Development and Evaluation of an Interactive Cognitive Training Program

描述(由申请人提供)：美国人的寿命延长了，开车的次数也增加了。此外，除了经验不足的司机外，老年人比任何其他年龄段的人都更容易发生撞车。然而，最近越来越多的文献表明，有撞车风险的老年司机可以通过简单的筛查电池来识别，一旦识别，对安全驾驶至关重要的认知技能就可以得到提高。特别是，通过UFOV(R)测试测量的处理速度对未来的碰撞事件具有高度的预测性。此外，视觉处理速度的提高已被证明直接改善了道路上的驾驶性能，从而增强并保持了以后生活中的机动性。传统上，视觉处理速度的这种提高是通过在认证教练的指导下在一套计算机练习上进行训练来实现的。此Fast Track应用程序的目的是开发和验证这些经过验证的培训技术的增强型自我管理交互变体。因此，此Fast Track应用程序的具体目标是：第1阶段：1)开发增强的自我管理交互版本的处理速度培训，供在阿拉巴马州州立农场保险公司目前使用的Fitness to Drive评估期间表现出较高的撞车风险的个人使用。2)通过互动焦点小组程序评估该培训软件的可接受性和有效性，以实现可接受性，并通过基于实验室的测试来证明新软件相对于培训员指导方法的有效性。3)建立培训产品的大规模评估机制。第二阶段：在阿拉巴马州对培训产品进行全州范围的评估。为此，我们将继续与State Farm合作，协助我们在75岁及以上高危成年人的大样本(最低N=1000)上评估新的培训产品。具体地说，我们将1)检查培训后达到低风险状态的个人的比例，2)检查培训在降低撞车风险和保险索赔方面的有效性，涉及a)基线低风险的个人，b)基线高风险但拒绝接受培训的个人，以及c)比较撞车事件。相关性：该项目对公众健康的好处是显而易见的。通过为老年人开发一种方法来提高对安全驾驶至关重要的认知技能，而不需要培训师的帮助，可以降低大规模实施此类培训的成本，增加培训的可获得性，并改善长期安全性、机动性和生活质量。这个项目对公众健康的好处是显而易见的。通过为老年人开发一种方法来提高对安全驾驶至关重要的认知技能，而不需要培训师的帮助，可以降低大规模实施此类培训的成本，增加培训的可获得性，并改善长期安全性、机动性和生活质量。

DESCRIPTION (provided by applicant): Americans are living longer and driving more. Furthermore, older adults are more prone to crashes than any other age group except inexperienced drivers. However, a recent and growing body of literature has demonstrated that older drivers at risk for crashing can be identified with a brief screening battery and once identified, cognitive skills important for safe driving can be improved. In particular, Speed of Processing, as measured by the UFOV(r) test, is highly predictive of future crash involvement. In addition, improvements in visual processing speed have been shown to directly improve on-the-road driving performance, thereby enhancing and preserving mobility in later life. Traditionally, such improvements in visual processing speed have been achieved through training on a set of computer exercises with the guidance of a certified trainer. The purpose of this Fast Track application is to develop and validate an enhanced self-administered interactive variation of these validated training techniques. Therefore the specific aims of this Fast Track application are: Phase 1: 1) Develop an enhanced self-administered interactive version of Speed of Processing training for use by individuals who demonstrate elevated crash risk during a Fitness to Drive assessment currently being used by State Farm Insurance Company in Alabama. 2) Evaluate the acceptability and effectiveness of this training software through an interactive focus group process to achieve acceptability, and a laboratory based test to demonstrate effectiveness of the new software relative to the trainer guided method. 3) Establish the mechanisms for a large-scale evaluation of the training product. Phase II: Conduct a state-wide evaluation of the training product in Alabama. To this end, we will continue to work with State Farm to assist us in evaluating the new training product on a large sample (minimum N=1000) of adults aged 75 and older with high-risk status. Specifically we will 1) examine the proportion of individuals achieving low-risk status post-training and 2) examine the effectiveness of the training in lowering crash risk and insurance claims, relative to a) individuals who are low-risk at baseline, b) individuals who are high risk at baseline but decline to undergo training, as well as by c) comparing crash occurrence. Relevance: The public health benefits of this project are clear. By developing a method for older adults to improve the cognitive skills important for safe driving without the help of a trainer, the cost of implementing such training on a broad scale can be reduced, availability of training increased, and long term safety, mobility, and quality of life improved. The public health benefits of this project are clear. By developing a method for older adults to improve the cognitive skills important for safe driving without the help of a trainer, the cost of implementing such training on a broad scale can be reduced, availability of training increased, and long term safety, mobility, and quality of life improved.