A multicomponent structured health behaviour intervention to improve physical activity in long-distance HGV drivers: the SHIFT cluster RCT
Background: Long-distance heavy goods vehicle drivers are exposed to a multitude of risk factors associated with their occupation. The working environment of heavy goods vehicle drivers provides limited opportunities for a healthy lifestyle, and, consequently, heavy goods vehicle drivers exhibit hig...
| Main Authors: | , , , , , , , , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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NIHR Journals Library
2022-11-01
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| Series: | Public Health Research |
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| Online Access: | https://doi.org/10.3310/PNOY9785 |
| _version_ | 1811212931874947072 |
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| author | Stacy A Clemes Veronica Varela-Mato Danielle H Bodicoat Cassandra L Brookes Yu-Ling Chen Edward Cox Charlotte L Edwardson Laura J Gray Amber Guest Vicki Johnson Fehmidah Munir Nicola J Paine Gerry Richardson Katharina Ruettger Mohsen Sayyah Aron Sherry Ana Suazo Di Paola Jacqui Troughton Simon Walker Thomas Yates James King |
| author_facet | Stacy A Clemes Veronica Varela-Mato Danielle H Bodicoat Cassandra L Brookes Yu-Ling Chen Edward Cox Charlotte L Edwardson Laura J Gray Amber Guest Vicki Johnson Fehmidah Munir Nicola J Paine Gerry Richardson Katharina Ruettger Mohsen Sayyah Aron Sherry Ana Suazo Di Paola Jacqui Troughton Simon Walker Thomas Yates James King |
| author_sort | Stacy A Clemes |
| collection | DOAJ |
| description | Background: Long-distance heavy goods vehicle drivers are exposed to a multitude of risk factors associated with their occupation. The working environment of heavy goods vehicle drivers provides limited opportunities for a healthy lifestyle, and, consequently, heavy goods vehicle drivers exhibit higher than nationally representative rates of obesity and obesity-related comorbidities, and are underserved in terms of health promotion initiatives. Objective: The aim of this trial was to test the effectiveness and cost-effectiveness of the multicomponent Structured Health Intervention For Truckers (SHIFT) programme, compared with usual care, at both 6 months and 16–18 months. Design: A two-arm cluster randomised controlled trial, including a cost-effectiveness analysis and process evaluation. Setting: Transport depots throughout the Midlands region of the UK. Participants: Heavy goods vehicle drivers. Intervention: The 6-month SHIFT programme included a group-based interactive 6-hour education session, health coach support and equipment provision [including a Fitbit® (Fitbit Inc., San Francisco, CA, US) and resistance bands/balls to facilitate a ‘cab workout’]. Clusters were randomised following baseline measurements to either the SHIFT arm or the control arm. Main outcome measures: Outcome measures were assessed at baseline, with follow-up assessments occurring at both 6 months and 16–18 months. The primary outcome was device-measured physical activity, expressed as mean steps per day, at 6-month follow-up. Secondary outcomes included device-measured sitting, standing, stepping, physical activity and sleep time (on any day, workdays and non-workdays), along with adiposity, biochemical measures, diet, blood pressure, psychophysiological reactivity, cognitive function, functional fitness, mental well-being, musculoskeletal symptoms and work-related psychosocial variables. Cost-effectiveness and process evaluation data were collected. Results: A total of 382 participants (mean ± standard deviation age: 48.4 ± 9.4 years; mean ± standard deviation body mass index: 30.4 kg/m2 ± 5.1 kg/m2; 99% male) were recruited across 25 clusters. Participants were randomised (at the cluster level) to either the SHIFT arm (12 clusters, n = 183) or the control arm (13 clusters, n = 199). At 6 months, 209 (54.7%) participants provided primary outcome data. Significant differences in mean daily steps were found between arms, with participants in the SHIFT arm accumulating 1008 more steps per day than participants in the control arm (95% confidence interval 145 to 1871 steps; p = 0.022), which was largely driven by the maintenance of physical activity levels in the SHIFT arm and a decline in physical activity levels in the control arm. Favourable differences at 6 months were also seen in the SHIFT arm, relative to the control arm, in time spent sitting, standing and stepping, and time in moderate or vigorous activity. No differences between arms were observed at 16–18 months’ follow-up. No differences were observed between arms in the other secondary outcomes at either follow-up (i.e. 6 months and 16–18 months). The process evaluation demonstrated that the intervention was well received by participants and that the intervention reportedly had a positive impact on their health behaviours. The average total cost of delivering the SHIFT programme was £369.57 per driver, and resulting quality-adjusted life-years were similar across trial arms (SHIFT arm: 1.22, 95% confidence