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OBJECTIVES: To examine the dimensionality of the Wheelchair Use Confidence Scale for power wheelchair users (WheelCon-P), to identify items that do not fit the Rasch rating scale model as well as redundant items for elimination, and to determine the SEMs and reliability estimates for the entire range of measurements. DESIGN: Secondary analysis of cross-sectional data. SETTING: Community. PARTICIPANTS: Volunteer participants (N=189) using wheelchairs (mean age of the sample, 56.7±13.0y; mean years of wheelchair use experience, 20.4±16.4). INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: 59-Item WheelCon-P. RESULTS: Principal component analyses confirmed the presence of 2 self-efficacy dimensions: mobility and social situation. Eleven mobility items and 5 social situation items fit the Rasch rating scale model. Three items misfit the model using all 16 items (ie, WheelCon-P short form). In each of the mobility, social situation, and WheelCon-P short form range of measurements, the 2 lowest and 2 highest measures had internal consistency reliability estimates below .70; all other measures had reliability estimates above .70. CONCLUSIONS: The WheelCon-P is composed of 2 self-efficacy dimensions related to mobility and social situations. The scores from the WheelCon-P short form and the 11-item mobility and 5-item social situation dimensions using a 0 to 10 response scale have good reliability.
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Personas con Discapacidad/psicología , Autoeficacia , Silla de Ruedas , Adulto , Anciano , Estudios Transversales , Femenino , Humanos , Locomoción , Masculino , Persona de Mediana Edad , Limitación de la Movilidad , Análisis de Componente Principal , Psicometría , Reproducibilidad de los Resultados , Participación Social , Encuestas y CuestionariosRESUMEN
OBJECTIVE: To test the hypothesis that caregivers enhance the wheelchair skills capacity and confidence of the power wheelchair users to whom they provide assistance, and to describe the nature of that assistance. DESIGN: Multicenter cross-sectional study. SETTING: Rehabilitation centers and communities. PARTICIPANTS: Participants (N=152) included caregivers (n=76) and wheelchair users (n=76). INTERVENTIONS: None. MAIN OUTCOME MEASURES: Version 4.3 of the Wheelchair Skills Test (WST) and the Wheelchair Skills Test-Questionnaire (WST-Q). For each of the 30 individual skills, we recorded data about the wheelchair user alone and in combination (blended) with the caregiver. RESULTS: The mean total WST capacity scores ± SD for the wheelchair users alone and blended were 78.1%±9.3% and 92.4%±6.1%, respectively, with a mean difference of 14.3%±8.7% (P<.0001). The mean WST-Q capacity scores ± SD were 77.0%±10.6% and 93.2%±6.4%, respectively, with a mean difference of 16.3%±9.8% (P<.0001). The mean WST-Q confidence scores ± SD were 75.5%±12.7% and 92.8%±6.8%, respectively, with a mean difference of 17.5%±11.7% (P<.0001). The mean differences corresponded to relative improvements of 18.3%, 21.0%, and 22.9%, respectively. The nature and benefits of the caregivers' assistance could be summarized in 7 themes (eg, caregiver provides verbal support [cueing, coaching, reporting about the environment]). CONCLUSIONS: Caregivers significantly enhance the wheelchair skills capacity and confidence of the power wheelchair users to whom they provide assistance, and they do so in a variety of ways. These findings have significance for wheelchair skills assessment and training.
