R01NR020174

NYC Transit Workers and COVID-19: Impact of Multilevel Interventions - Summary (Abstract)

During the COVID-19 pandemic, New York City (NYC) public transportation has been an essential service to ensure that other essential workers can get to their jobs. Many of the predominantly racial and ethnic minority transit workers have been exposed to risks both at work and at home, as many workers also reside in high prevalence communities. The pandemic thrust transit workers into the role of frontline workers, even though they lacked the training, experience, supplies, equipment, and supervision typically provided for traditional frontline workers (i.e., healthcare and first responders).

This study, conducted in partnership with the Transport Workers Union (TWU), Local 100, is designed to:

1. Evaluate the cumulative impact of multilevel interventions to date on current worker health and resilience.
2. Develop and assess a worker-driven model of crisis management to facilitate worker resilience as the pandemic and policy responses evolve (e.g., restore lockdown with resurgence, deployment of vaccine).
3. Disseminate findings to provide input into policy changes and operations to protect non-healthcare essential workers during pandemic events with a focus to decrease health disparities in high-risk populations.

To achieve these aims, we propose to conduct serial cross-sectional surveys of a systematic sample of the NYC transit workforce, with the logistical assistance of TWU, representing nearly 40,000 subway and bus workers. The timing of subsequent surveys will be dynamic to capture real-time shifts in the pandemic and ongoing changes in policies and practices that impact transit workers.

In the first phase, we will examine the impact of multilevel interventions already implemented by several entities, including:
A. Federal, state, and local governments and agencies.
B. The Metropolitan Transit Authority (MTA), the public authority in charge of NYC transit.
C. TWU, which provided advocacy, reinforcement of multilevel interventions, referrals, and social support.

Guided by a new pandemic preparedness and resilience model and informed by data from our recent transit workers pilot study, the existing multilevel interventions will be mapped onto the NIMHD framework and evaluated to determine their impact on workers' outcomes (e.g., infection, psychosocial, behavioral, interpersonal relations, resilience), perceived impact of TWU interventions (e.g., advocacy, reinforcement with outreach for education and social support), and individual adoption of recommended practices designed to mitigate community and workplace spread. We will examine potentially moderating effects of age, sex/gender, race, ethnicity, and occupational characteristics of the workers.

Initial and subsequent survey data will inform ongoing participatory action research (PAR) teams comprised of academics, workers, and other key stakeholders who will formulate data-driven strategies to increase the effectiveness of the multilevel interventions and further support worker resilience in the face of shifting pandemic events. Results will be widely disseminated to inform policy changes suggested by study findings.

