Success & Health Impacts For Transit Drivers During Onboarding

Epidemiological evidence indicates that bus driving is associated with increased risk for
obesity and some chronic diseases, and that it is time for interventions. In this regard, the
early transition into bus driving has been neglected. Not only are interventions lacking for
new employees entering potentially obesogenic occupations, but workplace training and
socialization programs for new hires (referred to as onboarding) rarely address potential
occupational health hazards.

To address research gaps, investigators will integrate an effective health intervention
approach with traditional onboarding programs for new bus drivers. This intervention
approach, which was originally developed with commercial truck drivers, was implemented
through a mobile friendly website, and tactics included an incentivized game-like competition
that was supported with behavior and body weight logging, computer-based training, and
motivational interviewing. In a cluster-randomized trial with commercial truck drivers the
intervention produced a mean body weight effect of -7.29 lbs (p<.0001; Olson et al, 2016),
which is among the strongest results observed globally with occupational drivers.

In the proposed intervention adaptation, the "SHIFT Onboard" intervention (Success & Health
Impacts For Transit drivers during Onboarding) will be designed to prevent weight gain among
new bus drivers while also supporting early adjustment and job success. The primary
hypotheses are that relative to usual practice, SHIFT Onboard participants will have (1)
superior energy balance behaviors (sleep, eating, exercise) and (2) less weight gain.
Investigators will also evaluate impacts on new employee adjustment and economic outcomes
that are critical to employers; the ultimate adopters of occupational health interventions.
This project will take place over five years and will accomplish three specific aims:

1. Adapt proven tactics and pilot SHIFT Onboard with new bus drivers: Through formative
research with transit partners and iterative testing with drivers investigators will
adapt existing web technology, intervention tactics, and training content for newly
hired mass transit bus drivers. The adapted SHIFT Onboard intervention will then be
pilot tested with new drivers at a partner transit authority.

2. Determine the efficacy of SHIFT Onboard for preventing weight gain. Metropolitan transit
authorities, stratified by size, will be randomly assigned to intervention or usual
practice control conditions. SHIFT Onboard will be implemented with natural groups of
bus operators who complete training together during the first year. Primary intervention
effectiveness outcomes will be between-groups differences at 1- and 2-year follow-ups in
changes in energy balance behaviors (sleep, eating, exercise) and body weight.

3. Evaluate new employee adjustment and economic impacts of SHIFT Onboard. Investigators
will also evaluate intervention impacts on new bus operator adjustment (role stress,
confidence, connectedness) and job attitudes (job satisfaction, intention to remain).
Economic return on investment calculations will contrast intervention costs relative to
savings projected from intervention effects (e.g., health care costs, absenteeism,
safety).

Investigators will also collect measures of work demands, stressors, and strains (responses
to stressors) at all time points to characterize occupational exposures among the sample, and
to explore for possible associations with workers' health outcomes.

Inclusion Criteria:

- Hired to work as a transit bus operator at a participating transit authority, and
currently in the pre-service training period

Exclusion Criteria:

- Female participants who are pregnant or become pregnant during the study period will
be excluded from body weight related intervention activities and outcome analyses