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Cuidadores/psicología , Personas con Discapacidad/psicología , Autoimagen , Silla de Ruedas/psicología , Anciano , Anciano de 80 o más Años , Estudios Transversales , Femenino , Humanos , Masculino , Persona de Mediana Edad , Centros de Rehabilitación , Encuestas y CuestionariosRESUMEN
OBJECTIVES: To test the hypothesis that powered wheelchair users who receive the Wheelchair Skills Training Program (WSTP) improve their wheelchair skills in comparison with a control group that receives standard care, and secondarily to assess goal achievement, satisfaction with training, retention, injury rate, confidence with wheelchair use, and participation. DESIGN: Randomized controlled trial. SETTING: Rehabilitation centers and communities. PARTICIPANTS: Powered wheelchair users (N=116). INTERVENTION: Five 30-minute WSTP training sessions. MAIN OUTCOME MEASURES: Assessments were done at baseline (t1), posttraining (t2), and 3 months posttraining (t3) using the Wheelchair Skills Test Questionnaire (WST-Q version 4.1), Goal Attainment Score (GAS), Satisfaction Questionnaire, injury rate, Wheelchair Use Confidence Scale for Power Wheelchair Users (WheelCon), and Life Space Assessment (LSA). RESULTS: There was no significant t2-t1 difference between the groups for WST-Q capacity scores (P=.600), but the difference for WST-Q performance scores was significant (P=.016) with a relative (t2/t1 × 100%) improvement of the median score for the intervention group of 10.8%. The mean GAS ± SD for the intervention group after training was 92.8%±11.4%, and satisfaction with training was high. The WST-Q gain was not retained at t3. There was no clinically significant difference between the groups in injury rate and no statistically significant differences in WheelCon or LSA scores at t3. CONCLUSIONS: Powered wheelchair users who receive formal wheelchair skills training demonstrate modest, transient posttraining improvements in their WST-Q performance scores, have substantial improvements on individualized goals, and are positive about training.
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Personas con Discapacidad/rehabilitación , Educación del Paciente como Asunto/organización & administración , Centros de Rehabilitación , Silla de Ruedas , Adulto , Anciano , Suministros de Energía Eléctrica , Femenino , Objetivos , Humanos , Masculino , Persona de Mediana Edad , Satisfacción del Paciente , Método Simple CiegoRESUMEN
BACKGROUND: As the demographic of older people continues to grow, health services that support independence among community-dwelling seniors have become increasingly important. Personal Emergency Response Systems (PERS) are medical alert systems, designed to serve as a safety net for seniors living alone. Health care professionals often recommend that seniors in danger of falls or other medical emergencies obtain a PERS. The purpose of the study was to investigate the experience of seniors living with and using a PERS in their daily lives, using a qualitative grounded theory approach. METHODS: Five focus groups and 10 semi-structured interviews, with a total of 30 participants, were completed using a grounded theory approach. All participants were PERS subscribers over the age of 80, living alone in a naturally occurring retirement community (NORC) with high health service utilization in a major urban centre in Ontario. Constant comparative analysis was used to develop themes and ultimately a model of why and how seniors obtain and use the PERS. RESULTS: Two core themes, unpredictability and decision-making around PERS activation, emerged as major features of the theoretical model. Being able to get help and the psychological value of PERS informed the context of living with a PERS. CONCLUSIONS: A number of theoretical conclusions related to unpredictability and the decision-making process around activating PERS were generated.
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Accidentes por Caídas/prevención & control , Toma de Decisiones , Sistemas de Comunicación entre Servicios de Urgencia/estadística & datos numéricos , Vida Independiente/psicología , Competencia Mental , Anciano de 80 o más Años , Actitud Frente a la Salud , Femenino , Grupos Focales , Humanos , Masculino , Ontario , Investigación CualitativaRESUMEN
OBJECTIVE: To examine the reliability, validity, and factor structure of the Late Life Disability Instrument (LLDI) in individuals who use power wheelchairs as their primary means of mobility. DESIGN: A 4-week, test-retest study design. SETTING: Five Canadian cities. PARTICIPANTS: The validity sample included 115 new and experienced power mobility users, and the reliability sample included 85 experienced users (N=115). These volunteer samples included individuals who were aged ≥50 years and independently used power mobility as their primary means of mobility. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURE: The LLDI measures participation in 2 dimensions of 16 life activities: frequency and perceived limitations. Validity measures included the Wheelchair Skills Test-power version, the Assistive Technology Outcomes Profile for Mobility, the Hospital Anxiety and Depression Scale, the Power Mobility Wheelchair Confidence Measure, and the Life Space Assessment. RESULTS: For the reliability sample, raw intraclass correlational coefficients for limitation and frequency dimension scores ranged from .855 (95% confidence interval .781-.905) to .883 (95% confidence interval, .822-.924), respectively. For the validity sample, scores on the LLDI were correlated as hypothesized with scores on validity measures. The factor structure that was identified with the original sample was not replicated among power wheelchair users. For LLDI frequency, exploratory factor analysis indicated that 5 of the original 16 items did not perform similarly among power wheelchair users. For LLDI limitations, a 1-factor, rather than a 2-factor, solution was identified. CONCLUSIONS: The study provides evidence in support of the reliability and validity of the measure but suggests that the original subscale scores may not be applicable to power wheelchair users.
