Effect of a group intervention to promote older adults' adjustment to driving cessation on community mobility: a randomized controlled trial.

OBJECTIVES The UQDRIVE program, a group education and support program, was developed to meet the needs associated with driving cessation for older adults. The current study investigated the effect of the program on community mobility. DESIGN AND METHODS A prospective, parallel, stratified randomized controlled trial was undertaken with a waitlist control group receiving current clinical practice (no intervention). Data were collected pre, post, and 3 months following the intervention. Participants were adults aged 60 years or older who had ceased driving or planned to cease driving within 12 months. RESULTS A total of 131 participants were included in analyses (67 intervention, 64 control). Participating in the intervention was significantly associated with a higher number of episodes away from home per week at immediately postintervention (z = 2.56, p = .01). This was not significantly maintained at 3-month follow-up. Participation in the intervention also significantly predicted higher use of public transport at immediately postintervention (z = 2.12, p = .034), higher use of walking at immediately postintervention (z = 2.69, p = .007), increased aspects of community mobility self-efficacy (z = 3.81, p = .0001), and higher satisfaction with transport at 3-month follow-up (z = 2.07, p = .038). IMPLICATIONS The program increased community mobility immediately postintervention and transport satisfaction at 3 months postintervention. Due to a high attrition rate, further research is required to clarify the long-term impact of the intervention.

[1]  J. Charlton,et al.  Attitudes to and Mobility Impacts of Driving Cessation: Differences Between Current and Former Drivers , 2009 .

[2]  E. H. Goulding,et al.  Cellular Telephones Measure Activity and Lifespace in Community‐Dwelling Adults: Proof of Principle , 2011, Journal of the American Geriatrics Society.

[3]  Jacki Liddle,et al.  Older Road Users: From Driving Cessation to Safe Transportation , 2004 .

[4]  L. Hakamies‐Blomqvist,et al.  Medical Screening of Older Drivers as a Traffic Safety Measure—A Comparative Finnish‐Swedish Evaluation Study , 1996, Journal of the American Geriatrics Society.

[5]  David Elliott,et al.  Older driver risks and counterneasures : source book , 1995 .

[6]  R. B. Taylor,et al.  The model of human occupation , 2013 .

[7]  Lisa J. Molnar,et al.  Promising approaches for promoting lifelong community mobility , 2007 .

[8]  L. Kostyniuk,et al.  Older Adults’ Driving Reduction and Cessation , 2013, Journal of applied gerontology : the official journal of the Southern Gerontological Society.

[9]  Gary Kielhofner,et al.  Model of human occupation : theory and application , 1985 .

[10]  K. McKenna,et al.  Improving outcomes for older retired drivers: The UQDRIVE program , 2006 .

[11]  T. Meuser,et al.  Assessment of Readiness for Mobility Transition (ARMT) , 2013, Journal of applied gerontology : the official journal of the Southern Gerontological Society.

[12]  P. Diggle,et al.  Analysis of Longitudinal Data , 2003 .

[13]  J. Gladman,et al.  Randomised controlled trial of an occupational therapy intervention to increase outdoor mobility after stroke , 2004, BMJ : British Medical Journal.

[14]  K. McKenna,et al.  Older Drivers and Driving Cessation , 2003 .

[15]  E. Pfeiffer A Short Portable Mental Status Questionnaire for the Assessment of Organic Brain Deficit in Elderly Patients † , 1975, Journal of the American Geriatrics Society.

[16]  N. Pachana,et al.  Participant Feedback and Satisfaction with the UQDRIVE Groups for Driving Cessation , 2011, Canadian journal of occupational therapy. Revue canadienne d'ergotherapie.

[17]  Jon E Burkhardt,et al.  Improving Public Transit Options for Older Persons , 2002 .

[18]  K. Lorig Outcome measures for health education and other health care interventions , 1996 .

[19]  Sherrilene Classen,et al.  International Older Driver Consensus Conference on Assessment, Remediation and Counseling for Transportation Alternatives: Summary and Recommendations. , 2005, Physical & occupational therapy in geriatrics.

[20]  P. Diggle,et al.  Analysis of Longitudinal Data. , 1997 .

[21]  Merrill Turpin,et al.  The Needs and Experiences Related to Driving Cessation for Older People , 2008 .

[22]  Patricia Rigby,et al.  The Person-Environment-Occupation Model: A Transactive Approach to Occupational Performance , 1996 .

[23]  Lesley A Ross,et al.  Driving status and three-year mortality among community-dwelling older adults. , 2009, The journals of gerontology. Series A, Biological sciences and medical sciences.

[24]  K. Anstey,et al.  The role of perceived control in explaining depressive symptoms associated with driving cessation in a longitudinal study. , 2007, The Gerontologist.

[25]  Maria Vegega,et al.  Medical conditions and driving : a review of the literature (1960-2000). , 2005 .

[26]  T. Meuser,et al.  Decoding the Miss Daisy Syndrome: An Examination of Subjective Responses to Mobility Change , 2011, Journal of gerontological social work.

[27]  Jean W. Wilkins,et al.  Premature Reduction and Cessation of Driving: Preliminary Study of Women Who Choose Not To Drive or To Drive Infrequently , 1999 .

[28]  J O Prochaska,et al.  Stages of change in the modification of problem behaviors. , 1992, Progress in behavior modification.

[29]  C. M. Parkes Psycho-social transitions: a field for study. , 1971, Social science & medicine.

[30]  Mônica Sanches Yassuda,et al.  DRIVING CESSATION: THE PERSPECTIVE OF SENIOR DRIVERS , 1997 .