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Health Care Provider Mobility Counseling Provision to Older Adults: A Rural/Urban Comparison

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Abstract

The current study examined rural–urban differences in health care provider (HCP) perceptions, attitudes, and practices related to driving safety/cessation-related anticipatory guidance provision to older adults. A cross-sectional survey was conducted with HCPs in several north central states. Exploratory factor analysis was used to examine dimensions of HCP perceptions and attitudes related to mobility counseling. Binary logistic regression analyses were conducted to determine if HCP rurality was significantly predictive of HPC provision of mobility counseling by age. Rural HCPs were less likely than urban HCPs to provide mobility counseling to their patients aged 75 or older. Rural HCPs were less likely to refer patients to a driving fitness evaluation resource if they had questions related to driving issues, and were less likely to perceive there were adequate resources to help with driving issues. Rural–urban differences in HCP mobility counseling provision may contribute to potential health disparities between urban and rural patients. Both rural and urban HCPs need training about older driver issues, so they may educate their patients about driving safety/cessation. Future research should examine the association between rural–urban differences in HCP mobility counseling provision and rural older adult overrepresentation in motor vehicle injuries and fatalities statistics.

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References

  1. Kostyniuk, L. P., & Shope, J. T. (2003). Driving and alternatives: Older drivers in Michigan. Journal of Safety Research, 34(4), 407–414. doi:10.1016/j.jsr.2003.09.001

    Article  PubMed  Google Scholar 

  2. Silverstein, N. M. (2008). When life exceeds safe driving expectancy: Implications for gerontology and geriatrics education. Gerontology and Geriatrics Education, 29(4), 305–309. doi:10.1080/02701960802497795

    Article  PubMed  Google Scholar 

  3. Rosenbloom, S. (2003). The mobility needs of older Americans. Taking the High Road: A Transportation Agenda of Strengthening Metropolitan Areas, 227–254.

  4. Pucher, J., & Renne, J. L. (2003). Socioeconomics of urban travel: Evidence from the 2001 NHTS. Transportation Quarterly, 57(3), 49–77.

    Google Scholar 

  5. U.S. Census Bureau. (2010). Urban and Rural Classification. Retrieved from http://www.census.gov/geo/reference/urban-rural.html

  6. Potts, I., Stutts, J., Pfefer, R., Neuman, T., Slack, K., & Hardy, K. (2004). A guide for reducing older driver collisions: Strategic Highway Safety Plan Implementation Guides Volume 9. Retrieved February 3, 2014 from onlinepubs.trb.org/onlinepubs/nchrp/nchrp_rpt_500v9.pdf

  7. Lyman, S., Ferguson, S. A., Braver, E. R., & Williams, A. F. (2002). Older driver involvements in police reported crashes and fatal crashes: Trends and projections. Injury Prevention, 8(2), 116–120. doi:10.1136/ip.8.2.116

    Article  PubMed  CAS  PubMed Central  Google Scholar 

  8. Meyer, J. (2004). Personal vehicle transportation. In R. W. Pew & S. B. Van Hemel (Eds.), Technology for adaptive aging. Washington, DC: National Academies Press.

    Google Scholar 

  9. Anderson, A., & Loeser, R. F. (2010). Why is osteoarthritis an age-related disease? Best Practice and Research Clinical Rheumatology, 24(1), 15–26. doi:10.1016/j.berh.2009.08.006

    Article  PubMed Central  Google Scholar 

  10. Carr, D. B., Duchek, J. M., Meuser, T. M., & Morris, J. C. (2006). Older adult drivers with cognitive impairment. American Family Physician, 73(6), 1029–1034.

    PubMed  Google Scholar 

  11. Lacherez, P., Wood, J. M., Anstey, K. J., & Lord, S. R. (2014). Sensorimotor and postural control factors associated with driving safety in a community-dwelling older driver population. The Journals of Gerontology Series A: Biological Sciences and Medical Sciences, 69(2), 240–244. doi:10.1093/gerona/glt173

    Article  Google Scholar 

  12. Federal Highway Administration, Department of Transportation. (2009). Highway Statistics 2009. Washington: FHWA. Retrieved from http://www.fhwa.dot.gov/policyinformation/statistics/2009/dl22.cfm

  13. National Highway Traffic Safety Administration [NHTSA]. (2013). Traffic safety facts, older population 2011, DOT HS 811 745. Washington, DC: NHTSA.

    Google Scholar 

  14. Eberhard, J. (2008). Older drivers’ “high per-mile crash involvement”: The implications for licensing authorities. Traffic Injury Prevention, 9(4), 284–290. doi:10.1080/15389580801895236

    Article  PubMed  Google Scholar 

  15. Eye Diseases Prevalence Research Group. (2004). Prevalence of age-related macular degeneration in the United States. Archives of Ophthalmology, 122(4), 564. doi:10.1001/archopht.122.4.564

    Article  Google Scholar 

  16. Malfetti, J. L., & Winter, D. J. (1986). Drivers 55 plus: Test your own performance. Washington, DC: AAA Foundation for Traffic Safety.