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Evaluación de la Discapacidad , Encuestas y Cuestionarios , Anciano , Canadá , Análisis Factorial , Humanos , Estudios Longitudinales , Persona de Mediana Edad , Psicometría , Reproducibilidad de los Resultados , Silla de RuedasRESUMEN
Despite a recognition of religion as a resource for coping in later life, few studies have examined how religion is summoned to cope with the stressors of late-life immigration. Drawing upon data generated in a phenomenological study of the aging-out-place experience, this article presents a hermeneutic analysis of textual extracts addressing 10 Sri Lankan-born late-life immigrants' Buddhist beliefs and practices, and how these beliefs and practices contributed to coping with immigration stressors. Four shared experiences facilitated through religious engagement were revealed: religious engagement as a source of purpose, making meaning of suffering and experiencing hope, non-attachment, and connecting to the past and the ethnoreligious community. Late-life immigrants drew on religious engagement to remain resolute amidst adversities, thus reinforcing the importance of culturally responsive milieus and services to support religion-focused coping. Findings are interpreted in relation to Pargament's (1997) theory of religious coping.
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BACKGROUND: Home adaptation processes enhancing occupational engagement rely on identifying environmental barriers, generally during time-consuming home visits performed by occupational therapists (OTs). Relevance of a 3D model to the OT's work has been attested, but a convenient and consumer-available technology to map the home environment in 3D is currently lacking. For instance, such a technology would support the exploration of home adaptations for a person with disability, with or without an OT visit. OBJECTIVE: The aim of this study was to document the development and acceptability of a 3D mapping eHealth technology, optimizing its contribution to the OT's work when conducting assessments in which home representations are essential to fit a person's needs. METHODS: A user-centered perspective, embedded in a participatory design framework where users are considered as research partners (not as just study participants), is reported. OTs, engineers, clinicians, researchers, and students, as well as the relatives of older adults contributed by providing ongoing feedback (eg, demonstrations, brainstorming, usability testing, questionnaires, prototyping). System acceptability, as per the Nielsen model, is documented by deductively integrating the data. RESULTS: A total of 24 stakeholders contributed significantly to MapIt technology's co-design over a span of 4 years. Fueled by the objective to enhance MapIt's acceptability, 11 iterations lead to a mobile app to scan a room and produce its 3D model in less than 5 minutes. The app is available for smartphones and paired with computer software. Scanning, visualization, and automatic measurements are done on a smartphone equipped with a motion sensor and a camera with depth perception, and the computer software facilitates visualization, while allowing custom measurement of architectural elements directly on the 3D model. Stakeholders' perception was favorable regarding MapIt's acceptability, testifying to its usefulness (ie, usability and utility). Residual usability issues as well as concerns about accessibility and scan rendering still need to be addressed to foster its integration to a clinical context. CONCLUSIONS: MapIt allows to scan a room quickly and simply, providing a 3D model from images taken in real-world settings and to remotely but jointly explore home adaptations to enhance a person's occupational engagement.
