Feasibility of a One-Day Driving Workshop for Combat Veterans During COVID-19

Stetten, Nichole; Wandenkolk, Isabelle; Jeghers, Mary; Poojary, Prerna; Winter, Sandra; Classen, Sherrilene · 2022 · Crossref

DOI: 10.21203/rs.3.rs-1327734/v1

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Summary

This study addresses the critical public health issue of motor vehicle crashes, which are a leading cause of death among combat veterans from Operations Enduring Freedom, Iraq Freedom, and New Dawn. Combat-related conditions such as post-traumatic stress disorder and mild traumatic brain injury further impair driving performance, increasing crash risk. The authors aimed to assess the feasibility of a condensed, one-day driving workshop designed to improve veterans’ fitness-to-drive abilities, adapting a previously established randomized controlled trial intervention to be more accessible for rural veterans during the COVID-19 pandemic. The researchers employed a feasibility design guided by Orsmond and Cohn’s framework, evaluating recruitment capability, data collection procedures, intervention acceptability, resource availability, and participant responses. The intervention utilized a mobile DriveSafety DS 250 simulator housed in a van and the Drive Focus™ tablet application. Eligible participants were rural combat veterans aged 19–70 with polytrauma, valid licenses, and reported driving difficulties. Recruitment involved 1,258 attempts through clinics, community events, and digital outreach. Due to pandemic restrictions, the protocol required strict social distancing, N95 mask usage, and reduced simulator interaction times. Despite extensive efforts, recruitment was severely hindered. Only 12 veterans expressed interest, five met eligibility criteria, and only two completed the workshop. The study failed to meet its enrollment goal of 30 participants. Primary barriers included the inability to convert the simulator-based intervention to an online format, restrictive eligibility criteria, and competing studies. Participants cited fear of license revocation, reluctance to wear N95 masks, and perceived lack of benefit as reasons for refusal. Additionally, pandemic-related delays in institutional review board approvals and logistical challenges in securing space for social distancing further constrained the timeline. The study concludes that while the intervention components were technically viable, the COVID-19 pandemic rendered the study impractical for this specific population. The findings highlight significant challenges in conducting device-based research with rural veterans during a global health crisis. The authors recommend that future recruitment strategies for younger veteran populations shift toward targeted social media marketing and online engagement to overcome accessibility barriers. This work underscores the need for adaptable research designs that can maintain engagement when in-person simulator use is restricted.

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• simulator training transfer

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• Applied Guidance: countermeasure evaluation
• Methodological Resource: tool software, validation psychometrics