Developing Best-Practice Guidelines for Improving Bus Operator Health and Retention (2014) / Chapter Skim
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Final Research Report P A R T I I
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141 S U M M A R Y Transit Health Protection and Promotion Research Transit Operator Health: Background Transportation sector employees, and transit bus operators in particular, are more likely to report hypertension, diabetes, and other serious and chronic health problems, compared to the US workforce: In a 2012 survey of 170,000 US workers, transportation workers reported the highest rates of chronic health problems, and achieved the lowest well-being index (Witters, 2013)
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142 This report describes the approaches that transit organizations in the US and Canada are taking to address the health problems faced by transit employees, including detailed practices and some of the problems identified. The accompanying Transit Workplace Health Protection and Promotion Practitioner's Guide and the Planning, Evaluation, and Return on Investment (ROI)
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143 planning to integrate their occupational health programs and health promotion activities to improve effectiveness. Both transit agency and labor contacts felt that their own organizations supported the program and made it a top priority, with less confidence in the other side of the table: most of the agency responders agreed (slightly to strongly)
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144 respondents also wanted to establish ongoing ways to communicate with others who are active in transit WHPP. Availability and Retention Are Not at the Top of the List of Health Promotion Targets Absenteeism is the top health impact of concern identified at most transit agencies, but health promotion efforts did not significantly affect absenteeism in many agencies, according to the survey responses.
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145 A Practical Application of WHPP models In traditional health promotion, the workplace can function as a convenient place to get access to individuals rather than an integral component in the human health equation. Workers have health problems, which they need to have diagnosed and treated.
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146 The Tools Practitioner's Guide The Transit Workplace Health Protection and Promotion Practitioner's Guide accompanying this report is designed for anyone involved in health protection and promotion in the transit workplace. The Guide outline is summarized in Appendix A: Roadmap and Best Practices for Transit Workplace Health Protection and Promotion.
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147 problems. They want to do something about the problems to keep workers healthier, transit agencies more successful, and the public moving.
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148 Introduction and Research Methods Background "An important tenet of Total Worker Health™ is that risks and our responses to them must be proportional. Highest risk occupations and workers require more frequent and more intense workplace heath interventions on both the health protection and the health promotion fronts.
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149 The TCRP Synthesis 52 survey produced a useful snapshot of then-current practice. The programs and activities described were largely informational and educational.
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150 rather than being integrated with other related programs and policies such as occupational safety and health protection, work design, and scheduling. Limited financial resources were seen as a major constraint to starting or broadening a program.
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151 5. Health and wellness program budget and annual business plan; 6.
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152 The survey follow-up in-depth interview questions, quantitative data collection questions, and case example questions are provided in Appendix E Case Studies After a review of the case example catalog, the F-17 research team and academic partners developed a set of criteria to identify effective programs for in-depth case study investigation.
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153 F-17 panel. (Detailed references available on request to the principal investigator.)
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Literature Review Literature Search A literature search was carried out on the National Library of Medicine search engine PubMed and the business resource LexisNexis. Titles generated were reviewed if they described health promotion efforts in transportation, discussed key elements of health promotion programs such as return on investment, or described health and safety factors affecting transit bus operators.
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155 (depression, anxiety, posttraumatic stress disorder) and behav ioural outcomes (substance abuse)
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156 (Hildebrandt, 1995)
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157 musculoskeletal disorders, digestive problems, fatigue, and sleep disorders (Tse et al., 2006)
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158 lost, and appropriate health care utilization, as well as on the total number of selfreported risk factors. It does not have a proven impact on fruit and vegetable intake, body composi tion, or overall fitness.
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159 et al., 2006)
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160 port employee was employed to provide health information and oneonone consulting to almost 1,300 coworkers. The program provided weekly cafeteria discounts to partici pants to promote onsite healthy food purchases, and vend ing contracts were altered so machines contained at least 60 per cent healthier options and were more affordable than less healthy choices; a significant decrease in participants' weight was reported (Davis et al., 2009)
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161 (Poulsen, Drewes, Grøn, Petersen, & Bach, 2005)
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162 the accompanying Transit Workplace Health Protection and Promotion Guide and Planning, Evaluation, and Return on Investment Template, describe the working conditions and complicating variables and a useful approach for designing and assessing effective interventions and programs. To assist in this, the Transit WHPP Practitioner's Guide includes a link for transit organizations to share their baseline, intervention, and program data with others.