interval 1.19 to 1.25; control arm: 1.25, 95% confidence interval 1.22 to 1.27). Limitations: A higher (31.4%) than anticipated loss to follow-up was experienced at 6 months, with fewer (54.7%) participants providing valid primary outcome data at 6 months. The COVID-19 pandemic presents a major confounding factor, which limits our ability to draw firm conclusions regarding the sustainability of the SHIFT programme. Conclusion: The SHIFT programme had a degree of success in positively impacting physical activity levels and reducing sitting time in heavy goods vehicle drivers at 6-months; however, these differences were not maintained at 16–18 months. Future work: Further work involving stakeholder engagement is needed to refine the content of the programme, based on current findings, followed by the translation of the SHIFT programme into a scalable driver training resource. Trial registration: This trial is registered as ISRCTN10483894. Funding: This project was funded by the National Institute for Health and Care Research (NIHR) Public Health Research programme and will be published in full in Public Health Research; Vol. 10, No. 12. See the NIHR Journals Library website for further project information. |
| first_indexed | 2024-04-12T05:37:47Z |
| format | Article |
| id | doaj.art-716c01b4acb946ee93cffd008a082c36 |
| institution | Directory Open Access Journal |
| issn | 2050-4381 2050-439X |
| language | English |
| last_indexed | 2024-04-12T05:37:47Z |
| publishDate | 2022-11-01 |
| publisher | NIHR Journals Library |
| record_format | Article |
| series | Public Health Research |
| spelling | doaj.art-716c01b4acb946ee93cffd008a082c362022-12-22T03:45:46ZengNIHR Journals LibraryPublic Health Research2050-43812050-439X2022-11-01101210.3310/PNOY978515/190/42A multicomponent structured health behaviour intervention to improve physical activity in long-distance HGV drivers: the SHIFT cluster RCTStacy A Clemes0Veronica Varela-Mato1Danielle H Bodicoat2Cassandra L Brookes3Yu-Ling Chen4Edward Cox5Charlotte L Edwardson6Laura J Gray7Amber Guest8Vicki Johnson9Fehmidah Munir10Nicola J Paine11Gerry Richardson12Katharina Ruettger13Mohsen Sayyah14Aron Sherry15Ana Suazo Di Paola16Jacqui Troughton17Simon Walker18Thomas Yates19James King20School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UKSchool of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UKIndependent researcher, Leicester, UKLeicester Clinical Trials Unit, University of Leicester, Leicester, UKSchool of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UKCentre for Health Economics, University of York, York, UKNational Institute for Health and Care Research Leicester Biomedical Research Centre, Leicester, UKDepartment of Health Sciences, University of Leicester, Leicester, UKSchool of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UKLeicester Diabetes Centre, University Hospitals of Leicester NHS Trust, Leicester, UKSchool of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UKSchool of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UKCentre for Health Economics, University of York, York, UKSchool of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UKSchool of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UKSchool of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UKLeicester Clinical Trials Unit, University of Leicester, Leicester, UKLeicester Diabetes Centre, University Hospitals of Leicester NHS Trust, Leicester, UKCentre for Health Economics, University of York, York, UKNational Institute for Health and Care Research Leicester Biomedical Research Centre, Leicester, UKSchool of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UKBackground: Long-distance heavy goods vehicle drivers are exposed to a multitude of risk factors associated with their occupation. The working environment of heavy goods vehicle drivers provides limited opportunities for a healthy lifestyle, and, consequently, heavy goods vehicle drivers exhibit higher than nationally representative rates of obesity and obesity-related comorbidities, and are underserved in terms of health promotion initiatives. Objective: The aim of this trial was to test the effectiveness and cost-effectiveness of the multicomponent Structured Health Intervention For Truckers (SHIFT) programme, compared with usual care, at both 6 months and 16–18 months. Design: A two-arm cluster randomised controlled trial, including a cost-effectiveness analysis and process evaluation. Setting: Transport depots throughout the Midlands region of the UK. Participants: Heavy goods vehicle drivers. Intervention: The 6-month SHIFT programme included a group-based interactive 6-hour education session, health coach support and equipment provision [including a Fitbit® (Fitbit Inc., San Francisco, CA, US) and resistance bands/balls to facilitate a ‘cab workout’]. Clusters were randomised following baseline measurements to either the SHIFT arm or the control arm. Main outcome measures: Outcome measures were assessed at baseline, with follow-up assessments occurring at both 6 months and 16–18 months. The primary outcome was device-measured physical