Transportation Research Part F 46 (2017) 462–476

Contents lists available at ScienceDirect

Transportation Research Part F

journal homepage: www.elsevier.com/locate/trf

Contextual Design for driving: Developing a trip-planning tool

for older adults
Rashmi P. Payyanadan ⇑, Madeleine Gibson, Erin Chiou, Mahtab Ghazizadeh, John D. Lee
Industrial and Systems Engineering Department, University of Wisconsin-Madison, United States

a r t i c l e i n f o a b s t r a c t

Article history: Independent living depends on mobility, and mobility depends on driving, particularly for
Received 1 January 2016 people 65 years and older. The longer older adults can safely drive, the longer they can
Received in revised form 29 June 2016 independently run errands, shop, exercise, and maintain social networks. Age-related
Accepted 26 August 2016
decline of perceptual, motor, and cognitive abilities can undermine the mobility and driv-
Available online 25 October 2016
ing safety of older drivers. Data from driving simulators, on-road tests, surveys, and crash
reports describe the driving safety and mobility challenges of older adults, but these meth-
Keywords:
ods offer a limited view of these challenges and fail to indicate design solutions. Contextual
Older adults
Contextual Design
Design—a combination of Contextual Inquiry interviews, model building, and affinity dia-
Navigation grams—offers a complementary approach to uncover challenges that older adult drivers’
Trip-planning experience. For two weeks, 39 drivers age 65 and above, had their vehicles instrumented
Route choice to collect driving and video data. Applying Contextual Design to these data showed that
Affinity diagram older drivers in urban and rural settings faced different mobility challenges and adopted
various strategies to mitigate risk: older drivers often involved their spouse or passenger
in the driving task, avoided certain driving maneuvers such as left turns, avoided unfamil-
iar or poorly lit roads at night, and planned trips to avoid risky driving situations.
Ridesharing and trip planning emerged as important strategies to improve the safety and
mobility of older drivers. Ridesharing could serve as a potential solution to prolong mobil-
ity; however, factors such as wait time, scheduling conflicts, costs, and trust were concerns
for older drivers. A paper prototype was developed to validate the driving challenges faced
by older drivers, and guide the development of a customized web-based trip-planning tool.
The trip-planning tool could help older drivers make safer route choices by offering routes
with fewer driving challenges, thereby enhancing their driving safety, mobility, and
independence.
Ó 2016 Elsevier Ltd. All rights reserved.

1. Introduction

From 2003 to 2013, the number of adults 65 and older in the U.S. increased from 35.9 million to 44.7 million, and is pro-
jected to more than double to 98 million by 2060 (Administration on Aging, 2014). This increase has led to a rise in the num-
ber of licensed older drivers, from 14% in 2000 to 16% in 2012 (TRIP, 2012). Along with this increase, the mobility patterns of
older drivers are also shifting. From 1990 to 2009, older drivers spent more time driving, made longer trips, and made greater
number of trips (Rosenbloom & Santos, 2014). This shift in driving patterns can be attributed to a number of factors such as

⇑ Corresponding author.
E-mail address: payyanadan@wisc.edu (R.P. Payyanadan).

http://dx.doi.org/10.1016/j.trf.2016.08.005
1369-8478/Ó 2016 Elsevier Ltd. All rights reserved.
 R.P. Payyanadan et al. / Transportation Research Part F 46 (2017) 462–476 463