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OBJECTIVES: To quantify levels of torso muscular demand during wheelchair ramp ascent and the ability of a geared wheel to influence trunk muscle activity. DESIGN: Repeated-measures design. Each participant completed manual wheelchair ramp ascents for each combination of 4 ramp grades (1:12, 1:10, 1:8, and 1:6) and 3 wheel conditions (in gear, out of gear, and a standard spoked wheel) in a block randomized order by wheel condition. SETTING: Biomechanics laboratory. PARTICIPANTS: Healthy novice wheelchair users (N=13; 6 men) from a university student population. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: Peak electromyographic activity, expressed as a percentage of maximal voluntary isometric contraction (MVIC) of the abdominals, latissimus dorsi, and erector spinae during ramp ascent. Temporal location of peak electromyographic activity (EMG) within a propulsive cycle and integrated electromyographic activity for a single propulsive cycle. RESULTS: Abdominal peak activity increased 13.9% MVIC while peak posterior trunk muscle activity increased 4.9% MVIC between the shallowest and steepest ramp grades (P<.05). The geared wheel prevented increased peak activity of the rectus abdominis and external oblique (P>.05). Only peak electromyographic timing of the erector spinae was influenced during the push phase by increasing ramp slope. CONCLUSIONS: Increased trunk muscular demand as a result of increasing ramp slope is required to enhance stiffness of the spinal column and provide a stable base during manual propulsion. Manual wheelchair users with compromised activity capacity, compromised abdominal muscle strength, or both, may be able to navigate more difficult terrains while using a geared wheelchair wheel because of reduced demands from the abdominal musculature in the geared wheel condition.
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Movimiento/fisiología , Músculo Esquelético/fisiología , Postura , Silla de Ruedas , Músculos Abdominales/fisiología , Adulto , Electromiografía , Diseño de Equipo , Femenino , Humanos , Masculino , Valores de ReferenciaRESUMEN
The investigation of vehicle safety needs for older drivers and passengers is integral for their safe transportation. A program of research on safe transportation for seniors was launched through AUTO21, a Canadian Network of Centres of Excellence. This national research network focuses on a wide range of automotive issues, from materials and design to safety and societal issues. An inductive qualitative inquiry of seniors' driving experiences, safety feature use, and strategies to prevent injury and manage risks was a first step in this program. We conducted interviews and focus groups with 58 seniors without disabilities and 9 seniors with disabilities. We identified a lack of congruity between the vehicle and safety feature design and seniors' needs. Seniors described strategies to manage their safety and that of others. Specific aspects of vehicle design, safety features, and action strategies that support safer use and operation of a vehicle by seniors are outlined.
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Conducción de Automóvil , Anciano , Anciano de 80 o más Años , Atención , Actitud , Personas con Discapacidad , Diseño de Equipo , Femenino , Humanos , Masculino , Persona de Mediana Edad , Investigación Cualitativa , Seguridad , Cinturones de Seguridad/estadística & datos numéricos , Análisis y Desempeño de TareasRESUMEN
BACKGROUND: Opportunities to travel from one place to another in the community, or community mobility, are especially important for mobility device users' ability to participate fully in society. However, contextual challenges to such mobility exist. PURPOSE: This study summarizes the literature on existing community mobility barriers and facilitators of mobility device users created by services, systems, and policies as defined by the International Classification of Functioning, Disability, and Health (ICF). METHOD: Arksey and O'Malley's approach for scoping studies was used for the review. The extraction chart was organized following the ICF, and frequency counts were used to report the data. FINDINGS: The findings suggest that certain factors, such as transportation, open-space planning, and architecture and construction, influence community mobility opportunities. However, little attention has been paid to services, systems, and policies in the research literature, limiting the knowledge on the subject. IMPLICATIONS: Further research is needed to examine the relationship between specific services, systems, and policies and mobility device users' mobility within their communities.
