Journal of Transport & Health最新文献

{"title":"Walking, public transit, and transitions to non-driving among US Medicare enrollees","authors":"Kellia J. Hansmann ,&nbsp;W. Ryan Powell ,&nbsp;Ronald Gangnon ,&nbsp;Stephanie Robert ,&nbsp;Carolyn McAndrews","doi":"10.1016/j.jth.2025.102054","DOIUrl":"10.1016/j.jth.2025.102054","url":null,"abstract":"<div><h3>Background</h3><div>Many older adults rely on private vehicles for their mobility and may continue to drive when they are advised to stop. Walking and public transit can fulfill mobility needs in some contexts, but in the U.S. these options may not adequately substitute for driving when older adults reduce or stop driving. We examined whether baseline walking or taking public transit was associated with reductions in older adults’ driving after a three-year period in the United States.</div></div><div><h3>Methods</h3><div>We analyzed National Health and Aging Trends Study data from community-dwelling older drivers in 2015 (n = 4574). We used weighted logistic regression to estimate associations between older drivers’ walking and use of public transit in 2015 and changes in their driving behavior three years later—avoiding more driving conditions, driving less often, or not driving at all. We also examined associations between neighborhood walkability and driving behavior change three years later.</div></div><div><h3>Results</h3><div>There were no statistically significant associations between walking or taking public transit in 2015 and the adjusted odds of driving behavior change three years later. However, older drivers living in the most walkable neighborhoods in 2015 had greater adjusted odds of avoiding more driving conditions compared to those in the least walkable neighborhoods (adjusted Odds Ratio (aOR) = 1.66; 95 % Confidence Interval (95 % CI): 1.23<strong>-</strong>2.25). Living in the most walkable neighborhoods compared to the least walkable neighborhoods was also associated with an increased odds of no longer driving in 2018 (aOR = 1.56; 95 % CI: 1.04–2.36).</div></div><div><h3>Discussion</h3><div>The walkability of one's neighborhood area—shorter distances between blocks, diverse land uses, and proximity to transit stops—is associated with driving behavior changes over time for older drivers. This work can inform programs and policies designed to connect older adults with alternative transportation options to driving.</div></div>","PeriodicalId":47838,"journal":{"name":"Journal of Transport & Health","volume":"42 ","pages":"Article 102054"},"PeriodicalIF":3.2,"publicationDate":"2025-04-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143820863","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"工程技术","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Can immersive training complement on-road cycle training for children? Two intervention studies in urban and rural UK communities","authors":"Daniel T. Bishop ,&nbsp;David P. Broadbent ,&nbsp;Damon Daylamani-Zad ,&nbsp;Kaisei Fukaya ,&nbsp;Benjamin R. Smith","doi":"10.1016/j.jth.2025.102048","DOIUrl":"10.1016/j.jth.2025.102048","url":null,"abstract":"<div><h3>Introduction</h3><div>Cyclists are frequent casualties in road traffic collisions; failure to look is a contributory factor. Recent research shows that immersive training may improve children's performance, including their observational skills, when cycling on roads. However, robust data in this regard are scarce.</div></div><div><h3>Methods</h3><div>In two related studies, we collected data from 95 children aged 9–11 years across two different UK locations – a cycling-supportive city and a rural town – to ascertain the effects of immersive cycle training on their cycling attitudes and confidence, their situation awareness, and on-road performance. In the urban study we employed a traditional control group design (immersive intervention vs. control); in the rural study, we compared two immersive interventions (with verbal prompts vs. without). At pre-intervention, post-intervention, and 4–6 weeks later (retention), the children reported their attitudes and confidence and completed video-based situation awareness tests (SATs) and on-road cycling assessments (ORCAs). Changes in parental confidence and attitudes were also recorded.