Be Well at Work-Plus: Engaging low-wage workers in the design and implementation of a depression and physical activity intervention

工作顺利+：让低薪工人参与抑郁症和身体活动干预的设计和实施

• 批准号: 10776158
• 负责人: Jessica Lauren McCurley
• 金额: $ 19.19万
• 依托单位: SAN DIEGO STATE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-08-15 至 2026-07-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10776158
• 关键词: Address; Adult; Behavior Therapy; Behavioral; Behavioral Sciences; Blood Pressure; Body mass index; Cardiometabolic Disease; Cardiovascular Diseases; Caring; Chronic; Clinical; Cognitive Therapy; Coping Behavior; Data; Development Plans; Diabetes Mellitus; Disparity; Ecological momentary assessment; Economics; Educational Curriculum; Educational workshop; Effectiveness; Employee; Employee Health; Employment; Evidence based intervention; Feedback; Financial Hardship; Food; General Hospitals; Goals; Grant; Health; Health Promotion; Health behavior; High Prevalence; Hospitals; Housing; Impairment; Individual; Industry; Information Dissemination; Intervention; Intervention Trial; Interview; Low Income Population; Low income; Massachusetts; Mental Depression; Mentorship; Methods; Moods; Obesity; Occupations; Outcome; Participant; Phase; Physical activity; Pilot Projects; Population; Positioning Attribute; Prevalence; Preventive care; Process; Provider; Publications; Randomized; Randomized, Controlled Trials; Research; Research Personnel; Risk; Risk Factors; Scientist; Sleep; Suggestion; Technology; Testing; Text; Text Messaging; Time; Training; Wages; Waiting Lists; Wellness Program; Work; Workplace; Writing; acceptability and feasibility; adverse outcome; arm; cardiometabolic risk; cardiometabolism; care coordination; career; career development; clinically relevant; cost; depressive symptoms; design; disability; efficacy trial; evidence base; exercise intervention; feasibility testing; health equity; implementation science; improved; innovation; intervention delivery; intervention refinement; low socioeconomic status; mHealth; physical inactivity; pilot trial; poor sleep; preference; pressure; primary outcome; programs; randomized trial; scale up; secondary outcome; skill acquisition; sleep quality; social; social determinants; social disparities; social health determinants; telephone delivery; telephone session; text messaging intervention; texting support; therapy design; trial comparing; trial design; uptake

Depression and physical inactivity are leading contributors to cardiometabolic diseases such as obesity, diabetes, and cardiovascular disease. Low-wage workers, who comprise one-third of all workers in the U.S. and are essential to many industries, are more likely to be physically inactive and to have cardiometabolic conditions and depression, yet they are half as likely as higher wage workers to utilize preventive care. Targeted workplace initiatives have been successful in improving employee health, but low-wage workers are difficult to engage, in part due to a high burden of social disadvantage (e.g., food and housing insecurity, time and financial constraints). Currently, to our knowledge, there are no workplace interventions for depression that specifically target low-wage workers and their unique social risk factors. This study was conceptualized using a planned adaptation approach that involves low-wage workers in the design of the intervention to increase engagement and feasibility in this population. The proposed study will adapt an evidence-based 8-session telephone-delivered depression intervention for working adults, Be Well at Work, and add critical enhancements for low-wage workers: assessment and referrals for social determinants of health, physical activity promotion, and personalized text message behavioral support via ecological momentary assessment and intervention. The adapted intervention, Be Well at Work-PLUS, will be developed and tested in three phases: (1) qualitative interviews with low-wage workers to understand social determinants of health, barriers and facilitators of engagement, and intervention preferences (Aim 1); (2) a single-arm pilot (N=10) with exit interviews to refine the intervention content and delivery (Aim 2); (3) a pilot randomized controlled trial comparing Be Well at Work-PLUS to a waitlist condition (N=60; Aim 3). This iterative process will yield results on feasibility, acceptability, and preliminary clinical outcomes of Be Well at Work-PLUS and provide data to apply for an R01 efficacy trial. To compliment these research aims, Dr. McCurley has designed a training plan to gain expertise in (1) implementation science, including planned adaptation of evidence-based interventions and participatory design methods for improving reach and engagement in low-income groups, (2) mobile health, specifically, text messaging for increased intervention feasibility and uptake; and (3) randomized controlled trial design. The career development plan involves regular mentorship with experts in implementation science, mobile health, randomized behavioral intervention trials, as well as didactic courses and workshops in these topics, dissemination of results through presentations and publications, and support for grant writing and additional skill development to advance Dr. McCurley’s career as an independent behavioral scientist. This K23 proposal will position Dr. McCurley to become an independent investigator developing interventions that fuse technology and behavioral science to address depression, health behavior, social determinants of health, and cardiometabolic diseases in low-income populations.

