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.