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163 individual behavior and resources (the right corner of the triangle) but also on the sum of the organizational polices, programs, and practices that affect health, and on the phys ical environment (top of triangle)
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Findings and Applications: A Profile of the Industry Background This chapter describes the current state of transit agency workplace health protection and promotion (WHPP) programs, detailing the aggregate characteristics, structure, and impact of programs in locations across the US and Canada.
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165 (average 74 percent) , but in some agencies women and younger workers are strongly represented.
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166 Median Maximum Number of Transit Modes 2 6 Size Percent by ridership Percent by VOMS Tertiles by Number of Operators Large 34.8 25 <113 Medium 21.4 23 113-600 Small 30.4 31 >600 Missing 13.0 21 Mode Percent Fixed-Route Buses 100 Paratransit 60.9 Light Rail 18.8 Other 17.4 Commuter Rail 14.5 Heavy Rail 11.6 Table 5. F-17 survey respondents: distribution by mode and size.
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167 Figure 3. Workplace conditions affect operator health (% reporting some or a lot)
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168 • Have done bits and pieces and now need to tie it all together and re-brand. • No participants.
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169 Budget Reported budgets range from $0 to $372,000. Some programs support a full-time staffer or more, others just the promotional handouts or educational material, with everything in between.
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170 Program Responsibility Percent Reporting Human Resources 75.0 Operations 23.1 Safety 25.0 Other 19.2 Stand Alone 19.2 Medical/Occupational Health 17.3 WHPP Committee Representation Percent Including Human Resources 77.4 Transit Bus Operators 51.9 Line Managers 42.3 Other (from other or all divisions, consultants, health care providers) 54.8 Top Managers 32.7 Safety Staff 26.9 Union Representatives 28.8 Partners Percent Reporting Health Plan 69.2 Commercial Vendors 44.2 Community Groups (for example, Weight Watchers™, American Cancer Society)
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171 • How competent were the programs? • How did the transit agencies rate their program impact?
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172 Respondents were on the whole positive when rating support for their programs and the program strength, although not strongly overall (1 = somewhat agree)
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173 development. In eight cases where ratings were supplied by both agency and union, the agency respondent rated the same programs 2–3 points higher than the union respondent did for available resources, links to other areas, and use of data, and about one point higher on everything else (data not shown)
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174 involvement across the organization. Medium-sized transit agencies seemed stronger in all areas than the larger or smaller respondents.
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175 WHPP and Workplace Policy Fewer than half of respondents include organizational or policy changes as a direct role for their WHPP programs. However, related policies such as return to work accommodations, assault or customer conflict prevention programs, workplace health and safety inspections, and other workplace health, wellness, and safety programs were each reported by more than half the respondents.
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176 to influence other areas beyond health promotion. The largest numbers report an influence on safety rules (38.5 percent)
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177 Case Examples and Case Studies Background Before selecting the case study locations, the F-17 research team developed a catalog of workplace health promotion programs using the survey responses and follow-up interviews. This catalog provided a snapshot of agency and union survey responses, summarizing the agency's programs and identifying any perspective barriers to program implementation.
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178 makes it easier for employees to leave work and not go to the fitness center locations. Agency 2 (Small)
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179 Retention is not a concern with less than 1 percent turnover per year. The agency tries to hire more experienced people; although this does mean an older and possibly less healthy workforce.
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180 The agency would like to make health and fitness less voluntary for employees (e.g., require smokers to quit, require obese employees to enter a weight loss program, and other interventions to require healthy lifestyles) , and to work with the union on putting in place incentives for participation and disincentives for unhealthy lifestyle.
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181 expenses by having them complete individual action plans and track their progress online. There are 3 levels of benefit statuses, with "Gold" status providing the lowest out-of-pocket employee expense.
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182 from becoming an equal partner in the design and implementation of the health and wellness initiatives. Because of lack of trust and confidentiality concerns, the potential for medical disqualification becomes a "fear factor" for operators who might otherwise participate in the sleep apnea program.
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183 pre sent their proposals to the entire committee, describing the proposed initiative, timeline for completion, budget, staffing, marketing, and materials needed to effectively implement the proposed plan. The wellness specialist considers these proposals when designing the yearly wellness plan proposal for upper management.
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184 E Organization and Integration The wellness program collaborates with other DART departments to help make the wellness program more efficient and effective.
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185 of a wellness online quiz that shift workers can utilize to gain wellness points, but it is recognized that this is not enough. Currently, DART is looking into ways to more effectively address this health and wellness program concern for transit bus operators and the operations department as a whole.
