Decisional Balance and Readiness to Change Driving Behavior in Older Adults: A Pilot Study

Abstract

Many older adults self-regulate driving behavior, but little is known about the process underlying this behavior change. We adapted a decisional balance instrument assessing the cognitive and motivational aspects of decision-making for use in the context of driving restriction by older adults. In this exploratory study of forty drivers aged 57 to 90, it was shown that the four subscales assessing positive and negative aspects of driving in relation to self and others yielded generally Holly A. Tuokko is a Canadian Institutes of Health Research (CIHR) Institute of Aging senior investigator and a professor in the

Self-rated confidence and on-road driving performance among older adults

“…DHI. The DHI (Kowalski et al, 2012) is a self-report questionnaire adapted from another short tool (Tuokko, McGee, & Rhodes, 2006) designed to obtain information about driving restriction and driving cessation. One item was isolated to investigate driving confidence (characterized by comfort with various driving situations).…”

Attitudes: Mediators of the Relation between Health and Driving in Older Adults

“…The Driving Comfort Scale (DCS; Myers, Paradis, & Blanchard, 2008) and the Decisional Balance scale (DBS; Lindstrom-Forneri, Tuokko, & Rhodes, 2007; Tuokko, McGee, & Rhodes, 2006) were assessed as psychosocial predictors in the analyses. The 13-item Day and 16-item Night DCS scales (DCS-D and DCS-N, respectively) were developed inductively with older drivers to assess their level of comfort and confidence to drive in different situations, controlling for contexts in relation to traffic flow, speed, and road type.…”

Psychosocial Constructs as Possible Moderators of Self-Reported Driving Restrictions

“…And consistent with Bandura’s social cognitive theory (Bandura, 1986), perceived confidence and abilities would be a better predictor of driving behaviour than actual driving skills (MacDonald et al, 2008). Tuokko et al (2006) found the DBP Con-self and Pro-other subscales were the most strongly associated with the likelihood of driving restrictions compared to the other DBP scales. It may be that the DBP Con-self once again emerged because, according to self-regulation theory (Bandura, 1986), individuals change their behaviour when they perceive changes to their functioning (e.g., vision, range of motion, comfort levels) and so it follows that feeling more negatively towards driving would provide motivation to change driving behaviour.…”

“…The Driving Comfort Scale (DCS; Myers et al, 2008) and the Decisional Balance Plus (DBP) scale (Lindstrom-Forneri et al, 2007; Tuokko et al, 2006) were assessed as psychosocial predictors in the analyses. The 13-item Day and 16-item Night DCS scales (DCS-D and DCS-N respectively) were developed inductively with older drivers to assess their level of comfort and confidence to drive in different situations, controlling for contexts in relation to traffic flow, speed, and road type.…”

“…These types of self-regulatory practices appear to increase with age (D'Ambrosio, Donorfi o, Coughlin, Mohyde, & Meyer, 2008 ;Donorfi o et al, 2008 ), particularly by women (D'Ambrosio et al, 2008 ;Gwyther & Holland, 2012 ;Molnar & Eby, 2008 ;Turano et al, 2009 ). Other documented factors infl uencing driving patterns include lifestyle (e.g., household income, retirement status, presence of other drivers in the household, need to drive), involvement in crashes, and attitudes and perceptions (i.e., comfort) of driving (Charlton et al, 2006 ;Ragland, Satariano, & MacLeod, 2004 ;Myers et al, 2008 ;Tuokko et al, 2006 ).…”