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. Some of our ongoing or recently completed projects are summarized below.
The Impact of ITN on Quality of Life
This evaluation project funded by the Atlantic Philanthropies officially launched in May 2007. The first component of this project is designed to understand the impact of ITN on the quality of life for older adults who stop or limit their driving. We are conducting telephone interviews with customers in five ITNAmerica affiliate communities: Charleston, South Carolina; Lexington, Kentucky; Los Angeles, California; Orlando, Florida; and Portland, Maine. Telephone interviews are conducted with customers when they initially sign up with the program and then 6 and 12 months later.
In April 2009, we initiated a second component of the evaluation with family members of ITN customers in the same five ITNAmerica affiliate communities. A self-administered survey is mailed to family members at two points in time—just after their relative signs up for the service and then 6 months later.
Mobility Patterns of Older Adults Who Stop or Limit Their 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, age and region of the country? For more than 10 years, ITN has provided rides 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 ITN 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 all members who used ITN for at least one ride between January 2004 and December 2008. The sample includes 1,557 ITN members. We are preparing a journal article for publication review based on this research.
Health Care Practitioners' Willingness to Address the Driving Issue with Patients
Funded by a grant from The Silver Century Foundation, we completed a pilot study (4/07-8/07) designed to measure the impact of a training workshop on the knowledge, attitudes and practice behavior of health care practitioners regarding their elderly patients who drive. The main objective was to learn how knowledge about the availability of alternative transportation, such as ITN, impacts the practitioner's willingness to address driving issues with older patients. Dr. Germaine Odenheimer, a member of the ITNAmerica Research Group and an American Medical Association (AMA) designated trainer, presented AMA guidelines for assessing older drivers and alternative transportation options to health care practitioners attending a geriatric education conference in Portland, Maine. We conducted pre- and post-test surveys onsite and conducted a three month follow-up survey by mail and email (n= 103 at Time 1, 102 at Time 2, and 64 at Time 3). Findings suggest that training health care practitioners on the subject of older driver issues and having a reliable alternative transportation option in the community can increase the practitioner's willingness to address the driving issue with patients. We are preparing a journal article for publication review based on this research.
Mapping the Older Driver Evaluation Process
With a grant from The Silver Century Foundation, we conducted a pilot study in the state of Maine (10/07-12/08) to document the older driver evaluation process with a primary focus on how the introduction of alternative transportation into that process might impact the older adult's transition to driving cessation (n=8). Occupational therapists, physicians, and driving instructors were asked to incorporate alternative transportation information into their routine driving evaluation process and discussions and to document each of those discussions using uniform reporting forms. In-depth interviews were conducted with each evaluation specialist at two points in time; before and after the alternative transportation information was incorporated into their driving evaluation process and discussions.
After the first round of interviews, the driving evaluation specialists discussed transportation alternatives with patients more often and at earlier points throughout the evaluation process than they did prior to the intervention. Results indicate that alternative transportation discussions with older drivers are particularly beneficial when a family member is present. The family member offers support and helps facilitate the transportation plan recommended by the evaluation specialist, thus creating a less difficult transition from driving to non-driving. The findings also suggest that older drivers are more receptive to the discussion when it occurs early in the process and before they are told they must stop driving entirely.