</div></div><div><h3>Findings</h3><div>In both studies, ORCA performance improved pre-to-post-intervention, irrespective of group. SATs scores did not improve but were somewhat correlated with ORCA performance. Although the children's cycling attitudes did not change, their confidence increased post-intervention. Parents' confidence in their child's ability to cycle increased significantly from pre-intervention to follow-up, after watching POV footage recorded during their child's retention phase ORCA.</div></div><div><h3>Conclusions</h3><div>The contribution of immersive training to young children's on-road cycling ability is indeterminate. We tentatively suggest that a combination of independent on-road, immersive, and video-based cycling experiences may improve this ability and consequently increase parental confidence.</div></div>","PeriodicalId":47838,"journal":{"name":"Journal of Transport & Health","volume":"42 ","pages":"Article 102048"},"PeriodicalIF":3.2,"publicationDate":"2025-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143817558","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"工程技术","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Implementing a novel signage-only School Streets approach: Facilitators, barriers, and perceived outcomes","authors":"Yvanna Todorova ,&nbsp;Denise Kendrick ,&nbsp;Luisa Vargas ,&nbsp;Veronica Varela-Mato ,&nbsp;Mark Gussy ,&nbsp;Lauren B. Sherar ,&nbsp;Elizabeth Orton ,&nbsp;Jo Barnes","doi":"10.1016/j.jth.2025.102049","DOIUrl":"10.1016/j.jth.2025.102049","url":null,"abstract":"<div><h3>Background</h3><div>School Streets is a time-specific traffic restriction scheme aimed to reduce traffic around schools during pick up and drop off times. This is believed to benefit school children by reducing surrounding air pollution, improving child safety, and encouraging active travel. Newcastle City Council implemented a novel signage-only School Streets at four primary schools in Newcastle.</div></div><div><h3>Methods</h3><div>Interviews (n = 46) and focus groups (n = 7 groups with a total of 48 participants) were conducted with stakeholders, school leaders, parents, pupils, and residents to understand the facilitators and barriers of the implementation of School Streets and the perceived effectiveness of this scheme. The interview guide and analysis were informed by the Consolidated Framework for Implementation Research.</div></div><div><h3>Results</h3><div>Most facilitator themes related to the simplicity of the signage-only design and the existing work structures. The barriers centred around infrequent communication within the inner setting (local authority, delivery partner and school leadership) and sustaining the level of engagement. The recipients of the scheme were in favour of the messaging behind School Streets but did not perceive changes in traffic or travel behaviour in the area, potentially related to the lack of enforcement. Minimal changes to travel behaviour may be due to external factors such as distance lived from school or physical infrastructure.</div></div><div><h3>Conclusion</h3><div>While the signage-only approach to School Streets reduced the implementation cost and infrastructure changes required, it required a high level of engagement and communication. Recipients desired more enforcement to increase and maintain compliance of the scheme long-term.</div></div>","PeriodicalId":47838,"journal":{"name":"Journal of Transport & Health","volume":"42 ","pages":"Article 102049"},"PeriodicalIF":3.2,"publicationDate":"2025-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143800248","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"工程技术","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Driving safety among adolescents with health conditions: An integrative review","authors":"Leigh Ann DiFusco ,&nbsp;Xiaoxuan (Priscilla) Liu ,&nbsp;Allison E. Curry ,&nbsp;Catherine C. McDonald","doi":"10.1016/j.jth.2025.102040","DOIUrl":"10.1016/j.jth.2025.102040","url":null,"abstract":"<div><h3>Introduction</h3><div>Obtaining a driver's license enhances independence and quality of life but can be challenging for adolescents with health conditions. Health conditions may impact driving behavior and not always require driving restrictions. Strategies that promote safe independent driving for adolescents with various health conditions are not well described.