Open Access
Research Article  |   May 2016
Research Opportunities in the Area of Driving and Community Mobility for Older Adults
Article Information
Community Mobility and Driving / Geriatrics/Productive Aging / Evidence-Based Practice
Research Article   |   May 2016
Research Opportunities in the Area of Driving and Community Mobility for Older Adults
American Journal of Occupational Therapy, May 2016, Vol. 70, 7004400010p1-7004400010p2. doi:10.5014/ajot.2016.704001
American Journal of Occupational Therapy, May 2016, Vol. 70, 7004400010p1-7004400010p2. doi:10.5014/ajot.2016.704001
Abstract

The American Occupational Therapy Association (AOTA) Evidence-Based Practice Project has developed a table summarizing the research opportunities in the area of driving and community mobility for older adults. The table provides an overview of the state of current available evidence on interventions within the scope of occupational therapy practice and is based on the systematic reviews from the AOTA Practice Guidelines Series. Researchers, students, and clinicians can use this information in developing innovative research to answer important questions within the occupational therapy field.

Planning a research project requires consideration of many factors. Level of interest and knowledge in a specific area, access to appropriate populations of participants, support of mentors and other researchers, and funding availability all help determine the focus of a future project. An additional component to be considered is whether adequate, up-to-date research has already been completed on a topic; if sufficient evidence is available in a given core area, this area might not be the best choice for another research project.
The best research topic may be one in which either little research has been done or the research to date is insufficient, inconclusive, or mixed. In addition, when research conducted to date provides a low level of evidence and is of limited quality, additional high-quality research in the area is needed.
The “Research Opportunities Table in the Area of Driving and Community Mobility for Older Adults” provides an overview of the state of current available evidence on interventions within the scope of occupational therapy practice. The table is based on the systematic reviews from the American Occupational Therapy Association’s (AOTA’s) Practice Guidelines Series. The table lists specific interventions and indicates either that the evidence is strong to support the intervention or that moderate, mixed, or few studies support the intervention and therefore it is a priority area for future research. Researchers, students, and clinicians can use this information in developing innovative research to answer important questions within the field of occupational therapy. Please refer to Occupational Therapy Practice Guidelines for Driving and Community Mobility for Older Adults (Stav, 2015) and the November/December 2014 issue of the American Journal of Occupational Therapy (Golisz, 2014) for more information on the topic area and the systematic review process. To access other research opportunities tables online and search for research opportunities in other practice areas, visit http://www.aota.org/researchopportunitiestables.
Researchers are also encouraged to enter their projects into AOTA’s Researcher Database at http://myaota.aota.org/research/. This database provides AOTA with information such as relevant clinical settings and populations; International Classification of Functioning, Disability and Health level (World Health Organization, 2001); funder (if any); and key words to help guide research advocacy and policy initiatives.
Research Opportunities Table in the Area of Driving and Community Mobility for Older Adults
Research Opportunities Table in the Area of Driving and Community Mobility for Older Adults×
CategoryInterventionsStrength of Evidence
Person Level
EducationCombining in-class sessions with individual on-road training can improve driving knowledge and on-road driving performance and greatly reduce unsafe driving actions in specific areas of a road test.Strong evidence
Imposing driving restrictions on drivers with declining skills yields safety profiles similar to those of “safe” drivers, good compliance with restrictions, and no incidence of reported traffic violations or crashes.Area for future research
CarFit participants are likely to implement one or more adjustments or use advanced technology safety features they learned about within 6 mo of a CarFit event.Area for future research
CarFit can improve the likelihood that an older driver will participate in a future course on self-regulatory behaviors.Area for future research
Cognitive–perceptual skillsCognitive–perceptual training that involves Useful Field of View can lower at-fault crashes, delay driving cessation, and improve driving performance in clients with stroke and right-hemisphere lesions.Area for future research
Video-based hazard perception training can reduce the latency of hazard perception ability in older drivers.Area for future research
Computer-based cognitive speed of processing training on a driving simulator can improve response times and on-road performance.Area for future research
Use of the Dynavision™ Light Training Board can improve on-road driving performance on a standardized on-road driving assessment of drivers after stroke.Area for future research
Physical fitnessPhysical fitness can improve the driving skills and reduce crash risk of older adults.Area for future research
Simulator trainingA 15-hr program of standardized driver simulation training can improve on-road driving performance in people with stroke.Area for future research
Active personalized feedback during videotaped simulated driving performance can improve identification of peripheral hazards, receptiveness to changing driving behaviors, and performance of secondary looks during real-world driving.Area for future research
On-road trainingOn-road training combined with a classroom session can increase real-world driving performance.Strong evidence
