Journal article
"Is it time to stop driving?": A randomized clinical trial of an online decision aid for older drivers
Journal of the American Geriatrics Society (JAGS), Vol.70(7), pp.1987-1996
07/01/2022
DOI: 10.1111/jgs.17791
PMCID: PMC9283277
PMID: 35441700
Abstract
Many older adults face the difficult decision of when to stop driving. We sought to test whether an online driving decision aid (DDA) would improve decision quality.
This prospective two-arm randomized trial enrolled English-speaking licensed drivers (age ≥70 years) without significant cognitive impairment but with ≥1 diagnosis associated with increased likelihood of driving cessation; all participants received primary care in clinics associated with study sites in three states. The intervention was the online Healthwise® DDA for older adults addressing "Is it time to stop driving?"; control was web-based information for older drivers only. The primary outcome was decision conflict as estimated by the Decisional Conflict Scale (DCS; lower scores indicate higher quality). Secondary outcomes were knowledge and decision self-efficacy about driving decisions. We examined postrandomization differences in primary and secondary outcomes by study arm using generalized linear mixed-effects models with adjustment for site and prerandomization scores.
Among 301 participants (mean age: 77.1 years), 51.2% identified as female and the majority as non-Hispanic (99.0%) and white (95.3%); 98.0% lived in an urban area. Participant characteristics were similar by study arm but differed across sites. Intervention participants had a lower mean DCS score (12.3 DDA vs 15.2 control; adjusted mean ratio [AMR] 0.76, 95%CI 0.61-0.95; p = 0.017). Intervention participants had higher mean knowledge scores (88.9 DDA vs. 79.9 control; OR 1.13, 95%CI 1.01-1.27, p = 0.038); there was no difference between groups in self-efficacy scores. The DDA had high acceptability; 86.9% of those who viewed it said they would recommend it to others in similar situations.
The online Healthwise® DDA decreased decision conflict and increased knowledge in this sample of English-speaking, older adults without significant cognitive impairment, although most chose to continue driving. Use of such resources in clinical or community settings may support older adults as they transition from driving to other forms of mobility.
ClinicalTrials.gov identifier "Advancing Understanding of Transportation Options (AUTO)" NCT04141891.
Details
- Title: Subtitle
- "Is it time to stop driving?": A randomized clinical trial of an online decision aid for older drivers
- Creators
- Marian E Betz - University of Colorado DenverLinda L Hill - University of California San DiegoNicole R Fowler - Indiana University – Purdue University IndianapolisCarolyn DiGuiseppi - Colorado School of Public HealthS Duke Han - University of Southern CaliforniaRachel L Johnson - Colorado School of Public HealthLauren Meador - University of Colorado DenverFaris Omeragic - University of Colorado DenverRyan A Peterson - Colorado School of Public HealthDaniel D Matlock - University of Colorado Denver
- Resource Type
- Journal article
- Publication Details
- Journal of the American Geriatrics Society (JAGS), Vol.70(7), pp.1987-1996
- DOI
- 10.1111/jgs.17791
- PMID
- 35441700
- PMCID
- PMC9283277
- NLM abbreviation
- J Am Geriatr Soc
- ISSN
- 0002-8614
- eISSN
- 1532-5415
- Grant note
- R01 EB006841 / NIBIB NIH HHS R01 EB005846 / NIBIB NIH HHS R01 AG059613 / NIA NIH HHS UL1 TR002535 / NCATS NIH HHS
- Language
- English
- Date published
- 07/01/2022
- Academic Unit
- Biostatistics; Internal Medicine
- Record Identifier
- 9984914146402771
Metrics
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