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

描述(由申请人提供)：这项提案旨在测试一种多层次的干预措施，旨在通过将体力活动(PA)和更健康的食物选择纳入工作场所的日常工作中，以NCMHD资助的三年规划拨款的初步结果为基础，来影响工作文化。相关性：以环境变化和个人生活方式变化为目标的以人群为基础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疾病差异的主要原因。这项提案针对的是工作人员，主要是有色人种妇女，他们为满足低收入和少数民族人口需求的机构工作。这些工人是他们家庭和社区的守门人。动员他们可能有助于创造抗击肥胖症流行所需的社会规范变化和政治意愿。将健身促进活动和产品整合到日常的商业活动中，是我们基于社区的参与性研究(CBPR)3年规划过程中产生的一个很有前途的干预方法。为了达到这些目标，我们采用了规划阶段出现的干预策略，例如：举行步行会议；在员工会议上安排短暂的运动休息时间；在工作中增加水果、蔬菜和水作为茶点；促进/改善楼梯间等。 具体来说，我们会： 1.在洛杉矶南部和东部招募保健和社会服务组织，以确定60个工作单位，每个单位有10-50名工作人员(每个工作单位平均为25人)。工作单位可以是整个组织，也可以是较大组织内的并置小组(工作地点)。 2.采用双臂、分组随机、等待名单对照研究设计，以工作现场为分析单位，严格评价该干预方法。主要测量结果是腰围(WC)。次要指标是体重指数(BMI)、心肺功能和血压(BP)。中介变量包括自我报告的PA和营养素摄入量、7天加速计计数和强度读数、PA审计、感知的体力活动和营养规范以及组织实践/政策。数据将在基线、6个月、12个月和18个月的随访中收集。 3.分析过程和结果数据；使用结果来制定传播计划。基本假设是，与对照组相比，实验组的平均WCs在12个月时不会增加，而显著增加。第二个假设是，与对照组相比，干预参与者在12个月时将体验到BMI稳定以及血压和健康状况的改善。预计在18个月时也会出现类似的结果。

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.