older adults leading a more active lifestyle, with improved health care, education and higher income (TRIP, 2012), and an
increasing number of older adults remaining in the work force well after retirement age (Rosenbloom & Santos, 2014).
Ninety percent of trips taken by adults 65 and older, and 80% of trips taken by adults 85 and older are taken in the comfort
of a private vehicle (Rosenbloom, 2003), and so driving continues to play an important role in maintaining the mobility and
independence of older adults.
Given these trends, a major concern for the driving safety and continued mobility of older drivers is age-related decline in
various abilities. Reduced visual acuity is associated with difficulty driving at night and on high traffic roads, reduced con-
trast sensitivity is associated with difficulty making left turns, and reduced useful field of view is associated with difficulty
driving in the rain (McGwin, Chapman, & Owsley, 2000). More severely, ocular diseases such as cataract (Owsley, Stalvey,
Wells, & Sloane, 1999), bilateral glaucoma, and age-related macular degeneration have been associated with the decision
to cease driving (Ramulu, West, Munoz, Jampel, & Friedman, 2009). Decline in cognitive abilities, such as memory, processing
speed, and verbal reasoning (Anstey, Windsor, Luszcz, & Andrews, 2006), along with cognitive impairments associated with
physical decline (Marottoli et al., 1993) due to Parkinson’s disease, stroke (Campbell, Bush, & Hale, 1993), and dementia
(Lafont, Laumon, Helmer, Dartigues, & Fabrigoule, 2008) also result in the decision to cease driving. While these studies show
that age-related decline can result in older driver’s decision to cease driving; neurological disorders such as Alzheimer’s dis-
ease, epilepsy, stroke, vision disorders, rheumatoid arthritis, joint and movement-related disorders, that severely impair the
ability to drive safely, can result in drivers getting their license revoked (Charlton et al., 2010). Thus, when age-related
decline affects older adults’ ability to drive safely, they are faced with the decision to either reduce their driving exposure
or cease driving, both of which undermine their mobility.
Many older drivers with age-relate cognitive and physical decline continue to drive (Stutts, 1998). These older drivers
sometimes compensate by reducing their exposure to challenging driving situations (Baldock, Mathias, McLean, & Berndt,
2006). For example older adults with cataract regulate their driving exposure by driving fewer miles, at lower speeds,
and taking fewer trips (Owsley, McGwin, & Ball, 1998). Despite this compensation, serious impairment in contrast sensitivity
due to cataract is associated with elevated crash risk (Owsley, Stalvey, Wells, Sloane, & McGwin, 2001). Older drivers also
become increasing fragile with age, which contributes to having an injury rate 8–37 times that of 30–59 year old drivers
(Meuleners, Harding, Lee, & Legge, 2006), and accounts for 60–95% of the excess death rates per vehicle mile driven (Li,
Braver, & Chen, 2003).
Although the risk of fragility and age-related driving impairments pose obvious risks, reduced mobility has subtler, but
potentially graver consequences. Reduced mobility can increase social isolation, symptoms of depression, and healthcare
costs (Windsor, Anstey, Butterworth, Luszcz, & Andrews, 2007). In one study, the inability to drive reduced the number of
trips to the doctor by 15%, shopping trips by 59%, and trips to attend social, personal, and religious events by 65% (Baily,
2004). Older people who stopped driving were also three times more likely to use mental health care services than those
that continued to drive (Naumann, Dellinger, Anderson, Bonomi, & Rivara, 2012), and those who stopped driving or never
drove and did not have access to alternate transportation options, were also more likely to enter a long term care institution
(Freeman, Gange, Muñoz, & West, 2006). According to the Genworth Cost of Care Survey (2011), the national median cost of
assisted living is approximately $3450 per month ($41,400 annually) compared to $2000 per month ($24,000 annually) for
an older adult living independently. These outcomes indicate the importance of understanding and addressing the mobility
needs and driving challenges of older adults.
Studies have long used data from simulators, self-reports, crash reports, and on-road testing to define the driving safety
challenges faced by older adults. Simulator studies are conducted in a controlled environment and provide a safe, precise,
and cost-effective way of assessing the impact of age-related changes on driving performance, such as multi-tasking and
divided attention (Brouwer, Waterink, Van Wolffelaar, & Rothergatter, 1991), risk perception (Pradhan, Hammel,
Deramus, Pollatsek, & David, 2005), and response time to sudden driving events (Edwards & Creaser, 2003). Self-report sur-
veys collect information on driver’s crash history, attitudes, self-evaluated skills and beliefs, to examine the relationship
between medical conditions and at-fault crashes (Sims, Owsley, Allman, Ball, & Smoot, 1998), the relationship between driv-
ing confidence and driving capacity (Parker, Macdonald, Sutcliffe, & Rabbitt, 2001), the association between driving cessation
and depressive symptoms (Ragland, Satariano, & MacLeod, 2005), and the impact of health experience on self-regulation of
driving behavior (Sargent-Cox, Windsor, Walker, & Anstey, 2011). Studies using crash data provide an objective representa-
tion of safety-critical challenges, such as the over-representation of older drivers in left-turn crashes (Reinfurt, Stewart,
Stutts, & Rodgman, 2000). On-road tests have the advantage of collecting objective driving data in a representative context,
and can help assess the effect of visual impairment on sign detection, peripheral reaction time, travel time (Wood, 1999), and
driving safety (Wood, Anstey, Kerr, Lacherez, & Lord, 2008). As a specific example, on-road tests showed the effect of Parkin-
son’s disease among older adults on route following tasks, navigation, and on the frequency of safety-critical errors (Uc et al.,
2007).
Although simulators, self-report, crash studies, and on-road tests have provided much needed insights on driving safety,
they fall short of helping design for the safety and mobility challenges of older drivers. Simulator studies use pre-specified
scenarios, and hence cannot discover the challenging driving scenarios that occur during day-to-day driving. Simulator stud-
ies also fail to capture the strategies older adults develop to compensate for their impairments (Fisher, Rizzo, Caird, & Lee,
2011). Self-report studies rely on the ability of drivers to recall past events (Lajunen & Summala, 2003), and thus lack a
detailed description of driving situations, and context surrounding challenging driving situations. Crash data include a stan-
dard set of descriptive variables that describe the crash such as location, crash type, road environment, vehicle information,
464 R.P. Payyanadan et al. / Transportation Research Part F 46 (2017) 462–476

driver information, and injury severity (Kweon, 2011). But interpreting such data relative to exposure presents a challenge,
particularly because exposure changes as older drivers adapt to their limits. On-road testing enables behaviors to be
observed in context, but in many cases, testing can introduce behavior adjustments, such as the Hawthorne effect; where
being observed affects behavior (Hunt & Arbesman, 2008). In addition, on-road testing often prescribes routes that may
not capture important challenges faced by older drivers during navigation, or when unanticipated traffic and weather events
occur (Odenheimer et al., 1994). Thus, these methods fail to clearly identify challenges faced by older drivers, and provide
little indication of design solutions that might improve driving safety and mobility.
Contextual Design complements simulator studies, self-reports, crash data, and on-road tests, and provides a design-
oriented view of challenges faced by older drivers. Contextual Design incorporates ethnographic methods that provide a
detailed description of people’s behavior in its natural context, along with the underlying motivations and challenges asso-
ciated with the behavior (Beyer & Holtzblatt, 1997). Contextual Design is conducted in a series of steps: Contextual Inquiry,
work modeling, model consolidation, affinity diagram, visioning, storyboarding, user environment design, and prototyping.
Contextual Inquiry uses ethnographic techniques to observe what people do and what they care about. Five different work
models organize these observations – flow, sequence, artifacts, cultural and physical. Consolidating these work models, and
developing affinity diagrams reveal the structure of the work across the population, and guide system design. Visioning, sto-
ryboarding, and the user environment design are then used to develop a design solution, with the user environment design
defining the structure and flow between parts of the new system. Lastly, the design is validated by testing paper prototypes
of the proposed system with users before developing the final interactive prototype.
This paper uses Contextual Design to identify the challenges faced by older drivers, and determine what design interven-
tions might address these challenges and enhance their safety and mobility. Our approach to Contextual Design was mod-
ified to suit the driving domain: we instrumented the vehicles of older drivers and added a work model to describe drivers’
routes. We designed a web-based trip-planning tool as a safety and mobility enhancing intervention, by providing routes
with fewer driving challenges, such as reducing the number of left turns and U-turns, and avoiding construction zones
and detours.

