Many older drivers with visual problems meet the legal requirements for licensing despite having functional impairments that elevate crash risk. In a sample of visually impaired older drivers, over half believed that their vision was not likely to cause them to crash. Eighty percent acknowledged that they would feel more protected against crashing if they avoided certain driving situations. However, 75 percent of the sample reported never or rarely avoiding such situations (e.g. left turns, interstate highways). Almost 70 percent of drivers reported high self-efficacy in their ability to self-regulate and use alternative strategies. These data imply that behavioral interventions promoting compensatory strategies of self-regulation may be useful in maintaining mobility while improving the safety of high-risk older drivers. These findings serve as baseline for our ongoing study evaluating whether an educational intervention will increase self-regulation and improve older driver safety.
Ball, K., & Owsley, C. (1993). The useful field of view: A new technique for evaluating age-related declines in visual function. Journal of the American Optometric Association, 64(1), 71–79.
2.
Ball, K., Owsley, C., Sloane, M. E., Roenker, D. L., & Bruni, J. R. (1993). Visual attention problems as a predictor of vehicle crashes among older drivers. Investigative Ophthalmology Visual Sciences, 34,3110–3123.
3.
Ball, K., Owsley, C., Stalvey, B., Roenker, D. L., Sloane, M. E., & Graves, M. (1998). Driving avoidance and functional impairment in older drivers. Accident Analysis and Prevention, 30(3), 313–322.
4.
Ball, K., Roenker, D. L., & Bruni, J. R. (1990). Developmental changes in attention and visual search throughout adulthood. In J. Enns (Ed.), Advances in psychology (pp. 489–508). North Holland: Elsevier Science.
5.
Bandura, A. (1986). Social foundations of thought and action: A social cognitive theory. Englewood Cliffs, NJ: Prentice Hall.
6.
Best, J. A., & Cameron, R. (1986). Health behavior and health promotion. American Journal of Orthopsychiatry, 2, 48–56.
7.
Bloom, M. (1996). Primary prevention practices. Thousand Oaks, CA: Sage.
8.
Branch, L. G., & Jette, A. L. (1984). Personal health practices among the elderly. American Journal of Public Health, 74, 1126–1128.
9.
Clark, N. M., Janz, N. K., Dodge, J. A., & Sharpe, P. A. (1992). Self-regulation of health behavior: The ‘take PRIDE’ program. Health Education Quarterly, 19(3), 341–354.
10.
Cooper, P. J., Tallman, K., Tuokko, H., & Beattie, B. L. (1993). Vehicle crash involvement and cognitive deficit in older drivers. Journal of Safety Research, 24, 9–17.
11.
Evans, L. (1991). Traffic safety and the driver. New York: Van Nostrand Reinhold.
12.
Evans, L. (1996). Comment: The dominant role of driver behavior in traffic safety. American Journal of Public Health, 86(6), 784–786.
13.
Ferris, F. L. III, Kassoff, A., Bresnick, G. H., & Bailey, I. (1982). New visual acuity charts for clinical research. American Journal of Ophthalmology, 94,91–96.
14.
Folstein, M. F., Folstein, S. E., & McHugh, P. R. (1975). ‘Mini-mental state’: A practical method for grading the cognitive state of patients for the clinician. Journal of Psychiatric Research, 12, 189–198.
15.
Given, B., & Given, C. W. (1983). Adherence to hypertensive therapy. Geriatric Nursing, 4(3), 172–175.
16.
Goode, K. T., Ball, K. K., Sloane, M., Roenker, D. L., Roth, D. L., Myers, R. S., & Owsley, C. (1998). Useful field of view and other neurocognitive indicators of crash risk in older adults. Journal of Clinical Psychology in Medical Settings, 5(4), 425–440.
17.
Grembowski, D., Patrick, D., Diehr, P., Durham, M., Beresford, S., Kay, E., & Hecht, J. (1993). Self-efficacy and health behavior among older adults. Journal of Health and Social Behavior, 34, 89–94.
18.
Grimley, D. M., Riley, G. E., Bellis, J. M., & Prochaska, J. O. (1993). Assessing the stages of change and decision making for contraceptive use of the prevention of pregnancy, sexually transmitted diseases, and acquired immunodeficiency syndrome. Health Education Quarterly, 20(4), 455–470.
19.
Harris, D. M., & Guten, S. (1979). Health protective behavior: An exploratory study. Journal of Health and Social Behavior, 20, 17–29.
20.
Higgins, P. (1989). Short term changes in health behaviors of older adults. Canadian Journal of Nursing Research, 21(1), 19–30.
21.
Johnson, C., & Keltner, J. (1983). Incidence of visual field loss in 20,000 eyes and its relationship to driving performance. Archives of Ophthalmology, 101, 317–375.
22.
Karoly, P. (1993). Mechanisms of self-regulation: A systems view. In L. W. Porter & M. R. Rosenzwieg (Eds.) Annual review of psychology, 44 (pp. 23–52). Palo Alto, CA: Annual Reviews.
