Skip to main content

Advertisement

SpringerLink
Log in

Supporting South Asian Taxi Drivers to Exercise through Pedometers (SSTEP) to Decrease Cardiovascular Disease Risk

  • Published:
Journal of Urban Health Aims and scope Submit manuscript

Abstract

There is considerable evidence demonstrating the positive impact of pedometers and walking programs for increasing physical activity and reducing risk for cardiovascular disease among diverse populations. However, no interventions have been targeted towards South Asian taxi drivers, a population that may be at high risk for developing cardiovascular disease. Supporting South Asian Taxi Drivers to Exercise through Pedometers (SSTEP) was a 12-week pilot study among South Asian taxi drivers to increase their daily step counts. SSTEP assessed the feasibility, acceptability, and potential impact of an exercise intervention employing pedometers, a step diary, written materials, and telephone follow-up to initiate or increase physical activity in this at-risk occupational group. Seventy-four drivers were recruited to participate at sites frequented by South Asian taxi drivers. Participant inclusion criteria were: (1) age 18 or over; (2) birthplace in India, Pakistan, or Bangladesh; (3) fluent in English, Hindi, Urdu, Punjabi, or Bengali; and (4) intention to remain in New York City for the 3-month study period. Comprehensive intake and exit questionnaires were administered to participants in their preferred languages. Intake and exit health screenings, including blood pressure, cholesterol, and glucose were completed. Daily step counts were obtained 4 days after recruitment, and at the 4-, 8-, and 12-week mark via phone calls. To measure the impact of the intervention, step counts, blood pressure, cholesterol, and body mass index were compared at intake and exit. Participants in SSTEP were sedentary at baseline. The SSTEP intervention resulted in a small increase in step counts among participants overall, and in a significant increase (>2,000 steps) among a subset (“Bigsteppers”). Drivers with higher baseline glucose values had significantly greater improvements in their step counts. Focused lifestyle interventions for drivers at high risk for cardiovascular disease may be particularly impactful.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

FIGURE 1.

Similar content being viewed by others

References

  1. World Health Organization. Global health risks: mortality and burden of disease attributable to selected major risks. Geneva: WHO; 2009.

    Google Scholar 

  2. Lau DC, Douketis JD, Morrison KM, Hramiak IM, Sharma AM, Ur E. 2006 Canadian clinical practice guidelines on the management and prevention of obesity in adults and children [summary]. CMAJ. 2007; 176(8): S1–13.

    Article  PubMed Central  PubMed  Google Scholar 

  3. Centers for Disease Control and Prevention. Phys Act Health. 2011; http://www.cdc.gov/physicalactivity/everyone/health/index.html. Accessed 7 Sept 2011.

  4. Tanasescu M, Leitzmann MF, Rimm EB, Hu FB. Physical activity in relation to cardiovascular disease and total mortality among men with type 2 diabetes. Circulation. 2003; 107(19): 2435–9.

    Article  PubMed  Google Scholar 

  5. Rothenbacher D, Hoffmeister A, Brenner H, Koenig W. Physical activity, coronary heart disease, and inflammatory response. Arch Intern Med. 2003; 163(10): 1200–5.

    Article  PubMed  Google Scholar 

  6. Tully MA, Cupples ME, Chan WS, McGlade K, Young IS. Brisk walking, fitness, and cardiovascular risk: a randomized controlled trial in primary care. Prev Med. 2005; 41(2): 622–8.

    Article  CAS  PubMed  Google Scholar 

  7. Hakim AA, Curb JD, Petrovitch H, et al. Effects of walking on coronary heart disease in elderly men: the Honolulu Heart Program. Circulation. 1999; 100(1): 9–13.

    Article  CAS  PubMed  Google Scholar 

  8. Baker G, Gray SR, Wright A, et al. The effect of a pedometer-based community walking intervention “Walking for Wellbeing in the West” on physical activity levels and health outcomes: a 12-week randomized controlled trial. Int J Behav Nutr Phys Act. 2010; 7(1): 51.

    Article  PubMed  Google Scholar 

  9. Bravata DM, Smith-Spangler C, Sundaram V, et al. Using pedometers to increase physical activity and improve health: a systematic review. JAMA. 2007; 298(19): 8.

    Article  Google Scholar 

  10. Chan CB, Ryan DA, Tudor-Locke C. Health benefits of a pedometer-based physical activity intervention in sedentary workers. Prev Med. 2004; 39(6): 1215–22.

