# Exercise as it relates to Disease/Increasing physical activity in commercial truck drivers

This wikibook's page is a critique of the research article “Exercise Among Commercial Truck Drivers” by Lisa M. Turner and Deborah B. Reed (2011)

### What is the background to this research?

Physical activity has many benefits including reducing the risk of chronic disease. Due to the sedentary nature of their occupation, truck drivers typically have higher obesity rates, predisposing them to health conditions such as cardiovascular disease, diabetes and hypertension. Australia’s Physical Activity and Sedentary Behaviour Guidelines for adults (aged between 18-64), states that a total of 150 to 300 minutes of moderate or 75 to 150 minutes of vigorous physical activity is to be achieved each week. As a result of the occupational environment and demands, three quarters of Australian truck drivers have been classified as inactive. The present study being critiqued, aims to assess the exercise habits and perceived barriers of exercise among commercial truck drives with the purpose of increasing physical activity among this population.

### Where is the research from?

The research was conducted at the University of Cincinnati Education and Research Centre and was supported by the National Institute for Occupational Safety and Health Pilot Program. The study was published in the Journal of The American Association of Occupational Health Nurses (AAOHN) in 2011 by Turner and Reed. The study is likely to be of high-quality with Reed having won many awards for her research into agricultural health and injury prevention and with Turner having previously published studies to do with obesity and physical activity in specific populations.

### What kind of research was this?

The present study 'Exercise Among Commercial Truck Drivers' can be classified as having a cross-sectional, non-experimental design. The nature of the study design deems it to be observational with its aim to describe the population. Limitations are presented in that causal inferences cannot be made due to being non-experimental. The quality of the study is likely to be unhindered given that its design is most appropriate for the occupational demands of commercial truck drivers. However, potential biases in the data should be considered as the study only represents the population at a specific point in time.

### What did the research involve?

300 participants recruited from six truck shows in the United States were used for the study. Body measurements and a self-administered questionnaire (Obesity Risk Factor Questionnaire) developed for the purpose of this study were collected from the participants who met the inclusion criteria. BMI was calculated from measuring the participants height and body weight. The Obesity Risk Factor Questionnaire consisted of 13 questions aimed to describe the exercise habits and perceived barriers. Questions included:
* on how many of the past 7 days did truck drivers engage in aerobic, stretching or strengthening exercise for 15 minutes or longer
* how often did they exercise for 30 minutes continuously in the past week
* did they exercised on a regular basis
The questionnaire required participants to check all boxes which were perceived as barriers. This could present as a potential bias in the study where participants are influenced with preconceived ideas of there being barriers. Furthermore, additional space was provided for participants to add barriers not listed, however as the questionnaire was self-administered with no incentive to do a good job the reliability of the questionnaire should be taken into consideration.
As the occupational environment was not directly observed by the authors, it hinders the validity of the study. Self-report data raises questions as to whether the participants were presenting a more favorable image of themselves. With the research being conducted in the United States where it is reported to have low levels of physical activity with only one in four adults meeting recommended levels of physical activity, the data may not be representative of all commercial truck drivers.

### What were the basic results?

The results showed that 20% of participants did not do any physical activity in the last 7 days. Nearly half did not engage in 30 minutes of continuous exercise on any given day. 93.3% of participants where considered to be overweight or obese with a BMI of 25 or above. The most reported barriers to exercise included: a lack of exercise facilities, not having enough time and not using exercise facilities if available. From the results, the authors of the study suggested the need to work with the industry to schedule blocks of exercise, for example 10 to 15 minutes of exercise when drivers are unloading their trucks. Furthermore, they suggested working with the industry to increase the availability of exercise equipment.

### What conclusions can we take from this research?

The study has been instrumental in determining the current physical activity levels and perceived exercise barriers in truck drivers. With the commercial truck driving industry operating 24/7 under tight schedules, it seems unlikely that companies will be willing to invest money, effort, and time away from driving hours. While the recommendation of short bouts of exercise is good in theory, the success of its adherence lies solely on motivation. Furthermore, in a population which reported being too tired and lacking the motivation to exercise as a major barrier towards physical activity, addressing motivation should be considered along with increasing exercise.

