| Older drivers have a disproportionately high rate of crash involvement that has been linked to age-related declines in visual function. However, many older drivers with visual deficits meet the legal requirements for licensing, despite impairments that elevate crash risk. Therefore, KEYS (Knowledge Enhances Your Safety) was developed to assist high-risk older drivers in coping with impairment by promoting safety through self-awareness of vision impairment and the adoption of self-regulatory behaviors. Four hundred and two high-risk older drivers were randomly assigned to either usual eye care or a usual care plus education group. A baseline and 6-month posttest assessment was conducted to test the efficacy of the educational curriculum in terms of attitudes and perceptions toward vision and driving, the performance of self-regulatory practices, and driving exposure (i.e., days, miles, places, trips per week). At baseline, 80% of older drivers acknowledged they would feel more protected against crashes if they avoided hazardous driving situations (night, rain, alone, left-turn, parallel parking, interstate, heavy traffic, rush-hour). Yet, 75% of the sample reported never or rarely avoiding such situations. A total of 194 older drivers participated in the educational curriculum based on the tenants of the Social Cognitive Theory, Health Belief Model, Transtheoretical Model, Principles of Self-Regulation, and Regulatory Self-Efficacy. At posttest, those who participated in the educational curriculum demonstrated an increase in self-perceptions of vision impairment, perceived a greater number of benefits to the performance of self-regulatory behaviors, and demonstrated more characteristics of the Action/Maintenance stage of change. When compared to controls, drivers who received education reported a higher frequency of avoiding challenging driving situations (i.e., left-turns) and reported a higher frequency of performing self-regulatory behaviors (i.e., making 3 right turns). Additionally, those participating in the educational sessions reported significantly fewer days, fewer places, and fewer trips made per week than those not participating in education. These findings suggest that visually impaired older drivers can benefit from educational interventions that promote self-regulation. This intervention serves as an example of a primary prevention approach focusing on the specific human behaviors performed by the driver in order to prevent crashes before they happen. |
