Environmental Approaches for Obesity Management at Dow

描述(由申请人提供)： 拟议研究的主要目的是评估在现有个性化干预措施的基础上，引入两种水平的环境干预措施以减少工作场所超重和肥胖对五组结果的边际影响：a.身体质量指数和其他与体重相关的生物测量指标；b)行为健康风险因素；c)与体重相关的健康状况；d)医疗保健利用和医疗支出；以及E.以减少缺勤和在职出勤衡量的员工生产率。设计还包括评估两种治疗的成本和效益，考虑到这种干预措施产生的医疗、缺勤和生产率好处，评估干预措施对工作场所气候的影响。我们提出了一种适合干预性质的准实验设计。陶氏化学公司在路易斯安那州和德克萨斯州运营的六个制造地点将雇用6000名工人作为研究地点。他们将被随机分配到中度环境处理组、强化环境处理组或对照组(仅限个体化处理)。温和的干预措施将包括廉价的环境变化(例如，提示和提醒)，而高强度的干预措施将包括让高级管理人员参与发展广泛支持员工改善体重和健康管理的工作场所文化。将对年度健康筛查和生物识别数据以及行政医疗索赔、缺勤记录和生产率调查数据进行分析，以确定计划的影响。非实验统计方法将用于控制随机化后不同地点之间的基线差异。这项研究还将提供有关雇主如何成功地在工作场所实施环境处理的广泛信息。

DESCRIPTION (provided by applicant): The primary objective of the proposed study is to evaluate the marginal effects of introducing two levels of environmental interventions directed at reducing overweight and obesity in the workplace, on top of existing individualized interventions, on five sets of outcomes: a. body mass index and other weight-related biometric measures; b) behavioral health risk factors; c) weight-related health conditions; d) health care utilization and medical expenditures; and e. employee productivity measured in terms of reduced absenteeism and on-the job presenteeism. The design also includes an assessment of costs and benefits of the two treatments, considering the medical, absenteeism and productivity benefits derived from such interventions, an assessment of the impact of the interventions on the worksite climate. We propose a quasi-experimental design that is appropriate for the nature of the intervention. Six manufacturing locations in Louisiana and Texas operated by The Dow Chemical Company, employing 6,000 workers will serve as study sites. They will be randomly assigned to a moderate environmental treatment, an intensive environmental treatment, or control (individualized treatment only). The moderate interventions will include inexpensive environmental changes (e.g., prompts and reminders), while the high intensity intervention will involve engagement of senior managers in development of a worksite culture that is broadly supportive of improved weight and health management by employees. Annual health screening and biometrics data along with administrative medical claims, absence records, and productivity survey data will be analyzed to determine program impacts. Non-experimental statistical methods will be used to control for baseline differences that remain across sites after randomization. The study will also produce extensive information about how employers can successfully implement environmental treatments at worksites.