School Worksite Weight Gain Prevention Intervention Study

描述(由申请人提供)：这项为期四年的研究名为“学校工作场所体重增加预防干预研究”，目的是确定与自我导向的、仅使用印刷材料的对照组相比，生态工作场所干预在减少马萨诸塞州公立高中员工体重增加方面的有效性。这种干预被称为先行一步，是针对健康行为改变的生态框架所建议的三个层面的综合干预：(1)组织(学校)层面，(2)人际层面，和(3)个人层面。社交营销活动将使用共同的徽标、主题和信息整合所有计划活动。对拟议干预措施的评估将通过随机对照试验(RCT)进行，其中随机和干预的单位是学校工作场所，评估和推断的单位是员工。18所学校将被分成三个层次：大城市学校、小城市学校或农村学校。在每一阶层内，学校将被随机分为生态干预或仅印刷材料控制条件。来自18所学校的540名教职员工将被录取和保留，其中360人来自干预地点，360人来自对照地点。评估将在五个时间点完成：基线、6个月、12个月、18个月和24个月。这项研究的主要目的是确定在24个月的干预期内，通过BMI和腰围的变化来衡量干预措施在预防员工体重增加方面的有效性。次要目标包括确定干预对员工的体力活动、卡路里摄入量、饱和脂肪摄入量和水果蔬菜消费量的影响，以及确定对旷工和出勤的影响。第三个目标是确定干预对中介和调节因素的影响，包括感知到的对员工健康的组织承诺、感知到的同事对健康饮食和体育活动的规范影响、对健康行为的社会支持、自我效能感和自我控制。这项拟议的研究建立在研究小组在设计、实施和评估生态工地干预措施以及在高中环境下进行大规模随机对照试验方面的先前研究和经验的基础上。调查分为三个阶段：第一阶段：招募学校和改进干预措施和手段；第二阶段：干预措施的实施和评价；第三阶段：分析和传播。公共卫生相关性：拟议的现场水平随机试验将测试基于生态框架的工作场所干预在预防马萨诸塞州高中员工体重增加方面的有效性。如果有效，这项干预措施旨在推广到全国各地的高中环境，并有可能降低这一重要人群中超重和肥胖的发病率、死亡率和经济成本。

DESCRIPTION (provided by applicant): The purpose of this four-year study, "School Worksite Weight Gain Prevention Intervention Study", is to determine the effectiveness of an ecological worksite intervention compared to a self-directed, print-materials only control group at reducing weight gain among public high school employees in Massachusetts. The intervention, called Step Ahead, is a comprehensive intervention targeting the three levels suggested by ecological frameworks for health behavior change: (1) the organizational (school) level, (2) the interpersonal level, and (3) the individual level. A social marketing campaign will integrate all program activities using common logos, themes and messages. Evaluation of the proposed intervention will be by a randomized controlled trial (RCT) in which the unit of randomization and intervention is the school worksite and the unit of evaluation and inference is the employee. Eighteen schools will be stratified into three strata: large urban, small urban or rural schools. Within each stratum, schools will be randomized to either the ecological intervention or print materials only control condition. A total of 540 teachers and staff from 18 schools will be enrolled and retained, 360 from intervention and 360 from control sites. Assessments will be completed at five time points: baseline, 6 months, 12 months, 18 months and 24 months. The primary aim of this study is to determine the effectiveness of the intervention in preventing employee weight gain, as measured by change in BMI and waist circumference, over the 24- month intervention period. Secondary aims include determining the effects of the intervention on physical activity, caloric intake, saturated fat intake and consumption of fruits and vegetables among employees, as well determining the effects on absenteeism and presenteeism. Tertiary aims are to determine the effects of the intervention on mediating and moderating factors, including perceived organizational commitment to employee health, perceived co-worker normative influences for healthy eating and physical activity, social support for healthy behaviors, self-efficacy and self- control. The proposed study builds off of the study team's previous studies and experiences in designing, implementing and evaluating ecological worksite interventions and in conducting large-scale randomized controlled trials in the high school setting. There are three phases to the investigation: Phase I: Recruitment of schools and intervention and instrumentation refinement; Phase II: Intervention implementation and evaluation; Phase III: Analysis and dissemination. PUBLIC HEALTH RELEVANCE: The proposed site-level randomized trial will test the effectiveness of a worksite intervention based on an ecological framework at preventing weight gain among high school employees in Massachusetts. If effective, the intervention is designed to be generalizable to high school settings across the country and has the potential to reduce the morbidity, mortality and economic costs of overweight and obesity in this important population.