Lisa A. D'Ambrosio

Older Adult Perceptions of Smart Home Technologies: Implications for Research, Policy & Market Innovations in Healthcare

Advances in information communications technology and related computational power are providing a wide array of systems and related services that form the basis of smart home technologies to support the health, safety and independence of older adults. While these technologies offer significant benefits to older people and their families, they are also transforming older adults into lead adopters of a new 24/7 lifestyle of being monitored, managed, and, at times, motivated, to maintain their health and wellness. To better understand older adult perceptions of smart home technologies and to inform future research a workshop and focus group was conducted with 30 leaders in aging advocacy and aging services from 10 northeastern states. Participants expressed support of technological advance along with a variety of concerns that included usability, reliability, trust, privacy, stigma, accessibility and affordability. Participants also observed that there is a virtual absence of a comprehensive market and policy environment to support either the consumer or the diffusion of these technologies. Implications for research, policy and market innovation are discussed.

The validity of driving simulation for assessing differences between in-vehicle informational interfaces: A comparison with field testing

Data from on-road and simulation studies were compared to assess the validity of measures generated in the simulator. In the on-road study, driver interaction with three manual address entry methods (keypad, touch screen and rotational controller) was assessed in an instrumented vehicle to evaluate relative usability and safety implications. A separate group of participants drove a similar protocol in a medium fidelity, fixed-base driving simulator to assess the extent to which simulator measures mirrored those obtained in the field. Visual attention and task measures mapped very closely between the two environments. In general, however, driving performance measures did not differentiate among devices at the level of demand employed in this study. The findings obtained for visual attention and task engagement suggest that medium fidelity simulation provides a safe and effective means to evaluate the effects of in-vehicle information systems (IVIS) designs on these categories of driver behaviour. Statement of Relevance: Realistic evaluation of the user interface of IVIS has significant implications for both user acceptance and safety. This study addresses the validity of driving simulation for accurately modelling differences between interface methodologies by comparing results from the field with those from a medium fidelity, fixed-base simulator.

Gender Differences in Self-Regulation Patterns and Attitudes Toward Driving Among Older Adults

ABSTRACT The automobile is essential for many older adults to fulfill their daily needs, especially since many live where they lack access to public transit or other acceptable modes of transportation. Increased self-regulation is one way older drivers continue to drive safely and maintain mobility. This research considers whether self-regulation attitudes and patterns differ by gender. Results indicate that women and men report distinct patterns of self-regulation behaviors. Age, health status, and household status also interact with gender, influencing the extent of self-regulation. The results also show that women report lower levels of confidence in their driving skills than men, although the difference varies based on whether or not a woman lives alone. Implications of these results are considered for an aging population—particularly women—that over the coming decades will be more reliant on the automobile for transportation than ever before.

To drive or not to drive, that isn't the question-the meaning of self-regulation among older drivers

PROBLEM This research examines older drivers and how they rationalize and cope with their own changing psychological and physical functioning vis-à-vis self-regulation and driving. METHOD A national survey was mailed to a sample of drivers over the age of 50. An overall response rate of 53.11% was achieved, with 3,824 valid responses returned. This paper discusses the qualitative findings of the open-ended questions in this survey. RESULTS A rich, multidimensional description of self-regulation emerged from the data. Driving self-regulation was not simply a checklist of behaviors performed but a combination of attitudes and behaviors, including important social and psychological processes and automobile attributes. Household composition played an important role in determining what ones options were for getting around and how serious they were in enforcing self-regulation behaviors. DISCUSSION & SUMMARY As a society, we must realize the importance of driving in maintaining independence, feelings of self-worth, and being connected to life and society. This research presents the qualitative findings of a nationwide survey of drivers over the age of 50. The results revealed that older drivers define self-regulation as much more than the changes in behaviors due to declining health and ability. The older adults in our research strongly emphasized the psychological processes surrounding independence, self-worth, remaining connected to life and society, and what role the automobile plays. Household composition impacted decisions related to self-regulation. For instance, those from a two-person household were more willing to let their partner drive or share in the driving, while those who lived alone were less likely to self-regulate their driving. IMPACT ON INDUSTRY Education programs targeting older adults need to be expanded to include not only the behavioral components of self-regulation, but also the psychological factors that play an equally meaningful role. Legislators devising policy programs need to reconsider what are viable transportation options for the older adult.

The impact of distractions on young adult drivers with attention deficit hyperactivity disorder (ADHD).

Young adults with attention deficit hyperactivity disorder (ADHD) are at higher risk for being involved in automobile crashes. Although driving simulators have been used to identify and understand underlying behaviors, prior research has focused largely on single-task, non-distracted driving. However, in-vehicle infotainment and communications systems often vie for a drivers attention, potentially increasing the risk of collision. This paper explores the impact of secondary tasks on individuals with and without ADHD, a medical condition known to affect the regulation of attention. Data are drawn from a validated driving simulation representing periods before, during, and after participation in a secondary cognitive task. A hands-free phone task was employed in a high stimulus, urban setting and a working memory task during low stimulus, highway driving. Drivers with ADHD had more difficulty on the telephone task, yet did not show an increased decrement in driving performance greater than control participants. In contrast, participants with ADHD showed a larger decline in driving performance than controls during a secondary task in a low demand setting. The results suggest that the interaction of the nature of the driving context and the secondary task has a significant influence on how drivers with ADHD allocate attention and, in-turn, on the relative impact on driving performance. Drivers with ADHD appear particularly susceptible to distraction during periods of low stimulus driving.

