), Dortmund D-44139, Germany.
| | - Michael Falkenstein
- Leibniz Research Centre for Working Environment and Human Factors at TU Dortmund (IfADo), Dortmund D-44139, Germany.
- Institute for Working, Learning, and Aging, Bochum D-44805, Germany.
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9
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Levasseur M, Audet T, Gélinas I, Bédard M, Langlais MÈ, Therrien FH, Renaud J, Coallier JC, D'Amours M. Awareness tool for safe and responsible driving (OSCAR): a potential educational intervention for increasing interest, openness and knowledge about the abilities required and compensatory strategies among older drivers. TRAFFIC INJURY PREVENTION 2015; 16:578-586. [PMID: 25802971 DOI: 10.1080/15389588.2014.994742] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
OBJECTIVE This pilot study aimed to verify the impact of the awareness tool for safe and responsible driving (OSCAR) on older adults' (1) interest, openness, and knowledge about the abilities and compensatory strategies required for safe driving; (2) awareness of changes that have occurred in their own driving abilities; and (3) actual utilization of compensatory strategies. METHODS A preexperimental design, including a pretest (T0) and posttest (T1) 8 to 10 weeks after exposure to the intervention, was used with 48 drivers aged between 67 and 84. The participants had a valid driving license and drove at least once a week. RESULTS Overall, the results demonstrate that OSCAR increased interest, openness, and knowledge about the abilities and compensatory strategies of older drivers (P <.01). After exposure to OSCAR, the majority of the participants confirmed that changes had occurred in at least one of their abilities. Moreover, half of the older drivers reported having started using 6 or more compensatory strategies. CONCLUSION In summary, in addition to increasing older adults' interest, openness, and knowledge to discussion about driving, OSCAR also improved awareness of the changes that could negatively impact safe driving and enhanced utilization of compensatory strategies. While promoting safe driving and the prevention of crashes and injuries, this intervention could ultimately help older adults maintain or increase their transportation mobility. More studies are needed to further evaluate OSCAR and identify ways to improve its effectiveness.
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Affiliation(s)
- Mélanie Levasseur
- a Research Centre on Aging, Health and Social Services Centre, University Institute of Geriatrics of Sherbrooke (CSSS-IUGS) , Sherbrooke , Quebec , Canada
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Wong IY, Smith SS, Sullivan KA, Allan AC. Toward the Multilevel Older Person's Transportation and Road Safety Model: A New Perspective on the Role of Demographic, Functional, and Psychosocial Factors. J Gerontol B Psychol Sci Soc Sci 2014; 71:71-86. [PMID: 25186955 DOI: 10.1093/geronb/gbu099] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2014] [Accepted: 07/07/2014] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVES Self-regulation refers to the practice of using self-imposed restrictions to protect oneself from situations that are, or are perceived to be, unsafe. Within the driving context, self-regulation refers the compensatory practices that some older adults adopt to restrict their driving to situations in which they feel safe. However, the way in which demographic, functional, and psychosocial factors, and the interactions between these factors, influence older adults' driving self-regulation is not well understood. Improving this understanding could lead to new ways of considering the mobility concerns faced by older drivers. METHOD A systematic review of the current literature was conducted to explore this issue. Twenty-nine empirical studies investigating the factors associated with older adults' self-regulatory driving behaviors were examined. RESULTS The review findings were used to construct the Multilevel Older Persons Transportation and Road Safety (MOTRS) model. The MOTRS model proposes that individual and environmental factors such as age, gender, and the availability of alternative transportation predict older adults' practice of driving-related self-regulation. However, these variables influence self-regulation through psychosocial variables such as driving confidence, affective attitude, and instrumental attitude toward driving. DISCUSSIONS The MOTRS model extends previous attempts to model older adults' driving by focusing on a novel target, driving self-regulation, and by including a wider range of predictors identified on the basis of the systematic literature review. This focus enables consideration of broader mobility issues and may inform new strategies to support the mobility of older adults.
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Affiliation(s)
- Ides Y Wong
- School of Population Health, The University of Queensland, Brisbane, Australia. Centre for Accident Research and Road Safety-Queensland (CARRS-Q), Queensland University of Technology, Brisbane, Australia.
| | - Simon S Smith
- Centre for Accident Research and Road Safety-Queensland (CARRS-Q), Queensland University of Technology, Brisbane, Australia. Institute of Health and Biomedical Innovation (IHBI), Queensland University of Technology, Brisbane, Australia
| | - Karen A Sullivan
- Institute of Health and Biomedical Innovation (IHBI), Queensland University of Technology, Brisbane, Australia. Clinical Neuropsychology Research Group, School of Psychology and Counselling, Queensland University of Technology, Brisbane, Australia
| | - Alicia C Allan
- Centre for Accident Research and Road Safety-Queensland (CARRS-Q), Queensland University of Technology, Brisbane, Australia. Institute of Health and Biomedical Innovation (IHBI), Queensland University of Technology, Brisbane, Australia
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De Boni RB, Pechansky F, Vasconcellos MTD, Bastos FI. Have drivers at alcohol outlets changed their behavior after the new traffic law? ACTA ACUST UNITED AC 2013; 36:11-5. [PMID: 24402182 DOI: 10.1590/1516-4446-2013-1131] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2013] [Accepted: 07/11/2013] [Indexed: 11/22/2022]
Abstract
OBJECTIVE In an attempt to reduce high levels of traffic crashes, a new legislation was approved in Brazil in 2008. This study aimed to assess behavioral change among drivers who had drunk at alcohol outlets (AO) after implementation of the law. METHOD A three-stage probability sampling survey was conducted in Porto Alegre, state of Rio Grande do Sul, Brazil. Individuals seen leaving AOs after drinking were approached (n=3,018). Selected drivers (n=683) answered a structured interview, were breathalyzed, and had saliva specimens collected for drug screening. RESULTS Overall, 60.3% (SE 4.5) of drivers reported they did not change their behavior. Among those who reported behavioral changes, most reported drinking less as their main strategy toward safer driving behavior. Variables independently associated with behavior change included having drunk at a high outlet density area (odds ratio [OR] 1.7 [1.1-2.8]) and having a favorable opinion about the law (OR 4.3 [2.1-8.9]). CONCLUSIONS Our findings suggest that awareness of the law has not been enough to promote behavioral change. As most drivers had a favorable opinion of the law and this variable was found to be the strongest predictor of behavior change, efforts to better integrate education and enforcement seem to be pivotal and might be well received by the population.
