Health Care Access Interventions for Taxi Drivers

Age: 18+

Sex: Male

Trial Phase: Academic

Sponsor: Memorial Sloan Kettering Cancer Center

Disqualifiers: Part-time driver, others

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Compensation: Varies

Number of Visits: 1

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial seeks to determine the best way to help taxi drivers in New York City attend important medical appointments and maintain a regular doctor. Researchers are testing various methods: usual health fair services alone, those services plus Navigation Case Management (NCM), or those services plus Taxi Health Improvement Promoters (TIP). Male taxi drivers who haven't had an annual check-up in the past year and lack a primary care doctor may be suitable for this study. Participants will receive follow-up support and reminders, including completing questionnaires, to ensure they receive necessary healthcare. As an unphased trial, this study provides a unique opportunity for participants to contribute to innovative solutions for improving healthcare access.

Will I have to stop taking my current medications?

The trial information does not specify whether you need to stop taking your current medications. It seems focused on health care access rather than medication changes.

What prior data suggests that these interventions are safe for taxi drivers?

Research shows that the treatments studied in this trial, such as Navigator Case Management and Taxi Health Improvement Promoters, are generally safe and aim to improve healthcare access for taxi drivers. Previous studies have found that Navigator Case Management helps drivers secure better insurance coverage and visit their primary care doctors more regularly, enhancing their health management. No reports of negative effects have emerged from these interventions.

The Taxi Health Improvement Promoter approach includes regular check-ins and reminders about health appointments, which participants handle well. These interventions are designed to help drivers attend important medical appointments and maintain healthier habits.

This trial is in the "Not Applicable" phase, focusing on how these interventions work in real-life settings rather than testing a new drug or treatment for safety. Therefore, these interventions are considered low-risk, as they involve support and reminders instead of new medical therapies. ^{1 2 3 4 5}

Why are researchers excited about this trial?

Researchers are excited about these healthcare access interventions for taxi drivers because they offer proactive, personalized support that goes beyond the usual care options. The Health Fair + Navigator Case Management approach stands out by providing tailored monthly assistance, appointment reminders, and consistent follow-ups, ensuring that drivers stay engaged with their healthcare. Meanwhile, the Health Fair + Taxi Health Improvement Promoters arm adds weekly check-ins and text messaging for appointment scheduling and health promotion, which could significantly enhance engagement and adherence to medical advice. These strategies aim to address the unique challenges taxi drivers face in accessing healthcare, potentially leading to better health outcomes for this group.

What evidence suggests that this trial's interventions could be effective for improving healthcare access for taxi drivers?

This trial will compare different interventions to improve healthcare access for taxi drivers. Research has shown that adding Navigator Case Management (NCM), one of the interventions in this trial, to regular health fairs helps more people access healthcare. One study found that insurance coverage increased from 40% to 63%, and more drivers began visiting primary care doctors, rising from 52% to 60%. This indicates that extra support, such as appointment reminders and monthly check-ins, enables more taxi drivers to receive necessary healthcare.

Similarly, the Taxi Health Improvement Promoters (TIP) approach, another intervention in this trial, also aims to make healthcare more accessible for drivers. It includes regular check-ins and reminders to attend medical appointments. This method has been linked to better health for drivers, who often face health risks due to their sedentary jobs. Both NCM and TIP show promise in helping taxi drivers stay healthier by facilitating access to medical care. ^{1 6 7 8 9}

Who Is on the Research Team?

Francesca Gany, MD, MPH

Principal Investigator

Memorial Sloan Kettering Cancer Center

Are You a Good Fit for This Trial?

This trial is for male taxi drivers aged 21-85 in NYC who speak English, Bengali, Urdu, Spanish, or French. They must own a cell phone capable of texting and lack a regular doctor. Participants should not have had an annual physical outside of work requirements within the last year and plan to stay in NYC for at least one more year.

Inclusion Criteria

Garage/Enrollment Site Inclusion: Located in the NYC Borough of Manhattan, Queens, Brooklyn, or the Bronx and has a roster of at least 100 drivers or is a site frequented by drivers

I am a male taxi driver in NYC, aged 21-85, without a primary doctor and haven't had a physical in the last year.

I am a male taxi driver in NYC, aged 21-85, who cares about health and helping others.

Exclusion Criteria

I do not agree to host health screenings at my location.

Driver Exclusion: Part-time driver (drives fewer than 30 hours per week)

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Health Fair

Participants attend a health fair to receive standard services and initial assessments

1 day

1 visit (in-person)

Intervention

Participants receive Navigation Case Management (NCM) or Taxi Health Improvement Promoters (TIP) interventions, including follow-up calls and health promotion reminders

12 months

Monthly check-ins (in-person or phone)

Follow-up

Participants are monitored for the establishment of a primary care provider and other health outcomes

3 months

What Are the Treatments Tested in This Trial?

