Date Presented 04/06/19
OTs are well positioned to support older drivers (65+) with determining their fitness to drive but are in need of an evidence-informed method to identify at-risk older drivers. This presentation will discuss 10 years of research and development of the Fitness-to-Drive Screening Measure (FTDS) for identifying at-risk older drivers. The FTDS may aid OTs with initial fitness-to-drive decisions and in determining an older driver’s risk probability.
Primary Author and Speaker: Shabnam Medhizadah
Additional Authors and Speakers: Sherrilene Classen, Sandra Winter
INTRODUCTION: Over the next ten years, it is estimated that older adults (65 years of age or older) will represent the fastest growing segment of the North American population. As a result of this projected growth, there is a mounting need to support older drivers and their caregivers by identifying the driver’s fitness to drive. Fitness to drive may be affected by age-related declines in visual, cognitive and motor functioning, contributing to motor-vehicle collisions and its resulting injuries and deaths(Classen, Winter, Velozo, Hannold, & Rogers, 2010). Occupational therapists can play a vital role in driver rehabilitation across clinical settings and are currently participating in the screening, comprehensive evaluation, and retraining of older drivers (Korner-Bitensky, Menon, von Zweck, & Van Benthem, 2010). Occupational therapists have the skills to emerge as leaders in the field of driver rehabilitation by screening at-risk older drivers, supporting older drivers with fitness to drive decisions, and increasing the older drivers’ awareness of their driving-related challenges. The Fitness-to-Drive Screening Measure©(FTDS) is a valid and reliable screening tool that may aid occupational therapists in all of these responsibilities (Classen, Velozo, Winter, Bédard, & Wang, 2015). The measure is available for free, online and uses proxy rater (family members, friends, formal/informal caregivers) responses to 54 driving-related items to identify at-risk older drivers. The proxy rater responses are used to classify older drivers as an at-risk (consider driving cessation), routine (can continue to perform basic driving tasks), or accomplished driver (may continue to drive) (Classen et al., 2010). The FTDS provides specific resources and recommendations and a keyform identifying areas of challenge for the older driver. The FTDS is currently available in an American and Canadian version, with a short form and Japanese version in development.
OBJECTIVE: To examine and appraise the FTDS regarding its form, function, use, uptake, 15-item short form, and potential impact in clinical occupational therapy settings.
APPROACH: In this poster, we will introduce the participants to the free web-based FTDS. First, we will provide an overview of the 54-item FTDS’ and its development and psychometric properties. Second, using Google analytics data, we will discuss FTDS user patterns and uptake amongst more than 35,000 users. Third, we will introduce and discuss the expansion of the FTDS to include a Canadian version. Fourth, we will acquaint participants with the construction and validation of the 32-item FTDS using classical test theory and item response theory techniques. Fifth, we will introduce the newly-developed Rasch based 15-item FTDS short form and discuss its construction, and predictive validity. Lastly, we will discuss the FTDS potential clinical utility for identifying at-risk older drivers and supporting occupational therapists in making evidence-informed fitness to drive decisions.
CLINICAL IMPLICATIONS: The FTDS and FTDS short form have the potential to be used in clinical occupational therapy settings. Specifically, the FTDS and FTDS short form may enable occupational therapists to screen for and identify at-risk older drivers. The tool in clinical settings may also improve occupational therapists’ ability to guide older drivers and their families through the initial process of driver risk classification, and to make recommendations for driving cessation, referral to driver rehabilitation, or continued driving.
References
Classen, S., Winter, S. M., Velozo, C. A., Hannold, E. M., & Rogers, J. (2013). Stakeholder recommendations to refine the Fitness-to-Drive Screening Measure. The Open Journal of Occupational Therapy, 1(4), Article 3. http://dx.doi.org/10.15453/2168-6408.1054
Classen, S., Winter, S. M., Velozo, C. A., Be ́dard, M., Lanford, D. N., Brumback, B., et al. (2010). Item development and validity testing for a Self- and Proxy report: The Safe Driving Behavior Measure. American Journal of Occupational Therapy, 64, 296–305.
Classen, S., Velozo, C. A., Winter, S. M., Bédard, M., & Wang, Y. (2015). Psychometrics of the Fitness-to- Drive Screening Measure. OTJR: Occupation, Participation and Health, 35(1), 42-52. http://dx.doi.org/10.1177/1539449214561761
Korner-Bitensky, N., Menon, A., von Zweck, C., & Van Benthem, K. (2010). Occupational therapists’ capacity-building needs related to older driver screening, assessment, and intervention: A Canada wide survey. American Journal of Occupational Therapy, 64, 316-324. http://dx.doi.org/10.5014/ajot.64.2.316
