Transit Operator Health and Wellness Programs (2004)

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5 CHAPTER ONE INTRODUCTION BACKGROUND AND OBJECTIVES Health and wellness issues that affect transit operators that are not addressed or acted on may negatively affect transit agency safety, service, absenteeism, employee turnover, and workers’ compensation and medical costs. Conditions of con- cern include stress, hypertension, heart disease, mental health issues, stroke, back- and neck-related injuries, obesity, diabe- tes, tobacco use, and alcohol and other drug-related problems. The use of prescription or over-the-counter medication to treat various conditions may also negatively affect the operator and the agency. In addition, family-centered issues may af- fect an operator’s overall health and wellness. There are proactive models of organizations seeking to improve operator physical and psychological health and well-being. These models include wellness programs, fit- ness-for-duty evaluations, exercise programs, critical inci- dent stress management, employee assistance programs (EAPs), labor–management health and safety committees, nutrition and diet programs, mentoring programs, and smoking cessation programs. The objective of this synthesis is to document current information on prevention and intervention strategies and resources that can be used by transit agencies to proac- tively address operator health and wellness issues. PURPOSE AND SCOPE This synthesis surveyed transit agency and other applicable industry experience with employee health and wellness programs. The primary goal of the project was to gather data from transit agencies on their current practices related to the use of transit operator health and wellness programs. To obtain these data, a questionnaire was developed and sent to 33 transit agencies that had been previously deter- mined to operate health and wellness programs. The re- search pool was developed to represent transit agencies of various sizes, operating different modes of transit, and lo- cated around the nation. In addition, transit agency health and wellness contacts, developed while completing previ- ous TCRP studies, were used. For the purpose of this syn- thesis, a health and wellness program was defined as “a planned series of ongoing activities designed to improve the health and well-being of transit operators.” The survey was directed to individuals with responsibility for manag- ing health and wellness programs. The effort also included a literature review and case study information about innovative and successful prac- tices, as well as lessons learned and gaps in information. The six case studies were drawn from the 14 transit agen- cies that responded to the synthesis survey. They cover a number of topics, including how some of these agencies aligned health and wellness goals with overall organiza- tional strategic direction and priorities. ORGANIZATION OF RESEARCH AND METHODOLOGY Preparation of the draft questionnaire survey was aided by a preliminary review of relevant literature and research. Comments received from topic panel members about the questionnaire were integrated into the survey distributed in March 2003 to health and wellness staff at 33 transit agen- cies. Follow-up telephone calls to nonresponders were made to encourage completion and submission of the ques- tionnaire. The survey was designed to gather information on the following topics: • Transit agency characteristics, • Demographics related to the wellness program tar- geted audience, • Placement of a health and wellness program in the organizational structure, • Management support for the health and wellness pro- gram, • Union support for the health and wellness program, • Program data gathering and analysis, • Health and wellness program budget, • Integration of the health and wellness program with other organizational functions, • Incentives to encourage participation, • Annual operating plan, • Program communication processes and activities, • Supportive organizational environment, • Scope of health and wellness activities (disease man- agement, prevention, etc.), • Specific health and wellness activities offered, • Policies supportive of the health and wellness program, • Family participation in program activities, and • Evaluation of the program outcome. Furthermore, an extensive review of relevant literature was summarized. The review included research on how the

6 nature of the job of operator affects health and well-being, health risk factors common among transit operators, regu- latory mandates related to operator qualifications, specific health conditions common to operators that may prevent them from continuing their employment, health and well- ness interventions in similar work situations, and health and wellness program successes in the transit industry. An on-line search of transit industry, university, and govern- ment databases, and other sources, provided valuable re- sources for analyzing synthesis survey data. Results of the literature review are summarized by subject area. Survey responses were submitted by 16 transit agencies, 14 of which met the criteria set forth for the definition of health and wellness programs in the letter of introduction. Responses were tabulated and summarized, and data were organized by survey subject areas. Supporting documents submitted by respondents were reviewed and categorized. Follow-up contacts were made to transit agencies as needed. Six of the 14 agencies were selected for case studies. The case studies describe program content, processes, chal- lenges, and lessons learned in developing and implementing health and wellness programs for transit operators. These case studies also explore how the agencies align health and wellness goals with overall organizational strategic direc- tion and priorities. Case study agencies—different sized organizations, in many regions, some with bus operators only and others with bus and rail operators—use varied and innovative approaches to addressing health and well- ness issues of operators. In two cases, data were collected during site visits to the agency’s wellness facilities. This synthesis report documents current information on prevention and intervention strategies and resources that can be used by transit agencies to proactively address op- erator health and wellness issues. The summary of success- ful practices and innovations reflects a combination of data collected from questionnaires, case studies, and the litera- ture review. ORGANIZATION OF THE REPORT The synthesis report is presented in five chapters, with supporting references, a bibliography, a glossary of terms, and three appendixes. Chapter one describes the project background and scope, as well as the methodology used to complete the project. Chapter two focuses on the literature review. Chapter three summarizes survey data. Chapter four summarizes six case studies. Chapter five presents synthesis conclusions and recommendations for future re- search. The three appendixes consist of survey question- naires (Appendix A), a roster of responding agencies (Ap- pendix B), and supplemental information provided by case study agencies (Appendix C).