Weight Loss Intervention in Long-Haul Truck Drivers: A Pilot Study
Weight Loss Intervention in Long-Haul Truck Drivers: A Pilot Study
Being obese can be a risk factor for many health problems, including high cholesterol, high
 blood pressure, low back pain, heart attacks and some cancers. Truckers, who are integral to
 our economy, face challenges that put them at increased likelihood of being obese. The
 investigators want to come up with a program to help drivers get to a healthy weight and stay
 there.

 The WHEEL pilot study is a 12 week weight loss intervention in long-haul commercial truck
 drivers. The study involves two visits to the University of Utah's Rocky Mountain Center for
 Occupational and Environmental Health, one at the start of the study and a second one at the
 end of the study. Both visits include a general health history questionnaire, a 24-hour diet
 recall questionnaire, anthropometric measurements, as well as an assessment of blood
 pressure, hemoglobin A1c, and a cholesterol and lipid panel. Each truck driver is assigned a
 health coach who helps the driver create and achieve three health goals.

 The health coach works with the driver to set individualized goals specific to weight loss,
 and contacts the driver weekly to check in and tweak goals as needed.

 Drivers are also compensated for their participation in the study and get to keep all of the
 intervention materials that the investigators give them. All that the researchers ask is that
 they try their best to have a healthier lifestyle and give us feedback on what they liked and
 didn't like in the study.
The investigators recruited 13 truckers based in Utah's Wasatch Front (population 2.2
 Million) who expressed interest in participating in a weight loss intervention when they
 participated in the cross-sectional truck driver study (current enrollment, n= 817 truckers).
 Other options the investigators may pursue to maintain enrollment include enrolling
 participants directly through local trucking companies. Participants will be screened for
 eligibility based on

 -  Age > 21

 -  BMI > 30 kg/m2

 -  No reported unstable chronic disease

 Interstate truckers are required to be at least 21 years old. Participants will not be
 enrolled in the intervention until they complete the physical assessment component of the
 baseline visit that includes blood pressure, lipids, and HbA1c. Individuals who do not meet
 the established medical guidelines and regulations of the FMCSA will be excluded. Those
 individuals will be advised to follow-up for care with their personal physicians, and/or will
 be referred to a primary care clinic.

 Health coaches will have at least weekly contact with participants to discuss individual
 goals and behavior change. Motivational messages will be delivered in addition to weekly
 content via text messages and/or emails. Research suggests that individuals who begin losing
 weight quickly are more successful at weight loss and maintaining loss, therefore, after 3
 weeks individuals who have not lost at least 3 pounds will receive additional contacts with
 health coaches to address slow rate of weight loss. Individual Competitions surrounding
 successful healthy behaviors of Truckers will be conducted every other week. Winning
 behaviors will be shared with other participants by email, text, phone calls, blogs and/or
 other distance friendly format to both engage drivers and model successful peer behaviors.

 This is a study of weight loss intervention for long-haul commercial truck drivers who face
 unusual challenges to a healthy lifestyle while working. Participants (n=13) will be
 long-haul commercial truck drivers with a BMI over 30 kg/m2. Due to licensing issues, all
 interstate truck drivers are required to be at least 21 years old (US DOT, FMCSA), and thus
 proposed study participants will be at least 21 years old.

 The investigators are aware that there are some intrastate truck drivers who may be under age
 21, however they are a much smaller and different population. By definition they are not
 long-haul drivers, tend to have more job instability, have a different occupational
 environment that is relevant to this study (e.g., sleep at home), and thus are a different
 population that this research does not target. Thus, this study has sound rationale for not
 including children ages 18-20.

 The sampling will be convenient. Participants will be recruited using email, postal mail and
 opportunities for personal contact that are identified through the Utah Trucking Association
 website, newsletter, at truck stops, and at Commercial Truck Driver meetings. The
 investigators will inquire for current interest among subjects from our current cross
 sectional study who indicated interest in a follow-up study.

