Promoting Older Driver Safety: Guide for State Practices (2023)

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42 How to Evaluate an Older Driver Safety Program According to Guidance for Developing Highway Safety Plans (May 2020) from GHSA, SHSOs are responsible for developing and managing statewide and local highway safety programs designed to reduce the human and economic consequences of crashes, injuries, and fatalities experienced by the Nation’s road users. To accomplish the mission, each of the agencies must collect and analyze data, establish targets to reduce their crash problems and identify performance measures for assessing progress. This information is reported each year in the state’s HSP, which also includes strategies, proj- ects, and programs the SHSO funds. A companion annual report provides information on the accomplishments and challenges experienced by the SHSO in the prior fiscal year when imple- menting the various HSP programs and projects. All states are required to track and report to NHTSA annually on 11 core performance mea- sures, including traffic; serious injuries and fatalities per passenger vehicle miles traveled; and fatalities related to unrestrained vehicle occupants, alcohol impaired driving, speeding, motor- cyclists, unhelmeted motorcyclists, drivers ages 20 or younger, pedestrians, and bicyclists. In addition, SHSOs are required to track seat belt citations, impaired driving arrests, and speed citations issued during grant-funded enforcement activities as well as observed seat belt use for front seat outboard occupants in passenger vehicles. Collecting data on fatalities involving older drivers is not required, but most SHSOs report fatalities and serious injuries by age, including those 65+ in the HSP. States can use the following suggested performance measures to evaluate their older driver safety programs. • Annually track fatalities and serious injuries by age, and fatalities and serious injuries by age for each relevant performance measure, to provide outcome information. Because it is expected the number of older drivers on the road will increase over the next several years, SHSOs may want to track to the rate of older driver fatalities and serious injuries. These provide several ways to examine policy changes on mobility options, as well as second-order effects on core safety metrics such as pedestrian and bicycle crashes. • If moving forward with development and implementation of an older driver safety program or supporting a program conducted by another state agency or organization, consider output measures such as the following: – Number of licenses suspended or revoked due to at-risk driving. – Number of older drivers referred for evaluation and/or rehabilitation to an MAB or other medical professional (i.e., occupational or physical therapist, driver rehabilitation specialist). – Number of physicians reached with information on older driver safety, and their role in identifying and referring at-risk drivers. – Number of law enforcement officers reached with information on identifying and referring at-risk drivers. C H A P T E R 6

How to Evaluate an Older Driver Safety Program 43 – Number and type of public transit options for older drivers, statewide, by county, and in underserved communities. – Number of older drivers reached with information on vehicle technologies and how they can help with safe driving. This is not an exhaustive list, but it offers an idea of what information could be collected to determine the effectiveness and reach of an older driver safety program. If the SHSO is providing funding to another agency or organization, they will include required performance measures that the grantee must report on each year. For grants, the grantee will be asked to detail the nature and extent of the problem they wish to solve, the proposed solution, measurable objec- tives, and performance measures that are usually output measures much like the ones described. Florida’s Safe Mobility for Life Coalition’s comprehensive older driver program evaluation effort has identified specific performance measures for each of their goal areas. The Coalition reports these measures to the SHSO for grant funding the program receives. Their performance measures include • Number of agencies, organizations, and individuals who support the Coalition; • Number of materials and resources distributed; • Number of presentations given; • Number of communications delivered (social media messages, newsletters); • Number of events conducted and the number of participants; • Number of subscribers and interactions on social media channels; and • Number of materials and resources developed with other safety coalitions. The Coalition tracks and reports on these measures annually along with data on the number of age 65+ fatalities and serious injuries in the priority urban and rural counties that have expe- rienced the highest number of crashes. To ensure the program is focusing efforts in the areas of greatest need, Safe Mobility for Life will overlay locations where materials are distributed and education efforts conducted with information about where crashes are occurring. 6.1 Conclusion Evaluation is a critical component of any highway safety program. Evaluations tell whether the program did what it was intended to do and whether it was effective. Outcome measures for highway safety programs are sometimes difficult because many factors impact human behavior. However, reviewing the number and rate of older driver fatalities and serious injuries (includ- ing how the fatalities and serious injuries fluctuate by program area, and identifying where these incidents occur) can provide a sense of possible progress. Also, surveys conducted online, through senior centers, or through other venues frequented by older drivers can provide out- come information on older driver behaviors and attitude. Surveys are a useful tool to identify what messages resonate, or do not, with a particular group of road users and whether changes in behavior result. Surveys can provide insight on the effectiveness of older driver programs. Information on effective older driver countermeasures can be found in the NHTSA publication, Countermeasures that Work, and the FHWA Handbook for Designing Roadways for the Aging Population. SHSOs will gather important output measures that indicate whether programs and projects are being conducted and at what level. If there is still no progress on the number and rate of fatalities and serious injuries, such surveys provide information to support project-level evaluations. In Table 2, the research team outlined Guideline No. 13 elements and what metrics could be used to evaluate effectiveness. The table is based on the responses to the SHSO survey and interviews with states with well-developed programs.

