School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, LE11 3TU, UK.
NIHR Leicester Biomedical Research Centre, Leicester, LE5 4PW, UK.
BMC Med. 2022 May 24;20(1):195. doi: 10.1186/s12916-022-02372-7.
Long distance heavy goods vehicle (HGV) drivers exhibit higher than nationally representative rates of obesity, and obesity-related co-morbidities, and are underserved in terms of health promotion initiatives. The purpose of this study was to evaluate the effectiveness of the multicomponent 'Structured Health Intervention For Truckers' (SHIFT), compared to usual care, at 6- and 16-18-month follow-up.
We conducted a two-arm cluster RCT in transport sites throughout the Midlands, UK. Outcome measures were assessed at baseline, at 6- and 16-18-month follow-up. Clusters were randomised (1:1) following baseline measurements to either the SHIFT arm or usual practice control arm. The 6-month SHIFT programme included a group-based interactive 6-h education and behaviour change session, health coach support and equipment provision (Fitbit® and resistance bands/balls to facilitate a 'cab workout'). The primary outcome was device-assessed physical activity (mean steps/day) at 6 months. Secondary outcomes included the following: device-assessed sitting, physical activity intensity and sleep; cardiometabolic health, diet, mental wellbeing and work-related psychosocial variables. Data were analysed using mixed-effect linear regression models using a complete-case population.
Three hundred eighty-two HGV drivers (mean ± SD age: 48.4 ± 9.4 years, BMI: 30.4 ± 5.1 kg/m, 99% male) were recruited across 25 clusters (sites) and randomised into either the SHIFT (12 clusters, n = 183) or control (13 clusters, n = 199) arms. At 6 months, 209 (55%) participants provided primary outcome data. Significant differences in mean daily steps were found between groups, in favour of the SHIFT arm (adjusted mean difference: 1008 steps/day, 95% CI: 145-1871, p = 0.022). Favourable differences were also seen in the SHIFT group, relative to the control group, in time spent sitting (- 24 mins/day, 95% CI: - 43 to - 6), and moderate-to-vigorous physical activity (6 mins/day, 95% CI: 0.3-11). Differences were not maintained at 16-18 months. No differences were observed between groups in the other secondary outcomes at either follow-up.
The SHIFT programme led to a potentially clinically meaningful difference in daily steps, between trial arms, at 6 months. Whilst the longer-term impact is unclear, the programme offers potential to be incorporated into driver training courses to promote activity in this at-risk, underserved and hard-to-reach essential occupational group.
ISRCTN10483894 (date registered: 01/03/2017).
长途重型货车（HGV）司机的肥胖率以及肥胖相关合并症均高于全国代表性水平，而且在健康促进计划方面服务不足。本研究的目的是评估多组分“卡车司机结构化健康干预（SHIFT）”与常规护理相比，在 6 个月和 16-18 个月随访时的效果。
我们在英国中部的运输站点进行了一项两臂群组随机对照试验。在基线、6 个月和 16-18 个月随访时评估了结局指标。在进行基线测量后，按照 1:1 的比例将群组随机分配到 SHIFT 组或常规护理对照组。6 个月的 SHIFT 计划包括一个基于小组的互动式 6 小时教育和行为改变课程、健康教练支持以及设备提供（Fitbit®和阻力带/球，以促进“驾驶室锻炼”）。主要结局是 6 个月时设备评估的体力活动（平均每日步数）。次要结局包括以下内容：设备评估的坐姿、体力活动强度和睡眠；心血管代谢健康、饮食、心理健康和与工作相关的心理社会变量。使用完整案例人群的混合效应线性回归模型分析数据。
在 25 个群组（站点）中招募了 382 名 HGV 司机（平均年龄±标准差：48.4±9.4 岁，BMI：30.4±5.1kg/m，99%为男性），并将他们随机分配到 SHIFT（12 个群组，n=183）或对照组（13 个群组，n=199）。在 6 个月时，209 名（55%）参与者提供了主要结局数据。组间存在明显的每日步数差异，SHIFT 组更有利（调整后平均差异：1008 步/天，95%CI：145-1871，p=0.022）。与对照组相比，SHIFT 组在坐姿时间（减少 24 分钟/天，95%CI：-43 至-6）和中高强度体力活动（增加 6 分钟/天，95%CI：0.3-11）方面也有有利的差异。这些差异在 16-18 个月时没有维持。在其他次要结局方面，两组在两次随访时均没有差异。
SHIFT 计划在 6 个月时导致了试验组之间日常步数的潜在临床有意义差异。虽然长期影响尚不清楚，但该计划有可能被纳入驾驶员培训课程，以促进这一高危、服务不足和难以接触的基本职业群体的活动。
ISRCTN80531244（注册日期：2017 年 3 月 1 日）。
