Oldest old's travel mode choice and new mobility technology acceptance: case in America and China.

Introduction: The oldest olds (aged 85 and over) are the fastest-growing age segment. However, our understanding of their mobility is limited. To address this gap, we invited 19 U.S. and 30 Chinese "oldest old" to take part in focus groups and complete a mobility questionnaire. We focus on travel mode choice, which includes changes in travel modes, frequency of usage, and perceptions of comfort. Methods: Older adults' familiarity and acceptance of new mobility technologies (e.g., ridesharing, carsharing, and autonomous vehicles) were measured by questionnaire and focus group. Word clouds were also used to illustrate people's reasons for choosing their primary mode of transportation. Results and discussion: The results show that both panels of older adults similarly feel some extent of travel limitations. But the responses among the two groups differ: 18 American participants chose "drive myself" as their primary option a decade ago, while 11 chose it now; no Chinese participants selected it either a decade ago or now. Both currently and 10 years ago, there was a significant difference in mode choice between participants in China and the United States. However, this gap has narrowed over the past decade. Participants in China have significantly changed their transportation preferences compared to 10 years ago, while participants in the US have remained nearly unchanged. American respondents consider "ease" as an important factor, while Chinese respondents pay more attention to "safety" and "no other option to get around" when making travel mode choices. Compared to Chinese participants, American participants were more comfortable with driving an autonomous vehicle. These differences may result from the various developmental stages and transportation policies of the two countries. This study supports the development of new mobility technologies for the oldest old to improve their quality of life.

An Intersectional Approach to Understanding the Psychological Health Effects of Combining Work and Parental Caregiving.

OBJECTIVES: Role theory suggests occupying simultaneous family caregiving and employment roles in midlife may exert positive and negative effects on psychological health. However, there is a lack of causal evidence examining the degree to which combinations of these roles influence psychological health at the intersection of gender and racial identity. METHODS: Longitudinal data from the Health and Retirement Study (2004-2018) are used to estimate a series of individual fixed effects models examining combinations of employment status and parental caregiving situation on Center for Epidemiological Studies-Depression Scale (CES-D) depression scores among Black and White men and women aged 50-65. Subsequent models were stratified by intensity of caregiving situation and work schedule. RESULTS: Individual fixed effects models demonstrate combining work, and parental caregiving is associated with greater depressive symptoms than only working, and with lower depressive symptoms than only caregiving, suggesting that paid employment exerts a protective effect on psychological health whereas parental caregiving may be a risk factor for depressive symptoms in later life. Analyses using an intersectional lens found that combining paid work with parental caregiving exerted a protective effect on CES-D scores among White women and men regardless of participants' intensity of care situation or work schedule. This effect was not present for Black men and women. DISCUSSION: Accounting for intersectionality is imperative to research on family caregiving, work, and psychological health.

Non-task expert physicians benefit from correct explainable AI advice when reviewing X-rays.

Artificial intelligence (AI)-generated clinical advice is becoming more prevalent in healthcare. However, the impact of AI-generated advice on physicians' decision-making is underexplored. In this study, physicians received X-rays with correct diagnostic advice and were asked to make a diagnosis, rate the advice's quality, and judge their own confidence. We manipulated whether the advice came with or without a visual annotation on the X-rays, and whether it was labeled as coming from an AI or a human radiologist. Overall, receiving annotated advice from an AI resulted in the highest diagnostic accuracy. Physicians rated the quality of AI advice higher than human advice. We did not find a strong effect of either manipulation on participants' confidence. The magnitude of the effects varied between task experts and non-task experts, with the latter benefiting considerably from correct explainable AI advice. These findings raise important considerations for the deployment of diagnostic advice in healthcare.

Do as AI say: susceptibility in deployment of clinical decision-aids.

Artificial intelligence (AI) models for decision support have been developed for clinical settings such as radiology, but little work evaluates the potential impact of such systems. In this study, physicians received chest X-rays and diagnostic advice, some of which was inaccurate, and were asked to evaluate advice quality and make diagnoses. All advice was generated by human experts, but some was labeled as coming from an AI system. As a group, radiologists rated advice as lower quality when it appeared to come from an AI system; physicians with less task-expertise did not. Diagnostic accuracy was significantly worse when participants received inaccurate advice, regardless of the purported source. This work raises important considerations for how advice, AI and non-AI, should be deployed in clinical environments.

Hardly Silent: Exploring Civic Engagement and Participation among a Panel of Adults Ages 85.

The past twenty years have seen a surge of resources for and public attention devoted to civic participation opportunities for older adults in the United States. At the same time, technology has transformed the way information related to political and social issues is spread and shared. As more older adults migrate to using a wider range of communication tools and the internet, technology-mediated forms of engagement represent a new way for the oldest old to participate in society. In this study, a panel of adults ages 85 and older was surveyed to understand their experiences engaging with political and social issues. Responses to a questionnaire (N = 24) and focus groups (n = 22) indicate the oldest old are interested in social and political issues, and there are opportunities for technology to facilitate the oldest olds' civic and political action. This study identifies roles social workers may play in helping the oldest old engage with social and political issues in their communities.

