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A video feedback intervention for cognitively impaired older drivers
Author(s) -
Ott Brian R,
Papandonatos George D,
Burke Erin M,
Erdman Donna,
Carr David B,
Davis Jennifer D
Publication year - 2020
Publication title -
alzheimer's and dementia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 6.713
H-Index - 118
eISSN - 1552-5279
pISSN - 1552-5260
DOI - 10.1002/alz.041852
Subject(s) - intervention (counseling) , video feedback , baseline (sea) , medicine , randomized controlled trial , physical therapy , psychology , nursing , physics , optics , oceanography , geology
Background The goals of this study were to demonstrate that in‐car video technology can effectively detect unsafe driving events in cognitively impaired older adults, and that providing feedback about these events to the drivers and their family members can lead to a reduction in the frequency and severity of unsafe driving behaviors. Methods Unsafe driving events (UDE) were triggered by g‐forces leading to capture of a video record that was then transmitted wirelessly to a remote office where each event was analyzed, categorized, and scored for safety demerit points. During the baseline phase (3 months), all participants were monitored with no feedback. During the intervention phase (4‐6 months), half of the participants and their family members were randomly assigned to receive a weekly progress report in the mail along with a DVD of recorded unsafe driving events with recommendations. They also had continuous access to the videos and scores on a web site. The other half of the participants continued with monitoring only. During the post‐intervention monitoring phase (7‐12 months), there was continued monitoring of all participants, but no further feedback. Results Of 51 drivers enrolled at baseline (34 with CDR 0.5 and 17 with CDR 1; mean MMSE = 24.35±3.03), 50 drivers completed baseline monitoring and were randomized to monitoring or intervention. During the intervention, UDE frequency per 1,000 miles was reduced by 21% from baseline in the feedback group (Rate Ratio= 0.79, 95% CI=.53‐1.17), while remaining approximately constant in the monitoring group (Rate Ratio=1.02, 95% CI=.69‐1.52). UDE severity score per 1,000 miles was reduced by 48% from baseline in the feedback group (Rate Ratio=0.52, 95% CI=.21‐1.27), but increased by 37% in the monitoring group (Rate Ratio=1.37, 95% CI=.67‐2.83). No major accidents or injuries occurred throughout the course of the study. Conclusions These results suggest the potential to improve driving safety among older drivers with cognitive impairment using a behavior modification approach aimed directly at problem behaviors detected in their natural driving environment using g‐force triggered video technology.