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Brief ReportBrief Report

Physician and Family Discussions about Driving Safety: Findings from the LongROAD Study

Marian E. Betz, Leon Villavicencio, Deepika Kandasamy, Tara Kelley-Baker, Woon Kim, Carolyn DiGuiseppi, Thelma J. Mielenz, David W. Eby, Lisa J. Molnar, Linda Hill, David Strogatz, David B. Carr and Guohua Li; on behalf of the LongROAD Research Team
The Journal of the American Board of Family Medicine July 2019, 32 (4) 607-613; DOI: https://doi.org/10.3122/jabfm.2019.04.180326
Marian E. Betz
From the Department of Emergency Medicine, University of Colorado School of Medicine, Aurora, CO (MEB, DK); AAA Foundation for Traffic Safety, Washington, DC (LV, TK-B, WK); Department of Epidemiology, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, CO (CD); Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY (TJM, GL); Center for Injury Epidemiology and Prevention, Columbia University Medical Center, New York, NY (TJM, GL); University of Michigan Transportation Research Institute and Center for Advancing Transportation Leadership and Safety, Ann Arbor, MI (DWE, LJM); Department of Family Medicine and Public Health, University of California–San Diego, San Diego CA (LH); Bassett Research Institute, Bassett Healthcare Network, Cooperstown, NY (DS); Departments of Medicine and Neurology, Washington University School of Medicine, St. Louis, MO (DBC); Department of Anesthesiology, Columbia University College of Physicians and Surgeons, New York, NY (GL).
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Leon Villavicencio
From the Department of Emergency Medicine, University of Colorado School of Medicine, Aurora, CO (MEB, DK); AAA Foundation for Traffic Safety, Washington, DC (LV, TK-B, WK); Department of Epidemiology, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, CO (CD); Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY (TJM, GL); Center for Injury Epidemiology and Prevention, Columbia University Medical Center, New York, NY (TJM, GL); University of Michigan Transportation Research Institute and Center for Advancing Transportation Leadership and Safety, Ann Arbor, MI (DWE, LJM); Department of Family Medicine and Public Health, University of California–San Diego, San Diego CA (LH); Bassett Research Institute, Bassett Healthcare Network, Cooperstown, NY (DS); Departments of Medicine and Neurology, Washington University School of Medicine, St. Louis, MO (DBC); Department of Anesthesiology, Columbia University College of Physicians and Surgeons, New York, NY (GL).
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Deepika Kandasamy
From the Department of Emergency Medicine, University of Colorado School of Medicine, Aurora, CO (MEB, DK); AAA Foundation for Traffic Safety, Washington, DC (LV, TK-B, WK); Department of Epidemiology, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, CO (CD); Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY (TJM, GL); Center for Injury Epidemiology and Prevention, Columbia University Medical Center, New York, NY (TJM, GL); University of Michigan Transportation Research Institute and Center for Advancing Transportation Leadership and Safety, Ann Arbor, MI (DWE, LJM); Department of Family Medicine and Public Health, University of California–San Diego, San Diego CA (LH); Bassett Research Institute, Bassett Healthcare Network, Cooperstown, NY (DS); Departments of Medicine and Neurology, Washington University School of Medicine, St. Louis, MO (DBC); Department of Anesthesiology, Columbia University College of Physicians and Surgeons, New York, NY (GL).
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Tara Kelley-Baker
From the Department of Emergency Medicine, University of Colorado School of Medicine, Aurora, CO (MEB, DK); AAA Foundation for Traffic Safety, Washington, DC (LV, TK-B, WK); Department of Epidemiology, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, CO (CD); Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY (TJM, GL); Center for Injury Epidemiology and Prevention, Columbia University Medical Center, New York, NY (TJM, GL); University of Michigan Transportation Research Institute and Center for Advancing Transportation Leadership and Safety, Ann Arbor, MI (DWE, LJM); Department of Family Medicine and Public Health, University of California–San Diego, San Diego CA (LH); Bassett Research Institute, Bassett Healthcare Network, Cooperstown, NY (DS); Departments of Medicine and Neurology, Washington University School of Medicine, St. Louis, MO (DBC); Department of Anesthesiology, Columbia University College of Physicians and Surgeons, New York, NY (GL).
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Woon Kim
