School Worksite Weight Gain Prevention Intervention Study

描述（由申请人提供）：这项为期四年的研究的目的，“学校工作场所体重增加预防干预研究”，是为了确定生态工作场所干预的有效性相比，自我导向，印刷材料只有控制组在减少体重增加之间的公立高中雇员在马萨诸塞州。该干预被称为Step Ahead，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，（3）个人层面。社会营销活动将使用共同的标识、主题和信息整合所有计划活动。将通过随机对照试验（RCT）对拟议干预措施进行评价，其中随机化和干预的单位是学校工地，评价和推断的单位是员工。18所学校将分为三个层次：大城市、小城市或农村学校。在每一层中，学校将被随机分配到生态干预或仅印刷材料的对照条件。共有来自18所学校的540名教师和工作人员将参加并保留，360名来自干预地点，360名来自对照地点。将在5个时间点完成评估：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干预措施在防止员工体重增加方面的有效性，通过24个月干预期间BMI和腰围的变化来衡量。次要目标包括确定干预措施对员工体力活动、热量摄入、饱和脂肪摄入和水果蔬菜消费的影响，以及对缺勤和出勤的影响。第三个目标是确定干预对中介和调节因素的影响，包括员工健康的组织承诺，健康饮食和身体活动的同事规范影响，健康行为的社会支持，自我效能和自我控制。拟议的研究建立在研究小组以前的研究和经验，在设计，实施和评估生态工地干预措施，并在高中环境进行大规模随机对照试验。调查分为三个阶段：第一阶段：学校招募和干预措施及工具完善;第二阶段：干预措施的实施和评估;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措施在防止马萨诸塞州高中员工体重增加方面的有效性。如果有效，干预措施的目的是推广到全国各地的高中环境，并有可能减少发病率，死亡率和超重和肥胖的经济成本在这个重要的人口。

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.