Workplace Wellness Initiatives to Combat Obesity

对抗肥胖的工作场所健康举措

• 批准号: 8857151
• 负责人: Jason Perry Block
• 金额: $ 13.77万
• 依托单位: HARVARD PILGRIM HEALTH CARE, INC.
• 依托单位国家: 美国
• 财政年份: 2013
• 资助国家: 美国
• 起止时间: 2013-08-15 至 2016-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8857151
• 关键词: Absenteeism; Academic Medical Centers; Academic advising; Address; Adherence; American; Back; Behavior; Behavioral; Behavioral trial; Beverages; Biometry; Body Weight decreased; Boston; Calories; Clinic; Clinical Trials Design; Contracts; Deposition; Development; Dietary intake; Economics; Employee; Employee Health; Enrollment; Environment; Environmental Impact; Epidemic; Epidemiology; Evaluation; Faculty; Feedback; Fellowship; Focus Groups; Food; Food Services; Fostering; Frequencies; Goals; Health; Health Care Costs; Health Food; Hospital Restructuring; Hospitals; Hour; Incentives; Individual; Intake; Interdisciplinary Study; Internal Medicine; Intervention; K-Series Research Career Programs; Lead; Learning; Maintenance; Massachusetts; Measurement; Mentored Patient-Oriented Research Career Development Award; Mentors; Mentorship; Motivation; Natural experiment; Obesity; Occupational Health; Outcome; Overweight; Participant; Perception; Physicians; Physiological; Policy Maker; Primary Health Care; Protocol Compliance; Qualitative Research; Questionnaires; Randomized Controlled Trials; Reaction; Recording of previous events; Regrets; Research; Research Infrastructure; Research Personnel; Research Training; Resources; Risk; Sales; Series; Site; Time; Training; Training Activity; Trans Fats; Weight; Weight Gain; Woman; Work; Workplace; arm; base; behavior change; behavioral economics; career; career development; combat; cost; design; environmental intervention; experience; financial incentive; healthy weight; improved; information gathering; innovation; meetings; member; motivated behavior; novel; nutrition; population health; practical application; psychologic; response; saturated fat; service intervention; skills; success; weight loss intervention; weight maintenance

DESCRIPTION (provided by applicant): Dr. Jason Block is a general internal medicine physician committed to a research career focused on innovative interventions to combat obesity. This K23 Research Career Development Award will build upon his strong methodological skills obtained during a recently-completed population health research fellowship. With support from the K23, he will gain additional skills in advanced epidemiology, economics, qualitative research, analysis of quasi- and natural experiments, and randomized controlled trials. The goal of this K23 is for Dr. Block to learn these skills through coursework, mentorship and the practical application of these skills in Aims that evaluate workplace wellness initiatives to promote a healthy weight. Mentors with expertise in epidemiology, nutrition, biostatistics, behavioral economics, and economics will guide training and research for Dr. Block, and each mentor will meet with him at least monthly to provide training, feedback on projects and assessments of his career development. Dr. Block's department has a long history of supporting junior faculty members and developing them into independent investigators. The department will unequivocally protect 75% of Dr. Block's time for research during the K23 award period and will continue to provide institutional resources to support his work. The need for novel interventions to address the obesity epidemic in the US is the motivation for the Aims of Dr. Block's K23 proposal. Sustaining a healthy weight can be difficult because of the ubiquitous availability of low- cost, unhealthful foods and physiologic mechanisms that counteract weight maintenance. Intensive individual- level interventions, using behavioral counseling and educational initiatives that target one individual or a small group of individuals at a time, can lead to sustained weight loss but are costly and difficult to implement broadly. Environmental interventions, such as the restructuring of the menu in a workplace cafeteria, and financial incentives promoting weight maintenance are two strategies that might overcome the obesogenic environment and the physiological barriers to sustained weight loss. Workplaces are logical sites for these interventions because Americans spend much of their waking hours at work, and employers could gain financial benefits from a healthier and more productive workforce, especially through low cost interventions. An environmental food services intervention is one cited example of a relatively inexpensive intervention. Workplaces, especially those with existing infrastructure such as occupational health clinics and on-site primary care clinics, also are ideal settings to carry out low-cost, behavioral trials. Dr. Block proposes to evaluate two workplace wellness initiatives to reduce risk for overweight and obesity and to promote weight maintenance within Brigham and Women's Hospital, a large academic medical center in Boston, Massachusetts, with nearly 16,000 employees. The Aims are 1) to conduct focus groups among Brigham and Women's employees to gather their views on workplace wellness initiatives, their response to the environmental intervention in the cafeteria, including new menu, and their reaction to our proposal for a deposit contract weight maintenance trial; 2) to examine the extent to which a new cafeteria menu influences the sales of healthy and unhealthy food and beverages, decreases the calorie content of employees' meals in the cafeteria, and decreases the total daily calorie, trans fat, and saturated fat intake of employees, and 3) to determine the extent to which a deposit contract improves weight maintenance among employees who have lost 10 lbs during the prior year. These initiatives incorporate common behavioral economics principles, including the large effect of defaults on behaviors and the power of loss aversion, which is the natural inclination to avoid losses or regret, in motivating behavior change. Through the training activities, mentorship, and research experience provided by the K23, Dr. Block will become a successfully independent investigator, exploring mechanisms to combat obesity among Americans.

