Anticipatory guidance provision related to driving safety/cessation for older drivers : a rural-urban comparison.

Huseth, Andrea · 2014 · ROSA P / Mountain Plains Consortium

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Summary

This study addresses the critical public health issue of older driver safety, noting that older adults are overrepresented in motor vehicle crash fatalities and that this problem is projected to worsen with an aging population. The research specifically investigates the provision of anticipatory guidance regarding driving safety and cessation by health care providers (HCPs). It aims to determine the frequency of such counseling, identify barriers to its provision, and compare practices between rural and urban HCPs, recognizing that rural older adults often rely more heavily on driving for mobility and quality of life due to limited alternative transportation. The methodology involved administering surveys to older adults and HCPs in five Mountain-Plains states: North Dakota, South Dakota, Utah, Colorado, and Wyoming. The older adult survey targeted individuals aged 65 and older, stratified by rurality using USDA Rural-Urban Continuum Codes. The HCP survey targeted physicians and mid-level providers in family medicine, internal medicine, geriatrics, and ophthalmology/optometry, also stratified by the rurality of their practice location. Data collection occurred in two waves in 2013. The study analyzed responses regarding current driving status, reasons for cessation, receipt of counseling, and HCP attitudes, perceptions, and perceived barriers to discussing driving issues. The findings reveal that older adults rarely receive counseling on driving safety. Approximately 96% of older adult respondents reported that their HCP had never provided information on safe driving habits, and nearly 99% stated they had never been told to limit or discontinue driving. Among HCPs, the frequency of discussing driving safety increased with patient age, but overall provision remained low. Rural HCPs were less likely than urban counterparts to provide this guidance. The most significant barrier cited by HCPs was lack of time during patient visits. Rural HCPs were significantly more likely to cite loss of patient independence and lack of access to alternative transportation as barriers. Furthermore, rural HCPs were less likely to believe there were adequate resources for assessing driving fitness or to know where to refer patients for such evaluations. The study concludes that anticipatory guidance regarding driving safety is severely underutilized by HCPs, particularly in rural settings. The disparity in resource availability and referral knowledge between rural and urban providers highlights a systemic gap in rural healthcare infrastructure. The authors suggest that HCPs should be encouraged to advise older patients on driving fitness, but that addressing barriers such as time constraints and lack of local resources is essential for improving counseling practices, especially in rural communities where driving cessation poses a greater threat to independence.

Key finding

Rural health care providers were significantly less likely than urban providers to provide anticipatory guidance on driving safety to older patients and reported greater barriers related to lack of time and insufficient local resources for driving fitness assessments.

Methodology

survey

Sample size: 1094

Provenance

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Summary generated by qwen3.6-27b-prismaquant on 2026-06-10; verification: verified.

Topics

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• older drivers
• urban rural setting
• older driver retraining

Information type

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• Empirical Findings: observational prevalence