Behind the wheel: Examining the long-term effects of a safe transport education program on driving patterns in older adults

Abstract

Background

Safe mobility is key to healthy, active ageing. The ‘Behind the Wheel’ program was designed to promote self-regulation of older drivers' driving habits to help them maintain their safety and preserve their mobility. This study examines changes to driving habits four years after 366 participants completed the ‘Behind the Wheel’ randomised controlled trial.

Methods

All 366 participants who completed the original RCT were invited to participate in the follow-up. All participants in the follow-up completed one home visit where information on driving was self-reported using the Driving Habits Questionnaire. The Keele Assessment of Participation measured community participation while depression was defined as a score of ≥2 on the five-item Geriatric Depression Scale. Two odometer readings collected eight weeks apart were used to estimate driving exposure. Between groups differences in driving exposure and self-regulation were analysed using generalised estimating equations and regression models run in R v4.2.2.

Results

215 participants (mean age = 84 years; 59% of original cohort who completed the RCT) completed the four-year follow-up. Most were still driving with no plans to stop (intervention = 88%, control = 92%). The intervention group was more likely to only drive in their home suburb or local government area than the control (Odds Ratio (OR) 164, 95%Cl 1.03–1.32, adjusted for sex). Most participants in both groups reported using alternative transport in the last month (intervention = 65%, control = 75%, p = 0.05). There were no differences between the two groups on total mileage driven, community participation, crash involvement or depressive symptoms.

Conclusion

Four years after exposure to the education program, older drivers were more likely to restrict their driving to local areas than those who were not exposed. Any effects of older driver education programs on driving patterns may therefore only be noticeable over a long period of time. Further work is needed to balance safe mobility and healthy ageing.