Occupational Therapy Driving Intervention for Returning Combat Veterans.

Summary

Driving is a portal into general life functioning, and impaired driving skill can pose a serious threat to the combat veterans (CV), passengers and others; and involves increased risk of subsequent injuries, medical expenses and legal sequelae. Motor vehicle crashes (MVC) among post deployed CV are one of the top four causes of injury and disability, hospitalization, and outpatient visits across the military, and are a leading cause of death among Army service members. The risk of motor vehicle (MV) death is significantly increased in years immediately following return from the battlefield. In sum, the effects of Traumatic Brain Injury (TBI)/ Post Traumatic Stress Disorder (PTSD) and other blast related injuries, combined with the "battlefield" mindset and lack of community reintegration programs place CV at risk for MVC and fatalities. On-road assessments, the gold standard, presents a risk for crash or adverse advents in this population of CV. Alternately, simulated driving evaluation measures driving performance in a safe, accurate and objective manner with evidence of absolute and relative validity when compared to real world (on-road) driving. Knowing participants can or cannot safely resume driving, and providing rehabilitation for those with a potential for resuming safe driving could result in: increased safe driving behaviors; avoidance of injuries, collisions, citations and participants residua; and resuming safe driving with its attendant benefits in the realms of family functioning, participation in society and satisfaction with life. The overarching objective of this proposal is to discern, after clinical and simulated driving performance testing , if Occupational Therapy Driving Intervention (OT-DI) can improve the safe driving performance (less errors) over the short term (immediately following intervention) and intermediate term (3 months).

Conditions

• Traumatic Brain Injury (TBI)
• Post Traumatic Stress Disorder (PTSD)

Interventions

BEHAVIORAL

Driving Behavior Interview

This will be completed thrice, at baseline, post-test1 and at post-test2

BEHAVIORAL

Fitness-to-Drive Screening Measure

This will be completed thrice, at baseline, post-test1 and at post-test2 (3 months after post test1)

OTHER

Clinical Driving Assessment

Clinical Driving Assessment includes Optec vision screening, Useful Field of View, Range of Motion, Strength. This will be completed thrice, at baseline, post-test1 and at post-test2 (3 months after post test1)

BEHAVIORAL

Propensity for Angry Driving Scale

This questionnaire will be completed thrice, at baseline, post-test1 and at post-test2 (3 months after post test1)

BEHAVIORAL

Community Integration Questionnaire

This questionnaire will be completed thrice, at baseline, post-test1 and at post-test2 (3 months after post test1)

BEHAVIORAL

Satisfaction with Life Questionnaire

This questionnaire will be completed thrice, at baseline, post-test1 and at post-test2 (3 months after post test1)

PROCEDURE

Driving simulator evaluation

The driving simulator evaluation uses a driving simulator with simulated drives engineered to address Veteran driving concerns such as reactions to other drivers and road conditions (e.g., debris). The simulator is used at baseline and post-tests 1 and 2. The intervention sessions (X3) also occur using simulator.

OTHER

Focus Group Discussion Interview Guide

Focus group discussion will occur once using the interview guide

Sponsors & Collaborators

• United States Department of Defense

  collaborator FED

• US Department of Veterans Affairs

  collaborator FED

• University of Western Ontario, Canada

  collaborator OTHER

• University of Florida

  lead OTHER

Principal Investigators

• Sandra Winter, PhD · University of Florida

Study Design

Allocation

RANDOMIZED

Purpose

TREATMENT

Masking

SINGLE

Model

PARALLEL

Eligibility

Min Age

18 Years

Max Age

85 Years

Sex

ALL

Healthy Volunteers

No

Timeline & Regulatory

Start

2013-01-31

Primary Completion

2015-09-30

Completion

2018-11-30

Countries

• United States

Study Locations