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Taxi Health Access Interventions for Linkages and Lifestyle (HAILL)

针对联系和生活方式的出租车健康访问干预措施 (HAILL)

基本信息

批准号：
9070785
负责人：
FRANCESCA M GANY
金额：
$ 72.11万
依托单位：
SLOAN-KETTERING INST CAN RESEARCH
依托单位国家：
美国
项目类别：
财政年份：
2015
资助国家：
美国
起止时间：
2015-05-19 至 2020-02-29
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/9070785
关键词：
Address African Area Bangladesh Blood Pressure Caring Case Management Central obesity Chicago Communities Community Outreach Country District of Columbia Dominican Republic Effectiveness of Interventions Face Familiarity Food Funding General Population Gryllidae Haiti Health Health Fairs Health Promotion Health Services Accessibility Health Status Health system Healthcare Healthcare Systems Home environment Hour Hypertension Immigrant India Intervention Knowledge Life Life Style Linguistics Longevity Malignant neoplasm of lung Memorial Sloan-Kettering Cancer Center Methodology Minority Monoclonal Antibody R24 National Health Interview Survey New York City Obesity Occupational Outcome Overweight Pakistan Physicians Population Populations at Risk Poverty Prevention Primary Health Care Provider Randomized Controlled Trials Reminder Systems Resources Risk Risk Factors San Francisco Services Soccer Social Network Stress Structure Telephone Vendor Vulnerable Populations Work Workplace arm base blood pressure regulation cancer health disparity cardiovascular disorder risk compare effectiveness cost cost effectiveness health care availability health care delivery health care service health care service utilization improved male meetings metropolitan mobile computing multi-component intervention news peer support personalized approach primary outcome programs promoter screening secondary outcome sedentary teacher trafficking uptake waist circumference

项目摘要

DESCRIPTION (provided by applicant): Taxi drivers are a marginalized, large, growing, minority male population with multiple health risks. In New York City (NYC) alone, there are over 50,000 yellow taxi drivers and a similar number of livery drivers. Ninety nine percent of the taxi driver population in NYC is male. A large majority, 94 percent, are immigrants, mainly originating from India, Bangladesh, Pakistan, the Dominican Republic, Haiti, and West African countries. Taxi drivers are at greater risk for cardiovascular disease (CVD) and its associated risk factors, and for lung cancer, compared with the general population. They are a sedentary population with high rates of stress and overweight/obesity, have high rates of uninsurance, long work hours that often interfere with their ability to access primary care, limited knowledge about health care resources, and cultural and linguistic barriers to care. To improve health outcomes in this vulnerable population, a tailored approach is necessary. Increasing access to primary care improves health status, particularly in minority populations living in poverty. Health fairs with screenings, referrals, and case management by health workers have been shown to increase health care uptake. Taxi HAIL builds upon the successful, ongoing work of the Immigrant Health and Cancer Disparities (IHCD) Service at Memorial Sloan-Kettering Cancer Center (MSKCC) with taxi drivers to address their overwhelming health risks. Our work with drivers in NYC has highlighted their significant underuse of health care services, high rates of overweight, abdominal obesity, and undiagnosed and untreated hypertension. We have developed and implemented a multifaceted intervention, an occupationally tailored worksite screening health fair with case management, which has facilitated health care access and reduced health risk. However, this approach is costly. Taxi drivers, while facing tremendous health risk, also have notable potentially health promoting assets within their own taxi driver communities. In our NIMDH-funded R24 project, Taxi Network, 10 percent of NYC taxi drivers participating in a health fair intervention were teachers and several were physicians in their home country. Drivers, through their existing social networks, constantly exchange information about traffic, food vendors, cricket and soccer games, and home country news. They are highly networked by telephone, presenting a potentially powerful, inexpensive resource for health promotion and systems linkage. This project will use a three arm cluster randomized controlled trial to compare the effectiveness of the proposed Taxi HAIL interventions on increasing the proportion of drivers with a Usual Primary Care Provider, the Primary Outcome. These interventions incorporate a worksite screening health fair intervention (Arm 1), with navigation case management in Arm 2, and a mobile messaging health care reminder system (`Mobile Technology') and telephone-based peer support (`Taxi health Improvement Promoters' or `TIPs') in Arm 3. We will also assess the interventions' incremental costs. Secondary Outcomes include changes in: Health Access Barriers, Blood Pressure Control, BMI, and Waist Circumference.