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Personas con Discapacidad/rehabilitación , Terapia Ocupacional/organización & administración , Equipo Ortopédico/estadística & datos numéricos , Políticas , Dispositivos de Autoayuda/estadística & datos numéricos , Accesibilidad Arquitectónica , Planificación Ambiental , Humanos , Terapia Ocupacional/normas , TransportesRESUMEN
OBJECTIVE: A number of training programs that seek to improve driving performance among older drivers are available accompanied by a growing interest in their effectiveness. The purpose of the present investigation was to examine the combined effect of (1) basic in-class training (BT); (2) on-road training with individualized feedback (OR); and (3) training on a driving simulator (S). METHODS: Using a randomized controlled trial study design, 78 older drivers were randomly assigned to one of 3 groups (BT, BT + OR, or BT + OR + S). All participants completed a pre- and postintervention on-road driving evaluation on a standardized route. The driving evaluations were recorded using video and Global Positioning System (GPS) equipment and were scored by a blind assessor. RESULTS: The results indicated a significant reduction of approximately 30% in overall number of driving errors/omissions among participants in the BT + OR and the BT + OR + S groups in comparison to participants in the BT group. CONCLUSIONS: This study adds to the mounting evidence demonstrating the effectiveness of individualized driver training in improving safe driving among older adults.
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Accidentes de Tránsito/prevención & control , Conducción de Automóvil/educación , Retroalimentación Psicológica , Desempeño Psicomotor/fisiología , Percepción Visual/fisiología , Accidentes de Tránsito/psicología , Anciano , Conducción de Automóvil/psicología , Femenino , Sistemas de Información Geográfica , Humanos , Masculino , Proyectos de InvestigaciónRESUMEN
PURPOSE: In this paper, we have sought to stimulate a critical dialog regarding the ways in which disability has been largely conceptualized and studied in literature addressing age-related vision loss (ARVL). We suggest an expansion of this largely biomedically informed research area to include alternative frameworks, namely critical disability perspectives. METHOD: To demonstrate the potential contributions of adopting a critical disability approach to enhance understandings of ARVL, this article outlined the primary tenets of the biomedical and social models of disability; the key aims, emphases, and assumptions of critical disability perspectives; and provided examples of how such an approach would lead to new research foci in the study of ARVL. RESULTS: The paper highlighted four qualities of critical disability perspectives that future ARVL research should ascribe to, including (a) a focus on interdependence over traditional notions of independence; (b) a broader conceptualization of 'normalcy'; (c) the influence of language as a means of describing or labeling disabled persons; and (d) the influence of the socio-political environment in the creation and sustainment of disability. CONCLUSIONS: This paper encouraged the incorporation of critical disability perspectives to provide new ways of conceptualizing, researching, writing about, and practicing in relation to ARVL. Implications for Rehabilitation The application of critical disability perspectives to expand the boundaries of low vision research can broaden low vision rehabilitation services (LVRS) in ways that more effectively attend to environmental features shaping and perpetuating disability for clients with age-related vision loss (ARVL). Low vision research, informed by critical disability perspectives, would inform a shift away from the exclusive focus on independence towards an acknowledgment of interdependence. The integration of participatory research approaches in ARVL research could generate new insights to inform rehabilitation by enhancing space and respect for the stories and knowledge of older adults aging with vision loss. Greater attention in low vision rehabilitation should be paid to how older adults' experiences of disability are tied to both the environmental context in which they exist and by the limitations caused by their impairment.
