Research on Older Adults’ Mobility (ROAM) 2026
Hosted by Alycia Bayne, MPA
Alycia Bayne, MPA is the Associate Director of the Public Health Research Department at NORC at the University of Chicago. She is a public health researcher and evaluator with 20 years of experience conducting research for the federal government, foundations, and associations. Bayne directs a portfolio of work exploring the intersection of transportation and health. She led a study for the Centers for Disease Control and Prevention on older adults' use of ride share services. For the AAA Foundation for Traffic Safety, Bayne leads projects on factors that influence seat belt use and impaired driving, and has led projects focused on drowsy driving countermeasures and evidence-based traffic safety campaigns. She also developed a rural transportation toolkit for the Federal Office of Rural Health Policy. Bayne was appointed by the Transportation Research Board to contribute to national committees focused on the mobility and safety of older adults and individuals with disabilities, including service as Chair of the Subcommittee on Older Drivers and as a member of two committees. She is also the Chair of the Healthy New Jersey 2030 Advisory Council, which sets the health promotion targets for the state of New Jersey. She has a Master in Public Affairs and a certificate in health and health policy from Princeton University.
Driver Monitoring and Feedback Systems for Older Drivers: Evidence from a Systematic Literature Review & Preliminary Qualitative Analysis
Ms. Nicole Booker and Dr. Johnathon Ehsani
Driver monitoring and feedback systems measuring distraction, speed compliance, and harsh maneuvers show promise for improving road safety. Despite older adults being a fast-growing driver demographic, vehicle telematics-related interventions tailored to this population remain limited. We conducted two studies to address this gap in research. First, we conducted a systematic review of English-language literature (2000-2024) and identified 74 studies with on-road driving data. Second, a study of 51 older adults (ages 50-85) was conducted utilizing StreetCoach, a smartphone-based driving coach app. Over 50 days, the app recorded 11,017 trips and provided personalized feedback on risky behaviors (acceleration, braking, cornering, speeding, phone use). Qualitative interviews were conducted with 43 participants to explore older drivers’ experience with automated feedback. The systematic review identified 2 RCTs and 2 quasi-experimental designs specifically focused on older drivers. Real-time feedback combined with video coaching or third-party involvement effectively reduces risky driving among seniors; however, treatment effects diminish when feedback is removed. Qualitative interviews identified two primary themes with respect to telematics: 1) increased self-awareness and motivation for improvement, and 2) distrust of the scores, particularly when scores conflicted with self-perception or felt like unwanted scrutiny. Participants consistently requested transparency on scoring parameters, and guidance on score improvement, and social benchmarking to compare performance against peers. Together, these findings suggest that effective older driver telematics interventions may require a hybrid approach: sustained, transparent feedback informed by older adults' core motivations for self-improvement, fair assessment, and social comparison.
Following the Journey: Portrait of an Older Driver
Dr. Anne Dickerson
Ever since 2003 and the Santa Monica crash, extensive research and development of important resources have focused on the aging driver. More correctly, work on clearly shown it is not age, but the medically at-risk driver continues to attribute increasing numbers of crashes of older adults. The holy grail of one test has not been achieved, and strategies to get medical care providers, generally tasked to “report” the medically-at-risk driver, has woefully failed to address the growing problem. This session will prevent a unique strategy to educate all stakeholders about the medically-at-risk driver and engage older drivers themselves and family members to understand the risks. The strategy will be the development of a story that will span three short films. The journey of Sharon and her son Steve will start as the navigate when Sharon is reported to the DMV. The second film clearly illustrates components of the driving evaluation, including key errors during the on-road component. The third (under development) will explore strategies to support social participation, and planning resources to support where Sharon needs and wants to go. The presenter will offer an array of tools and options to use.
Reaching a Threshold to Stop Driving: Lived Experiences of People with Dementia and Their Family Caregivers
Dr. KJ Hansmann
Older drivers with dementia will eventually need to stop driving due to cognitive decline impacts on driving ability. Family, friends, and clinicians can help plan for the transition to non-driving, but conversations about dementia and driving are logistically and emotionally complex and often delayed. There is an urgent need for evidence-based interventions that can address challenges and leverage opportunities for discussing transitions to non-dNMriving. The purpose of this qualitative study was to characterize opportunities and challenges for discussing transitions to non-driving by eliciting the experiences of a diverse cohort of (1) older drivers and former drivers with dementia and (2) their family caregivers. We recruited participants across urban, suburban, and rural communities in Wisconsin through dementia research and community outreach networks. We conducted individual semi-structured interviews and used thematic analysis with inductive coding to generate themes and subthemes from interview transcripts. We recruited 20 participants including people with dementia (n=5) and family caregivers (n=15). Caregivers and people with dementia described a process of noticing changes in the person with dementia’s driving ability and patterns and then evaluating whether they were still driving safely, weighing the risks of driving against the risks of stopping driving. Whether prompted by noticing changes in the person with dementia’s driving patterns or other changes in their day-to-day activities, many caregivers described actively monitoring the person with dementia’s driving patterns. Participants described how they considered the potential risks of the person with dementia continuing to drive, suggesting a threshold they reached for when a change in the person with dementia’s driving needed to happen. However, different participants had different thresholds for taking action depending on multiple contextual factors at environmental, social, and individual levels. People with dementia and caregivers in this study identified unmet communication needs from clinicians that include and extend beyond the decision of when to stop driving. Family caregivers in particular described daily challenges before, during, and after transitions to non-driving. Participants shared numerous opportunities to improve communication, resource navigation, and overall support during and after transitions to non-driving.