    Google Scholar 

  17. Thomas, E., Peat, G., Harris, L., Wilkie, R., & Croft, P. R. (2004). The prevalence of pain and pain interference in a general population of older adults: Cross-sectional findings from the North Staffordshire Osteoarthritis Project (NorStOP). Pain, 110(1), 361–368. doi:10.1016/j.pain.2004.04.017

    Article  PubMed  Google Scholar 

  18. Cranney, A. B., Harrison, A., Ruhland, L., Vaidyanath, C., Graham, I., Man-Son-Hing, M., & Dwosh, I. I. (2005). Driving problems in patients with rheumatoid arthritis. The Journal of Rheumatology, 32(12), 2337–2342.

    PubMed  Google Scholar 

  19. Prince, M., Bryce, R., Albanese, E., Wimo, A., Ribeiro, W., & Ferri, C. P. (2013). The global prevalence of dementia: A systematic review and metaanalysis. Alzheimer’s and Dementia, 9(1), 63–75. doi:10.1016/j.jalz.2012.11.007

    Article  PubMed  Google Scholar 

  20. Betz, M. E., Jones, J., Petroff, E., & Schwartz, R. (2013). “I wish we could normalize driving health:” A qualitative study of clinician discussions with older drivers. Journal of General Internal Medicine, 28(12), 1573–1580. doi:10.1007/s11606-013-2498-x

    Article  PubMed  PubMed Central  Google Scholar 

  21. Betz, M. E., Schwartz, R., Valley, M., & Lowenstein, S. R. (2012). Older adult opinions about driving cessation a role for advanced driving directives. Journal of Primary Care and Community Health, 3(3), 150–154. doi:10.1177/2150131911423276

    Article  PubMed  Google Scholar 

  22. Adler, G., & Rottunda, S. (2006). Older adults’ perspectives on driving cessation. Journal of Aging Studies, 20(3), 227–235. doi:10.1016/j.jaging.2005.09.003

    Article  Google Scholar 

  23. Adler, G., & Rottunda, S. J. (2011). The driver with dementia: A survey of physician attitudes, knowledge, and practice. American Journal of Alzheimer’s Disease and Other Dementias, 26(1), 58–64. doi:10.1177/1533317510390350

    Article  PubMed  Google Scholar 

  24. Lipski, P. S. (2002). A survey of general practitioners’ attitudes to older drivers on the New South Wales Central Coast. Australasian Journal on Ageing, 21(2), 98–100. doi:10.1111/j.1741-6612.2002.tb00425.x

    Article  Google Scholar 

  25. Jang, R. W., Man-Son-Hing, M., Molnar, F. J., Hogan, D. B., Marshall, S. C., Auger, J., & Naglie, G. (2007). Family physicians’ attitudes and practices regarding assessments of medical fitness to drive in older persons. Journal of General Internal Medicine, 22(4), 531–543. doi:10.1007/s11606-006-0043-x

    Article  PubMed  PubMed Central  Google Scholar 

  26. Carr, D. B., Schwartzberg, J. G., Manning, L., & Sempek, J. (2010). Physician’s guide to assessing and counseling older drivers (2nd ed.). Washington, DC: National Highway Traffic Safety Administration.

    Google Scholar 

  27. Zwerling, C., Peek-Asa, C., Whitten, P. S., Choi, S. W., Sprince, N. L., & Jones, M. P. (2005). Fatal motor vehicle crashes in rural and urban areas: Decomposing rates into contributing factors. Injury Prevention, 11(1), 24–28. doi:10.1136/ip.2004.005959

    Article  PubMed  CAS  PubMed Central  Google Scholar 

  28. Andrus, M. R., Kelley, K. W., Murphey, L. M., & Herndon, K. C. (2004). A comparison of diabetes care in rural and urban medical clinics in Alabama. Journal of Community Health, 29(1), 29–44. doi:10.1023/B:JOHE.0000007443.96138.03

    Article  PubMed  Google Scholar 

  29. Kemper, A. R., Uren, R. L., Moseley, K. L., & Clark, S. J. (2006). Primary care physicians’ attitudes regarding follow-up care for children with positive newborn screening results. Pediatrics, 118(5), 1836–1841. doi:10.1542/peds.2006-1639

    Article  PubMed  Google Scholar 

  30. Bogner, H. R., Straton, J. B., Gallo, J. J., Rebok, G. W., & Keyl, P. M. (2004). The role of physicians in assessing older drivers: Barriers, opportunities, and strategies. The Journal of the American Board of Family Practice, 17(1), 38–43. doi:10.3122/jabfm.17.1.38

    Article  PubMed  PubMed Central  Google Scholar 

  31. Petterson, S. M., Liaw, W. R., Phillips, R. L., Rabin, D. L., Meyers, D. S., & Bazemore, A. W. (2012). Projecting US primary care physician workforce needs: 2010–2025. The Annals of Family Medicine, 10(6), 503–509. doi:10.1370/afm.1431

