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Fitness-to-Drive Screening (FTDS) Measure for At-Risk Older Drivers

Background: With the aging of the Baby Boomers and ensuing Gray Tsunami, older drivers who are unfit to drive must be identified. The gold standard on-road test is expensive or not available to many older drivers. Caregivers, friends or loved ones, who are sharing lived experiences with older drivers, may potentially help to identify at-risk older drivers. To overcome the limitations of the on-road test and involve the public in identifying at-risk drivers, researchers at the University of Florida's Institute for Mobility, Activity and Participation, has under the direction of Dr. Sherrilene Classen, developed and tested the Fitness-to Drive Screening Measure (FTDS), formerly known as the Safe Driving Behavior Measure.

Description: The FTDS is a web-based tool ready for use by caregivers and/or family members of older drivers and occupational therapy practitioners (OT) to detect older drivers at risk. Essentially, the FTDS Measure can be accessed, for free, on-line here. Caregivers and/or family members who have driven with the driver in the last three months, can rate the drivers' difficulties by completing the on-line screening which pertain to 54 driving skills of the older driver. After completing the screening a keyform or rating profile of each driver is available which includes a classification of the driver into one of three categories (at-risk driver, routine driver, accomplished driver). Based on the specific driver category, recommendations, which are the logical next steps for caregivers or OTs, are suggested for each driver. The recommendations entail guidelines for continued fitness to drive, options for seeking intervention, or starting conversations about stopping driving.

Research: We determined measurement properties for the FTDS, including validity (face, content, and construct validity), factor structure, dimensionality, and item/person-level psychometrics [1-3] of 200 older drivers, 200 of their family members or loved ones' evaluations and via 200 comprehensive driving evaluations conducted by two evaluators. We determined the rater severity of the three rater groups (older driver, caregiver/family member, and driving evaluator) [4] and the criterion validity of the FTDS in relation to the reputed gold standard, on-road driving evaluation [5]. Lastly, we developed the FTDS as a web-based tool, including keyforms, ratings-based driver categories (i.e., basic, routine, and accomplished), each with targeted recommendations.

Implications: The findings suggest that this measure and keyform may be useful for:
(1) Family members and/or caregivers who can help to identify at-risk older drivers. Based on the keyform results this group can follow strategies to optimize the driver's fitness-to-drive skills.
(2) OT practitioners, who may from the keyform results, identify an entry point for further intervention or make appropriate referrals to other specialty health care professionals.
(3) Certified Driving Rehabilitation Specialists (CDRS), who may based on the keyform results, develop realistic and targeted intervention goals to promote driver fitness.

Acknowledgement: This project was funded by the National Institutes of Health/ National Institutes of Aging (2007-2009), the Department of Transportation (2009-2011), and the Florida Department of Transportation (2011-2012).

References

  1. Classen, S., Winter, S.M., Velozo, C., Bédard, M., Lanford, D.N., & Brumback, B., Lutz, B. Item Development and Validity Testing for a Safe Driving Behavior Measure (2010). American Journal of Occupational Therapy, 64 (2), 296-305.
  2. Winter, S. M., Classen, S., Bédard, et al., Focus group findings for a self-report Safe Driving Behavior Measure (2011). Canadian Journal of Occupational Therapy, 78(2), 72-79.
  3. Classen, S., Wen, P., Velozo, C., Bédard, M., Brumback, B., Winter, S.M., & Lanford, D.N. (2012). Psychometrics of the Self-Report Safe Driving Behavior Measure for Older Adults. American Journal of Occupational Therapy, 66(2),233-241.
  4. Classen, S., Wen, P., Velozo, C., Bédard, M., Brumback, B., Winter, S.M., & Lanford, D.N. (2012).Rater Reliability and Rater Effects of the Safe Driving Behavior Measure. (2011). American Journal of Occupational Therapy, 16,69-77.
  5. Classen, S., Wang, Y., Velozo, C., Bédard, M., Winter, S.M., & Lanford, D.N. (2013). Concurrent Criterion validity of the Safe Driving Behavior Measure: A Predictor of On-Road Driving Outcomes. American Journal of Occupational Therapy. In press.