How do you get truckers to skip the McDonald’s at the truck stop. And instead eat more apples and broccoli?
In a job where workers sit for up to 11 hours a day, how do you help them lose weight, making them healthier and at the same time more likely to be alert on the road?
Those are two of the basic questions — and challenges — that Ryan Olson with the OHSU-PSU School of Public Health has confronted with a research program he’s led over the past decade.
The short answer for both questions: you design a weight-loss competition that is specially tailored for truckers. The longer and more complicated answer is what Olson has been studying. His goal is to understand how to help workers in demanding jobs — especially solo workers in isolating environments like the open road — get and stay healthier.
Olson is an occupational health psychologist who specializes in studying organizational and behavioral change. He is also a founding investigator and an associate director of the Oregon Healthy Workforce Center at OHSU, which is a national Center of Excellence in Total Work Health®, funded by the National Institute for Occupational Safety and Health.
Most of the faculty at the Oregon Healthy Workforce Center, including Olson and Director W. Kent Anger, are also part of the School of Public Health. Their work drives the center toward its overall public health goal: to improve the health, safety and well being of workers by researching the effectiveness of health and safety programs.
Olson, an associate professor in Environmental Systems and Human Health, has a special interest in studying health interventions for “lone workers” — people who work by themselves away from a traditional office environment. His interest in working with transportation workers began in the late 1990s in graduate school, when he was doing safety intervention research with mass transit drivers and flight students. When he arrived at OHSU in 2005 and was planning his research agenda, he noticed that the research showed an “extreme scarcity” of any effective health and safety programs that had helped truck drivers.
“The trucking group just stood out — as they needed something,” Olson says.
Truck drivers’ work environment substantially impacts their health, Olson says. Truck drivers are required to drive, and sit, for very long periods. They often don’t have easy access to healthy food — and have much easier access to fatty and unhealthy fast food. The result, Olson says, is a high level of obesity and sleep problems, both of which can decrease alertness and increase crash rates. Professional truck drivers are much safer operators than the average passenger car driver, but when a large truck is involved in a crash, it is particularly deadly.
Thinking of these issues with truckers, Olson started a research program called Safety & Health Involvement For Truck drivers, or SHIFT.
In collaboration with Anger and Diane Elliot, M.D., an OHSU professor of medicine with expertise in workplace health promotion, he created a pilot intervention program with funding from his home institute at OHSU and the Northwest Center for Occupational Health & Safety. The program involved a weight-loss competition between groups of truckers at different companies, along with computer-based training, personal coaching, and drivers’ self-monitoring and reporting of their weight with mobile devices. Over the years other key collaborators have contributed to the line of research, including Brad Wipfli and Leslie Hammer, also School of Public Health faculty members.
A small pilot study of 29 truckers was conducted in 2007-08. After six months, the truckers had lost about eight pounds on average – about double the average weight loss seen in any prior peer reviewed study at the time. Tracking of their driving also showed decreased “hard braking” events — when a driver needs to apply the brakes very hard and quickly, Olson says. This measure is considered a barometer of a driver’s alertness at the wheel.
In a larger randomized controlled trial with 452 truckers — conducted from spring 2012 through spring 2014 with funding from National Heart Lung and Blood Institute — the truckers lost an average of about 7.5 pounds compared to the control group. The larger study did not focus on driving measures, but instead on increased training on healthy sleep and how it can impact both body weight management and safety. Truckers in the effective weight loss condition slept an average 15 minutes longer per night — which was considered a “trend” but not statistically significant.
The weight loss was medically meaningful and significant in both studies. And such weight loss, if maintained, can have a real effect on workers’ long-term health, Olson says.
“I think the big take-home message from what we did is you can engage truckers in a health program if it’s mobile friendly and tailored to them,” he says. Olson adds that while the overall research program has not compared competitive weight-loss programs to similar non-competitive programs, he believes the competition is probably important for engaging drivers. “My hunch is a competition creates an event that activates somebody — that will hold them accountable. I think we can reach and engage hard to reach workers as long as we make things mobile-friendly and add in something fun — something that engages them in a game-like experience.”
Olson’s trucking research is only one example of his work studying how to improve the health and safety of lone workers. Another line of research he led studied a socially supportive group approach to impact the health and safety of home health care workers.
Olson says his work strives to better understand programs meant to improve the health of vulnerable workers — and to determine which programs work and don’t work and why.
“The reason I went into organizational psychology and not clinical psychology is I didn’t want to simply work with one person at a time,” Olson says. “I wanted to have an influence on the environment where people spend much of their time — the workplace. You spend a third of your life at work — it’s an environment that has a huge effect on your overall health. And I think improving the work environment can be a major lever for improving public health.”