The structured health intervention for truckers (SHIFT) cluster randomised controlled trial: a mixed methods process evaluation

Amber J Guest* (Corresponding Author), Nicola J Paine, Yu-Ling Chen, Anna Chalkley, Fehmidah Munir, Charlotte L Edwardson, Laura J Gray, Vicki Johnson, Katharina Ruettger, Mohsen Sayyah, Aron Sherry, Jacqui Troughton, Veronica Varela-Mato, Thomas Yates, James King, Stacy A Clemes

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

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Abstract

BACKGROUND: This paper presents the mixed methods process evaluation of the randomised controlled trial (RCT) of the Structured Health Intervention For Truckers (SHIFT), a multi-component intervention targeting physical activity and positive lifestyle behaviours in a cohort of 382 truck drivers in the UK. The SHIFT RCT found a significant difference in daily steps between intervention and control groups at 6-months in favour of the intervention participants.

METHODS: SHIFT was evaluated within a cluster-RCT and involved 25 transport sites (12 intervention and 13 control sites). Intervention components included an education session, Fitbit, text messages, and cab workout equipment. Participants completed questionnaires at baseline and 6-months follow-up. Semi-structured focus groups/interviews were conducted with drivers (n = 19) and managers (n = 18) from each site, after completion of the final follow-up health assessment (16-18 months post-randomisation). Questionnaires and interviews collected information on fidelity, dose, context, implementation, barriers, sustainability, and contamination.

RESULTS: Questionnaire and interview data from intervention participants indicated favourable attitudes towards SHIFT, specifically towards the Fitbit with a high proportion of drivers reporting regularly using it (89.1%). 79.2% of intervention participants attended the education session, which was deemed useful for facilitating improvements in knowledge and behaviour change, dietary changes were predominantly recalled. Despite not being part of the intervention, participants reported that feedback from the health assessments motivated them to change aspects of their lifestyle (intervention = 91.1%, control = 67.5%). The cab workout equipment was used less and spoken unfavourably of in the interviews. The main barriers to a healthy lifestyle at work were reported as long hours and irregular shift patterns. The most suggested improvement for the intervention was more frequent contact with drivers. Managers were positive about the objectives of SHIFT, however almost all mentioned the challenges related to implementation, specifically in smaller sites.

CONCLUSIONS: Overall, SHIFT was predominantly implemented as intended, with minimal discrepancies seen between the delivery and protocol. Having said this, transport sites each have distinct characteristics, which may require adaptations to individual settings to encourage participation. Managers and drivers reported enthusiasm and necessity for SHIFT to be included in future Certificate of Professional Competence training.


Original languageEnglish
Pages (from-to)79
JournalThe International Journal of Behavioral Nutrition and Physical Activity
Volume19
Issue number1
DOIs
Publication statusPublished - 7 Jul 2022

Bibliographical note

Funding
This project was funded by the National Institute for Health Research (NIHR) Public Health Research programme (reference: NIHR PHR 15/190/42). The study was also supported by the NIHR Leicester Biomedical Research Centre which is a partnership between University Hospitals of Leicester NHS Trust, Loughborough University, and the University of Leicester. Laura Gray is supported by the National Institute for Health Research (NIHR) Applied Research Collaboration East Midlands (ARC EM). The views expressed are those of the authors and not necessarily those of the NHS, the NIHR or the Department of Health and Social Care. Funding to cover intervention costs (Fitbits, cab workout equipment) was provided by the Higher Education Innovation Fund, via the Loughborough University Enterprise Projects Group. The Colt Foundation provided funding for a PhD Studentship, awarded to Amber Guest (reference: JD/618), which covered Amber’s time and contributions to this project. None of the funding bodies had any role in study design; election, synthesis, and interpretation of data; writing of the report; or the decision to submit the manuscript for publication.

Acknowledgements
We gratefully acknowledge the support provided by senior Health and Safety personnel and Transport Managers at our partner logistics company in facilitating this research. We also thank all participants for taking part. We are grateful to the independent members of the Trial Steering Committee for their continued support and advice throughout the trial: Dr. Derrick Bennett, Prof Emma McIntosh, Prof Petra Wark and Mr. Paul Gardiner.

Data Availability Statement

The datasets used and/or analysed during the current study are available from the corresponding author on reasonable request.

Keywords

  • Behaviour change
  • Dietary behaviours
  • Healthy Lifestyle
  • Sedentary behaviour
  • Life Style
  • Surveys and Questionnaires
  • Process evaluation
  • Workplace
  • Physical activity
  • Occupational health
  • Truck drivers

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