Taxi Drivers at Risk: Tailoring Nutrition and Exercise Materials

  • Emily McNeill
  • Anuradha Hashemi
  • Julia Ramirez
  • Nicole Roberts-Eversley
  • Francesca GanyEmail author
Original Paper


Cognitive interviewing was used to refine nutrition and exercise health education materials for use in the New York City taxi driver community. Cognitive interviews were conducted with taxi drivers at garages and community centers across New York City. Interviews were conducted in five rounds with approximately 10 interviews conducted in each round. Modifications were made to the education materials between rounds based on driver feedback. Interviews were transcribed, coded to identify areas needing improvement, and then used to modify materials. Areas that needed adaptation included colloquialisms, literacy level, complex jargon/terminology, vague/confusing phrasing, driver-specific and ethnic-specific preferences, visual aids, and mathematical calculations. These were organized into four key themes: linguistic responsiveness, occupational and cultural adaptation, visuals, and calculations. Cognitive interviewing is a useful method for refining health education materials in the diverse driver population. Cognitive interviewing revealed a need to reduce literacy level, avoid complex terminology, make further occupational and cultural adaptations, use clear visual aids, and avoid the use of complex calculations. Cognitive interviewing is an effective method for refining health education materials for immigrant and low literacy populations.


Immigrants Minority health Health education Cognitive interviewing Nutrition 



This work was supported by National Cancer Institute P30 CA008748 Core Cancer Center Support Grant; National Institute on Minority Health and Health Disparities, U01 MD010648 Taxi STEP (Social networks, Technology, and Exercise through Pedometers), and National Institute of Nursing Research, R01 NR015265 Taxi HAILL (Taxi Health Access Interventions for Linkages and Lifestyle).

Compliance with Ethical Standards

Conflict of interest

The authors declare that they have no conflict of interest.


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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  • Emily McNeill
    • 1
  • Anuradha Hashemi
    • 1
  • Julia Ramirez
    • 1
  • Nicole Roberts-Eversley
    • 1
  • Francesca Gany
    • 1
    • 2
    Email author
  1. 1.Immigrant Health and Cancer Disparities Service, Department of Psychiatry and Behavioral SciencesMemorial Sloan Kettering Cancer CenterNew YorkUSA
  2. 2.Departments of Medicine and Public Health, Weill Cornell Medical CollegeMemorial Sloan Kettering CancerNew YorkUSA

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