Cardiometabolic health and lifestyle behaviours in UK heavy goods vehicle drivers

The aim of this thesis was to understand the cardiometabolic health and lifestyle behaviours of HGV drivers in the UK using a mixed-methods approach.</p><p dir="ltr">This thesis uses data from the Structured Health Intervention for Truckers (SHIFT) randomised controlled trial (RCT) to examine cardiometabolic health, physical activity and sedentary behaviour in HGV drivers in the UK (Study 1 - Chapter Four). This was followed by an investigation into whether BMI influenced the effectiveness of responses to the SHIFT programme (Study 2 - Chapter Five).

The second part of the thesis focuses on dietary behaviour using an online survey to explore dietary patterns and lifestyle behaviours in HGV drivers (Study 3 - Chapter Six). Facilitators and barriers to healthy eating were then investigated using qualitative interviews (Study 4 - Chapter Seven).</p><p dir="ltr">This thesis highlights that HGV drivers in the UK have low levels of moderate-to-vigorous physical activity (9.8 mins/workday), high sitting times (12hrs/workday), high rates of overweight and obesity (88.1%) and unhealthy cardiometabolic health profiles.

Obesity classification influenced drivers’ response to the SHIFT programme. The intervention response differed favourably in daily steps (1872 steps/day), sedentary time (-57mins/day) and body weight (-2.37kg) in drivers with obesity relative to controls with obesity.</p><p dir="ltr">The survey data highlight differences in dietary patterns and physical activity behaviour between drivers with and without obesity. Drivers with obesity (49.6%) perceive more barriers to healthy eating and being active than drivers without obesity.

Drivers with obesity choose more unhealthy options as a snack, eat more often at fast-food chains, and fewer meet the physical activity guidelines. Additionally, the two groups differed regarding food and beverage choices on work and non-workdays.</p><p dir="ltr">Drivers mentioned within the interviews that a broad range of factors influence their eating behaviour. Limited availability of healthy food options on the road, food storage limitations and limited time for food preparation are common perceived barriers.

Drivers wish for more flexible break times, shorter shifts, secure parking places and better-equipped trucks to improve their diet.</p><p dir="ltr">This thesis shows the high need to develop health interventions specifically targeted to this underserved at-risk occupational group to inform policy changes and improve HGV drivers' working environment and health outcomes.</p>