</div></div><div><h3>Methods and population</h3><div>The goal of this integrative review was to summarize the body of literature about safe driving behaviors and strategies to promote positive driving experiences among adolescents (15–24 years old) with at least one of the following health conditions: attention deficit hyperactivity disorder (ADHD), autism spectrum disorder (ASD), disruptive behavior/conduct disorder, type 1 diabetes (TID), congenital heart disease (CHD), epilepsy/seizure disorder, neurological/neurobehavioral conditions, obstructive sleep apnea (OSA), restless leg syndrome (RLS), narcolepsy, and mental health conditions.</div></div><div><h3>Results</h3><div>Sixty-eight studies published between 2007 and 2024 were included in the review. Over 70 % of the included studies focused on ADHD and/or ASD. Driving attitudes, driving behavior/performance, licensure processes, driving interventions and other driving-related factors emerged as key outcome themes. Older age at licensure was common among the included sample. Evidence consistently showed that adolescents with ADHD, ASD, traumatic brain injury, developmental coordination disorders, and mood disorders experienced more unsafe driving compared to their age-matched peers. Blood glucose management was a common concern in studies examining driving behaviors among adolescents with T1D. Studies among adolescents with ADHD and ASD using well-developed interventions may serve as a model for future research examining the impact of other health conditions on driving behaviors.</div></div><div><h3>Conclusion</h3><div>Our findings substantiate the body of research devoted to understanding safe independent driving among adolescents with ADHD and ASD and reveal opportunities for more research among adolescents with disruptive behavior/conduct disorder, T1D, CHD, epilepsy/seizure disorder, neurological/neurobehavioral conditions, OSA, RLS, narcolepsy and mental health conditions to inform health policies and clinical practice.</div></div>","PeriodicalId":47838,"journal":{"name":"Journal of Transport & Health","volume":"42 ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143790203","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"工程技术","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cycling infrastructure and transportational and recreational physical activity in Canadians","authors":"S.A. Prince ,&nbsp;N. Doan ,&nbsp;G.P. Butler ,&nbsp;S.A. Srugo ,&nbsp;M. Winters ,&nbsp;R.C. Colley ,&nbsp;C. Vietinghoff ,&nbsp;R. Larouche ,&nbsp;D.G. Rainham ,&nbsp;J.J. Lang","doi":"10.1016/j.jth.2025.102046","DOIUrl":"10.1016/j.jth.2025.102046","url":null,"abstract":"<div><div>Built environments that support cycling, especially those that are comfortable and safe (e.g., protected cycle tracks), are positively associated with physical activity (PA). The objective was to determine the associations between cycling infrastructure and transportational (PA_TRA) and recreational (PA_REC) PA among urban-dwelling Canadians. Self-reported PA_TRA/PA_REC data (N = 120,648, aged 12+ years) from the 2017, 2018, 2020 and 2021 cycles of the Canadian Community Health Survey were linked to cycling infrastructure. Neighbourhood-level infrastructure included: total kilometres (km_unweighted), kilometres weighted by comfort/safety (km_weighted), and category of infrastructure level. Multivariable logistic and linear regression examined the association between cycling infrastructure and engagement and duration of PA_TRA/PA_REC. Approximately half (48.8 %) of urban-dwelling Canadians reported engaging in PA_TRA, while 58.2 % reported engaging in PA_REC. Greater exposure to infrastructure was both associated with engagement in PA_TRA (km_unweighted: aOR = 1.04, km_weighted: aOR = 1.07, p &lt; .0001) and PA_REC (km: aOR = 1.02, km_weighted: aOR = 1.03, p &lt; .0001), as well as duration of PA_TRA (km: β = 0.03, km_weighted: β = 0.06, p &lt; .0001) and PA_REC (km: β = 0.01, km_weighted: β = 0.02, p &lt; .0001). Compared to the lowest level of infrastructure (category 1), the highest level (category 5) was associated with greater engagement and duration of PA_TRA (aOR = 1.88, 95 % CI: 1.69–2.09; β = 0.50, 95 % CI: 0.42–0.58) and PA_REC (aOR = 1.26, 95 % CI: 1.13–1.39, β = 0.19, 95 % CI: 0.11–0.27). Cycling infrastructure, especially of higher comfort and safety, is associated with engagement and duration of PA_TRA and PA_REC among urban-dwelling Canadians. Future longitudinal work is needed to explore associations with cycling-only outcomes, as well as identifying the actual cycling infrastructure used.