    Article  PubMed  Google Scholar 

  32. Lee, P. P., Hoskins, H. D., Smith, R. E., Hutchinson, B. T., & Wong, B. A. (2007). Access to eye care: Response of the American Academy of Ophthalmology and its members to societal needs now and in the future. Archives of Ophthalmology, 125(3), 403–405. doi:10.1001/archopht.125.3.403

    Article  PubMed  Google Scholar 

  33. NHTSA. (2014). National highway traffic safety administration regional offices. Retrieved from http://www.nhtsa.gov/nhtsa/whatis/regions/

  34. Tabachnick, B. G., & Fidell, L. S. (2013). Using multivariate statistics (6th ed.). Boston, MA: Pearson.

    Google Scholar 

  35. Hair, J. F., Black, B., Babin, B., & Anderson, R. E. (2010). Multivariate data analysis (7th ed.). Upper Saddle River, NJ: Prentice Hall.

    Google Scholar 

  36. Geller, B. M., Skelly, J. M., Dorwaldt, A. L., Howe, K. D., Dana, G. S., & Flynn, B. S. (2008). Increasing patient/provider communications about colorectal cancer screening in rural primary care practices. Medical Care, 46(9 Suppl 1), S36. doi:10.1097/MLR.0b013e31817c60ea

    Article  PubMed  PubMed Central  Google Scholar 

  37. Leira, E. C., Hess, D. C., Torner, J. C., & Adams, H. P. (2008). Rural-urban differences in acute stroke management practices: A modifiable disparity. Archives of Neurology, 65(7), 887–891. doi:10.1001/archneur.65.7.887

    Article  PubMed  Google Scholar 

  38. Bonham, C., Salvador, M., Altschul, D., & Silverblatt, H. (2014). Training psychiatrists for rural practice: A 20-year follow-up. Academic Psychiatry,. doi:10.1007/s40596-014-0080-4

    PubMed  Google Scholar 

  39. Brems, C., Johnson, M. E., Warner, T. D., & Roberts, L. W. (2006). Barriers to healthcare as reported by rural and urban interprofessional providers. Journal of Interprofessional Care, 20(2), 105–118. doi:10.1080/13561820600622208

    Article  PubMed  Google Scholar 

  40. Chipp, C., Dewane, S., Brems, C., Johnson, M. E., Warner, T. D., & Roberts, L. W. (2011). “If only someone had told me…”: Lessons from rural providers. The Journal of Rural Health, 27(1), 122–130. doi:10.1111/j.1748-0361.2010.00314.x

    Article  PubMed  PubMed Central  Google Scholar 

  41. Chipp, C. L., Johnson, M. E., Brems, C., Warner, T. D., & Roberts, L. W. (2008). Adaptations to health care barriers as reported by rural and urban providers. Journal of Health Care for the Poor and Underserved, 19(2), 532. doi:10.1353/hpu.0.0002

    Article  PubMed  PubMed Central  Google Scholar 

  42. Johnson, M. E., Brems, C., Warner, T. D., & Roberts, L. W. (2006). The need for continuing education in ethics as reported by rural and urban mental health care providers. Professional Psychology: Research and Practice, 37(2), 183. doi:10.1037/0735-7028.37.2.183

    Article  Google Scholar 

  43. Redelmeier, D. A., Yarnell, C. J., Thiruchelvam, D., & Tibshirani, R. J. (2012). Physicians’ warnings for unfit drivers and the risk of trauma from road crashes. New England Journal of Medicine, 367(13), 1228–1236. doi:10.1056/NEJMsa1114310

    Article  PubMed  CAS  Google Scholar 

  44. Meuser, T. M., Carr, D. B., Irmiter, C., Schwartzberg, J. G., & Ulfarsson, G. F. (2010). The American Medical Association older driver curriculum for health professionals: Changes in trainee confidence, attitudes, and practice behavior. Gerontology and Geriatrics Education, 31(4), 290–309. doi:10.1080/02701960.2010.528273

    Article  PubMed  PubMed Central  Google Scholar 

  45. Sims, J., Rouse-Watson, S., Schattner, P., Beveridge, A., & Jones, K. M. (2012). To drive or not to drive: Assessment dilemmas for GPs. International Journal of Family Medicine,. doi:10.1155/2012/417512

    PubMed  PubMed Central  Google Scholar 

  46. VanGeest, J. B., Johnson, T. P., & Welch, V. L. (2007). Methodologies for improving response rates in surveys of physicians a systematic review. Evaluation and the Health Professions, 30(4), 303–321. doi:10.1177/0163278707307899

    Article  PubMed  Google Scholar 

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Correspondence to Andrea L. Huseth-Zosel.

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Huseth-Zosel, A.L., Sanders, G., O’Connor, M. et al. Health Care Provider Mobility Counseling Provision to Older Adults: A Rural/Urban Comparison. J Community Health 41, 1–10 (2016). https://doi.org/10.1007/s10900-015-0055-8

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