 Participants will be screened for approximate BMI, and medical history prior to recruitment.
 Participants under current treatment for cancer will be excluded. Participants with
 significant medical issues (such as unstable blood pressure, diabetes mellitus) will be asked
 to provide a medical release from their physician prior to participation. Participants
 currently in treatment for cancer will be excluded. In addition participants will not be
 enrolled until they have completed the physical assessment component of the study with blood
 pressure below 159/99 mm Hg (stage 2 hypertension), HbA1c below 10.0%, and total cholesterol
 below 300 mg/dL. If participants do not meet these standards a letter of permission to
 participate from a physician will be required. Participants will be referred to their
 personal physician or the primary care clinic at the University of Utah Redwood Health Center
 if they do not have a personal physician to obtain such permission.

 Study visits will take place in the Occupational Medicine conference room at the University
 of Utah Redwood Health Center where Drs. Eric Wood practice, to gather demographic data,
 medical history, reported physical activity, occupational health outcomes (slips trips and
 falls) and psychosocial factors, self-efficacy, sleepiness scale, job satisfaction and
 measure blood lipids, hemoglobin A1c and HsCRP, and body weight and circumferences at
 baseline and 12 weeks for all participants t. Participants will weigh themselves weekly using
 a scale provided by the study and will report weekly weight to health coaches using a scale
 provided via telephone, text, or email. Participants will have at least weekly contact with
 research staff (health coaches) regarding the intervention in the first 12 weeks of WHEEL.
 Contact will continue bi-weekly after the first 12 weeks of WHEEL with a goal of continued
 weight loss or weight loss maintenance.

 All participants will receive the weight loss intervention. Participants will be monitored
 closely for weight loss success in the first 3 weeks of the intervention. If weight loss is
 not at least 3 pounds, then health coaches will double their efforts with these participants
 as it is known that early success is associated with better long-term success.

 The investigators will obtain information on questionnaires, asking a person's birth date,
 but only record a person's age in tenths of a year. The investigators will measure height,
 weight, waist, hip, chest, neck circumferences, blood pressure, heart rate, take a
 finger-stick to measure fasting glucose, hemoglobin A1c, highly sensitive C-Reactive Protein,
 and blood lipids using point of service analysis and perform a urinalysis. No blood specimens
 will be stored.

 Measurements and questionnaires will be completed in the Occupational Medicine conference
 room at the University of Utah Redwood Health Center in Salt Lake City. This clinic is
 conveniently located around the corner from a large truck stop, and close to both I-80 and
 I-15, the two main interstates in Salt Lake City. The clinic has ample truck-friendly
 parking. The investigators have obtained letters of support from The Utah Trucking
 Association. Data will be recorded on laptop computers that are encrypted. Consent forms will
 be transported to the University of Utah for storage in locked cabinets.
-  Participants will be screened for eligibility based on:

 -  Age > 21

 -  BMI > 30 kg/m2

 -  No reported unstable chronic disease.

 -  Participants will not be enrolled in the intervention until they complete the physical
 assessment component of the baseline visit that includes blood pressure, lipids, and
 HbA1c.

 -  Individuals who do not meet the established medical guidelines and regulations of the
 FMCSA will be excluded. Those individuals will be advised to follow-up for care with
 their personal physicians, and/or will be referred to a primary care clinic.

 Inclusion of women

 Women will be included as they are represented in this population, although, the
 investigators expect, at rates that are less than the overall population. This is a
 convenience sample, thus there will not be attempts to over or under represent genders. The
 individualization of the interventions increases the likelihood of success of the
 intervention with both men and women.

 Inclusion of minorities

 The investigators will include minorities when possible. This is a convenience sample, so
 there will not be attempts to either over or under represent any racial or ethnic group.

 Inclusion of Children

 Commercial truck drivers must be 21 to drive interstate routes. Therefore, children,
 including those 18-20 years old, will not be included.