2. Method

2.1. Sample population

Thirty-nine participants (65 years and older) were recruited from rural and urban settings in a Midwestern state in the
United States (Table 1). Some of the participants were spouses of other participants, who were included to understand how
passengers influenced driving behavior. The inclusion criteria required that all participants held a valid driver’s license, had
access to their own vehicle, and drove at least twice a week.

2.2. Study procedure

The Contextual Design process begins with Contextual Inquiry – an observation-based approach rooted in ethnography
(Beyer & Holtzblatt, 1997). However, observing and talking with people can be quite invasive and can interrupt safety-
sensitive tasks that require continuous attention, such as driving. As a consequence, the research team adapted the Contex-
tual Design process to the driving domain, as shown by Fig. 1. Specifically, we used video recordings of the drives, and asked
drivers to press a button when they encountered a challenging event while driving. These videos, and the segments associ-
ated with the button presses were used as prompts and context for the post-drive interviews.
The Contextual Design process integrates the observations using a set of standard work models. These models structure
the observations, and highlight challenges and design opportunities. The particular features of the driving domain high-
lighted the need for another work model—one that directly describes the navigation.

2.2.1. Data collection

Researchers met participants at their local senior centers to obtain consent, and instrument their vehicles with data recor-
ders for two weeks. The instrumentation consisted of a two-way facing camera, microphone for audio data, a button for dri-
vers to indicate challenging situations, and an OBD2 (on-board diagnostics) device to collect driving data. The button was
attached to the steering wheel of each participants’ vehicle (Fig. 2A). Participants were instructed to press the button after
a notable event, which could include particularly challenging or unforeseen events. When drivers pressed the button, it pro-

Table 1
Age, gender, and location of participants (N = 39).

Participants Age (standard deviation)

Urban Rural Urban Rural
Females 12 12 71.9 (5.1) 73.4 (6.2)
Males 6 9 79.5 (4.2) 77.1 (8.6)
 R.P. Payyanadan et al. / Transportation Research Part F 46 (2017) 462–476 465

Fig. 1. Comparison of the Contextual Design process by Beyer and Holtzblatt to the process adapted for driving.

Fig. 2. (A) Vehicle instrumentation consisting of a button press on the steering wheel, (B) two-way facing camera of the driver and the environment with
microphone for audio data, and (C) a data recording device placed under the driver seat.

vided a timestamp in the video recordings. The two-way facing camera and the microphone were installed behind the rear-
view mirror (Fig. 2B). The two-way facing camera recorded videos of both the driver and the driving environment. Data from
the camera, microphone, OBD2 device, and button press were recorded when the vehicle was turned on, and stored in a data
recording device placed under the drivers’ seat (Fig. 2C). Pictures of the vehicle interior were also taken to capture the arti-
facts that were used and stored in the participant’s vehicles.
After two weeks of data collection, post-drive interviews were conducted to review their driving experiences, focusing on
videos with button press events. Participants were asked to walk the research team through the videos to understand their
driving challenges, actions, and motivations. A customized software tool from Digital Artefacts LLC was used to play back the
video and data recordings synchronously. The software also mapped the route for each of the drives, and provided a location
marker that corresponded to the video frame (Fig. 3).

2.2.2. Data analysis and consolidation

After completing the post drive interviews, the research team reviewed all the videos. Excel spreadsheets were used to
record observations for each participant’s trips, including whom they travelled with, driving tasks conducted, challenges,
and events that occurred both inside and outside the vehicle during the drive. Once all the videos were reviewed, the
research team began data interpretation with model building and consolidation.
For each participant, the team built five work models: Flow, Sequence, Cultural, Artifact, and Physical model, as outlined
by the Contextual Design process (Beyer & Holtzblatt, 1997). After completing interpretation sessions for 11 participants
from rural and urban settings, no further themes were found, and the team concluded that data saturation was reached.
The type of routes participants drove, and trips that included multiple stops was an important task-related information that
was lost with the Beyer and Holtzblatt work models. Because the physical model was used to capture only the in-vehicle
environment, a new work model – Navigation was developed. The Navigation work model was represented on printed paper
maps (Fig. 4A) and helped capture information about the route driven, sequence of driving tasks, and challenges specific to
466 R.P. Payyanadan et al. / Transportation Research Part F 46 (2017) 462–476

Fig. 3. Custom software used to replay audio and video data for each drive with the driver, environment and GPS information. Button press events and
feedback from drivers’ during the post-drive interviews were annotated and shown as colored markers. (For interpretation of the references to color in this
figure legend, the reader is referred to the web version of this article.)