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186 collective bargaining agreement as part of the uniform paid for by the company. Winter driving training and reminders provide skills for work and personal safety.
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187 to analyze worksite hazard assessments, incident reports, and seasonal changes to define what health problems should be addressed in upcoming campaigns. The City of Edmonton has a multi-year commitment to a measurable sustainable wellness program, but wellness programming is more susceptible to budget availability than the robust OH&S program that is provincially mandated.
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188 to be of concern, including those identified through health plan data, the results of employee surveys following challenges, and the content of topical workshops and resources offered by the health plan and other resources. A committee made up of two transit bus operators from each of the three bus bases and maintenance from two bases meet monthly to discuss successes and make plans.
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189 ergonomics training only with initial training, OCTA maintains it on a 3-year cycle. Operators are encouraged to exercise and stretch during the work day, using first a stretch program video during required safety and health training then a palm card stretch series that focused on areas of particular concern for operators.
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190 responsibility for assessment, planning, and programming throughout the network of ambassadors and other active supporters could make the program stronger and ensure its longevity. It could also free up the wellness administrator to do more quantitative needs assessments and program impact evaluation.
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191 D Program Elements and Implementation During the 12 months prior to the case study, approximately 250 out of the 668 Capital Metro transit bus operators actively participated in the program.
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192 and 7.6 percent in 2007, for a savings of $450,000 compared with the cost of the 10.1 percent absenteeism rate in 2004. The wellness staff coordinates with benefits and operations on the calculation of wellness ROI.
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193 health plan and other vendors and community groups. The program is guided by explicit and quantitative 4-year strategic plans defining targets, activity, evaluation, and outcome goals.
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194 Program activities include lunch and learn events at all locations, wellness coaches to review screening results with participants, contributions to the company's safety TV network, a mobile vehicle with an occupational physician familiar with the demands of transit work, challenges and other participatory health activities including hula hoops and jump ropes, and 4–5 health fairs annually. A 6-week family exercise plan targets family health costs and rising childhood obesity, providing employees who commit to exercising weekly a basket of exercise aids and encouragements.
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195 actively participates in at least 1 activity each year. About 50 percent of transit bus operators participate, 31 percent engaging in disease management activities, 7 percent in weight loss or exercise challenges, and 24 percent using worksite exercise equipment or off-site gym access.
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196 work hours to the program. In contrast, across all responding agencies, 68 percent of agencies had a program administrator with an average of 38 percent of full-time work spent on the program.
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197 ing the annual maximum out-of-pocket medical expenses. In order to qualify for the lowest level of out-of-pocket expenses, employees and their covered spouses have to participate in a confidential wellness assessment and a follow-up program aimed at helping them reduce their health care risks.
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From Industry Practice to Best Practice Cataloging Effective Transit WHPP Practice There is some consensus on the types of interventions that are most likely to be effective in the American workforce, but the research evidence base strongly supports only a few. The CDC-led Community Preventive Services has identified a limited number of worksite health initiatives that have been shown to be effective (Task Force on Community Preventive Services, 2010)
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199 health -- clearly all organizations do health and safety activities, as do most unions, but usually not in the context of the WHPP programs. Table 24 lists the response distribution for "What health, safety, and wellness activity does your agency carry out?
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200 • Improve healthy food access and choice. • Increase physical activity.
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201 Table 26a. F-17 health practices.
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202 activities demonstrated a commitment to this principle, showing sensitivity and insight about what mattered to individuals. However, the programs they promoted did not always have flexibility in the face of operations, budget, or other organizational constraints to be as human-centered as desired.
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203 Table 26d. F-17 physical activity practices.
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204 barriers, especially between HR and operations, meant that programs were often run with no input or support from the very people who were needed to ensure success. The vertical chain of command common in transit also impeded lateral support.
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205 TWH Element 5. Integrate relevant systems.
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206 timely way. Some transit agencies are able to strengthen their programs by assigning responsibility for activities to supervisory and location management.
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207 Figure 8. F-17 transit workplace health protection and promotion roadmap.
