Senior SelfTest

Initiative details

In Belgium, as in Europe and large parts of the Western world, life expectancy is ever increasing. While this "aging" is made possible by very comprehensive preventive or curative health care, this certainly does not eliminate all the cognitive or motor impairments associated with aging. In addition, older people are also becoming increasingly mobile, and more specifically, they are using their own vehicle or car up to a higher age.

As people age, two risks that are often used in the context of road safety become important:
- Accident risk: the likelihood to be involved in an accident.
- Injury risk: the likelihood of injury, given an accident has occurred.

With this product, the senior selfTest, we focus on the triggers for accident risk with senior drivers.

Safe participation in traffic, in the context of an ageing population, presupposes two things: "driving skills" and "fitness to drive". Driving skills are strongly linked to learning processes, gaining experience, vehicle control and traffic insight. Fitness to drive has more to do with the physical and mental abilities of the driver: health, sensory and cognitive abilities, influence of alcohol, drugs or medication, etc.

Older road users usually have a very extensive mobility and traffic experience, and associated with that generally overall good driving skills. However, as drivers age, some of the mental and/or physical capacities needed to put those skills to good use gradually decrease. In other words, fitness to drive decreases. Examples are: reduced vision (sharpness, night blindness, etc.), poor hearing, higher reaction times, reduced muscle control or muscle strength, etc.

This decline in capacities is likely to proceed in two speeds. For most people it can be expected that this is a gradual process, which may also be partially absorbable or slowed down. Barring sudden illness and accidents, the decline in physical or mental functionality is a process of several decades. However, when looking at the oldest age categories, it can be expected that a quicker decrease in physical or mental functionality occurs as a result of (a higher likelihood of) more grave illnesses.

Although road users compensate for this natural decline in capacities to some extent (e.g. by driving less at night, driving slower, etc.), there is still a general risk that one's own skills and fitness to drive will be overestimated, or that a decline in skills and suitability will eventually go too fast. In other words, if a self-regulating compensation mechanism is used, it may not be enough to continue to drive “safely”. Different supporting measures need to be developed if we wish senior drivers to truly remain independently safely mobile.

With the SelfTest we present a product that aims at increasing awareness with senior drivers on the importance of psycho-cognitive factors and their own capacities in relation to accident risk, and therefor safe and comfortable driving.

The SelfTest, its development and use is described in the paragraph “project activities”.
The relevance towards improving road safety, compared to other actions taken to support safe driving by senior drivers, is described in the paragraph “evaluation”

Initiative date

to

Who was/is your target audience?

Policy makers
Public authorities
Adults
Seniors
Car drivers
Others

Topic

Knowledge building and sharing
Create awareness
Education in school or in community organizations

Organisation details

Psycho-cognitive selfTest for senior drivers
Enterprise
Belgium
Flanders

Contact name

Lars Akkermans (lars@F2S2.be) & Barbara Krol (barbara@F2S2.be)

Telephone number

+32495270618

Project activities

If you work together with external partners, list the most important partners and briefly describe their role.

Professor Adam Tarnowski (Nicolaus Copernicus University, Toruń): responsible for the scientific basis and correlation of the outcomes of the Selftest.

Please describe the project activities you carried/are carrying out and the time period over which these were implemented.

The SelfTest was developed within two European Active & Assisted Living projects (2019 onwards: CARA I & CARA II). During both projects, over 1500 seniors were interviewed, participated in workshops and were eventually tested with the SelfTest. As a result, we gained confidence that the SelfTest effectively provides its users with a first insight into the importance of psycho-cognitive skills for driving safely and comfortably, and their own skillsets.

The SelfTest was developed based on the outline that the following conditions were required to be a successful product:
- Online accessibility and ease of use: to reduce stress and the impact of stress from the simple act of taking a test in order to maintain face validity of test results.
- Short testing time: long test times and long procedures work in a deterring way and reduce senior driver participation (i.e. 30 minutes or more; having to go to a dedicated testing center or professional).
- Based on recent and relevant scientific findings and accepted testing practices: bringing strong scientific and professional practices closer to the target end-user.
- Modular structure: flexible use depending on end-user requirements.
- Simple user interface: the use of online tools is not yet a common practice among seniors. Providing an easy user interface and clear instructions supports the good use of this tool.
- Personalised feedback / reporting: positive and reinforcing feedback is provided to end users. This helps increase awareness on the importance of the different test modules and personal results are better translated into practical actions.
- Allowing for a professional referral and follow-up: the SelfTest is a home-use tool that does not replace medical or professional tests. It does however provide its users with good reasons to take such follow-up actions such as visiting (medical) professionals when required.
- Non-threatening: the goal of the SelfTest is not to take away people’s driving licenses. It is to positively encourage senior drivers to exercise their own (psycho-cognitive) capacities and take actions before they are forced into traditional (often restrictive) fitness-to-drive actions.

As a result, the SelfTest (as a product) is an online tool, which can be used on laptop or PC (or other HMI with sufficiently large screens. The test consists of the following modules:
- A general information module: “What is this test?”
- Demographic information module: “who are you?”
- TIPI test (Ten Item Personality Measure, Gosling 2003)
- 5 independent psycho-cognitive test modules
o Reaction time without choice: measuring psycho-motoric processing and attention
o Reaction time with choice: measuring more advance psycho-motoric processing and attention
o Perception/vision
o Memory
o Prediction skills / anticipation skills
- A feedback module providing the user with results.

The SelfTest is already being provided to individual users (home use) and being used as a supportive tool in workshops with senior drivers in Belgium and Poland. Further use is foreseen in the Netherlands and Germany.

Evaluation

What has been the effect of the activities?

