NYC Transit Workers and COVID-19: Impact of Multilevel Interventions

摘要(摘要) 在新冠肺炎疫情期间，纽约市(NYC)公共交通一直是 确保其他基本工人能够到达他们的工作岗位。许多以种族和少数民族为主的人 交通工人在工作和家庭中都面临着风险，因为许多工人也住在高地 流行社区。大流行迫使运输工人扮演一线工人的角色，甚至 尽管他们缺乏通常提供的培训、经验、补给、设备和监督 传统的前线工作人员(即卫生保健和急救人员)。这项研究是与以下机构合作进行的 运输工人工会(TWU)，地方100，旨在：(1)评估多个行业的累积影响 迄今对当前工人健康和复原力的干预措施；(2)制定和评估以工人为导向的 危机管理模型，以促进工人在大流行和政策反应演变时的复原力(例如， 恢复封锁并复活；(3)传播调查结果，为 政策变化和行动，以保护非医疗保健基本工作者在大流行事件期间 重点缩小高危人群的健康差距。 为达致这些目标，我们建议进行一系列有系统的横断面调查 纽约市运输工人，在TWU的后勤协助下，代表近40,000名地铁和公交车 工人们。后续调查的时间将是动态的，以捕捉大流行和正在进行的实时变化 影响过境工人的政策和做法的变化。在第一阶段，我们将首先检查影响 若干实体已经实施的多层次干预措施，包括：(A)联邦、州和地方 政府和机构；(B)大都会运输局(MTA)--负责纽约市的公共机构 (C)TWU，它提供宣传、加强多层次干预、转诊和社会服务 支持。以新的大流行防备和复原力模型为指导，并由我们的 最近的交通工人试点研究，现有的多层次干预措施将映射到NIMHD 框架和评估，以确定其对工人结果的影响(例如，感染、心理社会、 行为、人际关系、复原力)，TWU干预的感知影响(例如，宣传， 加强对教育和社会支持的外展)，并个别采纳建议 旨在减少社区和工作场所传播的做法。我们将研究潜在的缓和 年龄、性别/性别、种族、民族和工人的职业特征的影响。首字母和 后续调查数据将为正在进行的参与性行动研究(PAR)团队提供信息，这些团队包括 学者、工作者和其他关键利益相关者，他们将制定数据驱动战略，以增加 多层次干预的有效性和进一步支持工人面对轮班的复原力 大流行事件。结果将被广泛传播，以告知研究结果所建议的政策变化。

SUMMARY (ABSTRACT) During the COVID-19 pandemic, New York City (NYC) public transportation has been an essential service to assure that other essential workers can get to their jobs. Many of the predominantly racial and ethnic minority transit workers have been exposed to risks at both work and at home, as many workers also reside in high prevalence communities. The pandemic thrust transit workers into the role of frontline workers, even though they lacked the training, experience, supplies, equipment, and supervision typically provided for traditional frontline workers (i.e., health care and first responders). This study, conducted in partnership with the Transport Workers Union (TWU), Local 100, is designed to: (1) evaluate the cumulative impact of multi- level interventions to date on current worker health and resilience; (2) develop and assess a worker-driven model of crisis management to facilitate worker resilience as the pandemic and policy responses evolve (e.g., restore lock-down with resurgence; deployment of vaccine); and (3) disseminate findings to provide input into policy changes and operations to protect non-healthcare essential workers during pandemic events with a focus to decrease health disparities in high-risk populations. To achieve these aims, we propose to conduct serial cross-sectional surveys of a systematic sample of the NYC transit workforce, with the logistical assistance of TWU, representing nearly 40,000 subway and bus workers. Timing of subsequent surveys will be dynamic to capture real-time shifts in the pandemic and ongoing changes in policies and practices that impact transit workers. In the first phase, we will first examine the impact of multilevel interventions already implemented by several entities, including: (a) federal, state, and local governments and agencies; (b) the Metropolitan Transit Authority (MTA), the public authority in charge of NYC Transit; and (c) TWU, which provided advocacy, reinforcement of multilevel interventions, referrals, and social support. Guided by a new Pandemic Preparedness and Resilience model and informed by data from our recent transit workers pilot study, the existing multilevel interventions will be mapped onto the NIMHD framework and evaluated to determine their impact on workers’ outcomes (e.g., infection, psychosocial, behavioral, interpersonal relations, resilience), perceived impact of TWU interventions (e.g., advocacy, reinforcement with outreach for education and social support), and individual adoption of recommended practices designed to mitigate community and workplace spread. We will examine potentially moderating effects of age, sex/gender, race, ethnicity, and occupational characteristics of the workers. Initial and subsequent survey data will inform ongoing Participatory Action Research (PAR) teams comprised of academics, workers and other key stakeholders who will formulate data-driven strategies to increase effectiveness of the multilevel interventions and further support worker resilience in the face of shifting pandemic events. Results will be widely disseminated to inform policy changes suggested by study findings.