From the Department of Emergency Medicine, University of Colorado School of Medicine, Aurora, CO (MEB, DK); AAA Foundation for Traffic Safety, Washington, DC (LV, TK-B, WK); Department of Epidemiology, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, CO (CD); Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY (TJM, GL); Center for Injury Epidemiology and Prevention, Columbia University Medical Center, New York, NY (TJM, GL); University of Michigan Transportation Research Institute and Center for Advancing Transportation Leadership and Safety, Ann Arbor, MI (DWE, LJM); Department of Family Medicine and Public Health, University of California–San Diego, San Diego CA (LH); Bassett Research Institute, Bassett Healthcare Network, Cooperstown, NY (DS); Departments of Medicine and Neurology, Washington University School of Medicine, St. Louis, MO (DBC); Department of Anesthesiology, Columbia University College of Physicians and Surgeons, New York, NY (GL).
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Carolyn DiGuiseppi
From the Department of Emergency Medicine, University of Colorado School of Medicine, Aurora, CO (MEB, DK); AAA Foundation for Traffic Safety, Washington, DC (LV, TK-B, WK); Department of Epidemiology, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, CO (CD); Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY (TJM, GL); Center for Injury Epidemiology and Prevention, Columbia University Medical Center, New York, NY (TJM, GL); University of Michigan Transportation Research Institute and Center for Advancing Transportation Leadership and Safety, Ann Arbor, MI (DWE, LJM); Department of Family Medicine and Public Health, University of California–San Diego, San Diego CA (LH); Bassett Research Institute, Bassett Healthcare Network, Cooperstown, NY (DS); Departments of Medicine and Neurology, Washington University School of Medicine, St. Louis, MO (DBC); Department of Anesthesiology, Columbia University College of Physicians and Surgeons, New York, NY (GL).
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Thelma J. Mielenz
From the Department of Emergency Medicine, University of Colorado School of Medicine, Aurora, CO (MEB, DK); AAA Foundation for Traffic Safety, Washington, DC (LV, TK-B, WK); Department of Epidemiology, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, CO (CD); Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY (TJM, GL); Center for Injury Epidemiology and Prevention, Columbia University Medical Center, New York, NY (TJM, GL); University of Michigan Transportation Research Institute and Center for Advancing Transportation Leadership and Safety, Ann Arbor, MI (DWE, LJM); Department of Family Medicine and Public Health, University of California–San Diego, San Diego CA (LH); Bassett Research Institute, Bassett Healthcare Network, Cooperstown, NY (DS); Departments of Medicine and Neurology, Washington University School of Medicine, St. Louis, MO (DBC); Department of Anesthesiology, Columbia University College of Physicians and Surgeons, New York, NY (GL).
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David W. Eby
From the Department of Emergency Medicine, University of Colorado School of Medicine, Aurora, CO (MEB, DK); AAA Foundation for Traffic Safety, Washington, DC (LV, TK-B, WK); Department of Epidemiology, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, CO (CD); Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY (TJM, GL); Center for Injury Epidemiology and Prevention, Columbia University Medical Center, New York, NY (TJM, GL); University of Michigan Transportation Research Institute and Center for Advancing Transportation Leadership and Safety, Ann Arbor, MI (DWE, LJM); Department of Family Medicine and Public Health, University of California–San Diego, San Diego CA (LH); Bassett Research Institute, Bassett Healthcare Network, Cooperstown, NY (DS); Departments of Medicine and Neurology, Washington University School of Medicine, St. Louis, MO (DBC); Department of Anesthesiology, Columbia University College of Physicians and Surgeons, New York, NY (GL).
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Lisa J. Molnar
From the Department of Emergency Medicine, University of Colorado School of Medicine, Aurora, CO (MEB, DK); AAA Foundation for Traffic Safety, Washington, DC (LV, TK-B, WK); Department of Epidemiology, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, CO (CD); Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY (TJM, GL); Center for Injury Epidemiology and Prevention, Columbia University Medical Center, New York, NY (TJM, GL); University of Michigan Transportation Research Institute and Center for Advancing Transportation Leadership and Safety, Ann Arbor, MI (DWE, LJM); Department of Family Medicine and Public Health, University of California–San Diego, San Diego CA (LH); Bassett Research Institute, Bassett Healthcare Network, Cooperstown, NY (DS); Departments of Medicine and Neurology, Washington University School of Medicine, St. Louis, MO (DBC); Department of Anesthesiology, Columbia University College of Physicians and Surgeons, New York, NY (GL).
