ENHANCING WORKSITE CANCER PREVENTION THROUGH THE HOME

该项目的重点是下一代癌症预防， 在工地上的控制工作。 这是我们的高潮 自1984年以来，NCI持续资助的方案研究， 在理论上，以及现有的经验证据。 重点是更小的 到研究不足、服务不足的中等规模的工作场所， 蓝领和受教育程度较低的工人的人口，以及 以具有成本效益的方式改善公共卫生影响。 下一 干预措施的产生需要积极主动、持续和量身定制 当地的需要，多种风险因素，并结合个人和 环境变化 最终，干预必须是 制度化地融入到工作场所的文化结构中。 本研究 需要科学严谨性、操作实用性和可传播性， 合理的成本。 迄今为止在工作场所健康促进方面所做的最大努力 由于功效和覆盖面适中， 干预措施。 为了提高影响力和成本效益， 干预可以加强和补充工地渠道。 专家 系统允许重复、主动、交互和高度个性化 （量身定制的）干预措施在工作现场并不总是可行的。 本提案将评估下列因素的主要效应和附加效应： 工作场所和家庭为基础的干预渠道， 癌症预防（膳食脂肪、纤维、吸烟、紫外线暴露和锻炼） 在40个中等规模的工作地点， 地区 工作地点是任务分配和分析的单位， 现场与控制评价。 每个人都是随机分配的 在工作场所内，以家庭为基础或评估控制条件。 最终 在基线、12、24和36个月时测量结果。 工地 干预持续24个月，以便对 在36个月时维持和机构化。 个人和 组织计划、流程和中间结果数据是 收集资料，以阐明调解机制（诱发、促成 和干预）基于理论驱动的模型和假设。 一 一个先进的和实地测试的计算机跟踪系统， 项目评估和成本数据。 通径分析 和过程到结果的分析将揭示的机制， 对界定的服务不足者产生较大或较小影响的行动 工人的人口。 研究结果将推动工作场所癌症领域的发展 通过评估下一个项目的成本效益来控制研究 在工作场所和家庭采取干预措施。

This project focuses on the next generation of cancer prevention and control efforts at the worksite. It is the culmination of our programmatic research funded continuously by NCI since 1984, the advances in theory, and the available empirical evidence. The focus is on smaller to moderate-sized worksites that are under-researched, underserved populations of blue collar and less educated workers, and the challenge of improving the public health impact in a cost-effective manner. The next generation of interventions need to be proactive, sustained, and tailored to local needs, multiple risk factor, and integrating individual and environmental change. Ultimately, the intervention must be institutionalized into the fabric of the worksite culture. This research requires scientific rigor, operational practicality and disseminability at reasonable cost. The best efforts to date in worksite health promotion have produced modest impact due to moderate efficacy and reach of interventions. To improve the impact and cost-efficiency, a home-based intervention can enhance and complement a worksite channel. An expert system allows for repeated, proactive, interactive and highly personalized (tailored) interventions that are not always possible at the worksite. This proposal will evaluate the main effects and additive effects of worksite and home-based intervention channels on multiple risk factors for cancer prevention (dietary fat, fiber, smoking, UV exposure, and exercise) in 40 worksites of moderate size recruited from a defined geographic region. The worksites are the unit of assignment and analysis for the worksite versus control evaluation. Individuals are randomly assigned within worksites to home-based or assessment control conditions. Final outcomes are measured at baseline, 12, 24 and 36 months. The worksite intervention is sustained for 24 months, allowing for an evaluation of maintenance and institutionalization at 36 months. Both individual and organizational program, process and intermediate outcome data are collected to shed light on mediating mechanisms (predisposing, enabling and intervening) based on theory-driven models and hypotheses. A sophisticated and field-tested computer tracking system serves to collect program evaluation and cost data on a prospective basis. Path analyses and process-to-outcome analyses will shed light on the mechanisms of action that produce greater versus lesser impact on defined underserved populations of workers. Results will advance the field of worksite cancer control research by evaluating the cost-effectiveness of the next generation of both worksite and home-based interventions.