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208 WHPP Components and Elements Average Case Study Rating Process Measures: The organization tracks costs, participation, goals met, and barriers then uses data to improve the program 4.40 Impact and Outcome Measures: The program documents changes in impact measures and outcome measures 3.80 Cost-Benefit and Return on Investment: Quantify cost savings when program affects absenteeism, productivity (presenteeism) , health care utilization, and other costs, and document other benefits 2.60 Data-Driven Ongoing Improvement: The organization communicates the impact of the program 4.20 Maintaining Effectiveness with Growth 4.47 Maintaining: Workplace Health Protection and Promotion is essential to the organization, not an extra 4.40 Growing: The WHPP program adapts 4.80 A Realistic Perspective: The WHPP program prepares for difficulties 4.20 Implementing and Integrating an Effective Program 3.96 Comprehensive Range: The WHPP program offers varied activities and resources 4.20 Transit-Specific Implementation: The implementation structure is adapted to suit the mobile workforce, multiple base locations, and varied schedules including evening, night, early morning, and split shifts 4.00 Comprehensive Communications: Set up a strategic, comprehensive, and integrated communications plan with multiple communications pieces and delivery channels that are tailored to the transit population 4.00 Training Supports the Program: Training is designed to promote the program goals, not just deliver information, and is integrated into other agency training 3.80 Equitable Incentives: The organization utilizes equitable, nondiscriminatory incentives that encourage active involvement and a healthy workplace culture 3.80 Evaluation, Return on Investment, and Ongoing Improvement 3.70 Evaluation Framework: The organization establishes a comprehensive workplace health protection and promotion program evaluation plan 3.60 Integrated Data Management: Data collection, management, and analysis is coordinated throughout the organization 3.60 Committee: The organization sets up and supports a group to take action on workplace health protection and promotion 4.00 Champions and Ambassadors: Employee skills support and contribute to planning and implementation 4.20 Vendor Integration: The organization enlists health care providers and other vendors as partners in and contributors to the WHPP program assessment, planning, and implementation 3.60 Setting Targets 4.10 Setting Priorities: The organization establishes what matters and what can be done with available resources 4.20 A Comprehensive Health Risk Focus: The organization identifies and targets multiple contributing factors to operator health problems and conditions 4.00 Effective Components: The WHPP program activities are based on feasible and effective practices that address the identified program targets 4.20 Transit-Specific Implementation: The program planning and content address transitspecific risks, exposures, and conditions 4.00 Table 27.
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209 Program Evaluation and Return on Investment Background Evaluation and metrics are core elements in a systematic approach to determine whether intended outcomes are achieved. Good metrics have proven value for assessing how well the programs meet their objectives, demonstrating accountability to funders and others who are in a position to make decisions about the future of a program, and leading to continuous improvement of the program.
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210 $2.73 for every dollar spent (Baicker, Cutler, & Song, 2010)
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211 Several respondents noted that they could not be sure that their programs caused any observed health changes. Agencies participating in the case studies and other followup discussions reported using a wide variety of evaluation tools and have provided useful examples for the development of the Planning, Evaluation, and ROI Template in the second phase of the project.
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212 below. Additional solutions, resources, and tools that can help mitigate these concerns are provided in the Transit WHPP Practitioner's Guide and the Planning, Evaluation, and ROI Template.
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213 for maintaining and expanding the program. This data can also help win a stronger commitment from employees and their unions, establishing a virtuous cycle in the growth of the program.
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214 resulting in lower health care costs. But the cancer and some of the heart disease costs savings are so far into the future that it is difficult to determine accurately how much would be saved, and it is impossible to use health savings to show program efficacy in a timely way.
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215 Toward a Transit-Specific Program Answering the Initial Questions -- A Summary of Transit Agency and Union Survey Responses The initial F-17 research proposal asked about 22 areas relevant to bus operator workplace health protection and promotion. They covered responding transit agency characteristics, WHPP program structure and targets, evaluation, program integration and partners, and transit-specific and operations concerns.
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216 Most agencies used some type of incentive to encourage participation in the WHPP program. Individual prizes and cash or gift cards were most common, followed by group rewards.
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217 between worker health and the work organization and environment. The other recurring issue was the importance of trust and collaboration in workplace health protection and promotion.
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218 Workers have health problems, which they need to have diagnosed and treated. The health problems may result from factors beyond their control such as genetics or aging.
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219 Planning, Evaluation, and Return on Investment (ROI) Template As a complementary tool to the Practitioner's Guide, the Planning, Evaluation, and ROI template was developed to help transit organizations with program planning, tracking of program process, impact and outcomes measures, and calculation of ROI for their health and wellness programs.
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220 References Affinity Occupational Health.