Interventions

• Questionnaires

Trial Overview The study tests if adding Navigation Case Management (NCM), mobile text messaging (mTECH), and Taxi health Improvement Promoter (TIP) to usual follow-up improves healthcare access for taxi drivers. It aims to determine whether these interventions help drivers attend medical appointments and maintain regular healthcare.

How Is the Trial Designed?

Group I: Health Fair + Taxi Health Improvement Promoters Experimental Treatment 1 Intervention

Health Fair standard services Follow-up call or further in-person assistance within one day for urgent follow-up, or call within two weeks for regular needs. Three call attempts. Taxi health Improvement Promoters (TIPs) * Weekly check-ins with each participant, in person or by phone, about scheduling of, and attendance at, primary care appointments along with other health or study questions Mosio Text Messaging Program * Send primary care provider recommendations to participant up to three times * Two pre-appointment reminders \& one post-appointment check-in * Twice weekly health promotion reminders after primary care appointment

Group II: Health Fair + Navigator Case Management Experimental Treatment 1 Intervention

• Follow-up call or further in-person assistance within one day for urgent follow-up, or call within two weeks for regular needs. Three call attempts. Navigator Case Management by trained staff * Tailored assistance for any health needs a minimum of once a month 12 months. Assistance includes pre-appointment reminder calls, post-appointment follow up calls, and health promotion reminders. * NCM case management will continue follow-up at a minimum of once per month or as requested by the participant for the study duration and will consistently offer appointment reminders and follow-ups.

Group III: Health Fair Alone (Control) Active Control 1 Intervention

No Follow Up Participant does not require referrals or assistance and was not advised to see a provider in the next three months. Regular follow-up call within two weeks of health fair by IHCD intern or staff. Participant has abnormal values, requires referrals or assistance or was advised to see a provider in the next three months. Up to 3 call attempts to get participant into needed care. Further contact only by participant request. Urgent follow-up call or in-person assistance within 1 day of health fair by IHCD intern or staff Participant advised to seek urgent care within one week. Three total call or in-person attempts to get participant into needed care. Further contact only by participant request The follow up call attempts may extend up to 3 months past the date of health fair to complete any needs the driver may have.

Who Is Running the Clinical Trial?

Memorial Sloan Kettering Cancer Center

Lead Sponsor

Trials

1,998

Recruited

602,000+

SOUTH ASIAN COUNCIL FOR SOCIAL SERVICES

Collaborator

Trials

1

Recruited

760+

Citations

1. clinicaltrials.gov clinicaltrials.gov/study/NCT02508363

Randomized Controlled Trial Examining Health Care Access ... The purpose of this study is to compare the effectiveness of providing the usual health fair service and follow-up alone plus additional interventions of ...

2. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC10191218/

Health Insurance and Primary Care Access for Taxi/FHV ... The data revealed an increase in insurance coverage and primary care uptake across the four years, from 40% to 63% and 52% to 60%, respectively.

3. ajph.aphapublications.org ajph.aphapublications.org/doi/full/10.2105/AJPH.2014.302122

Step On It! Impact of a Workplace New York City Taxi Driver ... Data collected included sociodemographics, employment, health care access and use, height, weight, blood pressure, and random plasma glucose.

4. w.grantome.com w.grantome.com/grant/NIH/R01-NR015265-04

Taxi Health Access Interventions for Linkages and Lifestyle (HAILL) We have developed and implemented a multifaceted intervention, an occupationally tailored worksite screening health fair with case management, which has ...

5. researchgate.net researchgate.net/publication/391480306_Primary_Care_Uptake_Interventions_in_Taxi_App-Based_and_Other_For-Hire_Vehicle_Drivers_The_HAILL_Cluster_Randomized_Controlled_Trial

Primary Care Uptake Interventions in Taxi, App-Based, and ... All interventions increased healthcare access, with a positive trend in primary care uptake between arms 1 and 2. Health Fairs and Navigator case management ...

6. researchgate.net researchgate.net/publication/352875392_Cardiovascular_health_status_of_taxifor-hire_vehicle_drivers_in_the_United_States_A_systematic_review

Cardiovascular health status of taxi/for-hire vehicle drivers ... Arm 1 received the Health Fair only. Arm 2 received the Health Fair and Navigator case management for up to 12 months. Arm 3 received the Health ...

7. ajph.aphapublications.org ajph.aphapublications.org/doi/10.2105/AJPH.2014.302122

Step On It! Impact of a Workplace New York City Taxi Driver ... Objectives. We describe the impact of the Step On It! intervention to link taxi drivers, particularly South Asians, to health insurance ...

8. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC8485180/

Cardiovascular Health of Taxi/FHV Drivers in the United States This review sought to systematically investigate the literature given mounting evidence of poor taxi/FHV driver health.

9. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC3535147/

Health and Safety Strategies of Urban Taxi Drivers - PMC This study describes health and safety concerns and self-care strategies of San Francisco taxi drivers. Focus groups and a written cross-sectional survey ...