Innovative approaches to increase F&V intake thru worksites: The Fresh Initiative

描述（由申请人提供）：食用大量的水果和蔬菜（F&V）与降低慢性疾病（如许多癌症、心血管疾病和2型糖尿病）的风险有关。迫切需要采用具有成本效益的营养教育方法，帮助大量不同人群摄入更多的食品和饮料。工地是进行此类干预的一个有希望的渠道。拟议的研究将研究创新的工作场所干预的有效性，通过建立一个成功的试点干预-新鲜倡议，以提高员工的餐饮消费。这个试点项目是与一家私人食品和饮料分销公司、布朗大学、国际扶轮卫生部和国际扶轮工作场所健康委员会合作，定期向工作场所提供低成本、新鲜的食品和饮料。24个工作地点将随机分配到下面讨论的三个实验组之一。员工的餐饮消费将在基线、6个月、12个月和18个月进行测量。本研究的主要具体目的是采用一组随机试验来研究：1 .与比较(C)干预（a vs. C）相比，在工作场所以降价提供新鲜食品和饮料的干预措施对增加员工食品和饮料消费的效果（访问干预a）；2. 改变工作场所的信息和社会环境的干预措施(B)与单独的食品和饮料提供干预措施(A)相比，增加员工的食品和饮料消费（增强干预）。（A+B vs. C）；3 .与单独的Access干预相比，增强干预对增加员工餐饮消费的作用。（A+B vs. A）次要目标包括：1。实施广泛的实施过程评估，以确定成本、覆盖范围、保真度和剂量；2. 使用中介变量框架来检验重要的社会心理因素/决定因素与食品和饮料消费变化之间的关系；3. 在不同的实验条件下，比较6、12、18个月员工生产率的变化；4. 比较上述干预措施在积极干预期结束后6个月（基线后18个月）的疗效；5. 比较与食品和饮料消费变化相关的比较、获取和增强干预措施的成本效益。公共卫生相关性：多吃水果和蔬菜（F&V）是一项主要的国家饮食建议，因为它可以降低患许多癌症、心血管疾病和2型糖尿病的风险。然而，许多美国人没有吃足够的食物和饮料。本研究的目的是对24个工作场所进行随机研究，比较不同干预措施对提高员工餐饮消费的效果。

DESCRIPTION (provided by applicant): Eating ample amounts of fruits and vegetables (F&V) is associated with a lower risk of chronic diseases such as many cancers, cardiovascular diseases, and type 2 diabetes. Cost-effective nutrition education approaches to help large and diverse segments of the population to eat more F&V are greatly needed. The worksite is a promising channel for such interventions. The proposed research will study the efficacy of innovative worksite interventions to improve F&V consumption of employees by building upon a successful pilot intervention - the Fresh Initiative. This pilot is a partnership with a private F&V distribution company, Brown University, the RI Department of Health and the Worksite Wellness Council of RI to regularly deliver low-cost, fresh F&V to the worksite. Twenty four worksites will be randomized to one of three experimental groups as discussed below. Employee F&V consumption will be measured at baseline, 6, 12 and 18 months. The primary Specific Aims of this proposed research are to employ a group randomized trial to study the efficacy of: 1 An intervention to deliver fresh F&V at reduced prices for purchase at worksites on increasing employees' F&V consumption (Access intervention A) compared to a Comparison (C) intervention (A vs. C.); 2. Interventions to change the information and social environments at the worksite (B) combined with the F&V delivery intervention alone (A) on increasing employees' F&V consumption (Enhanced intervention) compared to a Comparison intervention. (A+B vs. C); 3 The Enhanced intervention on increasing employees' F&V consumption compared to the Access intervention alone. (A+B vs. A). Secondary aims include: 1. To implement extensive implementation process evaluation to determine costs, reach, fidelity and dose; 2. To use a mediating variable framework to examine relationships among important psychosocial factors/determinants with changes in F&V consumption; 3. To compare changes in employee productivity from baseline to 6, 12, and 18 months by experimental condition; 4. To compare the efficacy of the above interventions 6 months after the active intervention period ends (18 months after baseline); 5. To compare the cost effectiveness of the Comparison, Access and Enhanced interventions related to change in F&V consumption. PUBLIC HEALTH RELEVANCE: Eating more fruits and vegetables (F&V) is a major national dietary recommendation because it reduces risk for many cancers, cardiovascular diseases and type 2 diabetes. However, many Americans are not eating adequate F&V. The purpose of the proposed research is to conduct a randomized study with 24 worksites to compare the effectiveness of different interventions on improving employees' F&V consumption.