Abstract
This study allowed researchers to understand how OTPs trained in the CarFit program utilize the CarFit 1:1 model in practice. Researchers collected 268 surveys. Those who used the 1:1 model reported that it was quick, easy, and helped them determine AE for driving. However, the model will likely be underutilized, as 86 respondents were extremely unlikely to conduct a 1:1 session in the next year due to barriers related to time, billing, and lack of training.
Primary Author and Speaker: Judith Ismail
Additional Authors and Speakers: Laura Miear
The purpose of this study was to understand how CarFit trained OT practitioners use the CarFit 1:1 model to provide driver education to seniors and to discover perceived benefits and barriers of this model. A literature review showed no studies that measured the use and effectiveness of the 1:1 model in OT practice. Use of this model is low across the nation despite CarFit’s efforts to advertise and offer online trainings.
The PIs used a descriptive survey administered online and by paper format. The PIs used a panel of subject matter experts to establish content validity in addition to piloting the survey in the state of Virginia. Results of the pilot study helped guide the development of the national study. The PIs purposefully selected subjects from a group of approximately 6,000 OT practitioners trained as CarFit technicians, event coordinators, and/or instructors from the CarFit website. Subjects were informed of the study via email, the 2018 CarFit Newsletter, and flyers at the AOTA expo. Prospective subjects received an email invitation to participate in an online survey or complete a paper survey at the 2018 AOTA expo. The study took place from February-August 2018 with 268 respondents: 238 female, 29 male, 1 other. Multiple choice and open-ended survey questions gathered information related to practice area, OT and CarFit experience, knowledge and use of the 1:1 model, and benefits and challenges with this model. Researchers used SPSS for statistical analysis of the data and coding to analyze open-ended questions. Respondents were in the age range of 18-70 years, with the majority over the age of 30 (146). The majority of respondents (91) practiced in FL, NY, MA, PA and CA, with outpatient rehabilitation and skilled nursing facilities listed as the primary practice areas (151). The mode for degree of OT education was a Master’s (115) and number of years as an OT/COTA was > 30 years (45). Regarding addressing the IADL of driving in practice, the most frequent responses were “sometimes” (90) and “never” (60). Respondent’s CarFit training included CarFit 1:1 technicians (50), technicians (223), event coordinators (95), and instructors (22). Of those trained as 1:1 technicians, 48% had not conducted 1:1 sessions. The most frequently reported constraints were time and billing. Those who used the 1:1 model reported that it was quick, easy, and helped them determine AE for driving. The settings where 1:1 sessions were conducted most frequently included community-based, outpatient, and independent living facilities and the population most frequently included were clients with general debilitation related to aging. While only 14 out of 238 respondents reported that they were extremely unlikely to participate in a CarFit event within the next year, 75 out of 229 were extremely unlikely to conduct a 1:1 session in the next year. All felt that driving was vital to community mobility, OT skills were needed to conduct a 1:1, and time spent should be reimbursable. Respondents felt that CarFit is meeting their goal of improving the vehicle fit and that they feel more comfortable addressing driving with clients (229).
In conclusion, only 50 respondents were trained in the 1:1 model, with just over half of those trained utilizing it in practice. Barriers related to time, billing, and lack of training may be contributing to the underutilization of the model. Insight into the barriers to conducting CarFit events and 1:1 sessions can assist the CarFit organization in addressing these barriers, increasing the number of events conducted and seniors who are educated. The PIs hope that findings from this study will contribute to increased utility of the 1:1 model in practice and ultimately increased older driver safety across the country.
CarFit (2018). CarFit Winter 2018. CarFit Newsletter. Retrieved from https://www.car-fit.org/downloads/CarFit_Newsletter_Winter_2018.pdf
Lane, A., Green, E., Dickerson, A. E., Schold Davis, E., Rolland, B., & Stohler, J. T. (2014). Driver Rehabilitation Programs: Defining Program Models, Services, and Expertise. Occupational Therapy in Healthcare, 28 (2), 177-187. doi:10.3109/07380577.2014.903582