Fidelity of a Traffic Safety Education Intervention for Combat Veterans

Abstract

Equipoise, feasibility, and fidelity were studied for the control condition of an occupational therapy driving intervention in a randomized controlled trial. We ranked equipoise and feasibility of six traffic safety education methods and created an implementation fidelity competency checklist. Education method selection was informed using the proportion of concordant ranks analysis while literature and a peer review informed competency checklist development. A proctored-online course delivery had the highest rater agreement (equipoise = .96 [.87–1.00]; feasibility = .99 [.97–1.00]). Implementation fidelity was supported by a 19-component training and evaluation checklist. This study supports promoting the scientific rigor of the RCT via - equipoise, feasibility, and implementation fidelity.

Keywords:

• Combat Veterans
• implementation fidelity
• traffic safety education

Acknowledgments

Infrastructure and support were provided by the University of Florida’s Occupational Therapy Department and the Institute for Mobility, Activity, and Participation. Dr. William Perlstein, Associate Professor, University of Florida Department of Clinical and Health Psychology, provided his expert opinion on learning challenges associated with mild traumatic brain injury.

Data availability statement

The descriptive and statistical data used to support the findings of this study are included within the article.

Disclosure of interest

The authors of this manuscript have declared there are no potential conflicts of interests in regard to the research, authorship, and publication of this article.

Additional information

Funding

This work was supported by the Office of the Assistant Secretary of Defense for Health Affairs through the Congressionally Directed Medical Research Program, Award #W81XWH-15-1-0032, and resources provided by the North Florida/South Georgia Veterans Health System, Gainesville, FL and the VA Center on Disability and Rehabilitation Research. The views expressed in this article are those of the authors and do not reflect the official policy or position of the Veteran’s Affairs Administration, Department of Defense, or the U.S. Government.

Notes on contributors

Sandra M. Winter

Sandra Winter, PhD, OTR/L is a Research Assistant Scientist in the Department of Occupational Therapy, Associate Director of the University of Florida’s Institute for Mobility, Activity, and Participation (I-MAP). Dr. Winter’s research focuses on community mobility and driver rehabilitation across the lifespan.

Katelyn R. Caldwell

Katelyn Caldwell, MOT graduated from University of Florida with her Bachelors’ in Health Science (BHS) in 2018 and her Masters’ in Occupational Therapy (MOT) in 2019. This publication is based partly on her BHS honors work.

Babette A. Brumback

Babette Brumback, Ph.D., is Professor and Associate Chair of the Department of Biostatistics at the University of Florida. Her research is focused on methods for longitudinal data analysis, causal modeling, bias adjustment, and analysis of data from complex sampling designs.

Mary E. Jeghers

Mary Jeghers, MSOT is a practicing occupational therapist and driving rehabilitation specialist, with interests in community mobility, prevention programs, and healthy aging throughout the lifespan. She graduated from Columbia University’s Masters of Science in Occupational Therapy program in 2016. She is a doctoral student in the Rehabilitation Science program at the University of Florida.

Sherrilene Classen

Sherrilene Classen, PhD, MPH, OTR/L, FAOTA, FGSA is Professor and Chair, Department of Occupational Therapy, University of Florida. Dr. Classen is an internationally funded prevention-oriented rehabilitation scientist who studies fitness-to-drive issues in at-risk drivers using clinical assessments, driving simulators, on-road assessments, and autonomous vehicles.