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KEYS Knowledge Enhances Your Safety. Clinical Research Unit Department of Ophthalmology University of Alabama at Birmingham. Beth Stalvey, MPH, PhD, CHES. Target: High-Risk Older Drivers. Crash Involved Visually Impaired Legally Licensed High Driving Exposure. Curriculum.

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Presentation Transcript
slide1

KEYS

Knowledge Enhances Your Safety

Clinical Research Unit

Department of Ophthalmology

University of Alabama at Birmingham

Beth Stalvey, MPH, PhD, CHES

target high risk older drivers
Target: High-Risk Older Drivers
  • Crash Involved
  • Visually Impaired
  • Legally Licensed
  • High Driving Exposure
delivery
Delivery
  • One-on-One
  • Eye Care Clinic
  • Tailored to Individual
    • Visual Function
    • Driving Habits
  • Theory Based
1 informational component visual function and impact on driving
1) Informational Component: Visual Function and Impact on Driving
  • Visual Acuity
  • Contrast Sensitivity
  • Depth Perception
  • Peripheral Vision
  • Visual Processing
  • Objective Assessment (Exam; Screening)
skill building hazard avoidance and self regulation
Skill-Building: Hazard Avoidance and Self-Regulation

Driving Hazard

Alternative Strategy

Night

Rain

Interstate

Left-Turn

High-Traffic

Rush-Hour

Driving Alone

Day

No Rain

Access Road

3 Right-Turns; Arrow

Less Traveled Routes

Off-Peak Hours

Driving Companion

confidence building and behavior change
Confidence Building and Behavior Change
  • Vicarious Learning (Driving Scenes)
  • Goal Setting (Signed Contract)
  • Vicarious Experience (Testimonial)
  • Self-Efficacy (Homework)
    • Self-Assessment; Driving Diary
  • Booster
    • Skill Review; Verbal Reinforcement
slide9

Study Design

Usual

Eye Care

Control

R

A

N

D

Post

-Test

Comprehensive

O

Assessment

Baseline

Eye

M

6, 12, 18, 24

Assessment

I

months

Exam

Z

E

Educational

D

Intervention

+

Usual Eye

Care

2 Sessions

outcomes
Outcomes

At six-month post-test, those who participated in education session reported

significantly

  • Greater level of perceived vision impairment and understanding of impact on driving
  • Higher number of perceived benefits to self-regulation and hazard avoidance
  • Greater readiness to make driving behavior change
slide11

Driving Exposure

300

7

p=0.02

6

p=0.01

250

5

Usual Care

200

Usual Care

4

150

Intervention

3

100

Intervention

2

50

1

0

0

Miles Per Week

Places Per Week

slide12

Driving Exposure

p<0.0001

p<0.0001

Intervention

Intervention

Usual Care

Usual Care

Hazard Avoidance

Self-Regulation

summary
Summary
  • Education

Changes in knowledge and perceptions

  • Driver Performance

Reduction in driving exposure

Increased self-regulation

  • Safety

Similar crash rates

crash rate as safety outcome
Crash Rate as Safety Outcome
  • Sufficient Power to evaluate
  • Length of evaluation period
  • Fault of driver

Self-Awareness

Motivation

Skill

Self-Regulation

Confidence

?

Safety

Knowledge