Abstract
Wellness in trucking, like many corporate wellness programs can be difficult to measure. With driver turnover rates as high as 90%, companies are often reluctant to invest in driver health and well-being. However, the need is substantial. Chronic health conditions are highly prevalent among truck drivers due to the nature of the profession, including long driving hours, limited opportunities for physical activity, and restricted access to healthy food options. 1
The Fit Drivers Program was developed in response to these challenges. Its origins are personal: my father, a professional truck driver, experienced multiple health complications related to the occupation, including hypertension and diabetes. My brothers and I also became professional drivers. I ultimately chose to leave commercial driving to focus on improving driver health through education and wellness support.
The Health and Regulatory Landscape
Commercial Driver’s License (CDL) holders are required to complete a Department of Transportation (DOT) medical exam every two years. This comprehensive screening includes:2,3 • Vision and hearing assessments • Blood pressure and cardiovascular health screening • Diabetes and kidney disease evaluation • Sleep apnea screening • Respiratory, neurological, and musculoskeletal assessments
Drivers identified with conditions such as pre-diabetes or pre-hypertension may receive only a one-year certification (or less), requiring more frequent reevaluation to remain eligible to drive. In fact, according to the Federal Motor Carrier Safety Administration (FMCSA), 55% of the 3.5 million CDL holders operate on a one-year certification or less, and over 300 000 drivers are disqualified annually due to medical conditions. This creates significant financial strain for both drivers and employers. Replacing a driver can cost between $5000 and $12,000 due to recruiting, hiring, and training expenses. 4 Investing in driver health, therefore, is not only beneficial for drivers, but is also a cost-saving strategy for companies.
The “Fit to Pass” (FTP) Program
The “Fit to Pass” (FTP) program was created to address the health and well-being needs of commercial drivers by offering driver-centered health coaching at a fraction of the cost of replacing a driver who fails a DOT exam. The program’s primary goal is to reverse declining health outcomes among CDL drivers through achievable lifestyle changes and increased physical activity. 5
FTP delivers a program that is grounded in evidence-based guidelines from leading organizations including the American Heart Association (AHA),
6
American Diabetes Association (ADA),
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National Heart, Lung, and Blood Institute (NHLBI),8,9 and the U.S. Department of Agriculture (USDA).
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The program includes: • Personalized health coaching (remote or in-person) • Evidence-based health education • Access to a mobile health application • Mental health support from licensed professionals
The FTP coaching guide covers key health topics including blood pressure management, aerobic exercise targets, glucose control, diabetes diagnosis, and healthy nutrition. The health coaching also becomes more intensive in the 90 days leading up to a scheduled DOT exam, maximizing drivers’ chances of improving health outcomes and maintaining certification.3,5
Program Outcomes and Evaluation
An evaluation of 22 truck drivers participating in the FTP program demonstrated promising results. Participants represented diverse ages, genders, and racial backgrounds, with individuals with secondary hypertension excluded from the analysis. Key outcomes included improved medical certification length and weight and BMI reduction. Of the 22 drivers assessed, eight drivers were eligible to improve certification duration. Of these drivers, three (38%) progressed from a 3-month certification to a 12- or 24-month certification. When evaluating weight and BMI changes, it was found that participants experienced an average weight reduction of 4.6 pounds and a BMI decrease of 1.3 kg/m2. 11
These findings suggest that, with a larger sample size, statistically significant improvements in certification outcomes may be observed. Additionally, through evaluating the program, we identified program enhancements that should be considered, including regular tracking of clinical measures (eg, blood pressure, weight, BMI), longitudinal follow-up to assess sustained impact, and updates to the FTP coaching guide to reflect current FMCSA regulations, including guidance for insulin-treated drivers.2,5,11
A critical factor in the program’s success has been its in-terminal coaching network. To effectively engage drivers, we recognized the importance of meeting them where they live and, on the road, where they work. We established a network of 52 CDL health coaches embedded at carrier terminals across the United States. This approach allows us to connect with drivers in real time and provide consistent, accessible support. 5
Engagement cannot occur without trust and relatability. That is why hiring the right coaches is essential. One of the first questions we ask potential coaches is whether they have a family member or close connection to a professional driver, as this usually indicates a more deep understanding of the unique challenges drivers face.
The program has grown primarily through referrals, leading to partnerships with major organizations such as Covenant Transport, Sherwin-Williams, Greyhound Bus Lines, and WARD. We have also worked to establish collaborations with national partners, including pharmacy chains such as Kroger and Publix, to provide on-site education, biometric health screenings, and preventive care resources. These partnerships help ensure drivers are better prepared for their DOT exams and more likely to obtain long-term certification.
Conclusion
Today’s healthcare system often prioritizes medication over lifestyle education and preventive care. The FTP program was designed to fill this gap by focusing on behavior change and sustained support. By equipping drivers with practical tools that support healthy lifestyle behavior adoption, the program aims to improve both individual health outcomes and industry-wide sustainability.5,11
Footnotes
Acknowledgements
Thank you to Dr Karen Heaton and the University of Alabama at Birmingham team for evaluating the remote CDL Driver Coaching Program.
Funding
The author received no financial support for the research, authorship, and/or publication of this article.
Declaration of Conflicting Interests
The author declared the following potential conflicts of interest with respect to the research, authorship, and/or publication of this article: Bob is the founder of FIT DRIVERS.