    Article  PubMed  Google Scholar 

  11. Freak-Poli R, Wolfe R, Backholer K, de Courten M, Peeters A. Impact of a pedometer-based workplace health program on cardiovascular and diabetes risk profile. Prev Med. 2011; 53(3): 162–71.

    Article  PubMed  Google Scholar 

  12. Zoellner J, Connell C, Powers A, Avis-Williams A, Yadrick K, Bogle ML. Does a six-month pedometer intervention improve physical activity and health among vulnerable African Americans? A feasibility study. J Phys Act Health. 2010; 7(2): 224–31.

    PubMed  Google Scholar 

  13. Duru OK, Sarkisian CA, Leng M, Mangione CM. Sisters in motion: a randomized controlled trial of a faith-based physical activity intervention. J Am Geriatr Soc. 2010; 58(10): 1863–9.

    Article  PubMed Central  PubMed  Google Scholar 

  14. Panton LB, Kushnick MR, Kingsley JD, Moffatt RJ, Haymes EM, Toole T. Pedometer measurement of physical activity and chronic disease risk factors of obese lower socioeconomic status African American women. J Phys Act Health. 2007; 4(4): 447–58.

    PubMed  Google Scholar 

  15. Kobayashi F, Watanabe T, Watanabe M, et al. Blood pressure and heart rate variability in taxi drivers on long duty schedules. J Occup Health. 2002; 44: 214–20.

    Article  Google Scholar 

  16. Kurosaka K, Daida H, Muto T, Watanabe Y, Kawai S, Yamaguchi H. Characteristics of coronary heart disease in Japanese taxi drivers as determined by coronary angiographic analyses. Ind Health. 2000; 38(1): 15–23.

    Article  CAS  PubMed  Google Scholar 

  17. Wu S, Deng F, Niu J, Huang Q, Liu Y, Guo X. Association of heart rate variability in taxi drivers with marked changes in particulate air pollution in Beijing in 2008. Environ Health Perspect. 2010; 118(1): 87–91.

    CAS  PubMed Central  PubMed  Google Scholar 

  18. Blasi G, Leavitt J. Driving poor: taxi drivers and the regulation of the taxi industry in Los Angeles. Los Angeles: UCLA Institute of Industrial Relations; 2006.

    Google Scholar 

  19. Urban Justice Center. UNFARE: taxi drivers and the cost of moving the city. New York: Urban Justice Center; 2003.

  20. Enas E SA. Coronary artery disease in Asian Indians: an update and review. Int J Cardiol. 2002;1(2).

  21. Anand SS, Yusuf S, Vuksan V, et al. Differences in risk factors, atherosclerosis, and cardiovascular disease between ethnic groups in Canada: the Study of Health Assessment and Risk in Ethnic groups (SHARE). Lancet. 2000; 356(9226): 279–84.

    Article  CAS  PubMed  Google Scholar 

  22. Enas EA, Garg A, Davidson MA, Nair VM, Huet BA, Yusuf S. Coronary heart disease and its risk factors in first-generation immigrant Asian Indians to the United States of America. Indian Heart J. 1996; 48(4): 343–53.

    CAS  PubMed  Google Scholar 

  23. Cappuccio FP. Ethnicity and cardiovascular risk: variations in people of African ancestry and South Asian origin. J Hum Hypertens. 1997; 11(9): 571–6.

    Article  CAS  PubMed  Google Scholar 

  24. Holland AT, Wong EC, Lauderdale DS, Palaniappan LP. Spectrum of cardiovascular diseases in Asian-American racial/ethnic subgroups. Ann Epidemiol. 2011; 21(8): 608–14.

    Article  PubMed Central  PubMed  Google Scholar 

  25. Palaniappan LP, Wong EC, Shin JJ, Fortmann SP, Lauderdale DS. Asian Americans have greater prevalence of metabolic syndrome despite lower body mass index. Int J Obes (Lond). 2011; 35(3): 393–400.

    Article  CAS  Google Scholar 

  26. Dodani S, Butler M, Vacek J. Metabolic syndrome in South Asian immigrants: more than low Hdl requiring aggressive management. J Epidemiol Community Health. 2011; 65: A381–2.

