Older Drivers and Their Future Mobility: Views and Involvement of Their Adult Children.

In car-dependent societies like New Zealand, getting the right balance between mobility and safety could improve outcomes for older people but will require changes to policy and practice. Driving cessation is a major life transition with many impacts, and adult children are frequently involved in both the transition to non-driving and maintaining mobility afterward. This cross-sectional study (N = 675) sought perspectives of family members of drivers aged 65 or older enrolled in a longitudinal study. Most (94%) were adult children, two thirds were women, and 19% were moderately to extremely anxious about their parent's driving. Loss of independence, driving's role in identity, and reluctance to rely on family were recognized as important barriers to driving cessation. Most (80%) felt that families, as well as older drivers, would be adversely affected by driving cessation. Families identified accessible local information and services, alternative transport, and community-based programs for drivers and families as assistance most needed.

Understanding driving anxiety in older adults.

BACKGROUND/OBJECTIVES: Driving anxiety is a heterogeneous experience that can impact on everyday activities. Little is known about whether older adults experience driving anxiety and, if so, what impact it has on their health, functioning, and quality of life. This is particularly important given the ageing population and driving patterns of older drivers. The present study examines the extent of self-reported driving anxiety in older adult drivers. DESIGN: Population survey of community-dwelling older drivers. SETTING: New Zealand. PARTICIPANTS: 1170 adults aged 65 and over. MEASUREMENTS: Self-reported ratings of driving anxiety. RESULTS: 62.3% of participants reported no driving anxiety, 27.0% reported mild driving anxiety and 10.7% endorsed more moderate to extreme levels of driving anxiety, which is higher than has been identified with adults aged 55-72. Women were significantly more often (p < .01) represented in the groups of mildly and moderately anxious drivers, and those who were moderately to extremely anxious were more likely to be aged 70+ (p < .04). Those with moderate to severe driving anxiety tended to drive less often, for shorter distances, and to use alternative modes of transport more often than those with mild or no driving anxiety. CONCLUSION: Driving anxiety is experienced by many older adults, with quite a large proportion reporting high levels of driving anxiety and associated differences in driving patterns. Further research is needed to better understand why older drivers experience driving anxiety, and how it impacts health and wellbeing as well as driving self-regulation and cessation.

Associations of repeated high alcohol use with unsafe driving behaviors, traffic offenses, and traffic crashes among young drivers: Findings from the New Zealand Drivers Study.

OBJECTIVE: The objective of this study was to describe self-reported high alcohol use at each of the 3 licensing stages of graduated driver licensing and its relationship to drink-driving behaviors, intentional risky driving, aggressive driving, alcohol traffic offenses, non-alcohol traffic offenses, and traffic crashes. METHODS: The New Zealand Drivers Study (NZDS) is a multistage, prospective cohort study of newly licensed drivers interviewed at all 3 stages of the graduated driver licensing system: learner (baseline), restricted (intermediate), and full license. At each stage, alcohol use was self-reported using the Alcohol Use Disorders Identification Test (AUDIT-C), with high alcohol use defined as a score of ≥4 for males and ≥3 for females. Sociodemographic and personality data were obtained at the baseline interview. Alcohol-related, intentional risky, and aggressive driving behaviors were self-reported following each license stage. Traffic crashes and offenses were identified from police records. Crashes were also self-reported. RESULTS: Twenty-six percent (n = 397) reported no high alcohol use, 22% at one license stage, 30% at 2 stages, and 22% at 3 stages. Poisson regression results (unadjusted and adjusted) showed that the number of stages where high alcohol use was reported was significantly associated with each of the outcomes. For most outcomes, and especially the alcohol-involved outcomes, the relative risk increased with the number of stages of high alcohol use. CONCLUSIONS: We found that high alcohol use was common among young newly licensed drivers and those who repeatedly reported high alcohol use were at a significantly higher risk of unsafe driving behaviors. Recently introduced zero blood alcohol concentration (BAC) should help to address this problem, but other strategies are required to target persistent offenders.

Participation in driver education/training courses during graduated driver licensing, and the effect of a time-discount on subsequent traffic offenses: Findings from the New Zealand Drivers Study.