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221 Davila, E P., Florez, H., Fleming, L
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222 transit operators. International Journal of Occupational and Environmental Health, 2(2)
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223 Pietroiusti, A., Neri, A., Somma, G., Coppeta, L., Iavicoli, I., Bergamaschi, A., & Magrini, A
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224 List of Abbreviations AHRF Assessment of Health Risks with Feedback ATU Amalgamated Transit Union CDC Centers for Disease Control and Prevention CDL commercial driver's license CUTA Canadian Urban Transit Association CVD cardiovascular disease DART Dallas Area Rapid Transit EAP Employee Assistance Program ENWHP European Network for Workplace Health Promotion ETS Edmonton Transit System FMLA Family Medical Leave Act HR Human Resources HRA health risk assessment HRET Health Research and Educational Trust HSEC Health, Safety and Environmental Compliance HT hypertension IT Information Technology LACMTA Los Angeles County Metropolitan Transportation Authority MSD musculoskeletal disorder NIOSH National Institute for Occupational Safety and Health NRT nicotine replacement therapy OCTA Orange County Transportation Authority OH&S occupational health and safety OSA obstructive sleep apnea OSHA Occupational Safety and Health Administration PIR Partnerships in Injury Reduction PMR proportionate mortality ratio PTSD post-traumatic stress disorder RE-AIM Reach, Effectiveness, Adoption, Implementation and Maintenance RFP request for proposal ROI return on investment SHR standardized hospitalization ratio SME subject-matter expert TWH Total Worker Health™
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225 US United States UTU United Transportation Union VOMS vehicles operated in annual maximum service WCB Workers' Compensation Board WHPP workplace health protection and promotion
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A-1 Roadmap and Best Practices for Transit Workplace Health Protection and Promotion A P P E N D I X A
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A-2 Transportation Cooperative Research Program F-17 developed a framework of six action areas for transit workplace health protection and promotion (WHPP) , based on information collection from stakeholders, a literature review and analysis by subject-matter experts.
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A-3 as evidenced by documented communications, infrastructural initiatives, and health-focused policies. • Upper management approves the program.
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A-4 • Provide champions and ambassadors with schedule flexibility. • Sustain champion and ambassador role.
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A-5 • Keep the whole organization informed. • Assess the impact of the communication modes you use.
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A-6 Data-Driven Ongoing Improvement Best Practice 26. The organization communicates the impact of the program.
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B-1 Supplementary Tables B-1 B1 Responses by State and Province B-2 B2 Detailed Titles of F-17 Survey Respondents B-2 B3 Plans and Suggestions for More Effective Programs A P P E N D I X B AB 2 AK 3 AZ 2 BC 2 CA 15 CO 1 CT 2 DE 1 FL 2 GA 2 HI 1 IA 2 ID 1 IL 2 IN 3 KS 2 KY 2 MA 3 MB 2 MD 1 ME 2 MN 2 MO 2 MS 1 MT 2 NC 3 NE 1 NJ 2 NS 1 NY 3 OH 2 OK 1 ON 10 PA 2 QC 4 RI 1 SD 1 SK 1 TN 1 TX 3 UT 2 VA 1 VT 1 WA 5 WI 2 B1. Responses by state and province.
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B-2 B3. Plans and suggestions for more effective programs.
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B-3 B3. (Continued)
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B-4 Support/Integration We could use more leadership, promotion, and participation from our senior staff and board members Support/Integration Wider representation across organization on related committees Transit-specific information and practice We have been working with our healthcare provider to target the high-risk lifestyle behaviors. The have been able to provide us with programs from their program listing.
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C-1 TCRP F-17: Improving Transit Bus Operator Health, Wellness, and Retention -- Management Survey A P P E N D I X C
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C-2 Improving Transit Bus Operator Health, Wellness, and Retention -- Management Survey Welcome to the TCRP F-17 Improving Transit Bus Operator Health, Wellness, and Retention survey. Your input is very important to the success of this project.
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C-3 5) How many bus operators: Work here Work full-time Work part-time Are contracted independently or via a contract employer Are female Are under 40 Are Hispanic/Latin American Are White/Caucasian Are Black/African American Are Asian/Pacific Islander Are American Indian or Alaskan native Are other or multiple races Background 6)
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C-4 Health, Wellness and Safety Concerns 10) Have these health problems affected or led to any of the following?
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C-5 13) If you do not have a program or it is not currently active, can you say why?
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C-6 18) For those planning a program, what will be the target of your WHP program?
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C-7 WHP Program Environment 21) How would you agree with the following statements about your organization's worksite health promotion culture?
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C-8 WHP Program Targets 22) Please answer both questions for each area (Select all that apply)
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C-9 26) What incentives does your organization use to encourage participation in your WHP programs?