44 Promoting Older Driver Safety: Guide for State Practices MetricsNHTSA Guideline No. 13 Elements Program Management • Create cross-agency collaborative arrangements. • Collect better older driver crash data. • Improve older driver safety programs. • Incorporate older driver issues into the SHSP. • Designate lead agency for aging road user issues. Florida DOT • The extent to which senior safety and mobility issues are incorporated into other state programs. • The impact on older driver crash rates. • Outreach metrics such as social media hits, number of workshop attendees, etc. • Achieving the objectives in the Aging Road User Strategic Plan. Michigan DOT • The number of hits and downloads on a DOT website offering advice and guidance to aging road users. Recommendation • Specific improvements in the collection and analysis of aging road user data. Roadway Design • Make older driver safety an emphasis area in the SHSP. • Deploy guidelines to incorporate FHWA older road user guidelines into new construction and spot improvements. • Implement a communication and education plan. Recommendation • The extent to which the state and localities adopt FHWA aging road user guidelines for new construction and spot improvements. Driver Licensing • Require in-person renewal. • Ensure state medical review process is consistent with Gerontological Society of America guidelines. • Provide immunity to medical personnel who refer at-risk drivers. • Consider additional older driver restrictions. • Establish a MAB. • Train licensing staff to identify at-risk drivers. • Evaluate different at-risk driver referral sources. • Train medical personnel to refer at-risk drivers. • Provide community transportation information. Multiple States • The number of referred drivers whose driving was restricted or their license removed. • The number of drivers referred by medical personnel. • The accuracy of the medical assessment of the at-risk driver. • The number of drivers who gave up their license when they were referred as an at-risk driver. Medical Providers • Develop outreach to medical personnel. • Facilitate an award of CME credits for learning about driving safety. • Facilitate medical providers referring at-risk drivers. Recommendation • Evaluate the impact of training for medical personnel on the number and outcomes of doctors’ referrals of at-risk drivers, e.g., collect the number of drivers who were referred to certified driver rehabilitation specialists as an at-risk driver. Law Enforcement • Provide training and education to facilitate their referral of at-risk drivers. • Develop a communications plan to train law enforcement to recognize at-risk drivers. • Streamline the at-risk driver referral process. Minnesota DOT • The level of law enforcement involvement in referral of at-risk older drivers. Recommendation • Evaluate the impact of focused efforts to teach officers to recognize at-risk drivers at crash sites and while driving, as measured by referral rates and assessment outcomes. Table 2. Evaluation metrics for NHTSA Guideline No. 13 elements.

How to Evaluate an Older Driver Safety Program 45 NHTSA Guideline No. 13 Elements Metrics • Collaborate with state Agencies on Aging and other social service agencies. • Collaborate with state transit offices. • Develop a joint communications strategy to ease older drivers’ transition to no longer driving. Recommendation • Identify the number of former drivers who become regular riders of transit and other services when they cease driving. • Identify the number of transportation options by county. Communications Program • Establish a working group of state and local agencies interested in older driver safety and mobility. • Focus communications to support overall goals and policies. Florida DOT • Florida DOT, with help from the Pepper Institute on Aging at Florida State University, established the Safe Mobility for Life Coalition that includes representatives of state agencies, nonprofit organizations, and private sector businesses. • Safe Mobility for Life developed a communications plan that lays out the types of traditional and social media messages to be conducted throughout the year. Program Evaluation and Data • Support analysis of police reports of older driver crashes. • Support local organizations to evaluate programs. • Survey the public on knowledge of older driver safety issues. • Evaluate the effectiveness of educational programs and use of program resources. • Stay aware of national trends in older driver safety. North Carolina DOT • The North Carolina DOT performs quarterly evaluations of program outcomes versus stated goals to determine grantee performance. Missouri DOT • The Missouri DOT evaluates the number of courses and outreach activities grantees conduct on older driver issues. Louisiana Department of Transportation and Development (DOTD) • The Louisiana DOTD evaluates the number of older driver safety events and attendees at these events. Source: BTS-12 authors Social and Aging Service Providers Table 2. (Continued).