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Linda Hill
From the Department of Emergency Medicine, University of Colorado School of Medicine, Aurora, CO (MEB, DK); AAA Foundation for Traffic Safety, Washington, DC (LV, TK-B, WK); Department of Epidemiology, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, CO (CD); Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY (TJM, GL); Center for Injury Epidemiology and Prevention, Columbia University Medical Center, New York, NY (TJM, GL); University of Michigan Transportation Research Institute and Center for Advancing Transportation Leadership and Safety, Ann Arbor, MI (DWE, LJM); Department of Family Medicine and Public Health, University of California–San Diego, San Diego CA (LH); Bassett Research Institute, Bassett Healthcare Network, Cooperstown, NY (DS); Departments of Medicine and Neurology, Washington University School of Medicine, St. Louis, MO (DBC); Department of Anesthesiology, Columbia University College of Physicians and Surgeons, New York, NY (GL).
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David Strogatz
From the Department of Emergency Medicine, University of Colorado School of Medicine, Aurora, CO (MEB, DK); AAA Foundation for Traffic Safety, Washington, DC (LV, TK-B, WK); Department of Epidemiology, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, CO (CD); Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY (TJM, GL); Center for Injury Epidemiology and Prevention, Columbia University Medical Center, New York, NY (TJM, GL); University of Michigan Transportation Research Institute and Center for Advancing Transportation Leadership and Safety, Ann Arbor, MI (DWE, LJM); Department of Family Medicine and Public Health, University of California–San Diego, San Diego CA (LH); Bassett Research Institute, Bassett Healthcare Network, Cooperstown, NY (DS); Departments of Medicine and Neurology, Washington University School of Medicine, St. Louis, MO (DBC); Department of Anesthesiology, Columbia University College of Physicians and Surgeons, New York, NY (GL).
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David B. Carr
From the Department of Emergency Medicine, University of Colorado School of Medicine, Aurora, CO (MEB, DK); AAA Foundation for Traffic Safety, Washington, DC (LV, TK-B, WK); Department of Epidemiology, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, CO (CD); Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY (TJM, GL); Center for Injury Epidemiology and Prevention, Columbia University Medical Center, New York, NY (TJM, GL); University of Michigan Transportation Research Institute and Center for Advancing Transportation Leadership and Safety, Ann Arbor, MI (DWE, LJM); Department of Family Medicine and Public Health, University of California–San Diego, San Diego CA (LH); Bassett Research Institute, Bassett Healthcare Network, Cooperstown, NY (DS); Departments of Medicine and Neurology, Washington University School of Medicine, St. Louis, MO (DBC); Department of Anesthesiology, Columbia University College of Physicians and Surgeons, New York, NY (GL).
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Guohua Li
From the Department of Emergency Medicine, University of Colorado School of Medicine, Aurora, CO (MEB, DK); AAA Foundation for Traffic Safety, Washington, DC (LV, TK-B, WK); Department of Epidemiology, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, CO (CD); Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY (TJM, GL); Center for Injury Epidemiology and Prevention, Columbia University Medical Center, New York, NY (TJM, GL); University of Michigan Transportation Research Institute and Center for Advancing Transportation Leadership and Safety, Ann Arbor, MI (DWE, LJM); Department of Family Medicine and Public Health, University of California–San Diego, San Diego CA (LH); Bassett Research Institute, Bassett Healthcare Network, Cooperstown, NY (DS); Departments of Medicine and Neurology, Washington University School of Medicine, St. Louis, MO (DBC); Department of Anesthesiology, Columbia University College of Physicians and Surgeons, New York, NY (GL).
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Article Figures & Data