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C-10 What health promotion needs and interests of bus operators has your organization addressed in the last 12 months? (continued)
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C-11 31) Approximately how many bus operators participated in your WHP program in the past 12 months?
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C-12 35) If you calculated it, thinking across all the workplace health promotion programs your worksite offers, what was your ROI in the past year?
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D-1 TCRP F-17: Improving Transit Bus Operator Health, Wellness, and Retention -- Labor Survey A P P E N D I X D
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D-2 Improving Transit Bus Operator Health, Wellness, and Retention -- Labor Survey Welcome to the TCRP F-17 Improving Transit Bus Operator Health, Wellness and Retention survey. Your input is very important to the success of this project.
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D-3 4) How many bus operators: Work here Work full-time Work part-time Are contracted independently or via a contract employer Are female Are under 40 Are Hispanic/Latin American Are White/Caucasian Are Black/African American Are Asian/Pacific Islander Are American Indian or Alaskan native Are other or multiple races 5)
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D-4 Health, Wellness and Safety Concerns 9) How much impact do the following conditions at your workplace have on the health problems listed above?
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D-5 13) Are or were family members involved in the WHP program?
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D-6 If you do not have a WHP program and do not plan to start one, your work on this survey is almost done. Please complete the last page and return it with any comments or questions.
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D-7 23) How would you agree with the following statements about your organization's WHP program?
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D-8 Goals and Structure 24) Please answer both questions for each area (Select all that apply)
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D-9 28) What incentives does your organization (or Union if Union-only program)
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D-10 32) What health promotion needs and interests of bus operators has your organization addressed in the last 12 months?
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D-11 Targets and Involvement 34) How many bus operators participated in your health promotion program in the past 12 months?
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D-12 38) Thinking across all the health promotion, disease prevention and disease management programs and activities the worksite offers, how would you say these affected the following in the last 12 months Improves Has no effect Makes worse Health status [ ]
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E-1 F-17 Survey Follow-Up Data Collection Guidelines Survey Follow-Up Data Collection Guidelines Follow-up data collection will take place in three stages. First, all survey respondents who agree will be contacted and asked a brief set of questions.
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E-2 Question F-17 target What were the health outcomes of your program (if not clear from survey response)
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E-3 Question F-17 target Area What proportion of the eligible population participated in the program? Participation 8 Does your program address accommodations for people returning from disability or injury?
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E-4 Question F-17 target Area Describe the impact, if any, on retention. 6, 18 Describe the impact, if any, on the safety culture.
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E-5 3. What do you track in terms of program outcomes?
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E-6 Cost and Benefits/ROI 1. What do you track in terms of program costs (if not already provided in survey)
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F-1 Case Study Agency Snapshots A P P E N D I X F A LACMTA Program Snapshot (F-17 Survey Results)
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F-2 Work and family conflicts Mental health Other disease management Related policies and programs (programs with impact to date are bolded) Healthy food availability Targets Achieved Improved morale Evaluation Program success is tracked and measured by: Program participation rates Employee feedback Health care claims cost Employee availability ROI No ROI studies have been done.
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F-3 Program Summary: Company Program Status Current Length 7 years Activities (italicized if part of other program) Health risk assessments Health screenings Counseling/coaching Support for alternative health (for example yoga, massage)
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F-4 Evaluation Program success is tracked and measured by: Program participation rates Employee feedback Behavior change Health status Health care claims cost Workers' compensation claims cost Time lost/absenteeism Disability Cause of death conditions. ROI They do not calculate ROI.
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F-5 Structure/Committee Human Resources and Operations are responsible for the health and wellness program. They have a worksite wellness committee including: Line managers Human resources Transit bus operators Union representatives Wellness consultant Health Promotion Focuses Nutrition Weight management Stress management Threat assessment and management/violence prevention Mental health Related Policies and Programs (programs with impact to date are bolded)
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F-6 Conditions Affecting Health: Management Response Union Response Route schedules (Some) Route schedules (A lot)
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F-7 Related Policies and Programs (programs with impact to date are bolded) Assault or customer conflict prevention program Policies to prevent or reduce stress at work (scheduling, customer encounters, restroom access)
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F-8 Activities (italicized if part of other program) Health risk assessments Health screenings (high blood pressure/blood sugar/neck circumference/lipids/weight)
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G-1 Transit Agency Materials and Reports A P P E N D I X G UTU-LACMTA Presentation: Starting A Wellness Program: Best Practices London Transit Transportation Services Guide London Transit Wellness Committee Tracking Form OCTA Ergonomic Checklist for Coach Operators
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G -2 Starting A Wellness Program: Best Practices United Transportation Union Los Angeles County Metropolitan Transportation Authority Summary of Best Practices • Strategic Planning – Identify health conditions and risk factors driving costs, employee interests, and needs. – Establish measurable goals and objectives with deadlines.