A qualitative exploration of self-regulation behaviors among older drivers

ABSTRACT While much of the research on aging and driving has focused on sensory and motor changes, little is known about older drivers and the actual self-regulation adjustments they employ to continue driving safely. This research looks at how older drivers have made changes to driving patterns and behaviors that have allowed them to continue to drive without compromising their perceived safety, independence, and quality of life. Nine focus groups were held with older men and women aged 58 to 89 years. Some of the major themes that emerged were the following: older adults are very aware of age-related changes to driving; they perceive that self-regulation behaviors change with age; and they view transportation alternatives as limited or nonexistent. Policy implications include developing functional transit programs for older adults and car manufacturer training workshops to educate older adults on the safety features of newly purchased automobiles.

Task-Induced Fatigue and Collisions in Adult Drivers with Attention Deficit Hyperactivity Disorder

Objective. This study compares collision involvement between adult drivers with attention deficit hyperactivity disorder (ADHD) and control participants in a simulation experiment designed to enhance the effects of fatigue. Because the effects of ADHD include difficulties in maintaining attention, drivers with ADHD were hypothesized to be more susceptible to the effects of fatigue while driving. Methods. Data are drawn from a validated driving simulation study, portions of which were focused on enhancing the effects of fatigue. The simulator data are supplemented with written questionnaire data. Drivers with ADHD were compared with controls. Results. The self-report data indicated that drivers with ADHD were more likely to report having been involved in an accident within the previous five years. Simulation data showed that time of day of participation in the experiment were significantly related to likelihood of collision, and that these effects were further exacerbated by ADHD status. Participants with ADHD were more likely than controls to be involved in a crash in the simulator regardless of time of day, but the effects were particularly pronounced in the morning, and the rate of increase in accident involvement from the late afternoon into the evening was greater among participants with ADHD. No differences in self-reported sleep patterns or caffeine use were found between participants with ADHD and controls. Conclusions. The results suggest that drivers with ADHD became fatigued more quickly than controls. Such drivers thus face greater risk of involvement in accidents on highways or open roadways where the visual and task monotony of the environment contribute to greater driver fatigue.

At the Crossroads: Development and evaluation of a dementia caregiver group intervention to assist in driving cessation

ABSTRACT Deciding when an individual with dementia must reduce or stop driving can be a stressful issue for family caregivers. The purpose of this study was to develop a group intervention to assist these caregivers with driving issues and to provide a preliminary evaluation of the comparative effectiveness of this At the Crossroads intervention. Participants were randomized to one of three arms: (1) active intervention (four 2-hour manualized educational/support group meetings; n = 31); (2) written materials only (participants received written materials after a pretest; n = 23); and (3) control (participants received written materials after a posttest; n = 12). Participants were administered a battery of self-report and interview-based questionnaires at baseline and again 2 months later. At follow-up, the active intervention group scored significantly better than both other groups on key outcome variables, including self-efficacy, communication, and preparedness. The At the Crossroads caregiver intervention appears to effectively provide education and support needed for caregivers to address driving-related issues with their loved ones.

Travel Time and Subjective Well-Being

This paper explores the relative impacts of commute time on subjective well-being (SWB) with data from a Gallup–Healthways survey. Two different measures of SWB—a comprehensive measure of overall well-being and whether people experienced happiness for most of the day yesterday—are analyzed to address various definitions of SWB. The first measure takes a global view of SWB that encompasses both experienced and remembered utility, and the second measure looks at SWB as experienced utility dealing with feelings of happiness. With ordinary least squares and logit regression models, commute time is found to be statistically significant and negatively related to both the global evaluation of SWB and the experientially focused measure of SWB. Because this study uses 4 years of well-being data from the United States, results provide robust support that commute time does have a significant role in well-being in this country. The analysis also finds a strong correlation between commute time and congestion, which suggests that effective policies to reduce congestion can be one method of improving SWB for large segments of the population.

Family Matter: Older Drivers and the Driving Decision

Decisions about limiting or stopping driving are among the most difficult that older adults face. There is little research related to this decision making of older drivers, family members, and other trusted individuals who contribute to the decision. To report on the preferences that older drivers have for conversations with others with concerns about their driving, this paper draws on a series of focus groups and a U.S. survey of drivers age 50 and older. A majority of survey respondents indicated that they engaged in some degree of voluntary self-regulation of their driving. People generally preferred to be approached by individual family members as opposed to those outside the family for conversations about their driving. In terms of preferences for who should speak with the older driver, differences emerged on the basis of household status. Most older adults who were married preferred to hear first from a spouse, although the choice was not universal. Doctors and adult children were also preferred choices for conversations. The paper concludes with a discussion of pragmatic implications of the research for conducting conversations with older adults about concerns with their driving.