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Envejecimiento/patología , Investigación Biomédica , Personas con Discapacidad/rehabilitación , Trastornos de la Visión/rehabilitación , Comprensión , HumanosRESUMEN
To date, attention to the environmental production of disability among older adults with age-related vision loss (ARVL) has been limited. This critical ethnographic study aimed to reveal the ways in which environmental barriers produced and perpetuated disability for 10 older adults with ARVL. A modified version of Carspecken's five-stage approach for critical ethnography was adopted with three methods of data collection used, including a narrative interview, a participant observation session, and a semi-structured, in-depth interview. Findings revealed how disability is shaped for older adults with ARVL when they encounter environmental features that are embedded within an ageist and disablist society. These findings are illustrated via presenting analysis of three commonly discussed activities: shopping, eating, and community mobility. Our discussion suggests that addressing the environmental production of disability requires inclusive social policy, advocacy, and a focus on education in order to develop and sustain age and low-vision-friendly environments.
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Actividades Cotidianas , Envejecimiento/fisiología , Calidad de Vida , Baja Visión/psicología , Personas con Daño Visual/psicología , Anciano , Anciano de 80 o más Años , Femenino , Humanos , Masculino , Investigación CualitativaRESUMEN
In-vehicle navigation systems have the potential to simplify the driving task by reducing the drivers' need to engage in wayfinding, especially in unfamiliar environments. This study sought to characterize older drivers' overall assessment of using in-vehicle GPS technology as part of a research study and to explore whether the use of this technology has an impact on participants' driving behaviour. Forty-seven older drivers completed an on-road evaluation where directions were provided by an in-vehicle GPS navigation system and their behaviour was recorded using video technology. They later completed a questionnaire to assess their perception of the navigation system. After the study, participants were grouped based on whether they were able to accurately follow the instructions provided by the navigation system. The results indicated that most drivers were satisfied with the navigation technology and found the directions it provided to be clear. There were no statistically significant differences in the number of on-road errors committed by drivers who did not follow the directions from the navigation system in comparison to drivers who did follow the directions.
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Conducción de Automóvil/psicología , Sistemas de Información Geográfica/estadística & datos numéricos , Anciano , Anciano de 80 o más Años , Conducción de Automóvil/estadística & datos numéricos , Femenino , Humanos , Masculino , Percepción , Encuestas y Cuestionarios , Tecnología , Grabación en VideoRESUMEN
Road crashes are the leading cause of death and injury in children under 14 years of age in Canada, despite mandatory use of vehicle restraints. A survey design was used to examine parental knowledge and perceptions of the use of safety systems for children in 2 communities in the province of Ontario. Parents of children aged newborn to 9 years were recruited from 3 urban/rural school boards and from daycare centres and hospitals. A total of 1,263 parents reported on 2,199 children's use of safety systems. Data analysis revealed that only 68% of children used correct seats for their weight and that as the child advanced in age the rate of misuse increased significantly due to high rates of premature transitioning into safety seats inappropriate for the child's height and weight. The results also revealed that parents had limited knowledge concerning the correct use of safety seats and frequently used non-professional sources of information for vehicle safety information. The authors recommend that nurses develop a comprehensive and systematic strategy to ensure that families understand how to secure children in vehicles using the correct safety seat for the child's height, weight, and age.
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Actitud Frente a la Salud , Cuidado del Niño , Equipo Infantil/estadística & datos numéricos , Padres , Administración de la Seguridad , Accidentes de Tránsito/mortalidad , Accidentes de Tránsito/prevención & control , Accidentes de Tránsito/estadística & datos numéricos , Adolescente , Adulto , Factores de Edad , Estatura , Peso Corporal , Causas de Muerte , Niño , Cuidado del Niño/métodos , Cuidado del Niño/psicología , Mortalidad del Niño , Preescolar , Toma de Decisiones , Femenino , Conocimientos, Actitudes y Práctica en Salud , Humanos , Lactante , Recién Nacido , Masculino , Persona de Mediana Edad , Rol de la Enfermera , Ontario/epidemiología , Padres/educación , Padres/psicología , Administración de la Seguridad/métodos , Cinturones de Seguridad/estadística & datos numéricos , Encuestas y CuestionariosRESUMEN
INTRODUCTION: While previous research has explored the meaning of positive aging discourses from the perspective of older adults, the perspective of older adults aging with a disability has not been studied. In fact the intersection of aging and disability has been largely underexplored in both social gerontology and disability studies. METHOD: This critical ethnography engaged ten older adults aging with vision loss in narrative interviews, participant observation sessions, and semi-structured in-depth interviews. The overarching objective was to understand those attributes that older adults with age-related vision loss perceive as being the markers of a 'good old age.' The authors critically examined how these markers, and their disabling effects, are situated in ageist and disablist social assumptions regarding what it means to 'age well'. RESULTS: The participants' descriptions of the markers of a 'good old age' were organized into five main themes: 1) maintaining independence while negotiating help; 2) responding positively to vision loss; 3) remaining active while managing risk; 4) managing expectations to be compliant, complicit, and cooperative and; 5) striving to maintain efficiency. CONCLUSION: The study findings have provided helpful insights into how the ideas and assumptions that operate in relation to disability and impairment in late life are re-produced among older adults with age-related vision loss and how older adults take on an identity that is consistent with socially embedded norms regarding what it means to 'age well'.
