Importance of Driving and Potential Impact of Driving Cessation for Rural and Urban Older Adults.

PURPOSE: Analyses compared older drivers from urban, suburban, and rural areas on perceived importance of continuing to drive and potential impact that driving cessation would have on what they want and need to do. METHODS: The AAA LongROAD Study is a prospective study of driving behaviors, patterns, and outcomes of older adults. A cohort of 2,990 women and men 65-79 years of age was recruited during 2015-2017 from health systems or primary care practices near 5 study sites in different parts of the United States. Participants were classified as living in urban, surburban, or rural areas and were asked to rate the importance of driving and potential impact of driving cessation. Logistic regression models adjusted for sociodemographic and driving-related characteristics. FINDINGS: The percentages of older drivers rating driving as "completely important" were 76.9%, 79.0%, and 83.8% for urban, suburban, and rural drivers, respectively (P = .009). The rural drivers were also most likely to indicate driving cessation would have a high impact on what they want or need to do (P < .001). After adjustment for sociodemographic and driving-related characteristics, there was a 2-fold difference for rural versus urban older drivers in odds that driving cessation would have a high impact on what they need to do (OR = 2.03; 95% CI: 1.60-2.58). CONCLUSIONS: Older drivers from rural areas were more likely to rate driving as highly important and the prospect of driving cessation as very impactful. Strategies to enhance both the ability to drive safely and the accessibility of alternative sources of transportation may be especially important for older rural adults.

The healthy start partnership: an approach to obesity prevention in young families.

This article investigates the impact of community-based interventions developed by the Healthy Start Partnership (HSP) to promote healthy body weights in families. Intercept surveys were conducted to monitor community exposure. A nonconcurrent, no treatment control design was used to assess population-level weight outcomes. Control (n = 219) and intervention (n = 276) cohorts of pregnant women were recruited and followed until 6 months postpartum. Data were collected through 2 self-administered questionnaires and medical record audits. Results indicate community residents were exposed to interventions. However, little evidence of positive effects of interventions on weight outcomes was found for mothers or infants.

An asset-based community initiative to reduce television viewing in New York state.

BACKGROUND: Childhood obesity is an epidemic. Addressing this problem will require the input of many sectors and change in many behaviors. The "community" must be part of the solution, and the solution must be constructed on existing assets that lend strength to positive environmental change. OBJECTIVE: To catalyze an established asset-based community partnership to support efforts to reduce television viewing time by developing and providing alternative activities as part of a broader, 3-year study to reduce childhood obesity among preschool-aged children in rural, upstate New York. METHOD: Asset mapping was utilized to compile an inventory of individual and community strengths upon which a partnership could be established. Facilitated focus group sessions were conducted to better understand childcare environmental policies and practices, and to guide changes conducive to health and fitness. Planning meetings and targeted outreach brought key stakeholders together for a community-participatory initiative to support positive environmental change. RESULTS.: The partnership planned and initiated an array of after-school and weekend community activities for preschool-aged children and their families in the weeks preceding, during, and following a designated 'TV Turn-off' week in April, 2004 and March, 2005. CONCLUSION: Methods of asset-based community development are an effective way to engage community participation in public health initiatives.