Combat Veterans’ Strategies to Manage Risky Driving and Preferences for Driving Intervention

Combat veterans face an increased risk of motor vehicle crash leading to injury or death and have reported driving difficulty that affects their community reintegration (Plach & Sells, 2013). Both medical conditions and driving-related experiences are purported to underlie combat veterans’ driving difficulty (Lew et al., 2011; Possis et al., 2014). Understanding driving difficulty from the combat veterans’ point of view is essential for tailoring an intervention. As a part of a larger study testing an occupational therapy–based driving intervention (OT–DI), we examined combat veterans’ perspectives on driving. Our participants were returning combat veterans from conflicts in Iraq and Afghanistan with diagnoses of mild traumatic brain injury, posttraumatic stress disorder, or orthopedic injuries who also reported driving difficulty postdeployment. The moderated focus group addressed five themes: deployment training, deployment driving experiences, postdeployment driving experiences and challenges, strategies to manage driving behaviors, and preferences for intervention.

Combat veterans’ responses were transcribed and coded using thematic analysis. Combat veterans reported using combat-related tactics (driving close to other vehicles) during civilian driving in response to triggers (feeling followed by other drivers). They discussed the use of strategies such as self-talk to manage driving behaviors judged as unsafe. Overall, combat veterans expressed a preference for training with feedback from a driving rehabilitation specialist (simulator or on road).

Because these findings support the current intervention, the next steps are to determine the efficacy of the OT–DI in improving combat veterans’ simulated driving performance and tailoring additional simulator drives that address common triggers.

IMPACT STATEMENT: Our combat veteran respondents note the daily impact of driving difficulty on participation and community integration; tailored intervention has potential to address driving fitness.

References

Lew, H. L., Kraft, M., Pogoda, M. T., Amick, M. M., Woods, P., & Cifu, X. D. (2011). Prevalence and characteristics of driving difficulties in Operation Iraqi Freedom/ Operation Enduring Freedom combat returnees. Journal of Rehabilitation Research and Development, 48, 913–926.

Plach, H. L., & Sells, C. H. (2013). Occupational performance needs of young veterans. American Journal of Occupational Therapy, 67, 73–81. http://dx.doi.org/10.5014/ajot.2013.003871

Possis, E., Bui, T., Gavian, M., Leskela, J., Linardatos, E., Loughlin, J., & Strom, T. (2014). Driving difficulties among military veterans: Clinical needs and current intervention status. Military Medicine, 179, 633–639. http://dx.doi.org/10.7205/MILMED-D-13-00327