23.
Kelly, G. A. (1955). A theory of personality: The psychology of personal constructs. New York: Norton.
24.
Kelly, R., Zyzanski, S., & Alemagno, S. (1991). Prediction of motivation and behavior change following health promotion: Role of health beliefs, social support, and self-efficacy. Social Science and Medicine, 32(3), 311–320.
25.
Klein, B. E., Klein, R., Lee, K. E., & Cruickshanks, K. J. (1999). Associations of performance-based and self-reported measures of visual function: The Beaver Dam Eye Study. Ophthalmic Epidemiology, 6(1), 49–60.
26.
Kline, D. (1986). Visual aging and driving performance. Presented at Invitational Conference on Work, Aging, and Vision, Committee on Vision, National Research Council, Washington, DC.
27.
Klein, W. C., & Bloom, M. (1997). Successful aging: Strategies for healthy living. New York: Plenum.
28.
Lent, R., & Hacket, G. (1987). Career self-efficacy: Empirical status and future directions. Journal of Vocational Behavior, 30, 347–382.
29.
Mandavia, D., & Newton, K. (1998). Geriatric trauma. Contemporary Issues in Trauma, Emergency Medicine Clinics of North America, 16(1), 257–274.
30.
Mangione, C. M., Berry, S., Spritzer, K., Janz, N. K., Klein, R., Owsley, C., & Lee, P. P. (1998). Identifying the content area for the 51-item National Eye Institute Visual Function Questionnaire. Archives of Ophthalmology, 116, 227–233.
31.
Mangione, C. M., Lee, P. P., Pitts, J., Gutierrez, P., Berry, S., & Hays, R. D. (1998). Psychometric properties of the National Eye Institute Visual Function Questionnaire (NEI-VFQ). Archives of Ophthalmology, 116, 1496–1504.
32.
Martinez, R. (1995). Older drivers and physicians. Journal of the American Medical Association, 274(13), 1060-1060.
33.
Massie, D. L., Green, P. E., & Campbell, K. L. (1997). Crash involvement rates by driver gender and the role of average annual mileage. Accident Analysis and Prevention, 29(5), 675–685.
34.
McCloskey, L. W., Koepsell, T. D., Wolf, M. E., & Buchner, D. M. (1994). Motor vehicle collision injuries and sensory impairments in older drivers. Age and Ageing, 23, 267–273.
35.
Meichenbaum, D. H., & Smart, I. (1971). Use of direct expectancy to modify academic performance and attitudes of college students. Journal of Counseling Psychology, 18, 531–535.
36.
Mendes de Leon, C. F., Seeman, T. E., Baker, D. I., Richardson, E. D., & Tinetti, M. E. (1996). Self-efficacy, physical decline, and change in functioning in community-living elders: A prospective study. Journal of Gerontology: Social Sciences, 51B(4), S183–S190.
37.
Minkler, M. (1984). Health promotion in long term care: A contradiction in terms?Health Education Quarterly, 11(1), 77–89.
38.
Mischel, W., Cantor, N., & Feldman, S. (1996). Principles of self-regulation: The nature of willpower and self-control. In E. T. Higgins & A. W. Kruglanski (Eds.), Social psychology: Handbook of basic principles (pp. 329–360). New York: Guilford Press.
39.
NHTSA: National Highway Traffic Safety Administration. (1989). Conference on research and development needed to improve safety and mobility for older drivers. National Highway Traffic Safety Administration Technical Report DOT HS 807 554.Washington DC: US Department of Transportation.
40.
NHTSA: National Highway Traffic Safety Administration. (1993). Addressing the safety issues related to younger and older drivers. A Report to Congress on the Research Agenda of the National Highway Traffic Safety Administration, 19 January.
41.
NHTSA: National Highway Traffic Safety Administration. (1995). Traffic safety facts 1994: A compilation of motor vehicle crash data from the fatal accident reporting system and the general estimates system. National Highway Traffic Safety Administration, National Center for Statistics and Analysis. Washington DC: US Department of Transportation.
42.
Omenn, G. (1990). Prevention and the elderly: Appropriate policies. Health Affairs, 9, 80–93.
43.
Orlandi, M. A. (1987). Promoting health and preventing disease in health care settings: An analysis of barriers. Preventive Medicine, 16, 119–130.
44.
Owsley, C. (1997). Clinical and research issues on older drivers: Future directions. Alzheimer Disease and Associated Disorders, 11(1), 3–7.
45.
Owsley, C., Ball, K., McGwin, G. Jr., Sloane, M. E., Roenker, D. L., White, M. F., & Overley, E. T. (1998). Visual processing impairment and crash risk among older adults. Journal of the American Medical Association, 279, 1083–1088.
46.
Owsley, C., Ball, K., Sloane, M. E., Roenker, D. L., & Bruni, J. R. (1991). Visual/cognitive correlates of vehicle accidents in older drivers. Psychology and Aging, 6, 403–415.
47.
