Table 4 Synthesis of intervention studies involving education-based training programs

Coxon et al., [34]

n = 366

yr = between 75 and 94 years old.

c = Australia

RCT

To ascertain whether a safe-transportation program can change driving exposure while maintaining community participation of older drivers

Participants were randomized in 2 groups:

-Intervention group (n: 190): They had to participate in two sessions held 1 month apart. The session was delivered by an occupational therapist face to face and lasted 120 and 45 min, the first and second session, respectively

-Control group (n: 190): Did not receive any education.

Before the randomization all the participants performed the baseline assessment and self-reported questionnaires. Also, the driving exposure was measure over the 12 months of study through an in vehicle monitoring device.

(B) Driving exposure measure over the 12-month study period with an in-vehicle monitoring device

(B): Driving space and use of alternate transportation were measured using a questionnaire.

(B): Depressive symptoms were measured using the Geriatric Depression Scale.

B (−): An education program does not translate to significant differences in the distance driven per week, the restriction of driving space, the use of alternate transportation and the community participation after 12-month post intervention. Also, there was no difference between the control and intervention group in proportion of participants with two or more depressive symptoms at 12 months.

B (+): Participants in the intervention group were more likely to be closer to adopting self-regulatory driving practices at 12 months than control group. The odds of the participants in the intervention group being in a higher behavioral profile were 1.6 times greater than those in the control group.

Nasvadi and Vavrik, [35]

n = 139 (was considered phase 2)

yr = between 55 and 94 years old.

c = Canada

Retro-

Cohort

Determine if the crash rate of aging drivers can be mitigated by post-license driver education

The participants were divided in 2 group:

-Drivers who attended the 55 alive/mature driving courses between January 1, 2000 and July 31, 2003 (n: ns).

-Drivers who did not attend the educational program (n: ns).

Then were compared the crashes rates after the date of attendance at the course, until December 31, 2003

(CR): Crashes and violations were obtained from Insurance Corporation of British Columbia.

CR (−): Older men and women who attended the 55 Alive/Mature Driving course had a 1.5 times greater odds of being involved in a crash than their matched controls. These results were marginally significant

(p = .078). For women separately, there was no difference between subjects and controls for the number of post-course crashes, regardless of age category. However, for men, drivers aged 75 years and older who attended 55 Alive/Mature Driving were 3.8 times more likely to be involved in a crash (p = .050).

Nasvadi, [36]

n = 367

yr = between 55 and 94 years old.

c = Canada

Retro-

Cohort

Examine long-term learning outcomes of a sample of older drivers who attended a mature driver education program.

The cohort consisted of drivers aged 55 years and older who attended the 55 alive/mature driving course.

All participants were surveyed by telephone.

(SA/K) and (B): The survey contained open-ended and closed questions and asked respondents to recall what they had learned in the course, and how their driving behavior had changed because of attending.

SA/K (+) B (+): Three quarters of participants said they changed their driving habits as a result of attending the course (55 alive/mature) including: increased awareness and visual skills; changes in attitude; improved speed and space margins; avoidance of hazards; using more caution; obeying road rules; and improved vehicle maneuvers. Men were more likely to report their driving skills had improved since taking the course, and older men reported significantly higher mean comfort scores with their driving.

Jones et al., [37]

n = 58

yr = average age 70.9 years old (ages N/S). c = USA

RCT

Describe driving experiences and habits of a community sample of older drivers (60+ years) and to determine whether the program reduces these older adults’ driving risk exposures.

Participants were randomized in 2 groups:

-Intervention group (n: 33): 4 weeks of training in a classroom setting with 2 h of training per week. The 4 sessions include: roadwise review, road smart, safer driving and being medwise to stay roadwise medication.

-Control group (n:25): Did not receive training

The both group completed the baseline questionnaire and after the 4 weeks completed the questionnaire again.

(B): Driving habit risk exposure were divide in two types

-Higher driving risk exposure: defined as frequency of driving further than 10 miles from home, after dark, between 5 pm and 7 pm, and on interstates.

-Lower driving risk exposure: defined as frequency of driving less than 2 miles from home and before 9 am.

(B): They also asked for driving experience

B (−): There were no statistical differences in lower and higher driving risk exposure when comparing the intervention and control group.

Gaines et al., [38]

n = 195

yr = between 79 and 84 years old

c = NM

RCT

Assess the process and short-term effects of the CarFit program.

Participants were randomized in 2 groups:

-CarFit group (n: 83): the intervention was carried out in one day through an individual appointment with the community’s CarFit event coordinator. Each CarFit assessment required approximately 15 min for completion. Therefore, the total time could be 150 min.

-Comparison group (n:112): Did not receive training

All the participants answered the driving questionnaire in the baseline and six months after the CarFit intervention.

(B): A driving questionnaire based in 3 parts was applied:

-Driving Activity: a higher score indicates greater driving activity.

-Comfortable Driving: a lower score indicates greater comfort during the driving activities.

-Driving Behaviors: a lower score indicates safer driving behaviors.

B (−): There was no statistically significant difference between having a CarFit intervention or not receiving training after the six-month post CarFit intervention in driving behaviors.

Jones et al., [39]

n = 44

yr = average age 79 years old (ages N/S). c = USA

RCT

Compare the impact of a multi-session interactive, expert-led version of the training program (Seniors on the MOVE – Version-A) to a self-guided and less resource intensive version of the program (Seniors on the Move – Version-B) on older drivers’ knowledge and behavior pertaining to driving.

Participants were randomized in 2 groups:

-SOM-A (n: 20): Consisted in the four sessions utilized in the Jones et al., 2011 and the CarFit assessment.

-SOM-B (n: 24): Consisted in a self-guided and less intensive version of the SOM-A. The participants had to assist to a one session and two optional (one was in class and the other the CarFit assessment)

At the beginning of each session the groups completed the baseline questionnaire, then immediately after the completion of the programs and finally after 6 months after the baseline.

(SA/K): Self-reported driving knowledge 15 items were developed by the authors to assess specific details taught during the sessions.

SA/K (+): They found significant differences in SOM-A group between the baseline and the first follow up in the knowledge of the proper placement of the head restraint, the time checking tire pressure, muscle relaxers do not affect driving and the definition of moderate drinking for older adults. But this significant difference with the follow up two was only with the item of definition of drinking for older adults. For the other hand, the SOM- B demonstrated a significant difference between follow up two on knowledge about muscle relaxers.

SA/K (+/−): Comparing the mean total knowledge scores baseline and immediately after the completion of the training between the groups they found that the program with 4 obligatory sessions was significant greater than the self-guided program with only one required session. However, this difference was not significant after 6 months.