Public Health Model to Promote Safe Elderly Driving

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DESCRIPTION (provided by applicant): Older driver safety is a complex phenomenon that extends beyond the person level to multiple systems (e.g., regulatory, policy-making, societal and health care). Although a myriad of predictors for safe driving have been identified in the existing literature, they are not integrated into a meaningful causative model. Unless we use an integrated approach, grounded in a unifying public health model, we will not have taken the adequate steps to understand how behavioral, ecological, health education, administrative, policy and regulatory strategies may promote safe elderly driving. Continued neglect of these needs, accompanied with the "graying of America", could sharply increase the number of older people killed in crashes, and leave many more injured and disabled. The work I propose will develop a unifying public health model for safe elder driving. The Precede-Proceed Model of Health Promotion will provide the theoretical framework to: 1) review the current literature systematically by applying the Cochrane Collaborative Descriptive Methodology; 2) test the fit of existing population-based a) quantitative data, using epidemiological methods and structural equation modeling (SEM), and b) qualitative data using content analysis; and 3) refine the model to develop an intervention plan for safe elderly driving. This career development plan, vital to enhance my understanding of promoting safe elderly driving, includes: 1) supervised training in systematic reviews, data base analyses (SEM), model refinement and application; 2) research projects producing a narrative synthesis and meta-analysis of the older driver literature, (dis)confirmation of the Precede-Proceed model of health promotion for the older driver, and developing a pilot plan for safe elderly driving; and 3) formal didactic coursework to culminate fulfilling the requirements of this proposal. This period of supervised research and training, with the guidance from the College of Public Health and Health Professions and the College of Medicine's Departments of Epidemiology and Health Policy Research, and Biostatistics, combined with the specific supervised research proposed in this plan, will allow me to obtain novel data for application of a NIH R-03 award. This step will facilitate my transition to an independent federally funded investigator, and is directly related to my long-term goal of testing a public health model to guide a plan of assessment, prediction and promotion of safe elderly driving.