(ADED) Occupation-Based Coaching for Commercial Truck Drivers: A Pilot Study

PURPOSE: The purpose of this pilot study was to test the effectiveness of an occupation-based, over-the-phone coaching program for commercial truck drivers to improve overall health and life on the road through the development of personalized health behavior goals. Approximately 1.7 million people are employed as commercial truck drivers in the United States (Bureau of Labor Statistics, 2018). The combination of work environment and lifestyle choices for this population results in a high incidence of chronic health conditions and decreased life expectancy (Apostolopoulus et al., 2013). Occupational therapy practitioners are uniquely qualified to address the occupational needs related to the job demands of commercial truck driving to facilitate better occupational performance and health behaviors.

The research questions were as follows: How are changes in health and lifestyle, as measured on the Patient-Reported Outcomes Measurement Information System–57 v2.0 (PROMIS–57), different in the coaching group compared with the noncoaching group? How does participation in an occupation-based coaching program result in general health behavior and lifestyle changes? How do commercial truck drivers make changes in routines to meet personalized health goals through an occupation-based coaching program?

METHOD: This study used a quasi-experimental, mixed methods approach. A pretest–posttest control group design was used to determine changes related to the coaching program and to allow comparison of the coaching group to a noncoaching control group. Qualitative analysis was used to determine the effectiveness of coaching. Participants were recruited using convenience and snowball sampling through local trucking companies. Inclusion criteria were age 18 or older and possession of a current commercial driver’s license (CDL). Seven participants were enrolled in the pilot; four participants were randomly assigned to the coaching group and three to the noncoaching group.

An occupation-based coaching program was developed for this study. The Person–Environment–Occupation (PEO) Model and social cognitive theory served as a framework for the intervention. Coaching is a therapeutic tool that promotes client centeredness and integrated concepts of motivation and health behavior change (Graham, 2013). Goal attainment strategies were incorporated into each one-on-one coaching session. This study was approved by the institutional review board at Elizabethtown College.

PROMIS–57 was used to compare the coaching group with the noncoaching group and to determine change over the 8-wk coaching program. PROMIS–57 comprises 57 items across eight domains: depression, anxiety, physical function, pain interference, fatigue, sleep disturbance, ability to participate in social roles and activities, and pain intensity. The Canadian Occupational Performance Measure (COPM; Law et al., 2014) was used as a pre- and postintervention assessment for the coaching group only. Both groups completed the PROMIS–57 on study entry and 8 wk later. The coaching group completed the COPM and intake interview and participated in the 8-wk telephone coaching program.

Thematic analysis was completed across session notes, COPM data, and intake interviews. Comparisons between drivers were constructed using a mapping technique to draw connections between common themes and ideas. Matched pairs t test was used to measure change in raw scores within each domain of the PROMIS–57 for participants in the coaching group. An independent test of means of unequal variances was run to compare the mean differences in scores between the two groups.

RESULTS: Each participant in the coaching group experienced an increase in both performance of and satisfaction with their respective problem area indicated on the COPM after 8 wk. Results from a matched pairs dependent t test of each domain of the PROMIS–57 within the coaching group were not significant. Between-group analysis with an independent test of means of unequal variances did not yield any significant differences at an alpha level of p < .05.

CONCLUSION: Telephone-based coaching proved to be an effective method for reaching truck drivers and increasing their access to health-related programs. Using coaching with truck drivers offers new possibilities for improving health and wellness and opens the door for occupational therapy practitioners to work with an underserved population.

References

Apostolopoulos, Y., Sönmez, S., Shattell, M., Gonzales, C., & Fehrenbacher, C. (2013). Health survey of U.S. long-haul trucker drivers: Work environment, physical health, and healthcare access. Work, 46, 113–123. https://doi.org/10.3233/WOR-121553

Bureau of Labor Statistics. (2018). Heavy and tractor-trailer truck drivers. Retrieved from https://www.bls.gov/ooh/transportation-and-material-moving/heavy-and-tractor-trailer-truck-drivers.htm

Graham, F. (2013). Occupational therapist coaches: Old wine in new bottles or a new vintage emerging? Keynote address presented at the Occupational Therapy Australia Queensland Division’s Mental Health and Paediatric Symposia.

Law, M., Baptiste, S., Carswell, A., McColl, M. A., Polatajko, H., & Pollock, N. (2014). Canadian Occupational Performance Measure (5th ed.). Ottawa: CAOT Publications.