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Published byBernard Dennis Modified over 9 years ago
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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
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Target: High-Risk Older Drivers Crash Involved Visually Impaired Legally Licensed High Driving Exposure
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Curriculum
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Delivery One-on-One Eye Care Clinic Tailored to Individual –Visual Function –Driving Habits Theory Based
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1) Informational Component: Visual Function and Impact on Driving Visual Acuity Contrast Sensitivity Depth Perception Peripheral Vision Visual Processing Objective Assessment (Exam; Screening)
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2)Skill-Building: Hazard Avoidance and Self-Regulation 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 Driving HazardAlternative Strategy
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3)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
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Evaluation
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Study Design Baseline Assessment R A N D O M I Z E D Usual Eye Care Control Comprehensive Eye Exam Post-Test Assessment 6, 12, 18, 24 months Educational Intervention + Usual Eye Care 2 Sessions
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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
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Driving Exposure Intervention Usual Care p=0.02p=0.01 Intervention Usual Care 300 250 200 150 100 50 0 7 6 5 4 3 2 1 0 Miles Per WeekPlaces Per Week
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Driving Exposure p<0.0001 Intervention Usual Care p<0.0001 Intervention Usual Care Hazard AvoidanceSelf-Regulation
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Crash Involvement N # Crash Rate per 100 Person-Years Rate per 1,000,000 Person-Miles Intervention 227 53 11.8 448.4 py RR 1.08 (0.71-1.64) 15.3 3,459,032 pm RR 1.40 (0.92-2.12) Usual Care Only 176 38 11.1 341.7 py Reference 10.8 3,529,777 pm Reference
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Summary Education Changes in knowledge and perceptions Driver Performance Reduction in driving exposure Increased self-regulation Safety Similar crash rates
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Crash Rate as Safety Outcome Sufficient Power to evaluate Length of evaluation period Fault of driver Knowledge Self-Awareness Motivation Skill Self-Regulation Confidence Safety ?
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