INTRODUCTION: The New Zealand GDL includes a time-discount at the restricted license stage, for attendance at an approved driver education course. This is despite international evidence showing that earlier licensure associated with a time-discount can increase risk for newly licensed drivers. OBJECTIVE: To examine participation in driver education courses and especially those that qualify for a time-discount; compare the profiles of course participants with non-participants; examine reasons for participation; and examine the association between a time-discount and traffic offenses once fully licensed. METHOD: This study was based on the New Zealand Drivers Study (NZDS), a prospective cohort study of newly licensed drivers. Data on driver education courses were obtained at the full license interview (n=1763), driver license and traffic offense data from the NZ Driver Licence Registry, and other data at the NZDS interviews. RESULTS: 94% had heard of and 49% (n=868) participated in a defensive driving course (DDC). No other course had more than 1% participation. Compared with the others, the DDC group were young, non-Maori, and from an area of relatively low deprivation. Through GDL, the DDC group were relatively more compliant with the conditions, and less likely to crash or receive a traffic offense notice. The groups did not differ on personality, alcohol and drug use. The reason most (85%) attended a DDC was to get their full license sooner; 86% (n=748) received a time-discount. The time-discount group were 40% more likely to receive a traffic offense notice on their full license; this reduced to 10% after controlling for other factors. CONCLUSION AND PRACTICAL IMPLICATIONS: The results of this study, when viewed in conjunction with other NZ crash evidence, indicate that a time-discount should not be given for completing a DDC or Street Talk course.

Pre-licensed driving experience and car crash involvement during the learner and restricted, licence stages of graduated driver licensing: Findings from the New Zealand drivers study.

OBJECTIVE: The aim of this study was to determine whether pre-licence driving experiences, that is driving before beginning the licensing process, increased or decreased crash risk as a car driver, during the learner or the restricted licence stages of the graduated driver licensing system (GDLS). METHOD: Study participants were 15-24 year old members of the New Zealand Drivers Study (NZDS) - a prospective cohort study of newly licensed car drivers. The interview stages of the NZDS are linked to, the three licensing stages of the GDLS: learner, restricted and full. Baseline demographic (age, ethnicity, residential location, deprivation), personality (impulsivity, sensation seeking, aggression) and, behavioural data, (including pre-licensed driving behaviour), were obtained at the learner licence interview. Data on distance driven and crashes that occurred at the learner licence and restricted licence stages, were reported at the restricted and full licence interviews, respectively. Crash data were also obtained from police traffic crash report files and this was combined with the self-reported crash data. The analysis of the learner licence stage crashes, when only supervised driving is allowed, was based on the participants who had passed the restricted licence test and undertaken the NZDS, restricted licence interview (n=2358). The analysis of the restricted licence stage crashes, when unsupervised driving is first allowed, was based on those who had passed the full licence test and completed the full licence interview (n=1428). RESULTS: After controlling for a range of demographic, personality, behavioural variables and distance driven, Poisson regression showed that the only pre-licence driving behaviour that showed a consistent relationship with subsequent crashes was on-road car driving which was associated with an increased risk of being the driver in a car crash during the learner licence period. CONCLUSION: This research showed that pre-licensed driving did not reduce crash risk among learner or restricted licensed drivers, and in some cases (such as on-road car driving) may have increased risk. Young people should be discouraged from the illegal behaviour of driving a car on-road before licensing.

Parental influence on adolescent compliance with graduated driver licensing conditions and crashes as a restricted licensed driver: New Zealand drivers study.

AIM: To examine the influence of parental knowledge of, and support for graduated driver licensing (GDL) conditions, parental management of adolescent driving and parental driving behaviour on adolescent compliance with GDL conditions and crashes as a restricted licence driver. METHOD: This research was part of the New Zealand Drivers Study (NZDS), a prospective cohort study of 3992 newly licensed car drivers. NZDS participants were recruited at the learner licence stage, with follow-up aligned with the GDL stages. At the restricted licence stage 1200 parents of NZDS adolescents, aged 15-17 years at learner licensure, were recruited and completed interviews. 895 of these adolescents progressed to their full licence and completed the full licence interview. These 895 parent-adolescent pairs were the study population in this research. Topics examined included parental knowledge of, and support for GDL conditions, management of adolescent driving (driving rules, adolescent vehicle ownership, delaying licensure), and their own driving behaviours. Outcomes examined were adolescent compliance with GDL restricted licence conditions (night-time and passenger), and crashes as a driver during the restricted licence stage. RESULTS: After controlling for other variables, factors independently associated with adolescent low compliance with GDL conditions were: low parental knowledge of conditions, parents' implementing few driving rules, adolescent vehicle ownership, and parent crash involvement. Factors independently associated with adolescents being a crash involved driver were: parents' actively delaying licensure, adolescent vehicle ownership, and parent crash involvement. CONCLUSION: There is increasing recognition of the importance of parental involvement in adolescent driving. The results show that parents are influential in determining adolescent compliance with GDL and risk of crash. Parents can have considerable positive influence on their adolescent's driving through ensuring compliance with the components of GDL, limiting vehicle ownership and by modelling safe driving behaviours.

