Diet and Activity Promotion Among Older Working Adults

老年职业人士的饮食和活动促进

• 批准号: 7498078
• 负责人: GLADYS BLOCK
• 金额: $ 11.23万
• 依托单位: BERKELEY ANALYTICS, INC.
• 依托单位国家: 美国
• 财政年份: 2008
• 资助国家: 美国
• 起止时间: 2008-09-01 至 2009-02-28
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7498078
• 关键词: Absenteeism; Accounting; Address; Adoption; Adult; Advisory Committees; Age; Age Factors; Age-Years; Algorithms; American; Behavior; California; Cause of Death; Centers for Disease Control and Prevention (U.S.); Cessation of life; Characteristics; Chronic Disease; Computer software; Condition; Consumption; Control Groups; Cost of Illness; Data; Databases; Diet; Effectiveness; Effectiveness of Interventions; Electronic Mail; Employee; Enrollment; Ensure; Environment; Evaluation; Faculty; Feedback; Focus Groups; Fruit or Vegetable; Goals; Health; Health Care Costs; Health Priorities; Healthcare; Individual; Instruction; Intake; Intention; Intervention; Investments; Link; Literature; Measures; Medical; Medicare; Methods; Metric; Modality; Modification; Morbidity - disease rate; Numbers; Occupations; Outcome; Participant; Patient Self-Report; Performance at work; Persons; Phase; Phase I Clinical Trials; Physical activity; Population; Printing; Productivity; Psyche structure; Public Health; Publishing; Questionnaires; Randomized; Randomized Controlled Clinical Trials; Randomized Controlled Trials; Range; Relative (related person); Reporting; Research; Review Literature; Risk; Risk Assessment; Risk Factors; Sampling; Savings; Self Efficacy; Specific qualifier value; Staging; Statistically Significant; Surveys; System; Target Populations; Telephone; Telephone Number; Testing; Text; Time; To specify; Trans Fats; Treatment Efficacy; United States; Universities; Upper arm; Voice; Week; Work; Workplace; World Health Organization; Writing; age group; aged; base; behavior change; cost; cost effectiveness; disability; disorder risk; experience; fruits and vegetables; health economics; health related quality of life; improved; innovation; intervention program; lifestyle intervention; programs; response; sugar; usability

DESCRIPTION (provided by applicant): This project will modify an existing emailed program to improve diet and physical activity (PA), by making it more appropriate for workers 55-64 years of age and by adding the ability to deliver automated interactive telephone messages and printed materials tailored to the individual. It will then test the effectiveness and cost-effectiveness of those approaches among workers aged 55-64. Background: Poor diet and physical inactivity are two of the top three causes of chronic diseases and their subsequent medical costs (1). Inexpensive and cost-effective methods are needed to improve these behaviors in this age group, a group with increasing chronic disease and impending Medicare use. The research will build on an existing emailed intervention, ALIVE, which was proven effective in a randomized controlled trial in a worksite (2,3). ALIVE includes a Health Risk Assessment (HRA), tailored feedback, extensive tailoring, weekly goal- setting, interactive features, and health information. Methods: Aims in Phase I are to enhance all components of ALIVE to improve appropriateness for persons 55-64 years, based on focus groups, usability testing, and input from experts in PA ,diet behavior change and aging. Phase I will also demonstrate ability to link ALIVE with new automated telephone and print components. In Phase II, the age-tailored ALIVE will be tested in a randomized controlled trial. Staff and faculty on two campuses of the University of California will be enrolled; those aged 55-64 will be randomized to A) a control group receiving only the HRA and feedback; B) the age-tailored ALIVE program; C) the age-tailored ALIVE program plus phone & print materials. Baseline assessments include diet and PA, and the WHO Health and Work Performance Questionnaire (HPQ). Groups B & C then focus on either increasing PA, increasing fruits and vegetables, or decreasing saturated and trans- fats and added sugars. Over a 4-month period participants will receive tailored email messages and goals, plus phone/print (in group C). At the end of the 4-month period, control and intervention groups will repeat the baseline assessments. Intervention groups will then choose one of the other two goals. This will be repeated again at the end of the second 4-month period, for a total of one year of intervention, with repeat evaluations at the end. Changes in PA, diet, self-reported health and work outcomes will be evaluated using Intention to Treat. Two components of cost effectiveness will be evaluated. First, the effect of observed diet and PA changes on health care costs will be estimated using published external data on the effect of such changes on subsequent risk of chronic disease and cost impacts. Second, improvements in absenteeism and presenteeism as measured by the HPQ will be assessed and monetized based on the HPQ; this will also be expressed as Return on Investment, a metric wanted by employers in decisions about adoption of wellness interventions. The costs and effectiveness of the three treatment arms of the study will be compared. PUBLIC HEALTH RELEVANCE: Almost 45% of Americans have at least one chronic disease, and the medical costs for persons with chronic disease account for almost 75% of health care costs (1). Two of the top three leading causes of death are poor diet and physical inactivity (1). Improvement in these behaviors will result in less morbidity and lower health care costs, and this project will test the effectiveness of a very low-cost proven intervention in a high- risk age group.

