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Understanding barriers to evidence-based support for driving cessation

Published online by Cambridge University Press:  27 September 2023

Louise Gustafsson Open the ORCID record for Louise Gustafsson [Opens in a new window] ,
Jacki Liddle Open the ORCID record for Jacki Liddle [Opens in a new window] ,
Nancy A. Pachana Open the ORCID record for Nancy A. Pachana [Opens in a new window] ,
Theresa Lorraine Scott Open the ORCID record for Theresa Lorraine Scott [Opens in a new window] ,
Stacey George Open the ORCID record for Stacey George [Opens in a new window]  and
Kate Laver Open the ORCID record for Kate Laver [Opens in a new window]
Louise Gustafsson*
Affiliation:
Griffith University, Brisbane, Australia The Hopkins Centre - Menzies Health Institute of Queensland, Brisbane, Australia
Jacki Liddle
Affiliation:
University of Queensland, Brisbane, Australia Princess Alexandra Hospital, Brisbane, Australia
Nancy A. Pachana
Affiliation:
University of Queensland, Brisbane, Australia
Theresa Lorraine Scott
Affiliation:
University of Queensland, Brisbane, Australia
Stacey George
Affiliation:
Flinders University, Adelaide, Australia
Kate Laver
Affiliation:
Flinders University, Adelaide, Australia South Australian Local Health Network, Adelaide, Australia
*
Correspondence should be addressed to: Louise Gustafsson, Griffith University, Brisbane, Australia E-mail: louise.gustafsson@griffith.edu.au

Abstract

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Type
Letter to the Editor
Information
International Psychogeriatrics , Volume 36 , Special Issue 12: Issue Theme: Neurocognitive Disorders , December 2024 , pp. 1262 - 1263
Copyright
© The Author(s), 2023. Published by Cambridge University Press on behalf of International Psychogeriatric Association

Dear Editor,

International standards, including the Australian Assessing Fitness to Drive (Austroads, 2022), are designed to support medical practitioners’ decision-making related to driving. Conversations surrounding driving and non-driving, otherwise known as driving cessation, can be challenging. Driving cessation is often a difficult transition and older adults with and without dementia require support to adapt to a life without driving that is equal to a life with driving. Supporting an increasingly aging population to transition away from driving and toward alternative transport is essential and was the focus of a recently developed educational web-based resource (Stasiulis et al., Reference Stasiulis2023). Evidence supports the effectiveness of interactive driving cessation programs with individual goal achievement in increasing community mobility (Liddle et al., Reference Liddle2014; Peterson et al., Reference Peterson2023; Scott et al., Reference Scott2020); however, there is limited access to these programs in the community. For the past 17 years, we have been systematically working with health professionals, older adults with and without dementia, and their key support people to understand effective methods to provide support in driving cessation and the barriers to widespread implementation of a driving cessation support programs in practice (Liddle et al., Reference Liddle2023). Our research findings and experiences of barriers to implementation are presented in Table 1.

Table 1. Barriers mapped to the theoretical domain framework (Cane et al., Reference Cane, O’Connor and Michie2012)

Understanding the barriers is foundational to the identification of the intervention functions and behavior change techniques (Michie et al., Reference Michie2014) required to overcome this knowledge to practice gap. An essential next step in the knowledge to action framework is for health professionals and driving cessation researchers to work together to understand specific practice contexts and select, tailor, and implement interventions that support successful implementation across our health and primary care services. Without this, we will continue to fail to support older drivers to adapt to a life without driving.

Conflict of interest

They do not receive any personal financial benefit from this program.

Source of funding

Jacki Liddle, Nancy Pachana, and Louise Gustafsson are the founders of a program for driving cessation support which has been commercialized.

Description of authors’ roles

The draft of the letter was developed by Louise Gustafsson and all other authors contributed to the development and finalization.

References

Austroads (2022). Assessing Fitness to Drive: For Commercial and Private Vehicle Drivers. Sydney, NSW: Austroads.Google Scholar
Cane, J., O’Connor, D. and Michie, S. (2012). Validation of the theoretical domains framework for use in behaviour change and implementation research. Implementation Science, 7, 37. https://doi.org/10.1186/1748-5908-7-37.CrossRefGoogle ScholarPubMed
Liddle, J. et al. (2014). Effect of a group intervention to promote older adults’ adjustment to driving cessation on community mobility: a randomized controlled trial. The Gerontologist, 54, 409–422. https://doi.org/10.1093/geront/gnt019.CrossRefGoogle ScholarPubMed
Liddle, J. et al. (2023). Still in first gear: exploration of barriers for implementing driving cessation support. Australasian Journal of Ageing, 00, 1–5. https://doi.org/10.1111/ajag.13218.Google Scholar
Michie, S. et al. (2014). The Behaviour Change Wheel: A Guide to Designing Interventions. London: Silverback Publishing.Google Scholar
Peterson, C. M. et al. (2023). Refining a driving retirement program for persons with dementia and their care partners: a mixed methods evaluation of carFreeMeTM-Dementia. The Journals of Gerontology. Series B, Psychological sciences and social sciences, 78, 506–519. https://doi.org/10.1093/geronb/gbac151.CrossRefGoogle Scholar
Scott, T. et al. (2020). Adaptation of the CarFreeMe driver retirement intervention to provide driving cessation support to older people living with dementia. Brain Impairment, 21, 247–258. https://doi.org/10.1017/BrImp.2020.16.CrossRefGoogle Scholar
Stasiulis, E. et al. (2023). Developing the driving and dementia roadmap: a knowledge-to-action process. International Psychogeriatrics, 1–14. https://doi.org/10.1017/S1041610222001235.Google ScholarPubMed
Figure 0

Table 1. Barriers mapped to the theoretical domain framework (Cane et al., 2012)