Unsupervised driving by learner licence holders: associated characteristics and crash risk.

AIMS: To determine: (a) the association between socio-demographic, and behavioural factors and compliance with supervised driving condition as a learner licensed driver, (b) whether unsupervised driving as a learner licence holder was associated with elevated crash risk while holding a learner licence. STUDY DESIGN: The study population was the New Zealand Drivers Study (NZDS) cohort, a prospective cohort study designed to explore the relationship between a comprehensive range of driving and traffic safety related factors and subsequent traffic crashes and convictions among newly licensed drivers. RESULTS: Thirty-one percent of the study sample was non-compliant at least once with the supervised driving condition. Many socio-demographic and behavioural risk factors were independently associated with unsupervised driving. The strength of the associations was greatest for those with relatively high levels of unsupervised driving (13+ trips). High distance driven showed the strongest relationship: RR 8.91 (95% CI 5.27-15.07). Unsupervised driving was associated with increased risk of crash: 1-12 trips: RR 1.84 (1.29-2.61), and 13+ trips: RR 2.71 (1.94-3.80). Given that a significant portion of learner licence holders report driving unsupervised and those that violate this condition the most are more likely to crash, evaluation of strategies designed at improving compliance with learner licence supervised driving condition should be a research priority.

Establishment of the New Zealand Drivers Study.

AIM: Despite a significant improvement since graduated licensing was introduced, traffic related injury remains the leading cause of death and hospitalisation among young New Zealanders. The New Zealand Drivers Study (NZDS) was established with a view to providing information that would lead to an improvement in this situation. The NZDS is a prospective cohort study designed to explore the relationship between a comprehensive range of driving and traffic safety related factors and subsequent traffic crashes and convictions among newly licensed drivers. We describe key process objectives in establishing the cohort, and our success in meeting them and the implications arising thereof. METHODS: We compare what occurred with what was proposed in the research protocol. RESULTS: We successfully established a cohort of 3992 newly licensed car drivers with substantial heterogenity in sociodemographic, behavioural, and driving experiences. We have 825 Maori that will allow us to undertake a separate Maori analyses. Response rates to interviews at the restricted and full licence stages have been very high at 87% and 93%, respectively. We have been successful via linkage in following them through the stages of licensure and via linkage obtaining national data on the outcomes of interest. CONCLUSIONS: The NZDS is well placed to make a significant contribution to our knowledge of young driver road safety behaviour. This process has already commenced.

Nonprogression through graduated driver licensing: characteristics, traffic offending, and reasons for nonprogression.

OBJECTIVES: In a graduated driver license environment, (1) compare nonprogressors with progressors in terms of prelearner license sociodemographic and behavioral factors, (2) determine whether nonprogressors were more likely to have had a traffic offense than progressors, and (3) determine why nonprogressors chose not to progress. METHODS: Our study population was that of the New Zealand Drivers Study (NZDS), a prospective cohort study of newly licensed drivers designed to explore the relationship between a comprehensive range of driving and traffic safety related factors and subsequent traffic crashes and convictions among newly licensed drivers. Nonprogressors, those who had not progressed from a learner to a restricted license 2 years after being eligible to do so, were compared with progressors in terms of their sociodemographic, behavioral characteristics, and traffic offense outcomes. RESULTS: Nonprogressors represented 38 percent of the cohort and had different sociodemographic and behavioral profiles than progressors. A delay in progression was associated with reduced risk of being a traffic offender. The primary reasons reported for nonprogression were too lazy or busy or limited access to the means to drive. CONCLUSION: Before restricting how long a novice driver can hold a learner license, as has been suggested by the Ministry of Transport, consideration should be given to the potential increased risk of offending once unsupervised driving is permitted.