</div></div>","PeriodicalId":47838,"journal":{"name":"Journal of Transport & Health","volume":"42 ","pages":"Article 102046"},"PeriodicalIF":3.2,"publicationDate":"2025-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143767883","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"工程技术","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparing pedestrian and cyclist injuries from falls and collisions in British Columbia, Canada: Frequencies and population characteristics","authors":"Michael Branion-Calles ,&nbsp;Andrea Godfreyson ,&nbsp;Kate Berniaz ,&nbsp;Neil Arason ,&nbsp;Shannon Erdelyi ,&nbsp;Meghan Winters ,&nbsp;Kay Teschke ,&nbsp;Fahra Rajabali ,&nbsp;M. Anne Harris ,&nbsp;Jeffrey R. Brubacher","doi":"10.1016/j.jth.2025.102044","DOIUrl":"10.1016/j.jth.2025.102044","url":null,"abstract":"<div><h3>Introduction</h3><div>Walking and cycling offer health benefits but carry injury risks. Traditional road safety datasets often exclude pedestrian and cyclist falls, despite emerging evidence that injuries from falls occur more frequently than collisions with motor vehicles.</div></div><div><h3>Methods</h3><div>This research compared the frequency of pedestrian and cyclist injuries from falls versus collisions using hospital admissions data from a linked database of road traffic injuries in British Columbia, Canada, which combined hospital admissions, and sociodemographic information from 2015 to 2019. Additionally, we examined differences in injury severity and population characteristics between those injured in falls versus collisions.</div></div><div><h3>Results</h3><div>Of 6807 pedestrian hospital admissions, 68.8 % were from falls—2.3 times higher than motor vehicle collisions (29.2 %). Among 2409 cyclist admissions, falls accounted for 48.6 %–1.8 times higher than motor vehicle collisions (27.6 %). More severe injuries (MAIS3+) occurred less frequently in falls (25.0 % pedestrians, 17.9 % cyclists) than in collisions with motor vehicles (39.7 %, 27.4 %). We also found that falls disproportionately happen to older adults, females, higher-income individuals, and rural residents with more pronounced differences in pedestrians.</div></div><div><h3>Conclusions</h3><div>Our analysis revealed that pedestrian and cyclist falls are major contributors to the burden of road traffic injury and emphasizes the need for their inclusion in road safety surveillance and research. Reliance on datasets that exclude falls, or failing to consider falls as a road safety issue, can potentially hinder the development of infrastructure and built environment design solutions aimed at reducing the frequency and severity of fall injuries to pedestrians and cyclists.</div></div>","PeriodicalId":47838,"journal":{"name":"Journal of Transport & Health","volume":"42 ","pages":"Article 102044"},"PeriodicalIF":3.2,"publicationDate":"2025-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143760921","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"工程技术","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Revisiting independent mobility and healthy aging connection using a double machine learning","authors":"Yuexia Chen,&nbsp;Wanru Du,&nbsp;Peng Jing,&nbsp;Yaqi Liu,&nbsp;Jie Ye,&nbsp;Huiqian Sun","doi":"10.1016/j.jth.2025.102041","DOIUrl":"10.1016/j.jth.2025.102041","url":null,"abstract":"<div><h3>Introduction</h3><div>The rapid aging of the population has placed significant pressure on medical resources and hindered healthy aging. Scholars highlight the critical link between independent mobility and healthy aging, as it enables older adults to actively engage in social and community life. While existing studies often assess independent mobility through driving ability, they tend to overlook the impact of other travel patterns, such as public transport and walking. Differences in commonly used travel patterns may shape older adults’ perceptions of independent mobility, thereby influencing its effect on healthy aging.