On-road and classroom training of drivers with stroke can improve driving performance.Area for future research
Community Level
Licensure policyGeographic licensing restrictions can reduce moving violations, crashes, and fatalities.Area for future research
Driving cessationDriving cessation group intervention for caregivers of people with dementia can reduce depression, improve self-efficacy and communication, improve acceptance of circumstances and quality of life, optimize mobility, and better prepare the driver and caregiver for cessation of driving.Area for future research
Community mobilityAn education program to inform participants about mobility transition choices and features can increase their knowledge of community mobility options.Area for future research
Group transit training can increase bus use by older adults but may not reduce days of automobile driving.Area for future research
Walkable communitiesLiving in walkable neighborhoods can reduce driving and increase walking.Area for future research
Automobile Modification
High techEducation in the use of countermeasures such as blind spot detection, lane departure warning, and driver-state monitoring can assist with driving.Area for future research
Use of complex auditory navigation systems may decrease safety.Area for future research
Low techPostural support aids can improve driving performance and reduce exertion during driving.Area for future research
Hand controls do not present a higher task demand for older adults.Area for future research
An embedded warning signal (compared with conventional rear brake lights) can improve brake response times.Area for future research
Research Opportunities Table in the Area of Driving and Community Mobility for Older Adults
Research Opportunities Table in the Area of Driving and Community Mobility for Older Adults×
CategoryInterventionsStrength of Evidence
Person Level
EducationCombining in-class sessions with individual on-road training can improve driving knowledge and on-road driving performance and greatly reduce unsafe driving actions in specific areas of a road test.Strong evidence
Imposing driving restrictions on drivers with declining skills yields safety profiles similar to those of “safe” drivers, good compliance with restrictions, and no incidence of reported traffic violations or crashes.Area for future research
CarFit participants are likely to implement one or more adjustments or use advanced technology safety features they learned about within 6 mo of a CarFit event.Area for future research
CarFit can improve the likelihood that an older driver will participate in a future course on self-regulatory behaviors.Area for future research
Cognitive–perceptual skillsCognitive–perceptual training that involves Useful Field of View can lower at-fault crashes, delay driving cessation, and improve driving performance in clients with stroke and right-hemisphere lesions.Area for future research
Video-based hazard perception training can reduce the latency of hazard perception ability in older drivers.Area for future research
Computer-based cognitive speed of processing training on a driving simulator can improve response times and on-road performance.Area for future research
Use of the Dynavision™ Light Training Board can improve on-road driving performance on a standardized on-road driving assessment of drivers after stroke.Area for future research
Physical fitnessPhysical fitness can improve the driving skills and reduce crash risk of older adults.Area for future research
Simulator trainingA 15-hr program of standardized driver simulation training can improve on-road driving performance in people with stroke.Area for future research
Active personalized feedback during videotaped simulated driving performance can improve identification of peripheral hazards, receptiveness to changing driving behaviors, and performance of secondary looks during real-world driving.Area for future research
On-road trainingOn-road training combined with a classroom session can increase real-world driving performance.Strong evidence
On-road and classroom training of drivers with stroke can improve driving performance.Area for future research
Community Level
Licensure policyGeographic licensing restrictions can reduce moving violations, crashes, and fatalities.Area for future research
Driving cessationDriving cessation group intervention for caregivers of people with dementia can reduce depression, improve self-efficacy and communication, improve acceptance of circumstances and quality of life, optimize mobility, and better prepare the driver and caregiver for cessation of driving.Area for future research
Community mobilityAn education program to inform participants about mobility transition choices and features can increase their knowledge of community mobility options.Area for future research
Group transit training can increase bus use by older adults but may not reduce days of automobile driving.Area for future research
Walkable communitiesLiving in walkable neighborhoods can reduce driving and increase walking.Area for future research
Automobile Modification
High techEducation in the use of countermeasures such as blind spot detection, lane departure warning, and driver-state monitoring can assist with driving.Area for future research
Use of complex auditory navigation systems may decrease safety.Area for future research
Low techPostural support aids can improve driving performance and reduce exertion during driving.Area for future research
Hand controls do not present a higher task demand for older adults.Area for future research
An embedded warning signal (compared with conventional rear brake lights) can improve brake response times.Area for future research
×
Acknowledgments
This work is based on the November/December 2014 issue of the American Journal of Occupational Therapy (Golisz, 2014) and the Occupational Therapy Practice Guidelines for Driving and Community Mobility for Older Adults (Stav, 2015), developed in collaboration with the AOTA Evidence-Based Practice Project.