Fig. 4. (A) Example of the Navigation model representing a route driven by a participant to run errands, annotated with challenging driving situations along
the route. (B) The eight categories of the route specific information.

the route. This information was classified into eight categories and represented on the map using color-coded post-it notes:
breakdowns, driving strategies, road and weather conditions, passengers, origin and destination, route planning, construc-
tion, and quotables and notables (Fig. 4B). The six work models for all the participants were then consolidated to provide
a broad overview of the driving practices, strategies, challenges, and types of trips taken by older drivers.
Insights from the post drive interviews, videos, and work models were organized into affinity diagrams. Affinity diagrams
help define the key requirements for the system without losing individual variations (Beyer & Holtzblatt, 1997). Because par-
ticipants were recruited from different settings (urban and rural), the affinity diagram was built in two steps. First, separate
affinity diagrams were built for rural and urban settings. The rural and urban affinity diagrams were then consolidated into a
final wall-sized hierarchical diagram. For building the affinity diagram, insights were recorded on spreadsheets, printed, and
grouped into categories for each setting (Fig. 5A). For the consolidated affinity diagram, categories were color-coded to iden-
tify location (Fig. 5B). The final affinity diagram comprised of three levels of groupings (Fig. 5C).

2.2.3. Iterative design and understanding

A vision serves as a starting point that enables the team to build a story describing the new work practice enabled by
technology (Beyer & Holtzblatt, 1997, pp. 277). The final vision was implemented as storyboards. Storyboards show how
specific tasks will be accomplished with the new system (Beyer & Holtzblatt, 1997, pp. 287). To complete this step, the team
discussed characteristics and insights from the work models and affinity diagram that described participants’ driving chal-
lenges pertaining to the vision. The research team then brainstormed features and design solutions to build prototypes of the
vision.
 R.P. Payyanadan et al. / Transportation Research Part F 46 (2017) 462–476 467

Fig. 5. Building the affinity diagram. (A) Individual insights listed in spreadsheets were printed and cut into strips. (B) Colored post-it notes were used to
distinguish driving challenges specific to urban (orange) and rural (blue) settings. (C) The final affinity diagram organized the driving challenges into
hierarchical clusters. (For interpretation of the references to color in this figure legend, the reader is referred to the web version of this article.)

Features and design ideas were noted on post-it notes and grouped to form the User Experience Design (UED). The UED
was built in parallel with the storyboards as it allowed the research team to outline each feature associated with the vision,
determine how information from one feature flowed to another, and ensure that all the insights from the storyboards were
represented (Fig. 6A). From the UED, the research team created paper prototypes. The paper prototypes were hand drawn
using post-it notes, pencil, and markers as a low-fidelity testing tool for older drivers to experience and critique (Fig. 6B).
To evaluate the design, paper prototypes were tested with eight older drivers from rural and urban settings (Fig. 6C). To test
the prototypes, participants were asked to complete a set of predefined tasks. The research team noted instances that par-
ticipants found challenging while conducting the tasks using the paper prototypes, and used their feedback for the final pro-
totype design. The paper prototypes served as way of validating the driving challenges and preferences with the older
drivers. The final prototype design was implemented into a digital prototype using the rapid prototyping software,
JustinMind.

3. Findings

Thirty-nine adults 65 and older completed 1253 trips over a two-week period. Eighteen of them were from an urban set-
ting and twenty-one were from a rural setting. Older drivers in rural settings took trips that were 56% longer, and took 14%
more time compared to trips taken by older drivers living in urban settings (Table 2).

3.1. Videos, button press events, and post-drive interviews

For older drivers in both rural and urban settings, challenges commonly identified from the button press events involved
poor behavior of other drivers, such as being passed on the highway, drivers who failed to use turn signals, and drivers dis-
tracted by cell phone use. Other unsafe driving situations included making turns at uncontrolled intersections, merging and
changing lanes with limited time, and driving in construction zones, in poor weather conditions, and in heavy traffic.
In rural settings, older drivers faced additional challenges due to road infrastructure and limited access to transportation
alternatives. Older drivers in rural settings reported feeling unsafe driving on roads without shoulders, roads with animal
crossings, and on roads with roundabouts; as well as sharing roads with farm equipment and agricultural vehicles. Post-
drive interviews revealed that older drivers preferred to avoid these situations by driving during the day, during good
weather, and by selecting routes with little traffic.

Fig. 6. (A) Post-it notes from the UED were used to guide the design of the paper prototype. (B) Paper prototypes were built using sticky-notes, pencil, and
markers. (C) The paper prototype was tested on participants to receive feedback for the final prototype features and design.
468 R.P. Payyanadan et al. / Transportation Research Part F 46 (2017) 462–476

Table 2
Distribution of trips driven, distance, and travel time for rural and urban settings.

Setting Total trips driven Trips driven/day Average distance (miles) Average time (minutes)
Rural 720 2.4 8.78 16.01
Urban 533 2.1 5.62 14.07
Difference [95% CI] 0.3 [ 4, 4] 3.16 [2.27, 4.06] 1.94 [0.47, 3.41]

Table 3
Description and themes from the consolidated work models.

Work Description Themes

model
Flow Type of information exchanged between the Step-by-step navigation
driver and passenger
Driving task assistance from passengers Highlighting challenging driving situations to the driver
Driving familiar routes for common trips
Sequence Driving strategies to reduce risky situations Preparing for driving challenges related to the road infrastructure
Trip planning Preparing for road, weather, and traffic-related driving challenges
Order of trip errands Planning multiple stops
Artifact Tools used or modified while driving Reminders to aid with navigation (e.g., maps)
Appointment reminders in the vehicle
Cultural Social influences on the driver In urban settings, ride sharing, access to alternate transport, and aggressive driving
was common
In rural settings, courteousness to other road users was common. Ride sharing and
alternate transport was limited
Physical Use of the vehicle as a personal space Storing items of use (e.g., snacks, pet needs)
Navigation Route specific challenges Unanticipated problems during a frequently travelled route
Unfamiliar destination in a familiar area
Inadequate trip planning before departure