抑郁和缺乏运动是肥胖等心脏代谢疾病的主要诱因， 糖尿病和心血管疾病。低工资工人占美国所有工人的三分之一。 对许多行业来说都是必不可少的，更有可能是身体不活跃的， 他们的健康状况和抑郁症，但他们利用预防保健的可能性是高薪工人的一半。 有针对性的工作场所倡议在改善雇员健康方面取得了成功，但低工资工人 很难参与，部分原因是社会弱势的沉重负担（例如，粮食和住房不安全，时间 财政限制）。目前，据我们所知，没有工作场所干预抑郁症， 专门针对低工资工人及其独特社会风险因素。这项研究是概念化使用一个 有计划的适应方法，让低工资工人参与干预措施的设计， 在这一人群中的参与度和可行性。拟议的研究将采用基于证据的8个会议 电话传递抑郁症干预工作的成年人，在工作中做好，并添加关键 提高低工资工人的健康水平：评估和推荐健康、身体健康和 活动促进，以及通过生态瞬时评估的个性化短信行为支持 和干预。适应性干预，在工作中做得好，加，将开发和测试在三个 阶段：（1）与低工资工人进行定性访谈，以了解健康的社会决定因素， 和参与的促进者，以及干预偏好（目标1）;（2）具有退出的单臂飞行员（N=10） 访谈，以完善干预内容和交付（目标2）;（3）试点随机对照试验 将Be Well at Work-PLUS与等待名单条件进行比较（N=60;目标3）。这个迭代过程将产生结果 关于Be Well at Work-PLUS的可行性、可接受性和初步临床结局，并提供数据， 申请R 01疗效试验。为了实现这些研究目标，McCurley博士设计了一个培训计划， 获得（1）实施科学方面的专门知识，包括有计划地调整循证干预措施 和参与式设计方法，以提高低收入群体的覆盖率和参与度，（2）移动的 健康，特别是短信，以增加干预的可行性和吸收;和（3）随机 对照试验设计。职业发展计划包括与专家定期指导， 实施科学，移动的健康，随机行为干预试验，以及教学课程 和讲习班，通过演讲和出版物传播成果， 授予写作和额外的技能发展，以推进博士麦考利的职业生涯作为一个独立的 行为科学家。这项K23提案将使McCurley博士成为一名独立调查员 开发融合技术和行为科学的干预措施来解决抑郁症、健康行为， 健康的社会决定因素以及低收入人群的心脏代谢疾病。

项目成果

Assessment of the Massachusetts Flexible Services Program to Address Food and Housing Insecurity in a Medicaid Accountable Care Organization.

• DOI: 10.1001/jamahealthforum.2023.1191
• 发表时间: 2023-06-02
• 期刊: JAMA HEALTH FORUM
• 作者: McCurley, Jessica L;Fung, Vicki;Levy, Douglas E;McGovern, Sydney;Vogeli, Christine;Clark, Cheryl R;Bartels, Stephen;Thorndike, Anne N
• 通讯作者: Thorndike, Anne N

Health Literacy, Numeracy, and Health Promotion: A Secondary Analysis of the Choosewell 365 Workplace Trial.

• DOI: 10.1016/j.amepre.2021.12.020
• 发表时间: 2022-07
• 期刊: AMERICAN JOURNAL OF PREVENTIVE MEDICINE
• 影响因子: 5.5
• 作者: Jia, Jenny;Levy, Douglas E.;McCurley, Jessica L.;Anderson, Emma;Gelsomin, Emily D.;Porneala, Bianca;Thorndike, Anne N.
• 通讯作者: Thorndike, Anne N.

Chronotype Polygenic Score and the Timing and Quality of Workplace Cafeteria Purchases: Secondary Analysis of the ChooseWell 365 Randomized Controlled Trial.

时间型多基因评分与工作场所自助餐厅购买的时间和质量：ChooseWell 365 随机对照试验的二次分析。

• DOI: 10.1016/j.cdnut.2023.100048
• 发表时间: 2023
• 期刊: Current developments in nutrition
• 影响因子: 4.8
• 作者: Dashti,HassanS;Alimenti,Kaitlyn;Levy,DouglasE;Hivert,Marie-France;McCurley,JessicaL;Saxena,Richa;Thorndike,AnneN
• 通讯作者: Thorndike,AnneN

COVID-19 stressors and one-year changes in depression and anxiety in a longitudinal cohort of low-income adults in the United States.

• DOI: 10.1016/j.pmedr.2022.101730
• 发表时间: 2022-04
• 期刊: Preventive medicine reports
• 影响因子: 2.8
• 作者: Thorndike AN;Fung V;McCurley JL;Clark CR;Howard S;Levy DE
• 通讯作者: Levy DE

The association of impulsivity with effects of the ChooseWell 365 workplace nudge intervention on diet and weight.

冲动与 ChooseWell 365 工作场所助推干预对饮食和体重的影响之间的关联。

• DOI: 10.1093/tbm/ibac103
• 发表时间: 2023
• 期刊: Translational behavioral medicine
• 影响因子: 3.6
• 作者: McCurley,JessicaL;Buckholtz,JoshuaW;Roberto,ChristinaA;Levy,DouglasE;Anderson,EmmaM;Chang,Yuchiao;Thorndike,AnneN
• 通讯作者: Thorndike,AnneN