Worksite Health and Wellness

A Case Study on a Program for Commercial Motor Vehicle Operations

Erin MabryCenter for Truck and Bus Safety

Virginia Tech Transportation Institute

Health and Wellness: Why is it Important?

• Increased energy• Improved quality of life• Alertness and job performance • Longevity on the job• Increased life expectancy

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Benefits of Improving Employee Health

• Crash prevention• Job performance• Lower absentee rates• Reduced stress• Injury prevention• Weight control• Reduced fatigue

Components of wellness

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Work-Site Wellness Programs

• Prevent major health risk factors• Lifestyle-related diseases• Engaging and supporting employees

– Convenient– Motivation and support– Often includes family – Benefits employee and employer

• Becoming increasingly popular

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Health and Wellness (H&W) Program

• In 2008 Schneider National Inc. (SNI) launched a company-wide, voluntary H&W Program– Atlas Ergonomics– United Healthcare (UHC) and OptumHealth

• Targets– Health disparities – Safety-sensitive positions

CMV truck driver lifestyle

• Sedentary– 66% self-report no physical exercise (Moreno 2006)

Poor nutrition and eating habits 75% do not meet the USDA minimum recommendations

for daily vegetable consumption (Whitfield 2007)

Sleep deprivation 3.8 hr/night on workdays (Perez-Chada 2005)

Long and irregular work hours 11 hours driving and 14 hours on-duty (FMCSA 2005) Rotating day/night shifts

High Stress

CMV drivers and obesity

• Prevalence of obesity – CMV drivers: <70% (Smith 2011)

– U.S. adults: ~33% (Flegal 2010)

• Other chronic diseases including– Type II Diabetes (TIID)– Dyslipidemia– Obstructive sleep apnea (OSA)– Cancers– CVD

• Reduced life expectancy– 12-19 years

Cardiovascular disease: a health and safety concern

• Leading cause of medical illness and sudden death in CMV drivers (FMCSA Guidelines 2002)

• May increase crash risk (FMCSA Executive Summary 2006)

• May medically disqualify • Relevant to professions with safety-sensitive positions,

warranting early identification and treatment– Construction– Mining– Aviation

SNI Health and Wellness (H&W) Program Overview

• H&W Program targets: – Wellness coaching to >17,000 insured employees– Health behaviors and chronic disease prevention\

management– Ergonomic and injury prevention services– On-site physical and occupational therapy and health

screens– Nutrition and exercise education and counseling

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Scope of Problem

• Drivers may have a 12-19 year reduced life expectancy (Salzman 2007)

• Driver Quote: “Too many truckers are out of shape and overweight, anything that would help them be in better shape would make the roadways safer.”

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Project Goals

• Examine and detail the H&W Program• Participants’ opinions, perceptions, and

satisfaction with the H&W Program• Recommendations for CMV fleets wishing to

implement a H&W program

Methods

• Phone interviews with key personnel– Recruitment methods, tests and assessments,

wellness education, health coaching, health achievements, motivational strategies, and long-term follow-up

• Evaluate participant opinions, perceptions, and satisfaction with the H&W Program– 94 drivers and 27 staff completed

• Recommendations

Results: H&W Program Overview

• Recruitment– Voluntary, incentive

program– Well marketed– Address driver fears– Benefit champions

• Health Assessment and Biometric Screen– Safety and health behaviors,

stress, work satisfaction– BMI, BP, glucose and lipid

panel – Multiple modes of collection– Health rating for medical

referral

• Review and Coaching– Individualized review of results– Feedback, suggestions, goal-

setting– Face-to-face and phone coaching– Transtheoretical Model of Change– Educational materials– Follow-up

• Program Components and Activities– Additional health programs

• Smoking cessation, weight loss, etc.

– Group competitions

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04/19/2023

Results: Driver Opinions

• 67% chose to participate

• 61% reported improved health

• 95% would recommend the H&W Program

• Program Likes– Dedication to driver

health– Convenient– Financial incentive

• Program Likes Con’t– Health coaches– Proactivity and health

awareness– Resources, tools, and

support

• Program Dislikes– 59% reported none– Inadequate number of

participating sites– Concerns over privacy– Inconvenient for 3rd shift or

irregular schedules

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Driver Suggestions for Improvement

04/19/2023

• Greater availability of health coaches• Improve anonymity• More health information (holistic)• More/fewer health tests• Exercise opportunities

– Health club memberships

• Additional participating sites• Additional incentives

Results: Staff Opinions

• 68% of staff satisfied with the Program• Program Likes

– HRA incentive – Health assessment/testing (multiple modes)– Coach/driver rapport – Individualized assessments and coaching– On-site therapists – Health-specific programs – Wellness calls

• Program Dislikes– Driver participation inadequate – Driver motivation– Lack of wellness program participation

Staff Suggestions for Improvement

• Program marketing– Focused info at orientation and training– Health podcasts, videos

• Educate and train carrier staff• Ensure privacy of health information• Expand participating sites• Encourage driver initiative and self-motivation• Flexibility with driver schedules• Providing and encouraging opportunities for exercise• Enhance follow-up• Interim rewards

Lessons Learned

04/19/2023

• Convenient access to on-site healthcare • Distrust and confidentiality concerns • Health assessment and biometric screening • Individualized coaching • Drivers want coach advocates• Coaches work with drivers to anticipate

barriers and setbacks • Provide education and training materials that

cater to drivers and the challenges they face

Lessons Learned Con’t

• Driver-to-driver advice, coaching and support• Participation by a spouse/family member• Tobacco cessation and weight loss • Infrastructure changes

– facilities that enable and promote exercise and healthy eating

• Effective communication • Management support

Implications for the Construction Sector

• Low obesity rates (~20%) [CDC]

• Health concerns [OSHA]

– Musculoskeletal disorders/pain– Stress– Smoking– Poor nutrition– Fatigue

• Barriers to health– Long work days– Travel between worksites– Limited facilities for food storage/prep

• High-hazard occupation

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Implications for the Construction Sector con’t

• Construction workers recognize that better health improves safety, productivity, and reduces absenteeism

• Construction workers want to improve their fitness and dietary habits [Uher 1998]– Off-site exercise opportunities– Access to healthy food at work

Recommendations

• Market program• Educational component• Large network• Clinical and physical

testing– Multiple modes for data

collection

• Privacy of health information

• Trust and rapport

• Exercise coaching and monitoring– Regular communication,

individualized, follow-up

• Variety of health programs • Educational media and

social support– Health podcasts and videos– Discussion forums– Success stories

• Program flexibility• Participation incentives

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