3.2. Work models and their consolidation

Data from the video, button press events, and post-drive interviews were entered into spreadsheets and used to develop
the six work models for each participant: Flow, Sequence, Artifact, Cultural, Physical, and Navigation. These work models
were consolidated to reveal patterns and themes that occurred across drivers (Table 3).
The Flow model revealed the driver’s interaction with the passenger, and the type of trips taken. Consolidation of the Flow
model showed that older drivers relied on the passenger to assist with particular driving tasks. For those who travelled with
their spouses, one spouse was considered as the more capable driver, and was designated the primary driver for most trips.
Spouses who travelled together, conducted tasks as a team such as planning the trip together before leaving, assisting the
driver by prompting in advance of a turn, checking the driver’s blind spots, carrying a copy of directions, reading directions,
and informing the driver of others on the road who were driving poorly. For those who drove with friends, consolidation
revealed that a major challenge was receiving assistance from the passenger, especially with navigation. The consolidated
Flow model showed that the common trips taken by older drivers were driving to their doctor’s appointment, grocery shop-
ping, meeting with friends and family, attending social events, and going to church. Challenges in conducting these activities
were especially high for older drivers with deteriorating health conditions, reduced confidence in their ability to drive safely
or at night, lack of access to public transportation, and lack of support from the community to receive transportation
assistance.
The Sequence model revealed strategies of older drivers for trip planning. Consolidation of the strategies helped under-
stand how older drivers commonly planned their trips for different driving situations and driving environments such as gro-
cery shopping or driving in bad weather. The consolidated Sequence model also revealed the order and resources needed for
planning trips before a drive, and the routines followed for running errands. For different driving situations, trips were
planned in advance by checking traffic and weather conditions for the day. For different driving environments, older drivers
adopted strategies to work around the driving environment constraints. For example, poor road infrastructure such as lack of
shoulders on the road made them feel unsafe, and poor sign placement and visibility was frustrating as it would cause them
to miss a turn, get lost, drive in unfamiliar areas, and increase the demand for attention on searching for road signage rather
than the driving task. Poorly lit roads led to fear of driving in unfamiliar areas at night. Those who drove alone often avoided
such situations by driving only during the day, avoiding weather conditions that reduced visibility, and keeping away from
construction zones with detours. Although night driving was not considered particularly difficult, older drivers felt more
comfortable driving at night if they had a spouse or passenger in the car. Trips to run errands often involved making multiple
stops per trip, which depended on the location, traffic, detours, parking, number and types of errands. Drivers planned multi-
stop trips to reduce the need for multiple trips. Common challenges that hindered trip planning and running errands were
 R.P. Payyanadan et al. / Transportation Research Part F 46 (2017) 462–476 469

forgetting to check the weather, misplacing navigation notes, forgetting the route to the destination, unfamiliarity with the
route, and new landmarks that could disorient them.
The Artifact model highlighted the tools used by older drivers to coordinate and complete their trips. The context and
intent of use of the artifacts were determined through the post-drive interviews. The consolidated Artifacts model revealed
that older drivers used artifacts such as post-it notes in the vehicle to serve as appointment reminders, navigational notes
were either printed or handwritten to help with directions, a calendar in the vehicle to help remind of the upcoming sched-
ule for the week, maps of frequently visited counties and cities to help with navigational challenges, and carrying personal
notebooks with important information such as phone numbers and addresses as a back-up plan in case they got lost (Fig. 7).
Common challenges included entering incorrect appointment information, misplacing reminders, forgetting to note the
reminders, carrying outdate maps that had missing streets or old street names, and following written directions or notes that
were illegible.
The Cultural model highlighted the driving practices, norms, influences, expectations, and pressures on older drivers.
Consolidation of the Cultural model revealed differences in the driving culture in rural and urban settings. Older drivers from
urban settings reported that aggressive driving was common, and drivers were less courteous to others on the road. In urban
settings ride sharing was uncommon, and older drivers expressed concerns about the cost, safety, and trust related to ride
sharing. The greatest advantage to living in an urban setting for older adults was the access and availability to alternate
transportation options. Older drivers in rural settings felt that drivers were courteous and ridesharing was common. But
older drivers in rural settings feared driving cessation because of the limited accessible alternate transportation options –
making driving a necessity for independent living.
The Physical model illustrated how the vehicle was used as a personal space. Older drivers used the vehicle as a space to
store items. For example, older adults with health conditions such as diabetes stored snacks in the car at all times. Older
adults who needed to visit the doctor or take their spouse to the doctor, regularly stored separate copies of calendars and
reminders of their scheduled visits in the car. Items that needed to be returned or transported such as groceries and library
books, along with items that allowed their pets to be transported to the vet or to the dog park, were also stored in the car. The
Physical model described the space within the vehicle, but an essential gap in understanding the mobility needs and chal-
lenges of older drivers was to understand the physical space associated with driving within a rural and urban setting. To
understand the larger physical environment in which driving occurred, a Navigation work model was developed.
The Navigation work model involved mapping the routes on printed maps and annotating the driving breakdowns, strate-
gies, road and weather conditions, passengers, origin and destination, route planning, construction zones, and quotables and
notables along the route. The Navigation model showed the relationship between multiple stops on a trip, and the sequence
of events that occurred along a trip. Fig. 8 shows an example of a Navigation model for a long distance drive to an unfamiliar
destination. This example exhibits each of the categories in the Navigation model, color-coded using post-it notes (as shown
in Fig. 4B), and labeled in parentheses in the following description.
In the Navigation model (Fig. 8), the driver was travelling to an unfamiliar destination. The driver printed out directions
before she began the trip (route planning) and left her home to pick up one of her friends (origin). It is a sunny day (weather
conditions) and the driver puts on sunglasses and moves the visor down (driving strategy). On the way to her friend’s house
she drove through a construction zone (construction), which required her to turn around and take a different route (break-
down). The driver reaches her friend’s house and her friend enters the vehicle (passenger). The driver pulls away from the
house and asks the passenger to find the directions she printed. As they are looking for the printed directions, the driver
misses the turn (breakdown). The passenger realizes they made the wrong turn and gives the driver directions needed to exit
the residential area (passenger). They are still unable to find the printed directions and decide to pull into an empty parking
lot to avoid making another wrong turn (driving strategy). The driver gets out of the car and finds the printed directions in the
back seat. The driver gives the passenger the directions and begins driving again. Throughout the trip, the driver asks the
passenger to read the directions, however the passenger struggles to read the directions because they are handwritten,
and hence difficult to follow (breakdown). Fortunately, the driver has travelled this route once before and is able to success-
fully navigate even when the passenger was not able to provide the needed information.
The consolidated Navigation model revealed three types of challenging trips: unanticipated problems during a frequently
travelled route, unfamiliar destination in a familiar area, and inadequate trip planning before departure. Unanticipated prob-
lems that occurred along frequently travelled routes included sudden onset of bad weather, heavy traffic, unpredictable
behavior of other drivers, and construction sites that required detours. The second type of challenging trip occurred for
drivers who volunteered for ridesharing programs, as first responders, and for meal deliveries. These activities typically