Adolescent, and their parents, attitudes towards graduated driver licensing and subsequent risky driving and crashes in young adulthood.

PROBLEM: Although Graduated Driver Licensing Systems (GDLS) have helped reduce young driver crash rates, they remain significantly over-represented in crash statistics. To be effective GDLS rely heavily on support for the legislation by those directly involved; parents to enforce the restrictions and adolescents to comply. There is some evidence that practices regarding GDLS restrictions influence adolescent driving outcomes in the early stage of licensure. However there has been no examination undertaken on the influence of parent and adolescent attitudes toward GDLS on adolescents' driving behavior and crash experiences as they move into their young adult years. The aim of this research was to examine these relationships. METHOD: This investigation was based on a longitudinal study of a birth cohort, and uses data collected when the cohort members were aged 15, 18, and 21years. At age 15 both adolescent and their parent attitudes toward GDLS were measured. At age 18 adolescent GDLS attitudes were measured again. The association between these measures and self-reported risky driving behavior and crash involvement at age 21 were examined. RESULTS: Negative attitudes toward the learner supervisor restriction for males, and negative attitudes toward a GDLS for females were strongly associated with risky driving and crash involvement as young adults. IMPACT ON INDUSTRY: Targeting interventions to improve adolescents and parents understanding of the reasons for graduated licensing and the specific restrictions may improve attitudes and views and thereby contribute to a reduction in risky driving behaviors and crash risk among young adults.

The opinions of newly licensed drivers in New Zealand on the minimum car driver licensing age and reasons for getting a licence.

AIM: To investigate the opinions of newly licensed drivers towards the minimum age of car driver licensing, and reasons for getting a licence. METHOD: The New Zealand Drivers Study (NZDS) is a prospective cohort study of 3992 newly licensed car drivers in New Zealand, recruited between 1 February 2006 and 31 January 2008 from driver licensing agencies and licensing courses throughout New Zealand. The cohort comprises 51% females and 49% males, 49% were aged 15 years and 28% 16-17 years, 55% self-identified as New Zealand European, 21% Maori, 13% Pacific, 11% Asian, and 15% as "other". After passing the learner licence theory test all participants completed a questionnaire that included a range of questions on driver licensing topics, including minimum driver licence age and reasons for getting a car driver's licence. RESULTS: Overall, 51% of newly licensed drivers supported 15 years as the minimum age to start licensing but this varied significantly by the age, gender, and residential location of the learner driver. The most frequently reported reason for getting a licence related to independence and freedom. This applied equally to males and females, rural and urban drivers, and across all ages, although for learner drivers aged 18+ years, to drive to work was also a very important reason for having a licence. CONCLUSION: Contrary to what many may believe to be the case, the evidence presented here showed that there was not universal opposition by young people to raising the driver licensing age. Also those in rural and urban areas had much in common with respect to the reasons for obtaining a licence. With respect to the latter it is worth noting that travel for work was of most relevance to the learner drivers aged 18 years or older. Overall, these findings suggest that increasing the minimum age for licensing would have relatively little impact on essential travel among young people in New Zealand.

New Zealand drivers study: developing a methodology for conducting a follow-up study of newly licensed drivers.

PROBLEM: In recent years, there has been a significant reduction in traffic crash injury among young people, but they continue to be overrepresented in the traffic crash statistics. To improve this situation, sound scientific evidence is needed to develop effective policies and programs. METHOD: The aim of the proposed study is to provide this evidence by examining early driving and driving-related experiences of newly licensed drivers as they progress through the learner-, restricted-, and full-license stages of the graduated licensing system and to determine the impact of these experiences on subsequent negative traffic-related outcomes (risky driving behavior, injury traffic crashes, noninjury traffic crashes, infringements, convictions). Given the size and complexity of the proposed study, a comprehensive pilot study was undertaken to determine the feasibility of conducting a New Zealand-wide cohort study of newly licensed drivers. RESULTS: This article describes the pilot study process and the methodology that has been developed for the New Zealand-wide study.