Joining Forces with a Key Community to Combat Obesity Disparities-2

描述（由申请人提供）：该提案旨在测试一种多层次的干预措施，旨在通过将身体活动（PA）和更健康的食物选择纳入工作场所的日常工作来影响工作文化，基于为期三年的NCMHD资助的规划补助金的初步结果。相关性：针对环境变化和个人生活方式改变的基于人群的肥胖控制研究不足，特别是在服务不足的社区。然而，肥胖越来越被认为是慢性病差异的主要因素。该提案针对的是工作人员，主要是有色人种妇女，她们为解决低收入和少数民族人口需求的机构提供工作人员。这些工人是其家庭和社区的守门人。动员他们可能有助于创造社会规范的变化和打击肥胖流行病所需的政治意愿。将健身促进活动和产品融入到"业务"的常规行为中是一种很有前途的干预方法，来自我们为期3年的社区基础研究（CBPR）规划过程。为了达到这些目标，我们采用了在规划阶段提出的干预策略，例如：举行步行会议;在员工会议上进行短暂的运动休息;在工作中增加水果、蔬菜和水作为茶点;推广/改善楼梯间等。 具体而言，我们将： 1.招募洛杉矶南部和东部的卫生和社会服务组织，确定60个工作单位，每个工作单位10 - 50名工作人员（平均= 25个工作单位）。工作单元可以是整个组织或更大组织内的并置组（工作站点）。 2.采用双臂、分组随机、等候名单对照的研究设计，以工作场所为分析单位，严格评估这种干预方法。主要结果测量是腰围（WC）。次要结果指标是体重指数（BMI）、心肺功能和血压（BP）。中介变量包括自我报告的PA和营养摄入量，7天加速度计计数和强度读数，PA审计，感知的身体活动和营养规范，以及组织实践/政策。将在基线以及6、12和18个月随访时收集数据。 3.分析过程和结果数据;利用结果制定传播计划。主要假设是，与对照组的显著增加相比，实验组的平均WC在12个月时不会增加。次要假设是，与对照组相比，干预组参与者在12个月时将经历BMI稳定以及BP和健身的改善。预计18个月时会出现类似结果。

DESCRIPTION (provided by applicant): This proposal seeks to test a multi-level intervention designed to influence the work culture by incorporating physical activity (PA) and healthier food choices into the workplace routine, based on preliminary results of a three-year NCMHD-funded planning grant. Relevance: Population-based obesity control targeting environmental change as well as individual lifestyle change is understudied, particularly in underserved communities. Yet, obesity is increasingly recognized as a major contributor to chronic disease disparities. This proposal targets staff, mostly women of color, who staff agencies that address the needs of low-income and ethnic minority populations. These workers are gatekeepers for their families and communities. Mobilizing them may help to create the social norm change and political will needed to combat the obesity epidemic. Integrating fitness promoting activities and products into the regular conduct of "business" is a promising intervention approach arising from our 3-year Community Based Participatory Research (CBPR) planning process. We seek to achieve these goals by using the intervention strategies emerging from this planning phase, such as: conducting walking meetings; implementing brief exercise breaks in staff meetings; adding fruits, vegetables and water as refreshments at work; promoting /improving stairwells, etc. Specifically, we will: 1. Recruit health and social services organizations in southern and eastern Los Angeles to identify 60 work units of 10-50 staff members each (mean=25 per work unit). Work units may be entire organizations or collocated groups (worksites) within larger organizations. 2. Employ a two-armed, group-randomized, wait list-controlled study design with the work site as the unit of analysis to rigorously evaluate this intervention approach. The primary outcome measure is waist circumference (WC). Secondary outcome measures are body mass index (BMI), cardiorespiratory fitness and blood pressure (BP). Mediating variables include self-reported PA and nutrient intake, 7-day accelerometer count and intensity readings, PA audits, perceived physical activity and nutrition norms, and organizational practices/policies. Data will be collected at baseline, and 6, 12, and 18 months follow-up. 3. Analyze process and outcome data; use results to develop a dissemination plan. The primary hypothesis is that mean WCs in the experimental group will not increase at 12 months compared with significant increases in the control group. The secondary hypothesis is that intervention participants will experience BMI stabilization and improvements in BP and fitness, compared with controls, at 12 months. Similar outcomes are expected at 18 months.