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    Figure 1.

    Reported outcomes of discussions with physicians, by age and gender (n = 165).

Tables

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    Table 1.

    Participant Characteristics by Reported Discussions with Family Members or Physicians (n = 2990)

    CharacteristicnWith Family (n = 426)With Physician (n = 165)
    %95% CI%95% CI
    Total299014.213.0 to 15.55.54.7 to 6.3
    Age (years)*
        65 to 69124313.811.9 to 15.85.64.3 to 6.8
        70 to 74103712.510.5 to 14.65.54.1 to 6.9
        75 to 7971017.514.7 to 20.35.53.8 to 7.2
    Gender*
        Male140415.914.0 to 17.85.64.4 to 6.8
        Female158612.811.2 to 14.45.44.3 to 6.5
    Race
        White255714.613.2 to 165.54.6 to 6.4
        Black21211.37.1 to 15.65.72.5 to 8.8
        Asian6414.15.5 to 22.67.81.2 to 14.4
        Other15712.77.5 to 18.04.51.2 to 7.7
    Hispanic
        Yes8313.36.0 to 20.61.20.0 to 3.6
        No279414.513.2 to 15.85.84.9 to 6.6
    Educationb
        ≤Some college106212.010.0 to 13.95.23.8 to 6.5
        Bachelors69812.09.6 to 14.44.32.8 to 5.8
        ≥Masters122117.515.4 to 19.76.65.2 to 7.9
    Income
        ≤$49,99977512.610.3 to 156.24.5 to 7.9
        $50,000 to $79,99971914.311.8 to 16.97.05.1 to 8.8
        $80,000 to $99,99943114.811.5 to 18.25.83.6 to 8.0
        ≥$100,00095916.213.8 to 18.54.12.8 to 5.3
    Paid employment
        Yes90413.411.3 to 15.74.22.9 to 5.5
        No208414.513.0 to 16.16.15.1 to 7.1
    Marital status*
        Married/living with partner197415.313.7 to 16.95.54.5 to 6.5
        Separated/divorced60811.38.8 to 13.96.14.2 to 8.0
        Widowed37813.09.6 to 16.44.52.4 to 6.6
    Traffic event¶
        Yes70316.113.4 to 18.85.13.5 to 6.8
        No228613.712.3 to 15.15.64.7 to 6.5
    Driving reduction†,§
        No reduction244213.412.0 to 14.75.04.1 to 5.9
        For self-regulation17326.620.0 to 33.213.98.7 to 19.0
        For other reason(s)35513.510.0 to 17.15.43.0 to 7.7
    Other people…
        …depend on you for rides
            Yes76215.913.3 to 18.55.23.7 to 6.8
            No222213.712.3 to 15.15.64.6 to 6.5
        …can give you rides
            Yes282614.212.9 to 15.55.74.9 to 6.6
            No14813.58.0 to 19.02.00 to 4.3
    Driving scales‖Mean (SD)Mean (SD)
    Self-rated average ability†,§5.65 (0.73)5.67 (0.75)
    Errors†1.54 (0.34)1.47 (0.35)
    Violations†1.7 (0.41)1.61 (0.37)
    Strategic Self Regulation†,§2.96 (2.42)3.22 (2.56)
    Tactical Self Regulation†,‡3.18 (1.7)3.26 (1.68)
    • ↵Family discussion prevalence differs by characteristic at P < .05* or P < .001† via χ2 tests; physician discussion prevalence differs at P < .05‡ or P < .001§ via χ2 tests or Fisher's exact tests.

