Research

News from the Research Department

Research and impact measurement are essential areas of activity for ITNAmerica — part of the organization's commitment to integrating practice, research and policy as it works to support replication of the ITN model and serve as a leading voice for senior mobility. Our recent projects are summarized below.

Health Care Practitioners' Willingness to Address the Driving Issue with Patients
Families and the state government often call upon the health care community to make recommendations regarding driving safety. However, the state motor vehicle licensing division is the only legal entity with authority to remove or limit driving privileges. Families increasingly turn to their physicians and other health care practitioners for guidance, but the health care community is generally poorly trained to address these issues and is largely unfamiliar with associated ethical and legal responsibilities. In addition, because driving is such a powerful symbol of independence and because the transportation options are inadequate, practitioners are reluctant to address these concerns with the patient or to involve the state. Communication practices range from ignoring the issue completely, to aggressively prescribing cessation of driving and reporting a patient to the state.

Funded by a grant from the Silver Century Foundation, ITNAmerica initiated a pilot study to measure the impact of training on the knowledge, attitudes and practice behavior of health care practitioners regarding their elderly patients who drive. Dr. Germaine Odenheimer, a member of the ITNAmerica Research Group and an AMA designated trainer, presented AMA older driver materials and local alternative transportation options at the Maine Medical Center ‘Geriatric Education Day' conference in April 2007. We conducted pre- and post-test surveys onsite and conducted a three month follow-up survey. The objective was to learn how the availability of alternative transportation, such as the ITN, impacts the health care practitioner's willingness to address the driving issue with patients.

Immediately following the presentation by Dr. Odenheimer, 91% of survey participants said a reliable transportation program would increase the likelihood that they would advise a patient to stop driving (n=96). Three months later, 70% said they had increased the frequency with which they discussed driving cessation with their patients (n=53). Dr. Odenheimer presented findings from this project as part of an ITNAmerica symposium at the Annual Scientific Meeting of the Gerontological Society of America (GSA) in November 2007.

The Impact of ITN on Quality of Life
This four-year evaluation project funded by the Atlantic Philanthropies received IRB approval and officially launched in May 2007. The first phase of the study is designed to understand the impact of ITN on the quality of life for older adults who stop or limit their driving.

We are recruiting subjects and conducting telephone interviews in four ITN affiliate communities: Charleston, South Carolina; Orlando, Florida; Portland, Maine; and Santa Monica, California. ITN members in these communities are eligible for the evaluation when they initially register to become involved with the local ITN program; follow-up telephone interviews are planned at six months and twelve months after baseline. The evaluation plan also calls for identifying and conducting telephone interviews with older adults, not involved in the ITN program, in similar-sized communities geographically near selected ITN affiliate communities. Other planned evaluation components include interviews with family members of ITN members, and with volunteer drivers in ITN affiliate communities.

Mobility Patterns of Older Adults Who Stop or Limit Driving
Little is known about the travel patterns of older adults after they stop driving. When alternative transportation is readily available, where do older adults go, and to what extent are their choices influenced by gender and age? For more than 10 years, ITNPortland has provided rides in greater Portland, Maine to older adults and people with visual impairments who have stopped or limited their driving. The organization's data base provides a unique opportunity to examine actual destinations from home of ITNPortland customers.

Using the ITNRides data base, we are able to provide a portrait of mobility patterns among a cohort of older adults who stopped or limited their driving. For this study, we included only members aged 65 and older who used ITN for at least one ride between January 2004 and December 2006. The sample includes 586 ITN members. Results from this research were presented as part of an ITN symposium at the Annual Scientific Meeting of the GSA in November 2007. We are preparing a journal article for publication review based on this research.

Mapping the Older Driver Evaluation Process: A Case Study
With a grant from the Silver Century Foundation, ITNAmerica is conducting research to "map" the older driver evaluation process. The objectives are: to document how the driving evaluation process is presently carried out by three of the most common professionals conducting individualized driving evaluations with older adults—driving training instructors, occupational therapists, and geriatricians; to determine when during this driving evaluation process it is most feasible to introduce information about alternative transportation options; and to determine how the introduction of alternative transportation options into the driving evaluation process affects older adults' acceptance of the transition to driving cessation.

By achieving these objectives, we expect that an important gap in knowledge transfer to older adults having driving difficulties will be directly and practically addressed, so that the transition to driving cessation can become a planned and supportive process for these older drivers and their family members.

If you have questions about ITNAmerica research, please contact Research@ITNAmerica.org.