“We all know healthy behaviors are important, but sometimes they’re not our first choice,” says Wan-chin Kuo, PhD, RN, an assistant professor at the University of Wisconsin–Madison School of Nursing.
Everyone enjoys treats that aren’t so healthy. But imagine if most days you couldn’t get a good night’s sleep, or eat a home-cooked meal, or even go for a walk.
“Truck drivers spend about two-thirds of their nights away from their homes each year,” says Kuo. “If you pack your lunch, it’s in your truck for at least six hours.”
“Truckers tend to drive at night, because there’s less traffic,” she explains. “Their salaries are dictated by how many miles they drive. They always mention that time is money. Often, they take a break on the road because they can sleep in the truck, but that’s lower quality rest.”
Kuo’s research program seeks to help truck drivers and other industrial workers prevent cardiovascular disease.
“Truckers are only one type of industrial worker, but it’s a large group that moves our economy and our society,” says Kuo. “Unfortunately, they experience a lot of cardiometabolic risk and health disparities.”
“We cannot just ask them to stay healthy,” she adds. “No matter how hard individual workers try, if the environment is not supportive, how can you eat healthy? How can you sleep better? When you identify so many problems as a scientist and nurse, you want to see what you can do.”
One of Kuo’s current studies seeks to better understand truck drivers’ daily routines. During virtual visits, study participants talk with interviewers and fill out surveys. On their own, participants record their sleep, physical activity, dietary, and other health behaviors.
The last part of the study is the toughest for busy truck drivers: an in-person visit.
“We need the in-person visit to collect physiological data like lung function, cardiovascular function, and mobility and cognitive tests,” says Kuo. “But in-person visits are challenging. We can’t ask them to go to a community center, because there’s no place to park their truck. We’re working with their employers to figure out how we can go to their workplace.”
Kuo knows her research team needs to meet truck drivers where they’re at.
“How can we build that relationship without interrupting their work?” she asks. “This is very important.”
Based on the observational data her team is collecting, Kuo will work with colleagues to design an intervention that supports truck drivers’ health.
“We are working with industrial engineers, civil and environmental engineers, and surgeons in the VA Hospital,” she says. “We want our intervention to have a person-centered approach, but what does that look like? You cannot ask truckers to come to your clinic every other week. So, we are thinking about telehealth. How can you use a telehealth model that’s effective, feasible and acceptable with this group, and provides a good user experience?”
Kuo and her research team, including students, jump at the opportunity to attend award lunches and other events for truck drivers.
“Students really like to talk to truck drivers and listen to their perspectives,” she says. She wants students to learn that “researchers cannot just collect data and then go back and analyze and publish. Then you never solve the problem.”
“We can’t do this work without many people helping,” Kuo adds. “We thank the truck drivers, the employers, the Wisconsin Motor Carriers Association, and all the community partners involved.”
In addition to her observational study and intervention plans, Kuo is working on an assessment to tease out how an individual’s occupational environment shapes their health. She’s also interested in how policies could reduce the risk of cardiovascular disease. As an example, she points to loan programs that help truck drivers afford newer and less polluting vehicles.
“My hope is that in the future, healthy behaviors are the default setting,” she says. “So, we don’t even need to pay attention and a healthy environment naturally occurs for everyone.”
–Diane Farsetta