Journal article
An online driving decision aid for older drivers reduces ambivalence and regret about driving decisions: Randomized trial
Journal of the American Geriatrics Society (JAGS), Vol.73(2), pp.492-505
02/2025
DOI: 10.1111/jgs.19293
PMCID: PMC12001976
PMID: 39630631
Abstract
BackgroundDecisions about driving cessation can be stressful for older adults. We tested effects of a driving decision aid (DDA) on psychosocial outcomes among older drivers during two-year follow-up.MethodsMultisite randomized controlled trial of licensed drivers ages >= 70 with at least one diagnosis associated with increased likelihood of driving cessation, without significant cognitive impairment. The intervention was the online Healthwise (R) DDA, addressing "Is it time to stop driving?"; controls received National Institute on Aging web-based information for older drivers. Outcomes were assessed at baseline, 6, 12, 18, and 24 months. Primary outcomes were the Decision Regret Scale, Decisional Conflict Scale (assessing decisional ambivalence or uncertainty), and PROMIS Depression (4a) Scale. Self-reported Life-Space Assessment (assessing community mobility), crashes and driving outcomes were also assessed. Using intention-to-treat analyses, we tested whether DDA (vs. control) effects on each outcome differed during follow-up using a study group by time interaction. Longitudinal outcomes were modeled using generalized linear mixed models, accounting for repeated measures, age, site, and baseline visit before vs. during COVID.ResultsWe enrolled 301 participants (age at enrollment: mean 77.1 (range 70-92) years; 51% identifying as female). During follow-up, the DDA group had less decisional conflict (pinteraction = 0.010) and decision regret (pinteraction = 0.012). The DDA had its greatest effect on decisional conflict immediately post-intervention (adjusted mean ratio [aMR] = 0.87; 95%CI: 0.79, 0.97) and on decision regret at 12-month follow-up (aMR = 0.45; 95%CI: 0.27, 0.72). Odds of depression were similar between groups during follow-up (pinteraction = 0.237). The intervention did not negatively affect life space, crashes, or other driving outcomes.ConclusionsIn older drivers, the Healthwise (R) DDA reduced uncertainty and regret about driving decisions during longitudinal follow-up, without adversely affecting community mobility or crash risk. Use of DDAs in clinical and other settings may reduce the distress older adults often experience when making decisions about driving cessation.
Details
- Title: Subtitle
- An online driving decision aid for older drivers reduces ambivalence and regret about driving decisions: Randomized trial
- Creators
- Carolyn G. Diguiseppi - Colorado School of Public HealthLinda L. Hill - University of California San DiegoNicole R. Fowler - Indiana University – Purdue University IndianapolisRachel L. Johnson - Colorado School of Public HealthRyan A. Peterson - Colorado School of Public HealthS. Duke Han - University of Southern CaliforniaBrandon Josewski - University of Colorado Anschutz Medical CampusChristopher E. Knoepke - University of Colorado Anschutz Medical CampusDaniel D. Matlock - VA Eastern Colorado Health Care SystemFaris Omeragic - University of Colorado Anschutz Medical CampusMarian E. Betz - University of Colorado Anschutz Medical Campus
- Resource Type
- Journal article
- Publication Details
- Journal of the American Geriatrics Society (JAGS), Vol.73(2), pp.492-505
- DOI
- 10.1111/jgs.19293
- PMID
- 39630631
- PMCID
- PMC12001976
- NLM abbreviation
- J Am Geriatr Soc
- ISSN
- 0002-8614
- eISSN
- 1532-5415
- Publisher
- Wiley
- Number of pages
- 14
- Grant note
- National Institute on Aging; United States Department of Health & Human Services; National Institutes of Health (NIH) - USA; NIH National Institute on Aging (NIA)
- Language
- English
- Date published
- 02/2025
- Academic Unit
- Biostatistics; Internal Medicine
- Record Identifier
- 9984914149602771
Metrics
3 Record Views