Behind the Wheel: a randomised controlled trial evaluating a safe transport program for older drivers

Aims: To determine if a one-on-one safe-transport program can reduce driving exposure, while maintaining community participation, in a group of older drivers living in the community._x000D_
Methods: We evaluated an adapted version of the KEYS® program, in a randomised controlled trial involving 380 drivers aged 75 years and older, residing in the suburban outskirts of Sydney. The primary outcome was weekly driving collected via an in-vehicle data logger, which recorded second-by-second GPS location. Secondary outcomes included stage of behaviour change with regards to self-regulation, community participation (Keele Assessment of Participation) and use of alternative transport. _x000D_
Results: We recruited 380 participants (230 men, 150 women) with average age 80 years and average weekly mileage of 140±167 km; 366/380 (96%) completed the study and 362/380 (95%) vehicles were instrumented. The program was delivered to 183/190 (96%) allocated to the intervention. While there was no difference in weekly mileage (adjusted between group difference: -10km, p=0.25, 95%CI:-28 to 7km), those in the intervention group were more engaged in self-regulatory driving practices (OR:1.6, p=0.02, 95%CI:1.1-2.3). At 12 months there was similar usage of alternative forms of transport, on average 5 trips/month (mean difference 0.1 trips, 95% CI: -1.4 – 1.6). Importantly, there was no difference in community participation between those who received the education and those who did not (between group difference: -0.1, p=0.59, 95%CI:-0.6 to 0.3)._x000D_
Conclusions: This individualised safe transport program promoted behaviour change but did not significantly reduce weekly driving. Longer follow-up may be required to investigate changes to driving practices. _x000D_