Advancing Understanding of Transportation Options
Advancing Understanding of Transportation Options
This Stage II randomized, controlled, longitudinal trial seeks to assess the acceptability,
 feasibility, and effects of a driving decision aid use among geriatric patients and
 providers. This multi-site trial will (1) test the driving decision aid (DDA) in improving
 decision making and quality (knowledge, decision conflict, values concordance and behavior
 intent); and (2) determine its effects on specific subpopulations of older drivers
 (stratified for cognitive function, decisional capacity, and attitudinally readiness for a
 mobility transition). The overarching hypotheses are that the DDA will help older adults make
 high-quality decisions, which will mitigate the negative psychosocial impacts of driving
 reduction, and that optimal DDA use will target certain populations and settings.
The investigators will use a multi-site, two-armed randomized controlled trial of older
 drivers (n=300; ≥70 years) from clinical settings, and one family member each (n=up to 300),
 with longitudinal follow-up. Study goals are to test how much the DDA improves outcomes and
 identify who benefits most from the DDA. Evaluation of the DDA's efficacy (Aim 1) and its
 relative effect in subgroups (Aim 2) corresponds to Stage II in the NIH Stage Model for
 Behavioral Intervention Development. Findings from Aims 1 & 2 could identify necessary
 refinements (Stage I) and inform future efficacy, effectiveness or implementation trials.
Inclusion Criteria for drivers:

 -  70 years or older

 -  Fluent in English

 -  At least one medical condition linked in driving cessation

 -  Drive at least one time per week

 -  Have a study partner* (*drivers interested in participating in the study without a
 study partner will be placed on a wait list; they may be contacted as a later date for
 enrollment once 200 driver-study partner dyads have been enrolled across all sites)

 -  5-minute MoCA score greater or equal to 21

 Exclusion Criteria for drivers:

 -  In legal custody or institutionalized

 -  Significant cognitive impairment as measured by 5-minute Montreal Cognitive Assessment
 (MoCA)

 -  Since the last time they had their license renewed, has had at least one major change
 to health, vision, or hearing that has seriously impaired driving (based on potential
 participant self-report)

 -  Feels the Department of Motor Vehicles would have serious concerns about their driving
 (based on potential participant self-report)

 Inclusion Criteria for study partners:

 -  18 years or older

 -  Fluent in English

 -  Identified by Driver participant to contact for potential participation, i.e., part of
 a driver-study partner dyad

 -  5-minute MoCA score greater or equal to 21

 Exclusion Criteria for study partners:

 -  In legal custody or institutionalized

 -  Significant cognitive impairment as measured by 5-minute Montreal Cognitive Assessment
 (MoCA)