Purchase this article with an account.
C. Owsley, G. McGwin Jr, S.F. McNeal, J.M. Phillips; Impact of an Educational Program on the Safety of High-Risk, Visually-Impaired Older Drivers . Invest. Ophthalmol. Vis. Sci. 2003;44(13):790.
Download citation file:
© ARVO (1962-2015); The Authors (2016-present)
Purpose Older drivers with visual impairment have an elevated risk for motor vehicle collision. We conducted a controlled, randomized intervention trial designed to determine whether an individually administered and tailored health education program promoting strategies to enhance driver safety reduces the crash involvement of visually impaired older drivers at high-risk for crash involvement. Methods 403 licensed, current older drivers (ages 60-91 years) were enrolled and met the following characteristics indicating high risk for crash involvement: crash in the year prior to enrollment, drove at least 5 days and/or 100 miles per week, useful field of view impairment of 40% reduction or worse and/or VA 20/30 or worse. Subjects were randomized to either usual-care (a comprehensive eye exam) or to usual-care plus an educational intervention promoting strategies for safe driving. The intervention, consisting of 2 discussion sessions with a health educator, was highly interactive and individualized, and was based on the Social Cognitive and Transtheoretical Models used in the design of health promotion programs. The outcome variables were crash rate per person years of follow-up and crash rate per person miles of travel during the two-year follow-up period. Crash data were obtained from state records and driving exposure was obtained through the Driving Habits Questionnaire. Results There were no differences between the groups with respect to demographic variables, education, cognitive status, depression, general health, or visual function at the enrollment visit, or history of crash involvement in the prior five years. Those in the intervention group were similar to the usual-care-only group in terms of crash rate per 100-person-years (Relative Risk (RR) 1.08, 95% confidence interval (CI) 0.71-1.64) and per 1 million person miles of travel (RR 1.40, 95% CI 0.92-2.12). Conclusions An individualized educational intervention to promote safe driving strategies among visually-impaired, high risk older drivers does not enhance driver safety. The most effective public health initiatives for reducing crash risk in older drivers may be to focus on the timely treatment of chronic medical conditions in order to prevent, reverse, or slow functional decline. This is a reasonable approach given that common medical conditions in the elderly, including eye problems, have been shown to increase crash risk.
This PDF is available to Subscribers Only