Primary care uptake interventions in taxi, app-based, and other for-hire vehicle drivers: The HAILL cluster randomized controlled trial Journal Article
| Authors: | Gany, F.; Narang, B.; Kakade, A.; Wu, M.; Hashemi, A.; Meraji, N. N.; Li, Y.; Mehmood, R.; Acharya, S.; Leng, J. |
| Article Title: | Primary care uptake interventions in taxi, app-based, and other for-hire vehicle drivers: The HAILL cluster randomized controlled trial |
| Abstract: | Background: Taxi, app-based, and other for-hire vehicle drivers have major health risks and poor healthcare access. Objective: Compare workplace interventions to improve driver healthcare access. Design: Taxi Health Access Intervention for Linkages and Lifestyle (HAILL) was a three-arm cluster randomized controlled trial (2015–2022; analyses 2024) with outcomes assessed at 12 months. Randomization was at the cluster (taxi garage) level. Participants: We approached 97 taxi garages in New York City (garages with ≥ 100 drivers and app-based driver hubs), 32 were excluded, and 65 enrolled. Drivers attending workplace Health Fairs at the garages were consecutively screened for participation; 735 enrolled. Interventions: All sites received the Health Fair intervention (health history, screenings [blood pressure, etc.], clinician consult, and 3 months of primary care access facilitation follow-up). Arm 1 received the Health Fair only. Arm 2 received the Health Fair and Navigator case management for up to 12 months. Arm 3 received the Health Fair and up to 12 months of appointment reminder text messages and peer support. Main Measures: Medical Expenditure Panel Survey items measured primary care uptake (primary outcome). A Behavioral Risk Factor Surveillance Survey item measured insurance enrollment (secondary outcome). Two independent-sample t tests compared arm 1 versus 2 and arm 1 versus 3 primary care uptake proportions. Key Results: Sixty-one garages participated (arm 1, n = 20; arm 2, n = 22; arm 3, n = 19). In the cluster intention-to-treat analyses, primary care uptake was 44% in arm 1 versus 57% in arm 2 (P =.264) and versus 43% in arm 3 (P =.994); health insurance enrollment was 63% in arm 1 versus 58% in arm 2 (P =.627) and versus 50% in arm 3 (P =.197). Conclusions: All interventions increased healthcare access, with a positive trend in primary care uptake between arms 1 and 2. Health Fairs and Navigator case management should be considered by policy makers. Trial Registration: ClinicalTrials.gov NCT02508363 (https://clinicaltrials.gov/study/NCT02508363). © The Author(s), under exclusive licence to Society of General Internal Medicine 2025. |
| Keywords: | insurance; health; primary health care; workplace; case management; health fairs |
| Journal Title: | Journal of General Internal Medicine |
| ISSN: | 0884-8734 |
| Publisher: | Springer |
| Publication status: | Online ahead of print |
| Date Published: | 2025-05-05 |
| Online Publication Date: | 2025-05-05 |
| Language: | English |
| DOI: | 10.1007/s11606-025-09559-7 |
| PROVIDER: | scopus |
| PUBMED: | 40325340 |
| DOI/URL: | |
| Notes: | The MSK Cancer Center Support Grant (P30 CA008748) is acknowledge in the PDF -- Corresponding authors is MSK author: Francesca Gany -- Source: Scopus |
Altmetric
Citation Impact
BMJ Impact Analytics
Related MSK Work