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G -3 Strategic Plan • Identify the direction in which the committee would like to steer your wellness program over the next 3-5 years. • It is necessary to understand your committee's current position and the course of action you wish to take to achieve the overall long term goal, set by the committee.
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G -4 Ambassadors/Champions • Select people that are supportive of your wellness program. • Ambassadors should be peers of your target group.
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G -5 Measurement Tools • To best determine the effectiveness of your program, it is essential to gather both "soft data" and "hard data". • Soft data: – Participant Surveys for the overall program – Program numbers for various events – Health Fair screening results – Educational Seminar surveys Measurement Tools cont.
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G -6 Strategic Plan Strategic Plan April 2012- March 31, 2013 Wellness and Health Insurance Cost Containment Strategy (WCCS) Key Strategies for 2012-2013 Long Term Goals: • Improve UTU-TCU-ASCME-MTA member health • Establish and grow a strong "health culture" within the UTU-TCU-ASCME-MTA organizations.
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G -7 Annual Calendar January 2013 S M T W T F S 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 April 2013 S M T W T F S 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24*
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G -8 Interest Survey cont. Indicate which of the below activities you would like offered within the next 12 months (choose top 6)
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G -9 Getting Started-Seminars Data Report Division A B C D E F G H I J K L M N O P Total Pop 620 575 574 592 86 696 521 679 655 209 688 624 344 129 105 2000 Actual 103 213 146 139 74 75 116 160 224 104 105 124 75 58 37 286 % 16% 37% 25% 23% 86% 10% 22% 23% 34% 49% 15% 15% 23% 44% 35% 14% Programs Tour De Sewer Revlon Run/Walk OCTA/MTA 10k ADA Walk 13 27 50 72 Programs Div Div Div Div Div Div Div Div Div Div Div Div Div Div Div Div 8 week 7 12 15 3 3 6 11 6 12 4 5 8 2 10 4 0 5k Challenge 026219278554342 Health Fairs Division Total Populaon Registraon #'s % Aendance Completed Screenings % Screening Compleon Union A Union B Union C Union D Union E A 424 89 21% 72 80% 67 3 4 8 7 111502%1642%269336B 2 C 1500 228 15% 98 44% 25 7 7 5 71 D 512 80 15% 58 78% 68 3 1 3 0 912203%6614%572628E 6 Division A B C D E F G H I J K L M N O P Fitness 63 137 51 88 53 57 98 141 70 80 92 87 63 40 34 0 Wellness 74 118 121 97 38 72 143 54 184 78 57 68 25 25 20 286 resiaKnoitpircseDerusaeM Permanente So. CA Regional Average (2011 Q4)
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G -10 UTU-MTA Trust Fund Rate Increase History 2009-2013 • Over the 5-year period 2009 – 2013, the UTU-MTA Trust Fund's annual rate increase for Kaiser has averaged 7.0%, compared to Kaiser's overall Southern California average of 7.4%. • The Trust Fund's January 1, 2013 rate increase is 3.8%, compared to Kaiser's overall average of 6.0%
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G -11 INTRODUCTION: London Transit has the responsibility to provide its passengers with an efficient, safe, convenient and attractive Transit system. As an employee, you share these responsibilities and therefore have an obligation to yourself, the public you serve and to London Transit to provide the best possible service to our customers.
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G -12 FIRE ON THE BUS: THE SAFETY OF THE OPERATOR AND CUSTOMERS IS THE FIRST CONSIDERATION WHEN A FIRE OCCURS. Open all doors to permit everyone to alight and lead people to a safe location away from the vehicle and any other hazards (traffic, etc.)
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G -13 PERSONAL SAFETY: Bus Seats: It is important that seats are adjusted using proper procedures and employing ergonomic principles. Properly adjusted seats offer a safe and comfortable ride.
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G -14 Universal Precautions: Blood, certain body fluids and sharp objects are considered to be potentially infectious and handling them must be avoided whenever possible. If exposed, avoid hand to mouth/eye contact and wash hands as soon as possible.
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G -15 ADJUSTMENT PROCEDURES FOR ERGO METRO SEATS: . DEFENSIVE DRIVING: What is a defensive driver?