New York University

NURSES UNDERSTAND THAT IMPROVING HEALTH AND WELL-BEING MEANS ADDRESSING PEOPLE'S NEEDS IN MULTIPLE SETTINGS, CONTEXTS, AND OVER THE WHOLE LIFE COURSE. SCIENCE SUPPORTED BY THE NATIONAL INSTITUTE OF NURSING RESEARCH (NINR) USES THIS HOLISTIC PERSPECTIVE TO IMPROVE INDIVIDUAL AND POPULATION HEALTH AND ADVANCE HEALTH EQUITY. NINR-SUPPORTED RESEARCH PROMOTES HEALTH AND WELL-BEING BY ADDRESSING NEEDS AT MULTIPLE LEVELS INDIVIDUAL, FAMILY, COMMUNITY, AND SOCIETAL LEVELS AND DEVELOPING TREATMENT AND PREVENTION STRATEGIES THAT ARE RESPONSIVE TO THE REALITY OF PEOPLE'S LIVES. NURSES KNOW PEOPLE, AND PEOPLE TRUST NURSES. PATIENT AND FAMILIES INTERACT WITH NURSES MORE THAN ANY OTHER CLINICIANS. NURSING SCIENCE USES THIS SPECIAL RELATIONSHIP TO BETTER UNDERSTAND PATIENTS, FAMILIES, AND COMMUNITIES AND THE MANY FACTORS THAT INFLUENCE THEIR HEALTH. NURSING SCIENCE SUPPORTED BY NINR USES THIS KNOWLEDGE TO DEVELOP STRATEGIES FOR IMPROVING HEALTH AND WELLNESS ACROSS POPULATIONS, HEALTH CARE SETTINGS, AND THE LIFESPAN, WITH AN EMPHASIS ON ACHIEVING HEALTH EQUITY. NINR-SUPPORTED SCIENTISTS HAVE DEVELOPED INTERVENTIONS FOR: SUPPORTING PARENTS OF PREMATURE INFANTS, PROMOTING HIV PREVENTION IN UNDERSERVED POPULATIONS, IMPROVING TRANSITIONAL CARE LEADING TO BETTER OUTCOMES AND COST-SAVINGS, AND HELPING INNER-CITY CHILDREN MANAGE ASTHMA. NURSING SCIENCE TRANSCENDS THE BOUNDARIES OF DISEASE AND RESEARCH DISCIPLINES TO BETTER UNDERSTAND THE EXPERIENCES OF INDIVIDUALS AND FAMILIES LIVING WITH ILLNESS AND TO DEVELOP PERSONALIZED APPROACHES THAT MAXIMIZE HEALTH AND WELL-BEING FOR INDIVIDUALS AT ALL STAGES OF LIFE, ACROSS DIVERSE POPULATIONS AND SETTINGS. NINR-SUPPORTED SCIENCE USES NURSING SCIENCE'S UNIQUE, PATIENT AND COMMUNITY-FOCUSED PERSPECTIVE AND WIDE REACH ACROSS CLINICAL AND COMMUNITY SETTINGS TO ADVANCE OUR UNDERSTANDING OF THE SOCIAL DETERMINANTS OF HEALTH: THOSE FACTORS THAT ARE AT THE ROOT OF THE INEQUITIES THAT WE SEE, SUCH AS FOOD INSECURITY AND ACCESS TO HEALTHCARE. NINR RESEARCH EFFORTS IN WELLNESS INVESTIGATE THE KEY BIOLOGICAL, BEHAVIORAL, AND SOCIAL FACTORS THAT PROMOTE LONG-TERM HEALTH AND HEALTHY BEHAVIORS AND PREVENT THE DEVELOPMENT OF ILLNESS ACROSS HEALTH CONDITIONS, SETTINGS, AND THE LIFESPAN. RESEARCH IN WELLNESS IS ALSO FOCUSED ON DEVELOPING AND TESTING CULTURALLY APPROPRIATE INTERVENTIONS TO PROMOTE HEALTH AND PREVENT ILLNESS IN MINORITY AND UNDERSERVED GROUPS. NINR ALSO SUPPORTS SCIENCE TO ASSIST INDIVIDUALS, FAMILIES, AND HEALTH CARE PROFESSIONALS IN MANAGING ADVANCED, SERIOUS ILLNESS, AND PLANNING FOR END-OF-LIFE DECISIONS. IN ADDITION, NINR PROMOTES TECHNOLOGICAL ADVANCEMENTS THAT ADDRESS A RANGE OF HEALTH CARE CHALLENGES AND FACILITATE THE DELIVERY OF REAL-TIME PERSONALIZED INFORMATION TO INDIVIDUALS AND FAMILIES, HEALTH CARE PROVIDERS, AND COMMUNITIES. FINALLY, NINR HAS A LONGSTANDING AND CONTINUING COMMITMENT TO DEVELOPING THE NEXT GENERATION OF NURSE SCIENTISTS: THOSE INDIVIDUALS AND TEAM MEMBERS WHO WILL CARRY THE FIELD OF NURSING SCIENCE INTO THE FUTURE. IN ORDER TO PREPARE AN INNOVATIVE, DIVERSE, AND TALENTED NEXT GENERATION OF NURSE SCIENTISTS, NINR SUPPORTS A VARIETY OF TRAINING OPPORTUNITIES FOR SCIENTISTS AND TRAINEES AT ALL CAREER LEVELS, PARTICULARLY THOSE AT AN EARLY CAREER STAGE WHO ARE SO CRITICAL TO SUSTAINING THE FUTURE OF INNOVATIVE RESEARCH AND HIGH QUALITY HEALTH CARE.

93.361 - Nursing Research

National Institute of Nursing Research (NINR) [HHS - NIH]

New York, New York 100039508 United States

Single Zip Code

Community Interventions to Address the Consequences of the COVID-19 Pandemic among Health Disparity and Vulnerable Populations (R01- Clinical Trial Optional) (PAR-20-237)

Amendment Since initial award the total obligations have increased 380% from $725,664 to $3,486,586.