Reducing Isolation and Loneliness Through Membership in a Fitness Program for Older Adults: Implications for Health.

Objectives: To explore the effects of membership in a fitness program for older adults on social isolation, loneliness, and health. Method: Using survey responses from SilverSneakers members and matched nonmembers, regression path analysis was used to examine the influence of SilverSneakers membership on physical activity, social isolation, loneliness, and health, and the interrelationships among these concepts. Results: SilverSneakers membership directly increased physical activity and self-rated health, directly decreased social isolation, and indirectly decreased loneliness. Decreased social isolation and loneliness were associated with better self-rated health: social isolation and loneliness had independent direct effects on health, while social isolation also had an indirect effect on health mediated through loneliness. Discussion: Members of SilverSneakers experienced better health through increased physical activity, reduced social isolation, and reduced loneliness. Future research should explore independent effects of social isolation and loneliness on health and the mechanisms by which membership reduces social isolation and loneliness.

The Influence of Feelings While Driving Regular Cars on the Perception and Acceptance of Self-Driving Cars.

Self-driving vehicles will affect the future of transportation, but factors that underlie perception and acceptance of self-driving cars are yet unclear. Research on feelings as information and the affect heuristic has suggested that feelings are an important source of information, especially in situations of complexity and uncertainty. In this study (N = 1,484), we investigated how feelings related to traditional driving affect risk perception, benefit perception, and trust related to self-driving cars as well as people's acceptance of the technology. Due to limited experiences with and knowledge of self-driving cars, we expected that feelings related to a similar experience, namely, driving regular cars, would influence judgments of self-driving cars. Our results support this assumption. While positive feelings of enjoyment predicted higher benefit perception and trust, negative affect predicted higher risk and higher benefit perception of self-driving cars. Feelings of control were inversely related to risk and benefit perception, which is in line with research on the affect heuristic. Furthermore, negative affect was an important source of information for judgments of use and acceptance. Interest in using a self-driving car was also predicted by lower risk perception, higher benefit perception, and higher levels of trust in the technology. Although people's individual experiences with advanced vehicle technologies and knowledge were associated with perceptions and acceptance, many simply have never been exposed to the technology and know little about it. In the absence of this experience or knowledge, all that is left is the knowledge, experience, and feelings they have related to regular driving.

Relationships Between Older Drivers' Cognitive Abilities as Assessed on the MoCA and Glance Patterns During Visual-Manual Radio Tuning While Driving.

Objective: Research has established that long off-road glances increase crash risk, and other work has shown increased off-road glance behavior in older drivers. This study investigated the relationship between older drivers' (M = 66.3, range 61-69 years) cognitive abilities and the duration of off-road glances while engaged in secondary visual-manual activities. Method: Twenty-two drivers completed the Montreal Cognitive Assessment (MoCA) prior to driving an instrumented vehicle and completing a set of radio-tuning tasks. Glance behavior was recorded and manually coded into 7 glance regions (toward the forward roadway, instrument cluster, center stack, rearview mirror, left, right, and other). Results: On average, older drivers with higher MoCA scores used shorter glances and glanced away from the forward roadway for less total time when manually tuning the radio. Discussion: These findings suggest that lower MoCA scores may represent a driving force behind the "age" differences reported in earlier studies of off-road glance behavior. Questions are raised concerning the identification of MoCA scores that might be used as inclusion cut-points in driving research and in identifying individuals needing further evaluation related to suitability for continuance of driving.

Walking a mile in another's shoes: The impact of wearing an Age Suit.

The "Age Suit" described in this article was developed to enable future designers, business leaders, and engineers to experience navigating the world as many older adults must. Tools such as this Age Suit offer the opportunity to "walk a mile" in another's shoes to develop empathy that can result in better design of spaces, goods, and services to meet the needs of a rapidly growing older population. This work first examined, through a series of clinical tests, whether younger adults' physical capacities were reduced in a direction consistent with aging by wearing a suit developed by the MIT AgeLab. An experiential learning task was then completed with the suit to understand its impact on completion of an instrumental activity of daily living. Results showed that younger adults wearing the suit experienced changes in task performance consistent with expected changes associated with aging. Participants' self-reports from the experiential learning task indicated that they were able to empathize with older adults regarding some issues they face while completing a grocery shopping task. Future research with the suit should involve a wider range of individuals from the population and examine what effect participants' levels of fitness have on the experience of wearing the suit.

Utilising psychophysical techniques to investigate the effects of age, typeface design, size and display polarity on glance legibility.