During the development phase of the SelfTest, we reached over 1500 senior drivers in Flanders, Austria and the Netherlands with the aim of testing and finetuning the SelfTest.

Once the development of the SelfTest within the CARA 2 project was finished, it was validated during several workshops. As a result thereof, we have tested senior drivers on the awareness raising potential of the SelfTest:

- On the familiarity with psycho-cognitive factors, prior to taking the SelfTest:
o 41% of seniors have heard about psycho-cognitive factors influencing safe driving, prior to taking the SelfTest, but didn’t realise how important they are;
o 47% of seniors are not familiar at all with psycho-cognitive factors influencing safe driving, and therefor also are not familiar with the importance thereof;
o 12% of seniors know about psycho-cognitive factors and the importance thereof for safe driving.

- On the impact of the SelfTest (awareness):
o 94% of seniors indicate that their knowledge on the importance of psycho-cognitive factors for safe driving has significantly (82%) or moderately (12%) increased
o 6% of seniors indicate that their knowledge on the importance of psycho-cognitive factors for safe driving has not increased

Further validation focused on the relevance of the SelfTest in relation to possible safety impacts:

- Psycho-cognitive skills:
o 24% of seniors that have executed the SelfTest score below their “peer average”. This would warrant further professional guidance/investigation and they have been encouraged to seek such assistance.
o 41% of seniors that have executed the SelfTest score around their “peer average”. They have been encouraged to exercise different aspects of their skillsets (i.e. memory exercises, reaction time exercises, etc.).
o 35% of seniors that have executed the SelfTest score above their “peer average”. Although this is a good (personal) result, they do receive encouragement to exercise different aspects of their skillsets.

- Senior drivers that receive such personal feedback indicate:
o that they did not actively consider or know that these psycho-cognitive functions would be that important. On hindsight, they realise that they are, but that they would not have thought about (looking into) it out of their own volition (without taking the test)
o that they would struggle finding possible solutions for possible psycho-cognitive issues. There is a need to couple selfTest feedback with (for example) (1) actions that they can undertake themselves (training/exercising/…) and (2) possible professionally supported actions. The latter off course also suggests that there are such professionals available with relevant know-how
o that they have a strong preference for using an online tool at home. The SelfTest is easy to use (laptop/PC) and easy to adopt to. They would strongly consider repeating this test and realise that the evolution in skills can be different from person to person and can be “event” based (i.e. sudden illness, etc.).

Please briefly explain why your initiative is a good example of improving road safety.

Currently, senior drivers are already an important focus group for road safety measures. This is expected to become even more so in the next decades. Because of this, they warrant even more attention in the creation and selection of safety measures. However, most measures related to this target group seems to be focused on “after the facts” remediation of a sub-optimal system.

The SelfTest is a good example of how road safety can be integrated into a wider structure: it focuses on creating awareness (which is proven), a positive feedback of an objectively measurable situation (facts, not opinions or interpretations, are presented in a human way) and gives both the person itself (the senior driver) as well as a professional environment clear options and insights. It focusses on the driver to take positive action, rather than a society to take restrictive or even punitive measures.

When comparing the SelfTest to other existing mitigating measures, the value of the SelfTest as a good example becomes more apparent. Furthermore, the SelfTest is complimentary to existing initiatives related to fitness-to-drive and does not impede with other actions.

How have you shared information about your project and its results?

The development of the SelfTest (within CARA 1 and CARA 2) as well as findings from the end-product “SelfTest” have been presented at different workshops, conferences, etc.:
- VSV workshop for driving instructors – 23 September 2019 (Puurs, Belgium)
- ITU-EC Regional Forum “ACCESSIBLE EUROPE: ICTs for All” - 4-6 December 2019 (Malta)
- AAL info day – 30 January 2020 (Vienna, Austria)
- Forum in partnership with the International Telecommunications Union (ITU) – 19 February 2020 (Vienna, Austria)
- NEOS workshop – 10 May 2022 (Puurs, Belgium)
- NEOS culture and events workshop – 14 June 2022 (Mechelen, Belgium)
- International Conference on Traffic and Transport Psychology – 22-24 August 2022 (Gothenburg, Sweden)
- seniors workshops “AUTO safety 50+” organized by Road Safety Partnership Poland (GRSP Poland) with PZU (largest insurance company) together with a launch a printed manual for seniors – 15 November 2022 (Warsaw, Poland)
- The SelfTest was promoted for Grandmother and Grandfather Day - press info and invitation with infographic sent to media and seniors’ organizations: https://www.pbd.org.pl/jakimi-kierowcami-sa-nasi-dziadkowie/
- Conference of Polish Signatories of the European Road Safety Charter, Warsaw, Poland, 29 Sept. 2023
- Presentation on the SelfTest and availability of the tool before and during the conference Mobility of people with special needs at Military Technical Academy, Warsaw, Poland, 26-27 Oct. 2023.


Public administrations responsible for road safety were informed on regular basis on the progression of the projects and eventual product:
- dMOW (Flemish department Mobility and Public Roadworks) (Belgium)
- AWV (Flemish administration Roads and Mobility) (Belgium)
- VSV (Vlaamse Stichting Verkeerskunde) (Belgium)
- VIAS (Belgium)
- Provincie Noord-Brabant (the Netherlands)
- National Road Safety Council and regional Road Safety Centers (Poland)
- Decra high level meeting on senior drivers: https://www.pbd.org.pl/relacja-z-konferencji-dotyczacej-bezpieczenstwa-w-ruchu-drogowym-osob-starszych/

The SelfTest was also presented in several radio broadcasts at the National Polish Radio, and in the dedicated podcast by prof. Tarnowski and Barbara Krol available at several open platforms: https://www.pbd.org.pl/20-polityka-senioralna-w-zakresie-brd/.