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12
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Molnar LJ, Eby DW, Charlton JL, Langford J, Koppel S, Marshall S, Man-Son-Hing M. Reprint of "Driving avoidance by older adults: Is it always self-regulation?". ACCIDENT; ANALYSIS AND PREVENTION 2013; 61:272-280. [PMID: 23896447 DOI: 10.1016/j.aap.2013.07.004] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
Self-regulation shows promise as a means by which older adults can continue to drive at some level without having to stop altogether. Self-regulation is generally described as the process of modifying or adjusting one's driving patterns by driving less or intentionally avoiding driving situations considered to be challenging, typically in response to an awareness that driving skills have declined. However, most studies asking older adults whether they avoid certain driving situations or have reduced the amount of driving they do under certain circumstances have not delved deeper into the motivations for such avoidance or driving reduction. There are many reasons for modifying driving that have nothing to do with self-regulation, such as no longer needing to take trips at certain times of day because of changes in preferences or lifestyles. The purpose of this study was to examine self-regulatory practices among older adults at multiple levels of driver performance and decision making, taking into account the specific motivations for avoiding particular driving situations or engaging in other driving practices. Study participants completed a computer-based questionnaire on driving self-regulation. Results suggest that self-regulation is a complex process that cannot be defined simply by the reported driving modifications made by drivers. Understanding the motivations for these behaviors is necessary and the study showed that they are varied and differ considerably across driving situations. Reasons for driving avoidance or other practices were often more closely related to lifestyle or preferences than to self-regulation. Based on these findings, three distinct groups were identified with regard to whether and for what reasons participants modified their driving.
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Affiliation(s)
- Lisa J Molnar
- University of Michigan Transportation Research Institute (UMTRI), 2901 Baxter Road, Ann Arbor, MI 48109-2150, United States; Monash University Accident Research Centre, Monash Injury Research Institute, Monash University, Building 70, Victoria 3800, Australia.
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13
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Molnar LJ, Eby DW, Charlton JL, Langford J, Koppel S, Marshall S, Man-Son-Hing M. Driving avoidance by older adults: is it always self-regulation? ACCIDENT; ANALYSIS AND PREVENTION 2013; 57:96-104. [PMID: 23659865 DOI: 10.1016/j.aap.2013.04.010] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/20/2012] [Revised: 03/28/2013] [Accepted: 04/09/2013] [Indexed: 06/02/2023]
Abstract
Self-regulation shows promise as a means by which older adults can continue to drive at some level without having to stop altogether. Self-regulation is generally described as the process of modifying or adjusting one's driving patterns by driving less or intentionally avoiding driving situations considered to be challenging, typically in response to an awareness that driving skills have declined. However, most studies asking older adults whether they avoid certain driving situations or have reduced the amount of driving they do under certain circumstances have not delved deeper into the motivations for such avoidance or driving reduction. There are many reasons for modifying driving that have nothing to do with self-regulation, such as no longer needing to take trips at certain times of day because of changes in preferences or lifestyles. The purpose of this study was to examine self-regulatory practices among older adults at multiple levels of driver performance and decision making, taking into account the specific motivations for avoiding particular driving situations or engaging in other driving practices. Study participants completed a computer-based questionnaire on driving self-regulation. Results suggest that self-regulation is a complex process that cannot be defined simply by the reported driving modifications made by drivers. Understanding the motivations for these behaviors is necessary and the study showed that they are varied and differ considerably across driving situations. Reasons for driving avoidance or other practices were often more closely related to lifestyle or preferences than to self-regulation. Based on these findings, three distinct groups were identified with regard to whether and for what reasons participants modified their driving.
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Affiliation(s)
- Lisa J Molnar
- University of Michigan Transportation Research Institute (UMTRI), 2901 Baxter Road, Ann Arbor, MI 48109-2150, United States.
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Levy BR, Ng R, Myers LM, Marottoli RA. A psychological predictor of elders' driving performance: social-comparisons on the road. JOURNAL OF APPLIED SOCIAL PSYCHOLOGY 2013; 43:556-561. [PMID: 26877547 DOI: 10.1111/j.1559-1816.2013.01035.x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Older individuals often believe they can drive better than their contemporaries. This belief is an example of downward social-comparisons; they can be self-enhancing tools that lead to beneficial outcomes. As predicted, we found that drivers who engaged in downward social-comparisons were significantly less likely to have adverse driving events over time, after controlling for relevant factors (p = .02). This effect was particularly strong among women, who tend to experience more negative driving stereotypes (p = .01). The study was based on 897 interviews of 117 elder drivers, aged 70-89 years, over 2 years. Our findings suggest that interventions to reduce adverse driving events among elders could benefit from including a psychological component.
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