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Envejecimiento/psicología , Retinopatía Diabética/psicología , Glaucoma/psicología , Degeneración Macular/psicología , Trastornos de la Visión/psicología , Adaptación Psicológica , Anciano , Anciano de 80 o más Años , Antropología Cultural , Actitud Frente a la Salud , Retinopatía Diabética/complicaciones , Femenino , Glaucoma/complicaciones , Conducta de Búsqueda de Ayuda , Humanos , Degeneración Macular/complicaciones , Masculino , Narración , Investigación Cualitativa , Trastornos de la Visión/etiologíaRESUMEN
Safe driving in older adulthood depends not only on health and driving ability, but also on the driving environment itself, including the type of vehicle. However, little is known about how safety figures into the older driver's vehicle selection criteria and how it ranks among other criteria, such as price and comfort. For this purpose, six focus groups of older male and female drivers (n=33) aged 70-87 were conducted in two Canadian cities to explore vehicle purchasing decisions and the contribution of safety in this decision. Themes emerged from the data in these categories: vehicle features that keep them feeling safe, advanced vehicular technologies, factors that influence their car buying decisions, and resources that inform this decision. Results indicate older drivers have gaps with respect to their knowledge of safety features and do not prioritize safety at the time of vehicle purchase. To maximize the awareness and uptake of safety innovations, older consumers would benefit from a vehicle design rating system that highlights safety as well as other features to help ensure that the vehicle purchased fits their lifestyle and needs.
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Actitud , Automóviles , Conducta de Elección , Seguridad , Accidentes de Tránsito/prevención & control , Accidentes de Tránsito/psicología , Anciano , Anciano de 80 o más Años , Canadá , Toma de Decisiones , Diseño de Equipo , Femenino , Grupos Focales , Humanos , Masculino , Equipos de SeguridadRESUMEN
The Candrive II/Ozcandrive study, a multicentre prospective cohort study examining the predictive validity of tools for assessing fitness to drive, aims to develop an in-office screening tool that will help clinicians identify older drivers who may be unsafe to drive. This paper describes the study protocol. We are following a cohort of drivers aged ≥70 years for up to 4 years. Starting in 2009, 928 participants have been recruited in seven cities in four Canadian provinces, as well as 302 participants in two sites in Melbourne, Australia and Wellington, New Zealand. Participants underwent a comprehensive assessment at baseline and repeat the assessment yearly thereafter, as well as a brief follow-up assessment at 4 and 8 months each year. A recording device is installed in participants' vehicles to assess driving patterns, and driving records are obtained from licensing authorities to determine the outcomes: at-fault crashes per kilometre driven and violations. To date, the protocol has been generally well adhered to, with 1230 participants, and barriers and challenges are being addressed, as necessary. The Candrive II/Ozcandrive study is unique owing to its size, duration, partnerships with Canadian, Australian and New Zealand stakeholders, and international research collaboration.