From Unacquainted to Optimistic: How Transportation Barriers Shape Older Adults’ Familiarity with New Mobility Options and Perception of Autonomous Vehicles in a Rural State
Dr. Suman Mitra
The objective of this study is to analyze older adults’ familiarity with new transportation options (ride-hailing services, bike-share services, and shared e-scooter services) and their perception towards autonomous vehicles (fully autonomous cars), as well as how transportation barriers influence their familiarity and perceptions, in Arkansas, a predominantly rural state. Data from 775 older adults aged 60 years or older were collected between October 2021 and October 2022. To fulfill the study objective, the study used Latent Class Cluster Analysis to segment older adults into classes based on their familiarity with new transportation options and their perceptions of autonomous vehicles. The effects of transportation barriers on class membership were analyzed by employing a Structural Equation Model. The Latent Class Cluster Analysis (LCCA) identified three distinct groups of older adults based on their familiarity with new mobility services and perceptions of autonomous vehicles (AVs). The first group, Unacquainted Older Adults with Negative Perceptions, lacked familiarity with new transportation options and held negative views on AVs. They were more likely to experience individual-level barriers, including mobility impairments, driving cessation, and lack of smartphone access. The second group, Acquainted Older Adults with Negative Perceptions, was aware of ride-hailing, car-sharing, and micromobility services but remained skeptical about AVs. They primarily faced interpersonal and community-level barriers, such as lack of informal rides, limited taxi access, and social support constraints. The third group, Acquainted Older Adults with Positive Perceptions, was the most familiar with new mobility options and exhibited a favorable attitude toward AVs. However, they faced car access limitations and environmental barriers, such as limited public transit and inadequate pedestrian infrastructure. These findings underscore the importance of targeted interventions, technology training, infrastructure improvements, and policy initiatives to enhance familiarity with new transportation options among older adults’ mobility and acceptance of AVs.
Teen and Senior Traffic Safety Risks
Dr. Bayliss Camp
Approximately once each decade, California DMV publishes its "Teen and Senior" report, providing crash and violation rates by age and sex, both on a per-licensed driver and a mileage-adjusted basis. This presentation covers licensure rates, crash involvement rates, and traffic offense rates, and cover how these have changed since the last report (published in 2013).
Mobility and Oral Health: Transportation Data as a Lens on Access and Equity
Mr. Zeve Marcus
Older adults can face complex barriers to health care that extend beyond clinical need. Mobility, scheduling, and distance all shape who actually makes it to an appointment. Drawing on over 1.6 million rides in ITNAmerica’s national database, this study integrates multiple analytic approaches to examine how behavioral engagement with transportation predicts oral-health participation among older adults. Results reveal a simple but powerful relationship: older adults who use transportation regularly for health and everyday errands are significantly more likely to engage in dental care. A one standard deviation increase in medical rides more than doubles the odds of dental participation, while increases in consumer rides (e.g., pharmacy, grocery) raise odds by 60%. These patterns persist even after accounting for distance, mobility aids, and time, underscoring that sustained engagement, not just access, drives participation. Equity gaps were also evident. Black, Other/Mixed, and Missing/Unknown-race riders exhibit roughly 30–35% lower odds of dental participation than White riders, and men are about 40% less likely than women to engage. Analyses also revealed patterns in ride cancellations: namely, that a protective effect of longer distances seen in the 2000s has reversed since 2020, with longer trips now predicting slightly higher cancellation risk. Our findings suggest that mobility patterns offer critical insight into health access. Building “ride momentum” through consistent, integrated opportunities for mobility, may meaningfully complement traditional access interventions to promote more equitable healthcare participation.
Exploring the Challenges and Rewards of Caregivers Who Provide Transportation Assistance to Older Adults
Dr. Colleen Peterson
Family caregivers increasingly assume transportation responsibilities to ensure access to healthcare, groceries, and community engagement. This study represents the first phase in the development of a scale to assess caregiver burden specifically related to transportation assistance. This new scale will lay the groundwork for designing targeted interventions to alleviate these burdens while acknowledging the benefits one might experience from this care. Ultimately, this scale will support caregivers' health and well-being and ensure safe mobility for aging adults. Four focus groups (N=21) were conducted with caregivers who provide transportation assistance to older adults. Thematic analysis identified common experiences (themes) and provided verbatim responses for the basis of the transportation burden scale items. The most commonly reported challenges were the time dedicated to providing transportation assistance and the conflict this creates with other priorities, such as work responsibilities or time for themselves. Transportation challenges intensify when care recipients have more physical and mental impairments and are further exacerbated by longer distances between family caregivers and their care recipients. On the other hand, participants expressed positive aspects of providing transportation, such as peace of mind and enjoying quality time with their care recipient. Though, this was sometimes accompanied by feeling guilty for not having time to provide more transportation assistance beyond medical appointments, such as for social or leisure activities. These findings highlight the complex emotions that result from providing this type of care. Detailed findings and illustrative quotes will be presented. How these findings informed subsequent development of the Transportation Assistance Burden Scale are discussed.
Panel: The Future of Mobility for Older Adults
Led by Ms. Alycia Bayne
This panel answered questions such as:
How will new vehicle technologies, safety programs, and education evolve to meet the needs of older drivers over the next decade?
What innovative tools or strategies could make the transition from driving to other forms of mobility easier for older adults and their caregivers?
How can transportation data be used to improve older adults’ access to healthcare and support their independence in the future?