</div></div><div><h3>Methods</h3><div>This paper utilizes Double Machine Learning to analyze the causal effects of independent mobility on healthy aging and explores the mediation role of social participation in this relationship.</div></div><div><h3>Results</h3><div>The findings show that independent mobility impacts healthy aging in multiple dimensions, with anxiety being the most significantly affected. Additionally, social activities, such as tai chi and square dancing, exhibit a statistically significant mediation effect.</div></div><div><h3>Conclusion</h3><div>These results provide valuable insights for policymakers, emphasizing the need to improve public transportation and pedestrian infrastructure while promoting social participation to enhance healthy aging among older adults.</div></div>","PeriodicalId":47838,"journal":{"name":"Journal of Transport & Health","volume":"42 ","pages":"Article 102041"},"PeriodicalIF":3.2,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143739442","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"工程技术","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Electric scooter use: The perspective of university students","authors":"Muhammed Emin Cihangir Bagdatli,&nbsp;Gokhan Godebey","doi":"10.1016/j.jth.2025.102039","DOIUrl":"10.1016/j.jth.2025.102039","url":null,"abstract":"<div><h3>Introduction</h3><div>E-scooters stand out as a vehicle that has the potential to support the mode shift towards more sustainable transport and to achieve greater equity in mobility. There is a need to examine the attitudes and views of various segments of society towards e-scooters to understand the impact of this new vehicle on cities and to provide various operational and safety solutions.</div></div><div><h3>Methods</h3><div>This study conducted a face-to-face survey focusing on revealing the perspectives of university students in nine major cities in Türkiye. A survey was carried out with a total of <em>1302</em> people, and <em>1211</em> valid questionnaires were provided for statistical analysis. Various results related to the university students' views and attitudes on e-scooter use were achieved through the binary and ordered logit models.</div></div><div><h3>Results</h3><div>Results principally provide the variables affecting the current and future use of e-scooters. The remarkable results are outlined as follows: (i) E-scooter use is positively affected by university students' attitudes that e-scooters are enjoyable and economical, and they offer time savings and ease of use. (ii) Short-distance and short-duration commute trips by e-scooters are embraced by university students. (iii) The risk of falling, the high fees of shared e-scooters, access problems to shared e-scooters, and aesthetic concerns are major obstacles to e-scooter use.</div></div><div><h3>Conclusions</h3><div>Developing all aspects of micromobility is well-known to be a critical task for a healthier and sustainable urban life. This study, which focuses on university students' perspectives on e-scooter use, can be seen as a part of this task, and the findings and discussions may be beneficial for transport infrastructure providers and policymakers.</div></div>","PeriodicalId":47838,"journal":{"name":"Journal of Transport & Health","volume":"42 ","pages":"Article 102039"},"PeriodicalIF":3.2,"publicationDate":"2025-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143734932","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"工程技术","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Deconstructing the barriers and facilitators of e-bike helmet usage: A structural equation modeling approach","authors":"Mingyang Pei ,&nbsp;Zikang Huang ,&nbsp;Ting Huang ,&nbsp;Ke Wang ,&nbsp;Xin Ye","doi":"10.1016/j.jth.2025.102035","DOIUrl":"10.1016/j.jth.2025.102035","url":null,"abstract":"<div><h3>Introduction</h3><div>E-bike accidents are on the rise in China as shared e-bikes become more popular. Helmet usage could prevent e-bike riders from severe head injuries in e-bike accidents. Investigating the underlying determinants that influence the intention towards helmet use is of paramount importance.</div></div><div><h3>Methods</h3><div>Drawing upon the theoretical underpinnings of the Theory of Planned Behavior, this study puts forth an augmented framework to analyze a dataset comprising responses from 1300 shared e-bike users in Guangzhou, China. By employing structural equation modeling, we aim to pinpoint the pivotal factors influencing helmet use intention, with a particular emphasis on attitudes, punishments for not wearing helmets, subjective norms, safety awareness, personal characteristics, and service level of helmets.