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

描述（由申请人提供）：该提案旨在测试多层次干预，旨在通过将体育活动（PA）和更健康的食物选择纳入工作场所的日常生活，以影响工作文化，基于ncmhd资助的三年规划拨款的初步结果。相关性：以环境变化和个人生活方式改变为目标的以人群为基础的肥胖控制尚未得到充分研究，特别是在服务不足的社区。然而，肥胖越来越被认为是造成慢性疾病差异的一个主要因素。这项提案的目标是为低收入和少数民族人口提供服务的机构的工作人员，主要是有色人种女性。这些工人是他们家庭和社区的看门人。动员他们可能有助于创造对抗肥胖流行病所需的社会规范变革和政治意愿。将健身推广活动和产品整合到“商业”的常规行为中，是我们为期3年的社区参与式研究（CBPR）规划过程中产生的一种有前途的干预方法。为了实现这些目标，我们采用了规划阶段提出的干预策略，例如：举行步行会议；在员工会议中进行短暂的运动休息；在工作时添加水果、蔬菜和水作为茶点；提升/改善楼梯间等。

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.