Development/Evaluation of Interactive Cognitive Training

描述（由申请人提供）：美国人的寿命越来越长，开车也越来越多。此外，除了经验不足的司机外，老年人比其他年龄段的人更容易发生撞车事故。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一个简短的筛选电池来识别，一旦识别出来，对安全驾驶很重要的认知技能就可以得到提高。特别是，UFOV测试测量的处理速度可以高度预测未来的坠机事件。此外，视觉处理速度的提高已被证明可以直接改善道路上的驾驶表现，从而增强和保持晚年的机动性。传统上，这种视觉处理速度的提高是通过在一名认证培训师的指导下进行一套计算机练习来实现的。这个快速通道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的自我管理的交互式变体。因此，该快速通道申请的具体目标是：1)开发一个增强的自我管理的交互式处理速度培训版本，供目前在阿拉巴马州州立农场保险公司使用的健康驾驶评估中显示撞车风险增加的个人使用。2)通过交互式焦点小组过程评估该培训软件的可接受性和有效性，以达到可接受性。并通过实验室测试证明了新软件相对于培训师指导方法的有效性。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岁及以上具有高风险状态的成年人的大样本（最少N=1000）上评估新的培训产品。具体而言，我们将1)检查培训后达到低风险状态的个人的比例，2)检查培训在降低坠机风险和保险索赔方面的有效性，相对于a)基线时风险低的个人，b)基线时风险高但拒绝接受培训的个人，以及c)在回顾和培训后间隔1至2年期间比较坠机事件和保险索赔。相关性：该项目的公共卫生效益是显而易见的。通过开发一种方法，让老年人在没有教练帮助的情况下提高对安全驾驶至关重要的认知技能，可以降低大规模实施此类培训的成本，增加培训的可用性，提高长期的安全性、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¿ 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 into 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 I: 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 the 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 and insurance claims during retrospective and post-training intervals of 1 to 2 years. 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.