Psychophysical research on text legibility has historically investigated factors such as size, colour and contrast, but there has been relatively little direct empirical evaluation of typographic design itself, particularly in the emerging context of glance reading. In the present study, participants performed a lexical decision task controlled by an adaptive staircase method. Two typefaces, a 'humanist' and 'square grotesque' style, were tested. Study I examined positive and negative polarities, while Study II examined two text sizes. Stimulus duration thresholds were sensitive to differences between typefaces, polarities and sizes. Typeface also interacted significantly with age, particularly for conditions with higher legibility thresholds. These results are consistent with previous research assessing the impact of the same typefaces on interface demand in a simulated driving environment. This simplified methodology of assessing legibility differences can be adapted to investigate a wide array of questions relevant to typographic and interface designs. Practitioner Summary: A method is described for rapidly investigating relative legibility of different typographical features. Results indicate that during glance-like reading induced by the psychophysical technique and under the lighting conditions considered, humanist-style type is significantly more legible than a square grotesque style, and that black-on-white text is significantly more legible than white-on-black.

A field study on the effects of digital billboards on glance behavior during highway driving.

Developments in lighting technologies have allowed more dynamic digital billboards in locations visible from the roadway. Decades of laboratory research have shown that rapidly changing or moving stimuli presented in peripheral vision tends to 'capture' covert attention. We report naturalistic glance and driving behavior of a large sample of drivers who were exposed to two digital billboards on a segment of highway largely free from extraneous signage. Results show a significant shift in the number and length of glances toward the billboards and an increased percentage of time glancing off road in their presence. Findings were particularly evident at the time the billboards transitioned between advertisements. Since rapidly changing stimuli are difficult to ignore, the planned increase in episodically changing digital displays near the roadway may be argued to be a potential safety concern. The impact of digital billboards on driver safety and the need for continued research are discussed.

Reductions in self-reported stress and anticipatory heart rate with the use of a semi-automated parallel parking system.

Drivers' reactions to a semi-autonomous technology for assisted parallel parking system were evaluated in a field experiment. A sample of 42 drivers balanced by gender and across three age groups (20-29, 40-49, 60-69) were given a comprehensive briefing, saw the technology demonstrated, practiced parallel parking 3 times each with and without the assistive technology, and then were assessed on an additional 3 parking events each with and without the technology. Anticipatory stress, as measured by heart rate, was significantly lower when drivers approached a parking space knowing that they would be using the assistive technology as opposed to manually parking. Self-reported stress levels following assisted parks were also lower. Thus, both subjective and objective data support the position that the assistive technology reduced stress levels in drivers who were given detailed training. It was observed that drivers decreased their use of turn signals when using the semi-autonomous technology, raising a caution concerning unintended lapses in safe driving behaviors that may occur when assistive technologies are used.

Assessing the impact of typeface design in a text-rich automotive user interface.

Text-rich driver-vehicle interfaces are increasingly common in new vehicles, yet the effects of different typeface characteristics on task performance in this brief off-road based glance context remains sparsely examined. Subjects completed menu selection tasks while in a driving simulator. Menu text was set either in a 'humanist' or 'square grotesque' typeface. Among men, use of the humanist typeface resulted in a 10.6% reduction in total glance time as compared to the square grotesque typeface. Total response time and number of glances showed similar reductions. The impact of typeface was either more modest or not apparent for women. Error rates for both males and females were 3.1% lower for the humanist typeface. This research suggests that optimised typefaces may mitigate some interface demands. Future work will need to assess whether other typeface characteristics can be optimised to further reduce demand, improve legibility, increase usability and help meet new governmental distraction guidelines. Practitioner Summary: Text-rich in-vehicle interfaces are increasingly common, but the effects of typeface on task performance remain sparsely studied. We show that among male drivers, menu selection tasks are completed with 10.6% less visual glance time when text is displayed in a 'humanist' typeface, as compared to a 'square grotesque'.

Impact of age and cognitive demand on lane choice and changing under actual highway conditions.

Previous research suggests that drivers change lanes less frequently during periods of heightened cognitive load. However, lane changing behavior of different age groups under varying levels of cognitive demand is not well understood. The majority of studies which have evaluated lane changing behavior under cognitive workload have been conducted in driving simulators. Consequently, it is unclear if the patterns observed in these simulation studies carry over to actual driving. This paper evaluates data from an on-road study to determine the effects of age and cognitive demand on lane choice and lane changing behavior. Three age groups (20-29, 40-49, and 60-69) were monitored in an instrumented vehicle. The 40's age group had 147% higher odds of exhibiting a lane change than the 60's group. In addition, drivers in their 60's were less likely to drive on the leftmost lane compared to drivers in their 20's and 40's. These results could be interpreted as evidence that older adults adopt a more conservative driving style as reflected in being less likely to choose the leftmost lane than the younger groups and less likely to change lanes than drivers in their 40's. Regardless of demand level, cognitive workload reduced the frequency of lane changes for all age groups. This suggests that in general drivers of all ages attempt to regulate their behavior in a risk reducing direction when under added cognitive demand. The extent to which such self-regulation fully compensates for the impact of added cognitive demand remains an open question.