### Practical advice

Further research into improving participants adherence to physical activity on an individual scale, rather than the industry as a whole, would be worthwhile. Other studies done on commercial truck drivers have shown promising results towards the effectiveness of using mobile health technology. This has been shown to increase driver awareness of their own health, and subsequently being able to monitor their own physical activity levels. Furthermore, using motivational interviewing as an intervention for patients with higher risk factors for cardiovascular disease was shown to be effective in increasing physical activity. Therefore, further research could be conducted to validate motivational interviewing for commercial truck drivers.
Instead of having scheduled exercise as suggested by the authors of the study, it may be more achievable to first implement small changes such as walking at rest stops, performing abdominal exercises while sitting or doing simple stretches. Additionally, drivers may work to increase physical activity habits on their days off which may over time translate to their workplace behaviour.

### Further information/resources

Exercise tips for truck drivers
Road trip stretches
Smartphone application

### References

* 1 2 3 4 5 6 7 Turner LM, Reed DB. Exercise among commercial truck drivers. Aaohn Journal [Internet]. 2011 Nov 10 [cited 2020 Aug 29];59(10):429-36. Available from: https://journals.sagepub.com/doi/pdf/10.1177/216507991105901005
* 1 2 3 Greenfield R, Busink E, Wong CP, Riboli-Sasco E, Greenfield G, Majeed A, et al. Truck driver’s perceptions on wearable devices and health promotion: a qualitative study. BMC public health [Internet]. 2016 July 30 [cited 2020 Aug 29];16(1):677. Available from: https://bmcpublichealth.biomedcentral.com/articles/10.1186/s12889-016-3323-3
* ↑ Department of Health, Australian Government [Internet]. [place, publisher, date unknown] [updated 2019 April 12; cited 2020 Aug 29]. Available from: https://www1.health.gov.au/internet/main/publishing.nsf/Content/health-pubhlth-strateg-phys-act-guidelines
* 1 2 Gilson ND, Pavey TG, Vandelanotte C, Duncan MJ, Gomersall SR, Trost SG, et al. Chronic disease risks and use of a smartphone application during physical activity and dietary intervention in Australian truck drivers. Australian and New Zealand journal of public health [Internet]. 2015 Dec 29 [cited 2020 Aug 29];40(1):91-3. Available from: https://onlinelibrary.wiley.com/doi/full/10.1111/1753-6405.12501
* 1 2 Levin KA. Study design III: cross-sectional studies. Evid Based Dent [Internet]. 2006 Mar [cited 2020 Aug 29];7:24-25. https://www.nature.com/articles/6400375
* ↑ Van de Mortel TF. Faking it: social desirability response bias in self-report research. Australian journal of advanced nursing [Internet]. 2008 Aug [cited 2020 Aug 29];25(4). Available from: https://search.informit.com.au/fullText;dn=210155003844269;res=IELHEA
* ↑ U.S Department of Health & Human Services. Centres for disease control and prevention. [Internet]. [place, publisher unknown] [updated 2019 Sep 25; cited 2020 Aug 29]. Available from: https://www.cdc.gov/chronicdisease/resources/publications/factsheets/physical-activity.htm#:~:text=Only%201%20in%204%20US,beyond%20that%20of%20daily%20living.
* ↑ Hardcastle SJ, Taylor AH, Bailey MP, Harley RA, Hagger MS. Effectiveness of a motivational interviewing intervention on weight loss, physical activity and cardiovascular disease risk factors: a randomised controlled trial with a 12-month post-intervention follow-up. International journal of behavioural nutrition and physical activity [Internet]. 2013 Mar 28 [cited 2020 Aug 29];10(1):40. Available from: https://ijbnpa.biomedcentral.com/articles/10.1186/1479-5868-10-40