Fig. 7. Artifacts used by older drivers: post-it notes, personal diaries, calendars, phonebooks, and maps.
470 R.P. Payyanadan et al. / Transportation Research Part F 46 (2017) 462–476

Fig. 8. A Navigation model capturing information about the route driven by an older driver for a long distance trip to an unfamiliar destination. Map is
annotated with different driving situations using color-coded post-it notes. (For interpretation of the references to color in this figure legend, the reader is
referred to the web version of this article.)

required drivers to travel to unfamiliar destinations in familiar areas. For example, knowing the street but not the location of
a particular house. Strategies for locating the destination included driving up and down the street, calling someone at the
destination, or asking someone nearby for directions. The last type of challenging trip – inadequate trip planning before
departure – had the most difficulties. In these situations, older drivers either printed directions or studied a map before leav-
ing. However, they had difficulty following the printed directions, recalling the correct route, orienting themselves to land-
marks, and getting back to the route if they missed a turn. These three types of challenging trips and their associated
difficulties indicated what support a system must provide to make these trips less challenging.

3.3. Affinity diagram and common driving challenges

Affinity diagram brings together the challenges and preferences documented in the consolidated work models into a sin-
gle hierarchical diagram. The affinity diagram revealed five major groups of challenges and preferences of older drivers
(Fig. 9).
Relationship between the driver and passenger – The role and level of responsibility of the passenger depended on their
relationship with the driver. When the passenger was the spouse or a family member – they helped with trip planning, nav-
igating, driving, and served as a co-pilot and second eye during the trip, alerting the driver to possible risks on the road.
Friends and other passengers sometimes served as navigators.
Driving situations that resulted in unsafe driving behavior – Unsafe driving behaviors observed through the video recording
and from the post-drive responses from older drivers included taking their seatbelt off while driving to check their blind
spots, and while reversing the car due to limited range of motion. Other unsafe driving behaviors included speeding when
 R.P. Payyanadan et al. / Transportation Research Part F 46 (2017) 462–476 471

Fig. 9. Affinity diagram highlighting the driving challenges and preferences of older drivers.

entering the dilemma zone, running a red light, late braking at stop lights, and waiting longer at a four-way stop sign,
thereby missing their turn.
Planning trips – Long and short distance trip planning involved checking for traffic and weather updates, but each trip had
different trip planning needs. For long distance trips, older drivers checked the number of tolls along the way, set aside ade-
quate change for the toll, checked for restaurants to stop at for rest and refreshment, as well as motels or hotels that were
economical to stay at for the night. Time of departure was important for long distance trips to ensure adequate driving time
during daylight. But time to complete a trip was not a concern as most of the older drivers were retired and preferred to plan
trips that did not involve time constraints. For short distance trips, artifacts such as post-it notes, reminder notes, calendars,
and diaries were used to plan daily trips. As seen from the Sequence model, short distance trips often involved multiple stops
to run errands.
Driver strategies to enhance safety – Older adults used strategies and compensatory mechanisms to reduce risky driving
situations. These involved conducting only certain driving maneuvers, assessing the road infrastructure before driving,
and avoiding driving situations that could be unsafe.
Using driver support systems – Older drivers reported using driver support systems while driving. The most commonly
used driver support systems were GPS devices. However, use of such devices were not observed in the video recordings. Par-
ticipants reported using GPS devices when driving in unfamiliar areas or on long distance trips. GPS devices were not always
considered reliable, especially in rural settings, as many of the rural roads were not listed or updated on the GPS device.
Other driver support systems used by older drivers included cruise control, parking-assists, back-up sensors, blind-spot
detectors, and lane-change assists. Older adults reported using cruise control for long distance driving to reduce driver
472 R.P. Payyanadan et al. / Transportation Research Part F 46 (2017) 462–476

fatigue, maintain speed limit, and to improve fuel economy. Older drivers whose cars were equipped with back-up sensors,
blind-spot detectors, and lane-change assists revealed that these systems were useful because they made them feel safe
while driving, enabled them to be more aware of their driving environment, alert them to potential risks while driving,
and gave them a sense of control.