Owsley, C., & Sloane, M. E. (1990). Vision and aging. In F. Boller & J. Grafman (Eds.), Handbook of neuropsychology (pp. 229–249).
48.
Owsley, C., Stalvey, B., Wells, J., & Sloane, M. E. (1999). Older drivers and cataract: Driving habits and crash risk. Journal of Gerontology: Medical Sciences, 54A, M203–M211.
49.
Price, R. H., Cowen, E. L., Lorion, R. P., & Ramos-McKay, J. (Eds.) (1988). 14 ounces of prevention: A casebook for practitioners. Washington, DC: American Psychological Association.
50.
Prochaska, J. O., DiClemente, C. C., Velicer, W. F., Ginpil, S., & Norcross, J. C. (1985). Predicting change in smoking status for self-changers. Addictive Behaviors, 10, 395–406.
51.
Radloff, L. S., & Teri, L. (1986). Use of the Center for Epidemiological Studies-Depression Scale with older adults. In T. L. Brink (Ed.), Clinical gerontology: A guide to assessment and intervention(pp. 119–136). New York: Haworth Press.
52.
Retchin, S. M., & Annapole, J. (1993). An overview of the older driver. Clinical Geriatric Medicine, 9,279–296.
53.
Robertson, L. S. (1977). Car crashes: Perceived vulnerability and willingness to pay for crash protection. Journal of Community Health, 3(2), 136–141.
54.
Rollnick, S., Heather, N., Gold, R., & Hall, W. (1992). Development of a short ‘readiness to change’ questionnaire for use in brief, opportunistic interventions among excessive drinkers. British Journal of Addiction, 87, 743–754.
55.
Rose, M. A. (1996). Effect of an AIDS education program for older adults. Journal of Community Health Nursing, 13(3), 141–148.
56.
Rosenstock, I. M. (1990). The health belief model: Explaining health behavior through expectancies. In K. Glanz, F. M. Lewis, & B. K. RimerHealth behavior and health education: Theory, research and practice (pp. 39–62). San Francisco: Jossey-Bass.
57.
Rowe, J. W., & Kahn, R. L. (1998). Successful aging. New York: Pantheon.
58.
Schlag, B. (1993). Elderly drivers in Germany: Fitness and driving behavior. Accident Analysis and Prevention, 25, 47–56.
59.
Schunk, D. (1989). Self-efficacy and achievement behaviors. Educational Psychology Review, 1,173–208.
60.
Schwab, C. W., & Kauder, D. R. (1992). Trauma in the geriatric patient. Archives of Surgery, 127, 701–706.
61.
Schwarzer, R. (Ed.) (1992). Self-efficacy: Thought control of action. Washington, DC: Hemisphere.
62.
Schweitzer, S. O., Atchison, K. A., Lubben, J. E., Mayer-Oakes, S. A., De Jong, F. J., & Matthias, R. E. (1994). Health promotion and disease prevention for older adults: Opportunity for change or preaching to the converted?American Journal of Preventive Medicine, 10(4), 223–229.
63.
Siebrecht, E. (1941). The construction and validation of a scale for the measurement of attitudes toward safety in automobile driving. Ann Arbor, MI: Xerox University Microfilms.
64.
Sleet, D. A. (1984). Reducing motor vehicle trauma through health promotion. Health Education Quarterly, 11(2), 113–125.
65.
Steinberg, E. P., Tielsch, J. M., Schein, O. D., Javitt, J. C., Sharkey, P., Cassard, S. D., Legro, M. W., Diener-West, M., Bass, E. B., Damiano, A. M., Steinwachs, D. M., & Sommer, A. (1994). The VF-14: An index of functional impairment in patients with cataract. Archives of Ophthalmology, 112,630–638.
66.
Stretcher, V., Devillis, B., Becker, M., & Rosenstock, I. (1986). The role of self-efficacy in achieving health behavior change. Health Education Quarterly, 13,73–92.
67.
Transportation Research Board. (1988). Transportation in an Aging Society, 1, Special Report 218. Washington, DC: National Research Council.
68.
Wagner, E. H., LaCroix, A. Z., Grothaus, L., Leveille, S. G., Hect, J. A., Artz, K., Odle, K., & Buchner, D. M. (1994). Preventing disability and falls in older adults: A population-based randomized trial. American Journal of Public Health, 84(11), 1800–1806.
69.
Walker, S. N., Volkan, K., Sechrist, K. R., & Pender, N. J. (1988). Health promoting life styles of older adults: Comparisons with young and middle-aged adults, correlates and patterns. Advances in Nursing Science, 11(1), 76–90.
70.
Weinstein, N. D. (Ed.) (1987). Taking care: Under-standing and encouraging self-protective behavior.New York: Cambridge University Press.
71.
Weinstein, N. D. (1993). Testing four competing theories of health-protective behavior. Health Psychology, 12(4), 324–333.
72.
Zimmerman, R., & Connor, C. (1989). Health promotion in context: The effects of significant others on behavior change. Health Education Quarterly, 16(1), 57–75.
