Interventions to Control Obesity in Colleges

描述（由申请人提供）：肥胖是流行病的比例，美国雇主每年花费估计785亿美元;但国家数据显示，只有不到25%的雇主提供疾病管理计划来解决肥胖问题。需要有效的减肥计划，这些计划可以很容易地适应忙碌的工作环境，维护员工的隐私，并随着时间的推移保持员工的参与（以帮助避免体重重新增加）。在与北卡罗来纳州社区学院系统，北卡罗来纳州蓝十字蓝盾，和国家教师和员工医疗计划合作，拟议的五年研究将测试两个有前途的工作场所为基础的减肥干预措施（基于网络的减肥计划和奖励支付）在936超重/肥胖的员工在12个社区学院设置。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，我们将使用随机分组、2x2析因设计：WEB（是或否）和激励性支付（是或否）对每个治疗组234名员工进行严格的干预措施测试。将在基线、6个月、12个月和18个月测量主要结局（体重减轻）。将在基线、12个月和18个月时评估大多数次要结局（减肥行为、中等强度体力活动;总热量、体脂百分比、水果/蔬菜摄入量、缺勤率、生产力、医疗支出和生活质量）。将在基线和18个月时收集客观饮食（24小时回忆）和体力活动（Actigraph）数据。过程跟踪数据将测量保真度、输送/接收的剂量和可接受性/满意度。将进行广泛的成本和成本效益分析，包括投资回报分析。如果被证明是有效的，这种强大的伙伴关系模式与强大的经济数据相结合，为整个社区学院校园系统的干预制度化和传播提供了一个独特的机会。

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.