3.4. From model consolidation to system visions

The consolidated work models and affinity diagram produced two main visions. For older adults who did not have a
spouse to rely on for driving, or did not want to drive long distances, a community Ridesharing System was envisioned. To
support the role of the older driver in driving safely, and planning trips efficiently, a Trip-planning System was envisioned.
Ridesharing with members of the community would allow older adults to continue to have access to resources and their
community in the comfort of a personal vehicle. Whereas trip planning would support safer driving, and prolong the mobil-
ity of older drivers by helping them avoid unnecessary driving challenges. Although a community ridesharing service has the
potential to serve the mobility needs of older adults, an initial review of its feasibility revealed many drawbacks. Older dri-
vers in urban settings reported that existing ridesharing services were costly, and participating in ridesharing was not con-
sidered safe due to a lack of trust and fear of being taken advantage of by others. Other studies have reported similar findings
about ridesharing: fragmented, has limited availability, and expensive, particularly for rural residents (Papagiannakis &
Vitopoulou, 2015). Thus, we focused on building a trip-planning tool for older drivers.
Results from the data analysis, work models, and affinity diagram showed that older drivers preferred to plan their trips
based on the weather forecast, traffic congestion during a particular time of day, road conditions, and traffic incidents along a
route. They reported watching the local news, listening to the radio, and calling the sheriff’s office to obtain information
about the road conditions – especially for county roads. In addition, they used maps, landmarks, and printed directions to
aid navigation, preferred to take routes with the shortest time and distance, and avoided certain driving maneuvers such
as left turns and U-turns. Thus, we developed a trip-planning tool to mitigate driving challenges faced by older drivers.

3.5. Paper prototyping and testing

The trip-planning vision guided the development of storyboards and the User Environment Design (UED). Storyboards
defined what the trip-planning tool would be, and how it would be used (Beyer & Holtzblatt, 1997, pp. 287). The UED defined
the systems structure, organization of content, activities to be supported, and high-level functionality. Together, the story-
boards and the UED were used to produce a paper prototype of the trip-planning tool.
A trip-planning paper prototype was built using post-it notes and markers (Fig. 10). The research team categorized the
driving safety challenges, resources needed, and preferences of older drivers into two route options – Fastest and Fewest chal-
lenges route. The Fastest route option was defined as a route with the least travel time and distance from a specified origin to
destination. The Fewest challenges route option was defined as a route with the fewest number of left turns, U-turns, round-
abouts, traffic incidents, and lane closures from a specified origin to destination, with minimal cost to distance and time. To
use the trip-planning tool, users first enter their ‘to’ and ‘from’ address. The tool also allows users to plan for multiple stops
per trip by adding more than one destination. Once the information is entered, the tool provides the option to select the Fast-
est route or the route with the Fewest challenges. The tool then displays the preferred route on a map along with printable
directions, important landmarks, and alerts (Fig. 10A). The alerts highlight the driving challenges and preferences, such as
the number of left turns and U-turns, traffic incidents, lane closures, and construction zones along the route (Fig. 10B).
The map also displays traffic and weather conditions, with tips to avoid these challenges (Fig. 10C).
The paper prototype was tested with eight older drivers. Interview responses revealed that in addition to the features
represented in the paper prototype, older drivers also wanted information about travel time between origin and destination,
trip distance, option to avoid roundabouts, know alternate route options, and schedules of public transportation options.
Interview responses guided the refinement of the trip-planning tool, and validated the challenges and preferences. The final
paper prototype was then translated into a digital prototype.

3.6. A web-based trip-planning tool for older drivers

A digital trip-planning prototype was built using JustInMind. The prototype served as a platform to visualize the content,
labels, flow, and use of the trip-planning tool (Fig. 11). In the digital prototype, step numbers were used to guide the infor-
mation entry and navigation flow: step 1 – enter address, step 2 – select mode of transport, and step 3 – select route choice.
Content hierarchy was maintained by grouping information entry steps horizontally at the top of the page, and information
output at the bottom of the page. Based on the paper prototype feedback, clear delineation between information using lines,
shapes, and color was implemented.
Because Google Maps provides the fastest route between any given origin and destination, Google Maps API was used to
display the Fastest route option with navigation directions on the web-based trip-planning tool. Google Maps API also pro-
vides 3–8 alternate route options for any given origin and destination. These route alternatives were used to search for routes
with the fewest number of left turns, U-turns, traffic incidents, and lane closures. Google Maps does not report weather
alerts, traffic incidents and road conditions along routes. For real-time traffic incidents, construction zones, lane closures,
 R.P. Payyanadan et al. / Transportation Research Part F 46 (2017) 462–476 473

Fig. 10. Paper prototype of the trip-planning tool. (A) For a chosen origin and destination, a route with fewer driving challenges (left turns and U-turns),
traffic incidents, and lane closures is provided. (B) Alerts, challenges, and landmarks along the route are highlighted on the map and in the printable
directions. (C) Driving safety tips based on traffic and weather conditions.

weather alerts, and road conditions; data was obtained from the 511 live traffic report feed under agreement and licensing
approval from the Department of Transportation (DOT). This information was then aggregated to provide a route option with
the Fewest challenges.