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G -16 Dealing with intersections: Intersections present a significant risk to drivers. A substantial number of multi-vehicle accidents occur at intersections and therefore special attention must be paid.
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G -17 During the day, re-adjust the chair to change pressure points and alter muscle use. Use core muscles while sitting and driving to protect your low back.
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G -18 DOOR OPENING CORRECT INCORRECT Adjusting the Outside Mirrors When adjusting the outside mirrors use the proper device to complete this task. Avoid over reaching Keep elbows tucked into side Watch out not to arch or extend at the low back when working above shoulder height ADJUSTING MIRRORS OUTSIDE CORRECT INCORRECT Steering Ensure steering wheel (if adjustable)
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G -19 LIFTING RAMPS CORRECT INCORRECT Opening and Closing the Windows Move body as close as possible to the levers. Ensure the window is not stuck before applying great force.
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G -20 DO WATCH YOURSELF AT FARE BOX DO ASSIST PATRONS WITH CARE DO GRIP WITH LOOSE GRIP DO TURN WITH SHUFFLE METHOD On the Job Exercises How to Stretch Hold stretch 10-20 seconds. Breathe when stretching.
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G -21 1. Hold left wrist and then right wrist as shown, making sure to keep fingers straight.
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G -22 Lower Neck Right hand behind back, neck looks to left armpit. Gently pull neck towards left armpit.
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G -23 Low Back Hands on buttocks. Lean back to extend low back.
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G -24with everyone who steps onto your bus, but you can communicate without speaking, for example by making eye contact and smiling. We all have different skill sets and maintain order on our bus in our own way, but the "TAC-COM" tools will help us all be consistent with our interactions.
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G -25 across – just saying something the wrong way may cause escalation. Ensue that you don't given commends – "Get off this bus!
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G-26 What to do if using these skills and techniques doesn't de-escalate the situation sometimes, despite your best efforts, you may be unable to deescalate the situation. If an operator is unsuccessful in de-escalating the situation, and has therefore lost control of the situation, assistance from an Inspector is required.
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G-28 Ergonomic Checklist for Coach Operators Employee Name: Badge: Base: Date: Evaluator: Badge: Date: Is seat is pushed back when getting IN?
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G-29 Is the sole of the foot in contact with the pedals? Yes No Explain if "No" Are the foot control switches at a comfortable level?
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H-1 Sleep Disturbance and Sleep Apnea for Transit Drivers A P P E N D I X H
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H-2 Sleep problems lead to fatigue, irritability and errors. Sleep debt can cause you to fall asleep briefly when you should be awake, even when driving.
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H-3 What can transit vehicle operators do about sleep disturbance? Establish the best possible sleep schedule You need time to sleep enough between work shifts.
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Abbreviations and acronyms used without definitions in TRB publications: A4A Airlines for America AAAE American Association of Airport Executives AASHO American Association of State Highway Officials AASHTO American Association of State Highway and Transportation Officials ACI–NA Airports Council International–North America ACRP Airport Cooperative Research Program ADA Americans with Disabilities Act APTA American Public Transportation Association ASCE American Society of Civil Engineers ASME American Society of Mechanical Engineers ASTM American Society for Testing and Materials ATA American Trucking Associations CTAA Community Transportation Association of America CTBSSP Commercial Truck and Bus Safety Synthesis Program DHS Department of Homeland Security DOE Department of Energy EPA Environmental Protection Agency FAA Federal Aviation Administration FHWA Federal Highway Administration FMCSA Federal Motor Carrier Safety Administration FRA Federal Railroad Administration FTA Federal Transit Administration HMCRP Hazardous Materials Cooperative Research Program IEEE Institute of Electrical and Electronics Engineers ISTEA Intermodal Surface Transportation Efficiency Act of 1991 ITE Institute of Transportation Engineers MAP-21 Moving Ahead for Progress in the 21st Century Act (2012) NASA National Aeronautics and Space Administration NASAO National Association of State Aviation Officials NCFRP National Cooperative Freight Research Program NCHRP National Cooperative Highway Research Program NHTSA National Highway Traffic Safety Administration NTSB National Transportation Safety Board PHMSA Pipeline and Hazardous Materials Safety Administration RITA Research and Innovative Technology Administration SAE Society of Automotive Engineers SAFETEA-LU Safe, Accountable, Flexible, Efficient Transportation Equity Act: A Legacy for Users (2005)
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Key Terms
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