A Randomized Trial of a Comprehensive Training Process to Enhance Safe Driving in Older Adults

Abstract

In Canada, older adult driving exposure is increasing quite drastically. However, older adult drivers have a higher motor vehicle collision fatality risk compared to younger age groups. Therefore, older adult driver safety is an area requiring considerable attention. Using a randomized controlled trial study design, the present study investigated the effectiveness of a comprehensive training process to enhance safe driving in older adults. Based on their age and sex, participants (n=78), aged 65 years and above, were block randomized to one of three driving training intervention groups: 1) in-class training (control); 2) in-class plus on-road training (with individualized feedback); and 3) in-class plus on-road plus simulator training (with individualized feedback). The main outcome measure was the number of unsafe-driving actions committed before and after receiving designated driving training interventions on a standardized on-road driving evaluation, captured by video and GPS technology, and scored by a blinded, independent rater. Driving knowledge and driving comfort data were also collected for all participants before and after receiving their designated interventions. 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 and observation errors. Driving knowledge also significantly improved from 74.4% to 83.2% of questions answered correctly before receiving the in-class training component to after receiving the in-class training component; however, there were no significant differences between intervention groups in post- intervention driving comfort levels. 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 are also discussed.