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.

描述（由适用提供）：出租车司机是一个边缘化的，大的，增长的少数族裔男人，具有多种健康风险。仅在纽约市（纽约），就有超过50,000名黄色出租车司机和类似数量的现场驾驶员。纽约市99％的出租车驾驶员人口是男性。绝大多数（94％）是移民，主要起源于印度，孟加拉国，巴基斯坦，多米尼加共和国，海地和西非国家。与普通人群相比，出租车司机患心血管疾病（CVD）及其相关危险因素的风险更大，肺癌的风险更大。他们是一个久坐的人群，压力较高，超重/肥胖症的持续时间很高，较长的工作时间通常会干扰他们获得初级保健的能力，对医疗保健资源的有限知识以及文化和语言的护理障碍。为了改善这种脆弱人群的健康结果，有必要采用量身定制的方法。增加获得初级保健的机会可以改善健康状况，尤其是在生活在贫困中的少数民族人口。健康卫生工作者的筛查，推荐和病例管理的博览会已被证明可以增加医疗保健的吸收。出租车冰雹基于纪念斯隆 - 凯特林癌症中心（MSKCC）的移民健康与癌症差异（IHCD）服务的成功，正在进行的工作，与出租车司机一起解决其压倒性的健康风险。我们与纽约市司机的合作强调了他们对医疗保健服务的严重不足，高度超重，腹部肥胖和未经治疗的高血压。我们已经开发并实施了一项多方面的干预措施，这是一个量身定制的工作场所筛查健康展览会，并通过病例管理制备了医疗保健访问并降低健康风险。但是，这种方法是昂贵的。出租车司机在面临巨大的健康风险的同时，在自己的出租车驾驶员社区内也有显着的健康促进资产。在我们的NIMDH资助的R24项目，出租车网络中，参加健康公平干预的纽约市出租车司机中有10％是教师，其中几位是其祖国的医生。驾驶员通过现有的社交网络不断交换有关交通，食品供应商，板球和足球比赛以及本国新闻的信息。它们通过电话高度网络，为健康促进和系统链接提供了潜在强大，廉价的资源。该项目将使用三个ARM群集随机对照试验来比较拟议的出租车冰雹干预措施对增加驾驶员比例与通常的初级保健提供者（主要结果）的有效性。这些干预措施纳入了工作场所筛查健康公平干预措施（ARM 1），ARM 2中的导航案例管理以及移动消息保健提醒系统（“移动技术”）和基于电话的同伴支持（``出租车健康改善启动者''或ARM 3。次要结果包括：健康障碍，血压控制，BMI和腰围的变化。