References
Golisz, K. (Ed.). (2014). Occupational therapy and driving and community mobility for older adults [Special issue]. American Journal of Occupational Therapy, 68(6).
Golisz, K. (Ed.). (2014). Occupational therapy and driving and community mobility for older adults [Special issue]. American Journal of Occupational Therapy, 68(6).×
Stav, W. (2015). Occupational therapy practice guidelines for driving and community mobility for older adults. Bethesda, MD: AOTA Press.
Stav, W. (2015). Occupational therapy practice guidelines for driving and community mobility for older adults. Bethesda, MD: AOTA Press.×
World Health Organization. (2001). International classification of functioning, disability and health. Geneva: Author.
World Health Organization. (2001). International classification of functioning, disability and health. Geneva: Author.×
Research Opportunities Table in the Area of Driving and Community Mobility for Older Adults
Research Opportunities Table in the Area of Driving and Community Mobility for Older Adults×
CategoryInterventionsStrength of Evidence
Person Level
EducationCombining in-class sessions with individual on-road training can improve driving knowledge and on-road driving performance and greatly reduce unsafe driving actions in specific areas of a road test.Strong evidence
Imposing driving restrictions on drivers with declining skills yields safety profiles similar to those of “safe” drivers, good compliance with restrictions, and no incidence of reported traffic violations or crashes.Area for future research
CarFit participants are likely to implement one or more adjustments or use advanced technology safety features they learned about within 6 mo of a CarFit event.Area for future research
CarFit can improve the likelihood that an older driver will participate in a future course on self-regulatory behaviors.Area for future research
Cognitive–perceptual skillsCognitive–perceptual training that involves Useful Field of View can lower at-fault crashes, delay driving cessation, and improve driving performance in clients with stroke and right-hemisphere lesions.Area for future research
Video-based hazard perception training can reduce the latency of hazard perception ability in older drivers.Area for future research
Computer-based cognitive speed of processing training on a driving simulator can improve response times and on-road performance.Area for future research
Use of the Dynavision™ Light Training Board can improve on-road driving performance on a standardized on-road driving assessment of drivers after stroke.Area for future research
Physical fitnessPhysical fitness can improve the driving skills and reduce crash risk of older adults.Area for future research
Simulator trainingA 15-hr program of standardized driver simulation training can improve on-road driving performance in people with stroke.Area for future research
Active personalized feedback during videotaped simulated driving performance can improve identification of peripheral hazards, receptiveness to changing driving behaviors, and performance of secondary looks during real-world driving.Area for future research
On-road trainingOn-road training combined with a classroom session can increase real-world driving performance.Strong evidence
On-road and classroom training of drivers with stroke can improve driving performance.Area for future research
Community Level
Licensure policyGeographic licensing restrictions can reduce moving violations, crashes, and fatalities.Area for future research
Driving cessationDriving cessation group intervention for caregivers of people with dementia can reduce depression, improve self-efficacy and communication, improve acceptance of circumstances and quality of life, optimize mobility, and better prepare the driver and caregiver for cessation of driving.Area for future research
Community mobilityAn education program to inform participants about mobility transition choices and features can increase their knowledge of community mobility options.Area for future research
Group transit training can increase bus use by older adults but may not reduce days of automobile driving.Area for future research
Walkable communitiesLiving in walkable neighborhoods can reduce driving and increase walking.Area for future research
Automobile Modification
High techEducation in the use of countermeasures such as blind spot detection, lane departure warning, and driver-state monitoring can assist with driving.Area for future research
