KEYS Knowledge Enhances Your Safety Clinical Research Unit

1
KEYS Knowledge Enhances Your Safety
Clinical Research Unit Department of
Ophthalmology University of Alabama at Birmingham
Beth Stalvey, MPH, PhD, CHES
2
Target High-Risk Older Drivers

• Crash Involved
• Visually Impaired
• Legally Licensed
• High Driving Exposure

3
Curriculum
4
Delivery

• One-on-One
• Eye Care Clinic
• Tailored to Individual
• Visual Function
• Driving Habits
• Theory Based

5
1) Informational Component Visual
Function and Impact on Driving

• Visual Acuity
• Contrast Sensitivity
• Depth Perception
• Peripheral Vision
• Visual Processing
• Objective Assessment (Exam Screening)

6
Skill-Building Hazard Avoidance and
Self-Regulation
Driving Hazard
Alternative Strategy
Night Rain Interstate Left-Turn High-Traffic Rush-
Hour Driving Alone
Day No Rain Access Road 3 Right-Turns Arrow Less
Traveled Routes Off-Peak Hours Driving Companion
7
Confidence Building and Behavior Change

• Vicarious Learning (Driving Scenes)
• Goal Setting (Signed Contract)
• Vicarious Experience (Testimonial)
• Self-Efficacy (Homework)
• Self-Assessment Driving Diary
• Booster
• Skill Review Verbal Reinforcement

8
Evaluation
9
Study Design
Usual
Eye Care
Control
R
A
N
D
Post
-Test
Comprehensive
O
Assessment

Baseline
Eye
M
6, 12, 18, 24
Assessment
I
months
Exam
Z
E
Educational
D
Intervention

Usual Eye
Care
2 Sessions
10
Outcomes

• At six-month post-test, those who participated
  in education session reported
• significantly
• Greater level of perceived vision impairment and
  understanding of impact on driving
• Higher number of perceived benefits to
  self-regulation and hazard avoidance
• Greater readiness to make driving behavior change

11
Driving Exposure
300
7
p0.02
p0.01
6
250
Usual Care
5
Usual Care
200
4
Intervention
150
3
Intervention
100
2
50
1
0
0
Miles Per Week
Places Per Week
12
Driving Exposure
plt0.0001
plt0.0001
Intervention
Intervention
Usual Care
Usual Care
Hazard Avoidance
Self-Regulation
13
Crash Involvement
14
Summary

• Education
• Changes in knowledge and perceptions
• Driver Performance
• Reduction in driving exposure
• Increased self-regulation
• Safety
• Similar crash rates

15
Crash Rate as Safety Outcome

• Sufficient Power to evaluate
• Length of evaluation period
• Fault of driver

Self-Awareness Motivation Skill Self-Regulation Co
nfidence
?
Safety
Knowledge