简介(由申请者提供)：Jason Block博士是一名普通内科医生，致力于研究抗击肥胖的创新干预措施。这一K23研究职业发展奖将建立在他在最近完成的人口健康研究奖学金期间获得的强大方法技能的基础上。在K23的支持下，他将在高级流行病学、经济学、定性研究、准实验和自然实验分析以及随机对照试验方面获得更多技能。这本K23课程的目标是让布洛克博士通过课程练习、指导以及在评估工作场所健康倡议以促进健康体重的目标中实际应用这些技能来学习这些技能。具有流行病学、营养学、生物统计学、行为经济学和经济学专业知识的导师将指导Block博士的培训和研究，每位导师将至少每月与他会面，提供培训、项目反馈和对其职业发展的评估。布洛克博士所在的部门在支持初级教员并将他们培养成独立调查人员方面有着悠久的历史。在K23获奖期间，司法部将毫不含糊地保护布洛克博士75%的研究时间，并将继续提供机构资源支持他的工作。需要新的干预措施来解决美国的肥胖症流行，这是布洛克博士K23提案目标的动机。保持健康的体重可能很困难，因为到处都可以买到低成本、不健康的食物，以及抵消体重保持的生理机制。集中的个人层面的干预，使用行为咨询和教育举措，每次针对一个人或一小群人，可以导致持续的减肥，但成本高昂，难以广泛实施。环境干预措施，如调整工作场所自助餐厅的菜单，以及促进体重保持的财政奖励，是可能克服肥胖环境和持续减肥的生理障碍的两项战略。工作场所是进行这些干预的合乎逻辑的场所，因为美国人醒着的大部分时间都花在工作上，雇主可以从更健康、更有生产力的劳动力中获得经济利益，特别是通过低成本的干预。环境食品服务干预是一种成本相对较低的干预措施。工作场所，特别是那些拥有现有基础设施的场所，如职业健康诊所和现场初级保健诊所，也是进行低成本行为试验的理想环境。布洛克博士建议对两项职场健康倡议进行评估，这两项倡议旨在降低超重和肥胖的风险，并促进布里格姆妇女医院的体重维持。布里格姆妇女医院位于马萨诸塞州波士顿，是一家大型学术医疗中心，拥有近1.6万名员工。其目的是1)在Brigham和女性员工中开展焦点小组，收集他们对工作场所健康倡议的意见，他们对自助餐厅环境干预的反应，包括新菜单，以及他们对我们提出的按金合同体重维持试验的反应；2)审查新的自助餐厅菜单对健康和不健康食品和饮料的销售的影响程度，减少员工自助餐厅用餐的卡路里含量，并减少员工每天的总卡路里、反式脂肪和饱和脂肪摄入量， 以及3)确定存款合同在多大程度上改善了前一年减掉10磅的员工的体重维持。这些举措包含了共同的行为经济学原理，包括违约对行为的巨大影响，以及在激励行为改变时损失厌恶的力量，这是避免损失或后悔的自然倾向。通过K23提供的培训活动、指导和研究经验，布洛克博士将成为一名成功的独立调查员，探索对抗美国人肥胖的机制。