    Article  Google Scholar 

  27. Tremblay MS, Bryan SN, Perez CE, Ardern CI, Katzmarzyk PT. Physical activity and immigrant status—evidence from the Canadian Community Health Survey. Can J Public Health. 2006; 97(4): 277–82.

    PubMed  Google Scholar 

  28. Fischbacher CM, Hunt S, Alexander L. How physically active are South Asians in the United Kingdom? A literature review. J Public Health (Oxford). 2004; 26(3): 250–8.

    Article  CAS  Google Scholar 

  29. Patel M, Phillips EP, Boutin-Foster C. Barriers to lifestyle behavioral change in migrant South Asian populations. J Immigr Minor Health. 2012; 14(5): 774–85.

    Article  PubMed  Google Scholar 

  30. National Health and Nutrition Examination Survey Questionnaire—physical activity and physical fitness—PAQ. Hyattsville, MD: US Department of Health and Human Services, Centers for Disease Control and Prevention. 1 Oct 2010.

  31. Inverness Medical. Cholestech LDX System. NJ: Princeton.

  32. Pfizer. High blood pressure and staying healthy. Florida: Books of Hope LLC; 2010.

    Google Scholar 

  33. Gany FM, Gill PP, Ahmed A, Acharya S, Leng J. “Every disease…man can get can start in this cab”: focus groups to identify South Asian taxi drivers’ knowledge, attitudes and beliefs about cardiovascular disease and its risks. J Immigr Minor Health. 2013; 15(5): 986–92.

    Article  PubMed  Google Scholar 

  34. Schaller B, Gilbert G. Factors of production in a regulated industry: New York taxi drivers and the price for better service. Trans Q; 1995; 49(4): 81–90.

    Google Scholar 

  35. Winkleby MA, Jatulis DE, Frank E, Fortmann SP. Socioeconomic status and health: how education, income, and occupation contribute to risk factors for cardiovascular disease. AJPH. 1992; 82(6): 816–20.

    Article  CAS  Google Scholar 

  36. Nomaguchi KM, Bianchi SM. Exercise time: gender differences in the effects of marriage, parenthood, and employment. J Marriage Fam. 2004; 66(2): 413–30.

    Article  Google Scholar 

  37. Karwalajtys T, Kaczorowski J. An integrated approach to preventing cardiovascular disease: community-based approaches, health system initiatives, and public health policy. Risk Manag Healthc Policy. 2010; 3: 39–48.

    PubMed Central  PubMed  Google Scholar 

Download references

Acknowledgments

Contributors

Thank you to S. Acharya, A. Aymed, and M. Khera from the South Asian Council for Social Services for assisting with the recruitment of taxi drivers. Thank you to J. Silberstein, A. Singh, and M. Mittal for assisting with conducting the health screenings and completing follow-up calls with the taxi drivers. Lastly, thank you to the South Asian Health Initiative for its insight throughout the study.

Funding

Funding for this study was provided by the New York State Department of Health Empire Clinical Research Investigator Program (ECRIP).

Author information

Authors and Affiliations

  1. Immigrant Health and Cancer Disparities Service, Department of Psychiatry and Behavioral Sciences, Department of Medicine, Memorial Sloan-Kettering Cancer Center, 300 E. 66th St., 15th Floor, New York, NY, 10065, USA

    Francesca Gany & Jennifer Leng

  2. Department of Public Health, Weill Cornell Medical College, 300 E. 66th St., 15th Floor, New York, NY, 10065, USA

    Francesca Gany & Jennifer Leng

  3. Immigrant Health and Cancer Disparities Service, Department of Psychiatry and Behavioral Sciences, Memorial Sloan-Kettering Cancer Center, 300 E. 66th St., 15th Floor, New York, NY, 10065, USA

    Pavan Gill

  4. Department of Epidemiology and Biostatistics, Memorial Sloan-Kettering Cancer Center, 307 E. 63rd St, New York, NY, 10065, USA

    Raymond Baser

Authors
  1. Francesca Gany
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Pavan Gill
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Raymond Baser
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Jennifer Leng
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Jennifer Leng.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Gany, F., Gill, P., Baser, R. et al. Supporting South Asian Taxi Drivers to Exercise through Pedometers (SSTEP) to Decrease Cardiovascular Disease Risk. J Urban Health 91, 463–476 (2014). https://doi.org/10.1007/s11524-013-9858-z

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11524-013-9858-z

Keywords

Search

Navigation