title: Trouble in transit: Organizational barriers to workers' health.
abstract: BACKGROUND
  Valuable insights on the health and behavior of transit workers can be obtained from qualitative research that considers the social environment, which affects job performance and determines levels of perceived stress.
  
  
  METHODS
  Using a grounded theory approach, semi-structured interviews were conducted with American transit workers (n = 32). Recorded interviews were transcribed and analyzed using a constant comparative method.
  
  
  RESULTS
  Participants described categories related to entrenched organizational practices, particularly managements' leadership style, which created an atmosphere of distrust. High demanding work schedules, as a result of technological advances, were discussed in relation to diminished breaks, fatigue, and unhealthy diets. Transit workers also attributed increased work demands and irregular working hours to compromised time with family and friends.
  
  
  CONCLUSIONS
  The described barriers to positive health behaviors and social support underscore the need for interventions that ensure adequate breaks and recovery between shifts and increase safety for transit passengers. Am. J. Ind. Med. 60:350-367, 2017. © 2017 Wiley Periodicals, Inc.
authors.affiliation: Laboratory of Neuroendocrinology, The Rockefeller University, New York, New York.|Division of Clinical Epidemiology and Evaluative Sciences, Weill Cornell Medical Center, New York, New York.
authors.forename: Nicole P
authors.identifier: http://orcid.org/0000-0003-3729-7082
authors.initials: NP
authors.lastname: Bowles
authors.affiliation: Laboratory of Neuroendocrinology, The Rockefeller University, New York, New York.
authors.forename: Bruce S
authors.initials: BS
authors.lastname: McEwen
authors.affiliation: Division of Clinical Epidemiology and Evaluative Sciences, Weill Cornell Medical Center, New York, New York.|Diversity Education and Research, SUNY Downstate Medical Center, Brooklyn, New York.
authors.forename: Carla
authors.initials: C
authors.lastname: Boutin-Foster
mesh_terms: D000328:Adult; D003430:Cross-Sectional Studies; D005221:Fatigue / Q000523:psychology; D005260:Female; D066296:Grounded Theory; D015438:Health Behavior; D006801:Humans; D008297:Male; D008875:Middle Aged; D000073397:Occupational Stress / Q000523:psychology*; D015279:Organizational Culture; D036301:Qualitative Research; D012931:Social Environment; D012944:Social Support; D014186:Transportation; D035502:Trust; D000066477:Work Performance / Q000458:organization & administration*; D014940:Work Schedule Tolerance / Q000523:psychology; D017132:Workplace / Q000458:organization & administration*
keywords: anger; fear; grounded theory; organizational behavior; stress; workplace aggression