Qualitative study of knowledge, perception, behavior and barriers associated with cardiovascular disease risk among overweight and obese Hispanic taxi drivers of South Bronx, NYC

Abstract

Background Taxi drivers are prone to developing cardiovascular disease (CVD) risk factors by adopting poor health behaviors due to their work environment. The population of Hispanic taxi drivers in inner city South Bronx, NYC, have not been studied. The goal of our qualitative study is to understand the perception, knowledge, behavior and barriers that influence CVD risk in overweight and obese inner-city Hispanic drivers. Methods A cross-sectional qualitative study was conducted among community-based taxi drivers in South Bronx, NYC. Hispanic taxi drivers with body mass index of greater than 25 kg/m2 were screened and recruited for the study. Focus groups were organized to evaluate CVD and obesity risk factors through open-ended questions. The discussions were recorded, transcribed and analyzed using standard qualitative techniques. The Health Belief Model framework was applied to understand and evaluate likelihood of promoting health behaviors in this population based on the findings from the focus groups. Results We conducted 3 focus groups (N = 25) and themes that emerged were evaluated. Through the Health Belief Model framework, Hispanic taxi driver participants reported demanding and stressful work shifts, barriers to better nutrition and good health, poor support systems, and low self-efficacy in overcoming barriers to improve their risk for CVD, due to lower perceived benefits and greater perceived barriers. Conclusions Inner-city Hispanic NYC taxi drivers have several contributing factors and barriers leading to a poor CVD risk and high body weight profile. Understanding their knowledge, perception and barriers the drivers face in improving their CVD risk, underscores the importance of community outreach programs to develop a framework in empowering and improving the health of this population.

Co-Design of an eHealth Intervention to Reduce Cardiovascular Disease Risk in Male Taxi Drivers: ManGuard

“…In addition, there appears to be a lack of health-related knowledge among this group. This is similar to findings from qualitative studies with taxi drivers, indicating a desire to be educated on healthy eating and physical activity to remove barriers towards successful behaviour change [ 15 , 52 ].…”

“…Such behaviours include physical inactivity [ 5 , 7 , 11 , 15 , 51 ] and poor dietary habits [ 51 , 52 ], and a high prevalence of cigarette smoking compared to the general population [ 53 , 54 ]. Interestingly, although the overconsumption of alcohol by taxi drivers has been regularly reported [ 9 , 16 , 52 , 54 ], survey responses indicate this as an area of little concern, with the average alcohol consumption only slightly higher than the recommended 14 units/week. However, it was stated by members of the PAG that many drivers would not admit to their regular alcohol intake.…”

“…It appears that although NI taxi drivers engage in greater levels of CVD-related risk behaviours, they are aware of the negative impact this has on their CVD risk. Interviews with taxi drivers report that the long shifts cause fatigue and a subsequent lack of energy for engaging in physical activity [ 52 ]. A lack of energy has been reported as a significant barrier for men engaging in physical activity [ 55 ].…”

Factors Affecting the Deterioration of the Physical Health Status of Taxi Drivers by Age Group

“…When we studied the BMI as a physical factor, being overweight or obesity was associated with a deterioration of physical health status in the age groups of 35–54 and 55–64, whereas in the groups of taxi drivers over 75 years of age, being overweight or obesity was related to an improvement of physical health status. Previous studies reported that taxi drivers have high rates of excess weight and obesity [ 43 ].…”

“…In addition, in this study, we noted that hypertension and diabetes mellitus were the most-represented chronic diseases among all age groups. Referring to the literature, an increase in BMI and chronic diseases, such as HTN and DM, are reported as factors that further increase the risk of CVD [ 17 , 43 ]. Middle age is considered the time when the risk of chronic diseases and cardiovascular disease (CVD) begins to increase [ 10 , 11 ].…”