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Age-related declines can compromise older adults' abilities to drive safely. Researchers have promoted self-regulation as a positive approach that can balance the needs for mobility and safety. The lack of a theoretically-informed model of driving self-regulation inhibits our ability to understand and describe such complex process. This thesis contributes to the theoretical understanding of older drivers' self-regulation by examining the applicability of the Precaution Adoption Process Model in categorising older adults into different stages of behaviour change while capturing a wide range of interpersonal, intrapersonal, and environmental factors that influence self-regulatory driving behaviour.

Self-regulation of driving has been proposed as an effective strategy to keep older adults driving safely for longer. Little is known of what influences older adults’ decision to adopt self-regulatory driving behaviours. Hassan and colleagues (2015) developed an initial model of self-regulation using the Precaution Adoption Process Model (PAPM) as a theoretical framework. The present study aims to build on the previous research by investigating whether a sample of older drivers can accurately be assigned to the PAPM stages of change. Further, the study aims to identify the psychosocial and environmental factors associated with different stages of the PAPM and those that predict the decision to adopt self-regulatory behaviour. Logistic regression analysis indicated that self-rated driving confidence, family feedback, self-rated quality of driving and driving relinquishment expectation were significant predictors of PAPM stages. Findings from this research have practical and theoretical applications for improving our understanding of the self-regulatory behaviours of older drivers.

Background: Norway has achieved a noteworthy reduction in smoking prevalence over the past forty years. In 2015, 13% of Norwegians aged 13–74 smoked daily and a further 9% smoked occasionally. One of the objectives of the Norwegian 2013–16 national strategy for tobacco control is to achieve a reduction in the daily smoking prevalence to < 10% by 2016. This paper aims to estimate how long it will take for Norway to achieve the 10% smoking prevalence. Methods: A dynamic forecasting model using smoking prevalence data from national survey data on the prevalence of current, former and never smokers in the Norwegian population from 1985 to 2012 was used to estimate future smoking prevalence in the Norwegian population based on a continuation of current patterns in smoking cessation and initiation rates. Results: The result suggests that Norway’s smoking prevalence among men and women will continue to decline if current trends of smoking initiation and cessation continue. Our model predicts, based on figures for 1985–2012, that the prevalence of current daily and occasional smoking among men and women will not fall below the 10% mark until 2029 for men and 2026 for women, if current trends continue. Conclusion: Smoking is likely to remain an important public health issue in Norway for many years. New strategies are needed to accelerate the decline in smoking in Norway.

This study investigated driving reduction in a diverse sample of 229 male and female older drivers aged 70 years and above in Queensland, Australia. The study sought to determine whether differences existed between male and female older drivers in regard to driving patterns, and to identify factors that were predictive of driving reduction in female versus male older drivers. Participants provided information on their health, self-reported driving patterns, driving perceptions, alternative transport options, and feedback. Overall, females were more likely to avoid challenging situations but less likely to reduce their driving when compared to males. Self-rated health and driving confidence were significant predictors for driving reduction among females. For males, driving importance was the only significant predictor for driving reduction in this sample. This study indicates the need for longitudinal research on the process of driving reduction and whether the planning process for driving cessation differ between females and males.

Self-regulation is a coping strategy that allows older drivers to drive safely for longer. Self-regulation depends largely on the ability of drivers to evaluate their own driving. Therefore the success of self-regulation, in terms of driving safety, is influenced by the ability of older drivers to have insight into their declining driving performance. In addition, previous studies suggest that providing feedback to older adults regarding their driving skills may lead them to change their driving behaviour. However, little is currently known about the impact of feedback on older drivers’ self-awareness and their subsequent driving regulatory behaviour. This study explored the process of self-regulation and driving cessation among older drivers using the PAPM as a framework. It also investigated older adults’ perceptions and opinions about receiving feedback in regards to their driving abilities. Qualitative focus groups with 27 participants aged 70 years or more were conducted. Thematic analysis resulted in the development of five main themes; the meaning of driving, changes in driving pattern, feedback, the planning process, and solutions. The analysis also resulted in an initial model of driving self-regulation among older drivers that is informed by the current research and the Precaution Adoption Process Model as the theoretical framework. It identifies a number of social, personal, and environmental factors that can either facilitate or hinder people’s transition between stages of change. The findings from this study suggest that further elaboration of the PAPM is needed to take into account the role of insight and feedback on the process of self-regulation among older drivers.

1. Introduction The success of self-regulation, in terms of enhancing older drivers’ safety and maintaining their mobility, depends largely upon older drivers’ awareness of the declines in their driving abilities. Therefore, interventions targeted at increasing older drivers’ safety should aim to enhance their awareness of their physical, sensory and cognitive limitations. Moreover, previous research suggests that driving behaviour change may occur through stages and that interventions and feedback may be perceived differently at each stage. 2. Study aims To further understand the process of driving self-regulation among older adults by exploring their perceptions and experiences of self-regulation, using the PAPM as a framework. To investigate the possible impact of feedback on their driving on their decision making process. 3. Methodology Research tool: Qualitative focus groups (n=5 sessions) Recruitment: Posters, media, newspaper advertisement and emails Inclusion criteria: Aged 70 or more, English-speaking, current drivers Participants: Convenience sample of 27 men and women aged 74 to 90 in the Sunshine Coast and Brisbane city, Queensland, Australia. 4. Analysis Thematic analysis was conducted following the process outlined by Braun and Clarke (2006) to identify, analyse and report themes within the data. Four main themes were identified.