SUMMARY (ABSTRACT) During the COVID-19 pandemic, New York City (NYC) public transportation has been an essential service to assure that other essential workers can get to their jobs. Many of the predominantly racial and ethnic minority transit workers have been exposed to risks at both 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., health care 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 multi- level 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 lock-down with resurgence; deployment of vaccine); and (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. 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 first 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; and (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 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.

PROJECT NARRATIVE The overarching goal of this proposed research is to help reduce COVID-19 health disparities in mass transit workers. Working in close collaboration with the Transport Workers Union, Local 100, our study will explore the impact of existing multilevel interventions on transit workers’ health and wellbeing.