Self-reported and observed risky driving behaviors among frequent and infrequent cell phone users.

The apparently higher crash risk among individuals who use cell phones while driving may be due both to the direct interference of cell phone use with the driving task and tendencies to engage in risky driving behaviors independent of cell phone use. Measurements of actual highway driving performance, self-reported aberrant driving behaviors as measured by the Manchester Driver Behavior Questionnaire (DBQ), and attitudes toward speeding, passing behaviors and relative concern about being involved in a crash were assessed. Individuals who reported frequently using cell phones while driving were found to drive faster, change lanes more frequently, spend more time in the left lane, and engage in more instances of hard braking and high acceleration events. They also scored higher in self-reported driving violations on the DBQ and reported more positive attitudes toward speeding and passing than drivers who did not report using a cell phone regularly while driving. These results indicate that a greater reported frequency of cell phone use while driving is associated with a broader pattern of behaviors that are likely to increase the overall risk of crash involvement.

Sensitivity of physiological measures for detecting systematic variations in cognitive demand from a working memory task: an on-road study across three age groups.

OBJECTIVE: To assess the sensitivity of two physiological measures for discriminating between levels of cognitive demand under driving conditions across different age groups. BACKGROUND: Previous driving research presents a mixed picture concerning the sensitivity of physiological measures for differentiating tasks with presumed differences in mental workload. METHOD: A total of 108 relatively healthy drivers balanced by gender and across three age groups (20-29, 40-49, 60-69) engaged in three difficulty levels of an auditory presentation-verbal response working memory task. RESULTS: Heart rate and skin conductance level (SCL) both increased in a statistically significant fashion with each incremental increase in cognitive demand, whereas driving performance measures did not provide incremental discrimination. SCL was lower in the 40s and 60s age groups; however, the pattern of incremental increase with higher demand was consistent for heart rate and SCL across all age groups. Although each measure was quite sensitive at the group level, considering both SCL and heart rate improved detection of periods of heightened cognitive demand at the individual level. CONCLUSION: The data provide clear evidence that two basic physiological measures can be utilized under field conditions to differentiate multiple levels of objectively defined changes in cognitive demand. Methodological considerations, including task engagement, may account for some of the inconsistencies in previous research. APPLICATION: These findings increase the confidence with which these measures may be applied to assess relative differences in mental workload when developing and optimizing human machine interface (HMI) designs and in exploring their potential role in advanced workload detection and augmented cognition systems.

A field study on the impact of variations in shortterm memory demands on drivers' visual attention and driving performance across three age groups.

OBJECTIVE: The aim of this study was to assess sensitivity of visual attention and driving performance for detecting changes in driver cognitive workload across different age groups. BACKGROUND: The literature shows mixed results concerning the sensitivity of gaze concentration metrics to variations in cognitive demand. No studies appear showing how age affects gaze allocation during cognitive demand. METHOD: Recordings of drivers' gaze and driving performance by individuals in their 20s, 40s, and 60s were captured in actual driving conditions during three levels of cognitive demand. RESULTS: Gaze concentration increased with task difficulty through the low and moderate levels of demand and then appeared to level out at the high demand level. At the moderate difficulty level, gaze concentration increased by 2.4 cm (approximately 2 degrees) from the reference period. The degree of gaze concentration with added cognitive demand is not related to age in the relatively healthy drivers studied. Driving performance measures did not show a consistent relationship with the objective demand level. CONCLUSION: Gaze concentration appears at low levels of cognitive demand prior to the appearance of marked decrements in driving control. There is no compelling evidence from this study that driving performance measures can be used to index differences in workload prior to capacity saturation. APPLICATION: Drivers' awareness of vehicle surroundings is incrementally affected by increases in cognitive demand. Developers of more advanced driver support systems should consider gaze concentration as a measure of driver cognitive workload. This recommendation is particularly relevant in light of the added benefits of gaze measurements for detecting visual demand.

Walking the tightrope: developing a systems approach to balance safety and mobility for an aging society.

In an aging population, safety and mobility are often viewed as being in conflict, when in fact they are two values that must be reflected equally in transportation policy. The challenge for policy makers and for society is to emphasize and optimize both. To achieve this, a comprehensive systems approach to driver health, personal decision-making and planning, community and transportation systems construction, vehicle design, and licensing regulations is needed. Such an approach requires crafting policies based on conceptualizing the issue as a continuum of resources facilitating safety and mobility regardless of driving status. The discussion that follows reviews components of the issue and suggestions for developing a comprehensive approach.