    • ↵¶ “Traffic event” was ≥1 motor vehicle crash, police stop, or traffic ticket within the past year.

    • ↵‖ See Methods for full description of scales.

    • CI, confidential interval; SD, standard deviation.

    • View popup
    Table 2.

    Factors Associated with Older Adults Reporting Driving Discussions with Family Members or Physicians

    CharacteristicFamily member AOR (95%CI)Physician AOR (95%CI)
    Age (years)
        65 to 691.00 (Ref)—
        70 to 740.86 (0.6 to 1.12)—
        75 to 791.16 (0.88 to 1.53)—
    Gender
        Male1.32 (1.05 to 1.66)*—
        Female1.00 (Ref)—
    Hispanic
        Yes—0.24 (0.03 to 1.75)
        No—1.00 (Ref)
    Education
         ≤Some college1.00 (Ref)1.00 (Ref)
        Bachelors0.92 (0.67 to 1.27)1.03 (0.64 to 1.68)
         ≥Masters1.65 (1.27 to 2.13)†1.77 (1.17 to 2.68)†
    Income
         ≤$49,999—1.00 (Ref)
        $50,000 to 79,999—1.13 (0.73 to 1.75)
        $80,000 to $99,999—0.91 (0.53 to 1.57)
         ≥$100,000—0.69 (0.42 to 1.13)
    Employed (paid)
        No—1.00 (Ref)
        Yes—0.75 (0.51 to 1.11)
    Traffic event§
        No1.00 (Ref)—
        Yes1.27 (0.99 to 1.63)—
    Driving reduction
        None1.00 (Ref)1.00 (Ref)
        Self-regulation1.68 (1.12 to 2.53)†2.10 (1.25 to 3.50)†
        Other reason(s)0.94 (0.66 to 1.33)1.14 (0.69 to 1.90)
    Others…
        …dependent for rides
            No1.00 (Ref)—
            Yes1.23 (0.96 to 1.58)—
        …can give rides
            No—1.00 (Ref)
            Yes—3.13 (0.98 to 10.04)
    Driving scales¶
    Self-rated driving ability0.67 (0.56 to 0.79)‡0.75 (0.59 to 0.95)*
    Errors1.65 (1.13 to 2.39)*—
    Violations1.45 (1.06 to 1.99)*—
    Strategic self-regulation1.09 (1.04 to 1.15)†1.10 (1.03 to 1.19)†
    Tactical Self-regulation——
    • AOR, adjusted odds ratio (adjusted for all other characteristics in AOR model); CI, confidential interval. Italics indicate statistically significant results.

    • ↵* P < .05;

    • ↵† P < .01;

    • ↵‡ P < .001.

    • ↵§ “Traffic event” was ≥1 crash, police stop, or traffic ticket within the past year.

    • ↵¶ See Methods for full description of scales.

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The Journal of the American Board of Family     Medicine: 32 (4)
The Journal of the American Board of Family Medicine
Vol. 32, Issue 4
July-August 2019
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Physician and Family Discussions about Driving Safety: Findings from the LongROAD Study
Marian E. Betz, Leon Villavicencio, Deepika Kandasamy, Tara Kelley-Baker, Woon Kim, Carolyn DiGuiseppi, Thelma J. Mielenz, David W. Eby, Lisa J. Molnar, Linda Hill, David Strogatz, David B. Carr, Guohua Li
The Journal of the American Board of Family Medicine Jul 2019, 32 (4) 607-613; DOI: 10.3122/jabfm.2019.04.180326

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Physician and Family Discussions about Driving Safety: Findings from the LongROAD Study
Marian E. Betz, Leon Villavicencio, Deepika Kandasamy, Tara Kelley-Baker, Woon Kim, Carolyn DiGuiseppi, Thelma J. Mielenz, David W. Eby, Lisa J. Molnar, Linda Hill, David Strogatz, David B. Carr, Guohua Li
The Journal of the American Board of Family Medicine Jul 2019, 32 (4) 607-613; DOI: 10.3122/jabfm.2019.04.180326
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