描述（由申请人提供）：该项目将修改现有的电子邮件计划，以改善饮食和身体活动（PA），使其更适合55-64岁的工人，并增加提供自动互动电话信息和针对个人定制的印刷材料的能力。然后，它将在55-64岁的工人中测试这些方法的有效性和成本效益。背景：不良饮食和缺乏运动是导致慢性病及其后续医疗费用的前三大原因中的两个(1)。需要廉价和具有成本效益的方法来改善这一年龄组的这些行为，这是一个慢性病增加和即将使用医疗保险的群体。该研究将建立在现有的电子邮件干预的基础上，ALIVE，在一个工作场所的随机对照试验中被证明是有效的（2,3）。ALIVE包括健康风险评估（HRA）、量身定制的反馈、广泛的剪裁、每周目标设定、互动功能和健康信息。方法：第一阶段的目标是基于焦点小组、可用性测试以及PA、饮食行为改变和老龄化专家的意见，增强ALIVE的所有组成部分，以提高55-64岁人群的适宜性。第一阶段还将展示将ALIVE与新的自动电话和打印组件连接起来的能力。在II期，针对年龄定制的ALIVE将在一项随机对照试验中进行测试。加州大学两个校区的教职员工将被录取；年龄在55-64岁之间的受试者将被随机分为两组：A)仅接受HRA和反馈的对照组；B)适合年龄的ALIVE计划；C)适合年龄的ALIVE计划加上电话和印刷材料。基线评估包括饮食和PA，以及世卫组织健康和工作绩效问卷（HPQ）。B组和C组则侧重于增加PA，增加水果和蔬菜，或减少饱和脂肪和反式脂肪以及添加糖。在4个月的时间里，参与者将收到量身定制的电子邮件和目标，以及电话/印刷品（C组）。在4个月结束时，对照组和干预组将重复基线评估。然后，干预小组将从另外两个目标中选择一个。在第二个4个月的干预期结束时，将再次进行评估，总共进行一年的干预，并在结束时进行重复评估。在PA，饮食，自我报告的健康和工作成果的变化将评估使用意向治疗。将评价成本效益的两个组成部分。首先，观察到的饮食和PA变化对医疗保健成本的影响将使用已发表的外部数据来估计这些变化对随后的慢性病风险和成本影响的影响。第二，由人力绩效指标衡量的缺勤和出勤情况的改善将根据人力绩效指标进行评估和货币化；这也将表示为投资回报率，这是雇主在决定采用健康干预措施时需要的一个指标。将比较研究中三个治疗组的成本和效果。公共卫生相关性：近45%的美国人至少患有一种慢性病，慢性病患者的医疗费用占医疗费用的近75%(1)。在导致死亡的三大主要原因中，有两个是饮食不良和缺乏运动(1)。这些行为的改善将导致更低的发病率和更低的医疗保健成本，该项目将测试一种非常低成本的干预措施在高风险年龄组中的有效性。