CMS Project # 92791
PI: Sherrilene Classen, Ph.D.
Title: Validity and Usability of a Safe Driving Behaviors Measure for Older Adults
Department: Occupational Therapy [View final report here.]

Fitness-to-Drive Screening Measure web-based tool: http://fitnesstodrive.phhp.ufl.edu

With the aging of the Baby Boomers and ensuing Gray Tsunami in Florida leading the USA, older drivers who are unfit to drive must be identified. The gold standard on-road test is expensive, sophisticated, not available to many older drivers, and can only be validly conducted by a certified driver rehabilitation specialist of whom we have about 500 in the nation. To overcome these limitations,we have developed the Fitness-to-Drive Screening Measure (FTDS, previously known as the Safe Driving Behavior Measure or SDBM), a free web-based tool ready for use by certified driver rehabilitation specialists (CDRS), occupational therapy practitioners, other health care professionals,and the caregivers/ family members of older drivers. This study used mixed methods, including item response theory, to refine self-report and proxy versions of a screening tool measuring driving behaviors of older adults, the SDBM. Understanding a driver’s level of ability or difficulty with driving behaviors is a critical step providing a logical entry point for effective interventions, identifying optimal training parameters, and predicting future driving ability.

We determined measurement properties for the SDBM, including validity (face, content, construct and criterion validity), factor structure, dimensionality, and item/person-level psychometrics. We determined the rater severity of the three rater groups (older driver, caregiver, and driving evaluator) and the criterion validity of the SDBM in relation to the reputed gold standard, on-road driving evaluation. Lastly, we developed the SDBM as a Web-based tool, including keyforms (rating profiles), ratings-based driver categories (i.e., basic, routine, and accomplished), each with targeted recommendations (i.e., next steps to assist in determining fitness to drive or to support driver health, knowledge, and skills). The findings suggest that this measure may be useful for: (1) family members/caregivers to identify at-risk older drivers and to follow logical next steps based on keyform recommendations; (2) occupational therapy practitioners to identify an entry point for further interventions or referrals; and (3) CDRS to develop realistic and targeted intervention goals to promote driving fitness. However, although not empirically tested, we also believe that this tool, available on-line: http://fitnesstodrive.phhp.ufl.edu, will have applicability to be used or disseminated among other health care practitioners, agents of the aging network, and stakeholders of the Safe Mobility for Life Coalition, in Florida.