4. Discussion and conclusion

Older drivers represent a rapidly growing segment of the driving population, both in terms of the number of licensed dri-
vers, and the number of miles driven per driver (Kerschner & Aizenberg, 2006). Consequently, it is critical to identify the driv-
ing challenges they face because understanding these challenges can help maintain the mobility and safety of older drivers.
We investigated these challenges using Contextual Design, which involved instrumenting vehicles to record and observe
how older people drive, post-drive discussion of their trips, and iterative development of a trip planning tool to address
the challenges. Contextual Design identified driving challenges older drivers face, and the strategies drivers used to over-
come these challenges. Contextual Design complements other approaches to identify driving challenges, such as simulators
and surveys, by capturing specific scenarios, and the rich context in which they occur.
Our application of Contextual Design revealed several major challenges related to navigation tasks, the driving task and
situation, and the road environment. Challenging navigational tasks occurred when drivers were unaware of the situation
along a route (high traffic, lane closures, construction zones, and traffic incidents), unfamiliar with the destination or the
route, causing them to get lost or miss a turn; and when they were not well prepared for the trip (forgetting the directions,
not checking the weather conditions, road conditions, and projected travel time in advance). A number of driving situations
(aggressive drivers on the road, tailgating, speeding, passing on the wrong side, near misses, forgetting to signal), and driving
tasks (taking left turns, U-turns, turning in uncontrolled intersections), made older drivers feel unsafe and less confident
about their driving. In addition, issues with the road environment (lack of signage, roads with no shoulders, and poorly-
lit roads) also made older drivers feel unsafe.
474 R.P. Payyanadan et al. / Transportation Research Part F 46 (2017) 462–476

Fig. 11. Digital prototype of the trip-planning tool.

To overcome these challenges, older drivers adopted various driving strategies. For older drivers who travelled with their
spouse, navigational tasks were planned out together before the trip. Similar to findings by Vrkljan and Polgar (2007), and
Bedard and Meyers (2004), the navigation task among older drivers in this study was conducted as a team task with the
spouse aiding in navigation, and alerting the driver to risky driving situations on the road. Navigational difficulties identified
through the post drive interviews were a result of unfamiliarity with the driving environment and unpreparedness for the
trip. Whereas other studies have shown that older drivers with decreased self-reported cognitive function and health factors,
primarily experienced navigation difficulties (Bryden, Charlton, Oxley, & Lowndes, 2013). To overcome navigational chal-
lenges, older drivers used maps, passenger guidance, handwritten directions, and navigation systems such as GPS devices.
To adapt to difficult driving situations such as aggressive driving, older drivers adjusted their driving behavior by chang-
ing lanes to prevent tailgating, and keeping a safe distance between other aggressive drivers on the road. Studies on aggres-
sive driving have shown that older drivers are more tolerant of aggressive drivers and adjust their driving behavior
accordingly than younger drivers in the same situation (Lajunen, Parker, & Stradling, 1998). Driving maneuvers such as left
turns, U-turns, and turning at intersections are known to be highly problematic for older drivers, and they are more likely to
be involved in crashes while conducting these maneuvers compared to younger drivers (Chandraratna & Stamatiadis, 2003).
The design of the road environment has also been shown to contribute to risky driving situations particularly for older dri-
vers (Fildes et al., 2000). To compensate for risky driving maneuvers and challenging road environments, older drivers self-
regulate their driving behavior by avoiding routes with many turns and uncontrolled intersections, and by avoiding driving
in unfamiliar areas and at night. Thus these findings complement results from simulator, self-reports, on-road tests, and
crash data studies by highlighting the processes by which older drivers make decisions based on their driving challenges
(Charlton et al., 2006; Kua, Korner-Bitensky, & Desrosiers, 2007; Owens, Wood, & Owens, 2007).
A number of the driving challenges were related to navigational difficulties, and avoiding particular driving maneuvers
and situations. Additionally, the work models and the affinity diagram showed that older adults tried to reduce their expo-
sure to risky driving situations by gathering trip information from different resources such as newspapers, news and weather
updates, and local traffic reports. From the contextual evidence, the research team designed and developed a customized
trip-planning tool for older drivers to help address their unique trip planning needs, and avoid risky driving situations.
Older drivers use online maps because they enable drivers to have more control over the routes they choose before their
trip (Emmerson, Guo, Blythe, Namdeo, & Edwards, 2013). A major drawback of the current online maps is that they do not
provide the level of information specific to the user’s needs and preferences (Dickerson et al., 2007). The trip-planning tool
potentially addresses the needs of older drivers by providing them with the option to choose the fastest and fewest challenges
route. Thus implementing Contextual Design as both a research and design method facilitated the translation of data to a
 R.P. Payyanadan et al. / Transportation Research Part F 46 (2017) 462–476 475

design opportunity to improve the mobility and safety of older drivers. No other method provides this perspective, which is
particularly useful in identifying the driving challenges faced by older adults. Findings from this study show how Contextual
Design can help understand the diverse mobility challenges faced by older adults.
Most mapping tools such as Google Maps, Yahoo! Maps, and MapQuest provide trip planning services. But to our knowl-
edge, this is the first study to develop a trip-planning tool specific to the driving safety needs and challenges of older drivers.
While this is an important contribution, a few limitations should be noted. Although the video and OBD2 data showed that
older drivers drove within the speed limit and wore their seatbelts, audio data revealed drivers conversing with passengers
about the camera in the car during their drives, and hence may have influenced the driving behavior outcomes. The use of
the button press to log driving events by older drivers, although considered an important part of the vehicle instrumentation,
proved to not be as useful. Placement of the button press on the steering wheel resulted in large number of false button
presses during certain driving maneuvers such as reversing and turning. The data was only collected for a period of two
weeks, which limits the generalizability of the study and does not capture seasonal changes in driving behavior.

Acknowledgements

The Agency for Healthcare Research and Quality is the primary funder of the study (grant 5P50HS019917-04). Epic Sys-
tems Corporation is a secondary funder. The authors would like to thank the Aging and Disability Resource Center (ADRC),
and the Center for Health Enhancement Systems Studies (CHESS), University of Wisconsin-Madison, Madison, WI 53706,
USA, for helping recruit the study participants. The authors would like to thank Digital Artefacts LLC for providing the cus-
tomized vehicle instrumentation devices for the study; Clifton Ratcliff for his insightful feedback, and the older adults who
have volunteered their time to participate in our study and provide valuable feedback.

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