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

总结（摘要） 在COVID-19大流行期间，纽约市（NYC）公共交通一直是一项重要服务， 确保其他重要工作人员能够上班。许多主要的种族和少数民族 运输工人在工作和家中都面临风险，因为许多工人也居住在高海拔地区。 流行社区。大流行病迫使过境工人成为一线工人的角色， 尽管他们缺乏训练、经验、补给、设备和监督， 传统的一线工人（即，卫生保健和第一反应者）。这项研究是与 运输工人工会（TWU），地方100，旨在：（1）评估多个累积影响， （2）制定和评估由工人驱动的 随着流行病和政策反应的演变，建立危机管理模式，以促进工人的复原力（例如， （3）传播调查结果，为以下方面提供投入： 在大流行事件期间保护非医疗保健基本工作人员的政策变化和操作， 重点是减少高危人群的健康差距。 为达致这些目标，我们建议对本港的 在TWU的后勤协助下，纽约市的交通工作人员代表了近40，000辆地铁和公交车 工人后续调查的时间安排将是动态的，以掌握疫情的实时变化， 影响过境工人的政策和做法的变化。在第一阶段，我们会先研究 多个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）大都会交通管理局，负责纽约市的公共机构 过境;（c）图瓦卢妇女联盟，提供宣传、加强多层次干预、转诊和社会服务， 支持.在新的大流行防范和复原力模型的指导下，并根据我们的 根据最近的运输工人试点研究，现有的多层次干预措施将被映射到NIMHD 框架并进行评估，以确定其对工人成果的影响（例如，感染，心理社会， 行为，人际关系，弹性），TWU干预的感知影响（例如，宣传， 通过教育和社会支持的外联加强），以及个别采用建议的 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 工人的年龄、性别、种族、民族和职业特征的影响。初始和 随后的调查数据将为正在进行的前瞻性行动研究（PAR）小组提供信息， 学者、工人和其他主要利益相关者，他们将制定数据驱动的战略， 多层次干预措施的有效性，并进一步支持工人在面对转变时的复原力 流行病事件。将广泛传播研究结果，以便为研究结果所建议的政策变化提供信息。

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.