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: 7765773
• 负责人: GLADYS BLOCK
• 金额: $ 43.03万
• 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 2011-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7765773
• 关键词: Absenteeism; Accounting; Address; 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; Consumption; Control Groups; Databases; Diet; Effectiveness; Effectiveness of Interventions; Electronic Mail; Employee; Ensure; Environment; Feedback; Focus Groups; Goals; Health; Health Care Costs; Healthcare; Individual; Instruction; Intake; Intervention; Link; Literature; Medical; Methods; Modality; Modification; Morbidity - disease rate; Occupations; Participant; Persons; Phase; Phase I Clinical Trials; Physical activity; Population; Printing; Productivity; Psyche structure; Public Health; Questionnaires; Randomized; Randomized Controlled Clinical Trials; Randomized Controlled Trials; Relative (related person); Reporting; Research; Review Literature; Risk Assessment; Risk Factors; Sampling; Savings; Self Efficacy; Specific qualifier value; Staging; Surveys; System; Target Populations; Telephone; Testing; Text; Time; To specify; Trans Fats; Treatment Efficacy; United States; Universities; Upper arm; Voice; Work; Workplace; Writing; age group; aged; base; behavior change; cost; cost effectiveness; disability; disorder risk; effective intervention; efficacy testing; experience; fruits and vegetables; group intervention; health economics; health related quality of life; improved; innovation; intervention program; lifestyle intervention; physical conditioning; population based; post intervention; programs; public health priorities; 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程序，以改善饮食和体力活动（PA），使其更适合55-64岁的工人，并增加提供自动交互式电话信息和为个人量身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慢性病及其后续医疗费用的三大原因之二（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，这一年龄组的慢性疾病不断增加，医疗保险即将使用。这项研究将建立在现有的电子邮件干预，ALIVE，这是在一个工作场所的随机对照试验证明有效（2，3）。ALIVE包括健康风险评估（HRA）、定制反馈、广泛定制、每周目标设定、互动功能和健康信息。研究方法：第一阶段的目标是加强ALIVE的所有组成部分，以提高55-64岁人群的适当性，基于焦点小组，可用性测试，以及PA，饮食行为变化和衰老专家的投入。第一阶段还将展示将ALIVE与新的自动电话和打印部件连接起来的能力。在第二阶段，年龄定制的ALIVE将在随机对照试验中进行测试。加州大学两个校区的工作人员和教师将被招募; 55-64岁的人将被随机分配到A）仅接受HRA和反馈的对照组; B）年龄定制的ALIVE计划; C）年龄定制的ALIVE计划加上电话和印刷材料。基线评估包括饮食和PA，以及WHO健康和工作表现问卷（HPQ）。然后，B和C组专注于增加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个月的时间内，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，干预组将选择其他两个目标之一。在第二个4个月期间结束时，将再次重复这一做法，总共进行一年的干预，并在结束时进行重复评价。PA、饮食、自我报告的健康和工作结果的变化将使用意向治疗进行评估。首先，将使用已发布的外部数据来估计观察到的饮食和PA变化对医疗保健成本的影响，这些数据涉及此类变化对后续慢性疾病风险和成本影响的影响。其次，将根据HPQ评估和货币化HPQ衡量的缺勤和出勤率的改善;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所希望的指标。将比较研究的三个治疗组的成本和有效性。公共卫生相关性：近45%的美国人至少有一种慢性疾病，慢性疾病患者的医疗费用占医疗保健费用的近75%（1）。死亡的三大主要原因中有两个是不良饮食和缺乏身体活动（1）。这些行为的改善将导致更少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有效干预措施在高危年龄组中的效果。