Use of complex auditory navigation systems may decrease safety.Area for future research
Low techPostural support aids can improve driving performance and reduce exertion during driving.Area for future research
Hand controls do not present a higher task demand for older adults.Area for future research
An embedded warning signal (compared with conventional rear brake lights) can improve brake response times.Area for future research
Research Opportunities Table in the Area of Driving and Community Mobility for Older Adults
Research Opportunities Table in the Area of Driving and Community Mobility for Older Adults×
CategoryInterventionsStrength of Evidence
Person Level
EducationCombining in-class sessions with individual on-road training can improve driving knowledge and on-road driving performance and greatly reduce unsafe driving actions in specific areas of a road test.Strong evidence
Imposing driving restrictions on drivers with declining skills yields safety profiles similar to those of “safe” drivers, good compliance with restrictions, and no incidence of reported traffic violations or crashes.Area for future research
CarFit participants are likely to implement one or more adjustments or use advanced technology safety features they learned about within 6 mo of a CarFit event.Area for future research
CarFit can improve the likelihood that an older driver will participate in a future course on self-regulatory behaviors.Area for future research
Cognitive–perceptual skillsCognitive–perceptual training that involves Useful Field of View can lower at-fault crashes, delay driving cessation, and improve driving performance in clients with stroke and right-hemisphere lesions.Area for future research
Video-based hazard perception training can reduce the latency of hazard perception ability in older drivers.Area for future research
Computer-based cognitive speed of processing training on a driving simulator can improve response times and on-road performance.Area for future research
Use of the Dynavision™ Light Training Board can improve on-road driving performance on a standardized on-road driving assessment of drivers after stroke.Area for future research
Physical fitnessPhysical fitness can improve the driving skills and reduce crash risk of older adults.Area for future research
Simulator trainingA 15-hr program of standardized driver simulation training can improve on-road driving performance in people with stroke.Area for future research
Active personalized feedback during videotaped simulated driving performance can improve identification of peripheral hazards, receptiveness to changing driving behaviors, and performance of secondary looks during real-world driving.Area for future research
On-road trainingOn-road training combined with a classroom session can increase real-world driving performance.Strong evidence
On-road and classroom training of drivers with stroke can improve driving performance.Area for future research
Community Level
Licensure policyGeographic licensing restrictions can reduce moving violations, crashes, and fatalities.Area for future research
Driving cessationDriving cessation group intervention for caregivers of people with dementia can reduce depression, improve self-efficacy and communication, improve acceptance of circumstances and quality of life, optimize mobility, and better prepare the driver and caregiver for cessation of driving.Area for future research
Community mobilityAn education program to inform participants about mobility transition choices and features can increase their knowledge of community mobility options.Area for future research
Group transit training can increase bus use by older adults but may not reduce days of automobile driving.Area for future research
Walkable communitiesLiving in walkable neighborhoods can reduce driving and increase walking.Area for future research
Automobile Modification
High techEducation in the use of countermeasures such as blind spot detection, lane departure warning, and driver-state monitoring can assist with driving.Area for future research
Use of complex auditory navigation systems may decrease safety.Area for future research
Low techPostural support aids can improve driving performance and reduce exertion during driving.Area for future research
Hand controls do not present a higher task demand for older adults.Area for future research
An embedded warning signal (compared with conventional rear brake lights) can improve brake response times.Area for future research
×