Be Well at Work-Plus: Engaging low-wage workers in the design and implementation of a depression and physical activity intervention.

工作顺利+：让低薪工人参与抑郁症和体育活动干预的设计和实施。

• 批准号: 10463551
• 负责人: Jessica Lauren McCurley
• 金额: --
• 依托单位: MASSACHUSETTS GENERAL HOSPITAL
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-08-15 至 2022-08-02
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10463551
• 关键词: Address; Adult; Behavior Therapy; Behavioral; Behavioral Sciences; Blood Pressure; Body mass index; Cardiometabolic Disease; Cardiovascular Diseases; Caring; Chronic; Clinical; Cognitive Therapy; Coping Behavior; Data; Development Plans; Diabetes Mellitus; Ecological momentary assessment; Economics; Educational Curriculum; Educational workshop; Effectiveness; Employee; Employee Health; Employment; Evidence based intervention; Feedback; Financial Hardship; Food; General Hospitals; Goals; Grant; Health; Health Promotion; Health behavior; High Prevalence; Hospitals; Housing; Impairment; Individual; Industry; Information Dissemination; Intervention; Intervention Trial; Interview; Low Income Population; Low income; Massachusetts; Mental Depression; Mentorship; Methods; Moods; Obesity; Occupations; Outcome; Participant; Phase; Physical activity; Pilot Projects; Population; Positioning Attribute; Prevalence; Preventive care; Process; Provider; Publications; Randomized; Randomized Controlled Trials; Research; Research Personnel; Risk; Risk Factors; Scientist; Sleep; Suggestion; Technology; Testing; Text; Text Messaging; Time; Training; Wages; Waiting Lists; Wellness Program; Work; Workplace; Writing; adverse outcome; arm; base; cardiometabolic risk; cardiometabolism; care coordination; career; career development; clinically relevant; cost; depressive symptoms; design; disability; efficacy trial; evidence base; exercise intervention; feasibility testing; health equity; implementation science; improved; innovation; intervention delivery; low socioeconomic status; mHealth; physical inactivity; pilot trial; poor sleep; preference; pressure; primary outcome; programs; randomized trial; scale up; secondary outcome; skill acquisition; sleep quality; social; social determinants; social disadvantage; social health determinants; telephone delivery; telephone session; text messaging intervention; texting support; therapy design; trial comparing; trial design; uptake

Depression and physical inactivity are leading contributors to cardiometabolic diseases such as obesity, diabetes, and cardiovascular disease. Low-wage workers, who comprise one-third of all workers in the U.S. and are essential to many industries, are more likely to be physically inactive and to have cardiometabolic conditions and depression, yet they are half as likely as higher wage workers to utilize preventive care. Targeted workplace initiatives have been successful in improving employee health, but low-wage workers are difficult to engage, in part due to a high burden of social disadvantage (e.g., food and housing insecurity, time and financial constraints). Currently, to our knowledge, there are no workplace interventions for depression that specifically target low-wage workers and their unique social risk factors. This study was conceptualized using a planned adaptation approach that involves low-wage workers in the design of the intervention to increase engagement and feasibility in this population. The proposed study will adapt an evidence-based 8-session telephone-delivered depression intervention for working adults, Be Well at Work, and add critical enhancements for low-wage workers: assessment and referrals for social determinants of health, physical activity promotion, and personalized text message behavioral support via ecological momentary assessment and intervention. The adapted intervention, Be Well at Work-PLUS, will be developed and tested in three phases: (1) qualitative interviews with low-wage workers to understand social determinants of health, barriers and facilitators of engagement, and intervention preferences (Aim 1); (2) a single-arm pilot (N=10) with exit interviews to refine the intervention content and delivery (Aim 2); (3) a pilot randomized controlled trial comparing Be Well at Work-PLUS to a waitlist condition (N=60; Aim 3). This iterative process will yield results on feasibility, acceptability, and preliminary clinical outcomes of Be Well at Work-PLUS and provide data to apply for an R01 efficacy trial. To compliment these research aims, Dr. McCurley has designed a training plan to gain expertise in (1) implementation science, including planned adaptation of evidence-based interventions and participatory design methods for improving reach and engagement in low-income groups, (2) mobile health, specifically, text messaging for increased intervention feasibility and uptake; and (3) randomized controlled trial design. The career development plan involves regular mentorship with experts in implementation science, mobile health, randomized behavioral intervention trials, as well as didactic courses and workshops in these topics, dissemination of results through presentations and publications, and support for grant writing and additional skill development to advance Dr. McCurley’s career as an independent behavioral scientist. This K23 proposal will position Dr. McCurley to become an independent investigator developing interventions that fuse technology and behavioral science to address depression, health behavior, social determinants of health, and cardiometabolic diseases in low-income populations.

抑郁和缺乏运动是导致心脏代谢疾病的主要原因，比如肥胖、