activity, expressed as mean steps per day, at 6-month follow-up. Secondary outcomes included device-measured sitting, standing, stepping, physical activity and sleep time (on any day, workdays and non-workdays), along with adiposity, biochemical measures, diet, blood pressure, psychophysiological reactivity, cognitive function, functional fitness, mental well-being, musculoskeletal symptoms and work-related psychosocial variables. Cost-effectiveness and process evaluation data were collected. Results: A total of 382 participants (mean ± standard deviation age: 48.4 ± 9.4 years; mean ± standard deviation body mass index: 30.4 kg/m2 ± 5.1 kg/m2; 99% male) were recruited across 25 clusters. Participants were randomised (at the cluster level) to either the SHIFT arm (12 clusters, n = 183) or the control arm (13 clusters, n = 199). At 6 months, 209 (54.7%) participants provided primary outcome data. Significant differences in mean daily steps were found between arms, with participants in the SHIFT arm accumulating 1008 more steps per day than participants in the control arm (95% confidence interval 145 to 1871 steps; p = 0.022), which was largely driven by the maintenance of physical activity levels in the SHIFT arm and a decline in physical activity levels in the control arm. Favourable differences at 6 months were also seen in the SHIFT arm, relative to the control arm, in time spent sitting, standing and stepping, and time in moderate or vigorous activity. No differences between arms were observed at 16–18 months’ follow-up. No differences were observed between arms in the other secondary outcomes at either follow-up (i.e. 6 months and 16–18 months). The process evaluation demonstrated that the intervention was well received by participants and that the intervention reportedly had a positive impact on their health behaviours. The average total cost of delivering the SHIFT programme was £369.57 per driver, and resulting quality-adjusted life-years were similar across trial arms (SHIFT arm: 1.22, 95% confidence interval 1.19 to 1.25; control arm: 1.25, 95% confidence interval 1.22 to 1.27). Limitations: A higher (31.4%) than anticipated loss to follow-up was experienced at 6 months, with fewer (54.7%) participants providing valid primary outcome data at 6 months. The COVID-19 pandemic presents a major confounding factor, which limits our ability to draw firm conclusions regarding the sustainability of the SHIFT programme. Conclusion: The SHIFT programme had a degree of success in positively impacting physical activity levels and reducing sitting time in heavy goods vehicle drivers at 6-months; however, these differences were not maintained at 16–18 months. Future work: Further work involving stakeholder engagement is needed to refine the content of the programme, based on current findings, followed by the translation of the SHIFT programme into a scalable driver training resource. Trial registration: This trial is registered as ISRCTN10483894. Funding: This project was funded by the National Institute for Health and Care Research (NIHR) Public Health Research programme and will be published in full in Public Health Research; Vol. 10, No. 12. See the NIHR Journals Library website for further project information.https://doi.org/10.3310/PNOY9785physical activitysedentary behaviouroccupational driversdietobesityworkplaceheavy goods vehicle |
| spellingShingle | Stacy A Clemes Veronica Varela-Mato Danielle H Bodicoat Cassandra L Brookes Yu-Ling Chen Edward Cox Charlotte L Edwardson Laura J Gray Amber Guest Vicki Johnson Fehmidah Munir Nicola J Paine Gerry Richardson Katharina Ruettger Mohsen Sayyah Aron Sherry Ana Suazo Di Paola Jacqui Troughton Simon Walker Thomas Yates James King A multicomponent structured health behaviour intervention to improve physical activity in long-distance HGV drivers: the SHIFT cluster RCT Public Health Research physical activity sedentary behaviour occupational drivers diet obesity workplace heavy goods vehicle |
| title | A multicomponent structured health behaviour intervention to improve physical activity in long-distance HGV drivers: the SHIFT cluster RCT |
| title_full | A multicomponent structured health behaviour intervention to improve physical activity in long-distance HGV drivers: the SHIFT cluster RCT |
| title_fullStr | A multicomponent structured health behaviour intervention to improve physical activity in long-distance HGV drivers: the SHIFT cluster RCT |
| title_full_unstemmed | A multicomponent structured health behaviour intervention to improve physical activity in long-distance HGV drivers: the SHIFT cluster RCT |
| title_short | A multicomponent structured health behaviour intervention to improve physical activity in long-distance HGV drivers: the SHIFT cluster RCT |
| title_sort | multicomponent structured health behaviour intervention to improve physical activity in long distance hgv drivers the shift cluster rct |
| topic | physical activity sedentary behaviour occupational drivers diet obesity workplace heavy goods vehicle |
| url | https://doi.org/10.3310/PNOY9785 |
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