</div></div><div><h3>Result</h3><div>Attitudes, punishments, subjective norms, safety awareness, and service level were identified as five statistically significant factors. Among these, the most potent determinant of an individual's intention to use a helmet was found to be their underlying attitude towards this safety measure. The first two factors (attitudes and punishments) have direct effects on helmet use intention, while the other three determinants have indirect effects that are mediated by attitudes.</div></div><div><h3>Conclusions</h3><div>Promoting positive attitudes toward helmet use may be more effective than other factors for encouraging their adoption among shared e-bikers. Positive attitudes can be fostered by establishing a helmet-use behavioral norm, increasing shared e-bikers’ safety awareness, and improving helmet quality provided by merchants. As a result of the findings, the current penalty for not wearing a helmet may need to be adjusted to motivate more people to wear helmets.</div></div>","PeriodicalId":47838,"journal":{"name":"Journal of Transport & Health","volume":"42 ","pages":"Article 102035"},"PeriodicalIF":3.2,"publicationDate":"2025-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143734931","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"工程技术","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Low uptake of driver refresher courses by older adults: An examination of potential explanatory variables using the Candrive cohort","authors":"Michel Bédard ,&nbsp;Hillary Maxwell ,&nbsp;Isabelle Gélinas ,&nbsp;Barbara Mazer ,&nbsp;Gary Naglie ,&nbsp;Michelle M. Porter ,&nbsp;Mark J. Rapoport ,&nbsp;Holly Tuokko ,&nbsp;Brenda Vrkljan ,&nbsp;Shawn Marshall","doi":"10.1016/j.jth.2025.102043","DOIUrl":"10.1016/j.jth.2025.102043","url":null,"abstract":"<div><h3>Introduction</h3><div>Older drivers benefit from driver refresher courses, particularly courses with on-road training. Yet, the uptake of these courses and the factors associated with taking them is poorly documented.</div></div><div><h3>Methods</h3><div>We used data from the Candrive prospective cohort (N = 928) to examine these issues using variables representing sociodemographic factors (e.g., age), health-related factors (e.g., medical conditions), and driving-related factors (e.g., driving comfort). The outcome variable was operationalized as having taken a non-mandatory refresher course in the last 10 years or never.</div></div><div><h3>Results</h3><div>Participants’ mean age was 76.21 (SD = 4.85) and 576 (62.1 %) were males. Ninety-eight participants (10.6 %) reported having taken a non-mandatory refresher course within the last 10 years, and less than half of those reported that it included an on-road component. Only nine percent of participants had discussed driving with a physician. The multivariable regression model (N = 746; −2 log likelihood = 515.10, p &lt; .001, Nagelkerke <em>R</em>² = 0.12) identified five variables as statistically significant. The odds of having taken a course were higher with age (OR = 1.53, 95 % CI = 1.23, 1.92), when one’s driving was perceived as important for others (OR = 1.87, 95 % CI = 1.26, 2.80), and for participants who spoke to their family (OR = 1.80, 95 % CI = 1.04, 3.09) or to a physician about driving (OR = 2.24, 95 % CI = 1.15, 4.36); the odds were lower for those who benefited the most personally from driving (OR = 0.64, 95 % CI = 0.51, 0.82).</div></div><div><h3>Conclusions</h3><div>The uptake of driver refresher courses is low and few discussions about driving took place with physicians. Further research is needed to understand the barriers and facilitators related to older drivers’ involvement in refresher courses.</div></div>","PeriodicalId":47838,"journal":{"name":"Journal of Transport & Health","volume":"42 ","pages":"Article 102043"},"PeriodicalIF":3.2,"publicationDate":"2025-03-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143726150","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"工程技术","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}