Effects of Physical Activity Calorie Expenditure (PACE) Food Labeling

描述（由申请人提供）：肥胖和缺乏身体活动每年导致超过40万人死亡，并大大增加了美国的医疗费用。非常需要有效的公共卫生干预措施来帮助遏制肥胖症的流行。政策制定者正在寻求干预措施，例如《平价医疗法案》中的规定，即连锁餐馆在菜单上显示“清晰和明显”的食物卡路里信息。然而，研究这种类型的菜单标签表明，它可能没有减少人们选择的膳食的实际卡路里的预期效果。在更容易理解的背景下传达信息的标签可能在激励行为改变方面更有效。最近，我们在一项使用假设场景的随机试验中发现，当显示身体活动卡路里消耗（PACE）食品标签时，人们选择卡路里总量较少的食物。 在这个项目中，我们现在将测试我们的PACE食品标签对实际食品的影响。 决策点的食物购买行为以及身体活动。我们将与北卡罗来纳州的蓝十字和蓝盾合作，在他们的三个校园食堂测试我们的标签的效果，为3600多名员工服务。主要结果将是三个队列中个人购买的卡路里量（通过收据和自我报告跟踪）以及通过加速度计和健身房使用测量的身体活动。作为次要措施，购买的卡路里和健身房的使用也将被衡量的总和（校园水平）。次要结果还包括队列中个体的体重指数、血压、血糖水平和胆固醇水平的变化。我们将使用中断时间序列分析比较干预前和干预后的结果，并将干预与对照组进行比较。将对各组进行总计24个月的随访。该项目的结果将为菜单标签的有效性提供有价值的证据，并为新的政策干预方法提供信息，这些方法可能会及时导致美国人更健康。

DESCRIPTION (provided by applicant): Obesity and physical inactivity are responsible for more than 400,000 deaths per year and contribute substantially to rising healthcare costs in the US. Effective public health interventions are greatly needed to help curb the epidemic of obesity. Policymakers are looking toward interventions such as the mandate in the Affordable Care Act that chain restaurants display "clear and conspicuous" calorie information for the food on their menus. However, studies examining this type of menu labeling suggest that it may not have the intended effect of decreasing actual calories of meals that people choose. Labels that convey information in a more readily understandable context may be more effective at motivating behavior change. Recently, we found in a randomized trial using hypothetical scenarios that people select foods totaling fewer calories when shown physical activity calorie expenditure (PACE) food labels. In this project, we now will test the effect of our PACE food labels on actual point-of-decision food purchasing behavior as well as physical activity. We will partner with Blue Cross and Blue Shield of North Carolina to test the effects of our labels in three of their campus cafeterias that serve over 3600 employees. Primary outcomes will be amount of calories purchased by individuals in three cohorts (tracked by receipts and self-report) and physical activity as measured by accelerometry and gym use. As secondary measures, calories purchased and gym use will also be measured in aggregate (campus level). Secondary outcomes will also include changes in body mass index, blood pressure, glucose level, and cholesterol level among individuals in the cohorts. We will compare pre-intervention to post-intervention outcomes using interrupted time-series analysis as well as intervention to a control group. The groups will be followed for a total of 24 months. The results of this project will provide valuable evidence on the effectiveness of menu labeling and inform new policy intervention approaches which might in time lead to healthier Americans.