A systematic review of trucking food, physical activity, and tobacco environments and tractor-trailer drivers' related patterns and practices in the United States and Canada, 1993-2021

Abstract

Truckers in the United States (U.S.) and Canada are at high risk for noncommunicable disease. Although trucking built environments have been highlighted for intervention, no systematic review has assessed aspects of trucking environments that may influence food, physical activity (PA), and smoking patterns/practices. The purpose of this systematic review was to characterize the state of the science on trucking food, PA, and tobacco environments and to examine truckers' food, PA, and tobacco patterns/practices. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines were used. Five databases were selected for searching in April 2020 and 2021 using key terms constructed by a librarian. Peer-reviewed research with data about U.S. and Canadian truckers' (i.e., drivers operating 18-wheelers or tractor trailers) food, PA, and/or tobacco environments and related patterns/practices were included. Quality was assessed using the Mixed Method Appraisal Tool. Thirty-eight studies were identified. Results included data from at least 16,600 truckers and 282 trucking settings in the U.S. (n = 32) and Canada (n = 6). Most studies were classified as quantitative descriptive and of poor quality (average score 3 of 7). The few studies (n = 4) that measured trucking food and PA environments characterized trucking sites as poor. Fifteen (47%) presented data about truckers' perceptions of food or PA environments and highlighted prominent environmental barriers. Truckers' food, PA, and smoking patterns and practices suggested poor diet quality, sedentary practices, and a high prevalence of smoking. The science of trucking food, PA, and tobacco environments is underdeveloped and requires much more focus using validated measures.

Keywords: BMI, Body Mass Index; CI, Confidence Interval; FCI, Food Choices Index; Food environment; HEATS, Healthy Trucker Survey; HEATWAI, The Healthy Trucking Worksites Audit Instrument; HPLP II, The Health-Promoting Lifestyle Profile II; Kcal, Kilocalorie; MET, Metabolic equivalent tasks; NAS, Nutrition Attitude Survey; NEMS, Nutrition Environment Measures Survey; NEMS-V, Nutrition Environment Measures Survey-Vending; Occupational health; PA, Physical activity; Physical activity environment; SE, Standard error; SNAP, Supplemental Nutrition Assistance Program; Tobacco; Truck drivers; U.S., United States.

Fig. 1

PRISMA Flow Diagram.