Interventions to Control Obesity in Colleges

描述(申请人提供)：肥胖症是一种流行病，据估计，美国雇主每年花费785亿美元；然而全国数据显示，只有不到25%的雇主提供疾病管理计划来解决肥胖问题。有效的减肥计划需要能够轻松适应繁忙的工作环境，维护员工隐私，并让员工随着时间的推移保持忙碌(以帮助避免体重再次增加)。与北卡罗来纳州社区学院系统、北卡罗来纳州蓝十字蓝盾以及州教师和员工医疗计划合作，这项为期五年的拟议研究将在12个社区大学环境中的936名超重/肥胖员工中测试两种有前景的基于工作场所的减肥干预措施(基于网络的减肥计划和奖励支付)。在为社区大学校园员工调整这些干预措施的形成性工作之后，我们将使用组随机2x2析因设计严格测试干预措施：网络(是或否)和奖励薪酬(是或否)，每个治疗臂有234名员工。主要结果(体重减轻)将在基线、6个月、12个月和18个月时进行测量。大多数次要结果(减肥行为、中等强度的体力活动；总卡路里、体脂百分比、水果/蔬菜摄入量、旷工、生产力、医疗费用和生活质量)将在基线、12个月和18个月时进行评估。目标饮食(24小时回顾)和体力活动(Actigraph)数据将在基线和18个月时收集。过程跟踪数据将衡量保真度、剂量发送/接收和可接受性/满意度。将进行广泛的成本和成本效益分析，包括投资回报。如果证明有效，这种强大的伙伴关系模式与强大的经济数据相结合，为干预提供了一个独特的机会，使其制度化，并在整个社区学院校园系统中传播。

DESCRIPTION (provided by applicant): Obesity is at epidemic proportions and costs US employers an estimated $78.5 billion annually; yet national data reveal that less than 25% of employers are offering disease management programs to address obesity. Effective weight loss programs are needed that are easily adaptable to busy work environments, maintain employee privacy, and keep employees engaged over time (to help avoid weight re-gain). In collaboration with the North Carolina Community College System, NC Blue Cross Blue Shield, and the State Teachers and Employee Medical Plan, the proposed five-year study will test two promising worksite-based weight loss interventions (Web-based Weight Loss Program and Incentive Payments) among 936 overweight/obese employees in 12 community college settings. After formative work to adapt these interventions for community college campus employees, we will rigorously test the interventions using a group-randomized, 2x2 factorial design: WEB (yes or no) and INCENTIVE PAYMENT (yes or no) with 234 employees per treatment arm. The primary outcome (weight loss) will be measured at baseline, 6, 12, and 18 months. Most secondary outcomes (weight loss behaviors, moderate-vigorous physical activity; total calories, percent body fat, fruit/vegetable intake, absenteeism, productivity, medical expenditures, and quality of life) will be assessed at baseline, 12 and 18 months. Objective diet (24 hr recalls) and physical activity (Actigraph) data will be collected at baseline and 18 months as well. Process tracking data will measure fidelity, dose delivered/received and acceptability/satisfaction. Extensive cost- and cost-effectiveness analysis, including return on investment, will be undertaken. If proven effective, this strong partnership model combined with powerful economic data offer a unique opportunity for intervention institutionalization and dissemination throughout the community college campus system.