Recruitment of Older Drivers from Primary Care Clinics for on‐Road Fitness‐to‐Drive Testing: Results of a Pilot Study
DOI: 10.1111/jgs.12913
archive: archived pipeline: cataloged
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Summary
This pilot study addresses the logistical and methodological challenges of recruiting older drivers from primary care clinics for off-site behind-the-wheel (BTW) fitness-to-drive testing. The motivation stems from the need to validate a tiered assessment system for older driver screening in primary care settings, which requires systematic recruitment from the specific clinical environments where such interventions will be implemented. Previous studies often relied on convenience samples from specialist clinics or the general community, limiting generalizability and failing to report participation rates. The study aimed to determine the feasibility of recruiting patients from outpatient primary care clinics for an off-site BTW evaluation and to estimate eligibility and completion rates. The study was conducted between April and June 2012 at a university hospital’s general internal medicine and geriatric clinics. Researchers targeted patients aged 65 and older who spoke English, lacked significant acute illness or dementia (defined by a Six-Item Screener score of ≥4), and had driven within the past 30 days. A research assistant identified eligible patients using clinic schedules and approached them in waiting areas during sessions lasting at least three consecutive hours. Participation involved completing a questionnaire, undergoing a free, confidential BTW evaluation at a site 10 miles from the clinics, and telephone follow-up. The primary outcomes were enrollment rates and the completion of the off-site BTW evaluation. During 97 hours of research assistant presence, 310 older patients presented for care. The assistant missed 20% of potentially eligible participants due to interactions with other patients. Of the remaining 248 patients, 53% were ineligible, primarily because they were non-drivers. Ineligible patients were significantly more likely to be female (77% vs. 22%) and older (median age 83 vs. 77 years) than eligible patients. Overall enrollment among eligible patients was 24%, equating to 0.29 participants per hour of research assistant presence. Of the 28 enrolled participants, 14 (50%) completed the BTW evaluation. Participants rated the ease of scheduling and the utility of the on-road session highly. When asked about their willingness to pay for the evaluation (priced at $99), the median response was $10, with a mean of $21. The findings indicate that while recruiting older drivers from primary care clinics for off-site testing is feasible, it is challenging. The most common reason for declining participation was concern over the location of the off-site BTW evaluation, suggesting that closer or multiple testing sites may be necessary to improve participation. Monetary incentives alone may not address concerns about driving in unfamiliar neighborhoods or fears of license revocation. The study highlights that integrating physician involvement and advance planning for future driving changes could mitigate barriers. These results underscore the importance of systematic recruitment from primary care settings to ensure the generalizability of evidence-based screening tools and facilitate their widespread adoption in clinical practice. Limitations include the small sample size and limited data on nonparticipants, which restricts conclusions about participation biases and generalizability to other clinic populations.
Provenance
The full processing record for this entry. Every stage of this paper's journey through the pipeline is logged — what ran, with which tool and model, how many attempts it took, and when it last completed. Discovered via author_sweep_intake on 2026-05-27.
| Stage | Outcome | Tool | Model | Prompt | Attempts | Completed |
|---|---|---|---|---|---|---|
| discover | success | author_sweep | — | — | 2 | 2026-05-27 |
| archive | success | manual_pmc_pow_fetch | — | — | 37 | 2026-08-22 |
| extract | success | cached | — | — | 4 | 2026-08-23 |
| clean | success | clean | — | — | 1 | 2026-06-04 |
| chunk | success | chunk | — | — | 1 | 2026-06-04 |
| embed | success | embed | Qwen/Qwen3-Embedding-8B | — | 1 | 2026-06-04 |
| enrich | skipped | — | — | — | 3 | 2026-06-04 |
| promote | success | — | — | — | 1 | 2026-06-04 |
| summarize | success | llm | qwen3.8-27b-gittensor | summ-v5 | 2 | 2026-08-23 |
| tag | success | vector_similarity | — | — | 15 | 2026-06-11 |
Summary generated by qwen3.8-27b-gittensor on 2026-08-23; verification: pending re-verification.
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