Care2bWell: A Worksite Physical Activity & Wellness Program for Child Care Staff

描述(由申请人提供)：美国大约有130万儿童保育员，其中大部分是小时工，被归类为低收入者。在北卡罗来纳州，这些工人中有一半是非裔美国人或西班牙裔。许多人没有医疗保险，这增加了他们患肥胖症、糖尿病和高血压等许多严重和慢性健康疾病的风险。众所周知，经常的体力活动(PA)可以降低患许多慢性病的风险；不幸的是，大多数美国人，特别是低收入个人和少数族裔，未能达到PA的建议。在儿童保育中提供基于工作场所的多层次PA干预是一种创新的战略，可以接触到这些低工资工人，并解决这些高危人群中的健康差距。虽然我们干预的主要目标是 工作者PA，我们期望更健康和更积极运动的工作者将成为他们照顾的儿童更好的榜样和健康生活方式的推动者。这项双臂群集式RCT(n=104个中心，每个中心有4名员工)将测试与财务授权(FE)控制部门相比，为期6个月的Care2b Well(CARE)干预措施在提高员工PA方面的有效性。护理干预将包括一个启动研讨会，参与者在那里获得关于他们的健康风险的定制反馈并设定行为目标，然后是三个为期两个月的健康活动，在此期间，工作人员监控PA，收到定制的反馈，并分组竞争奖品。中心主任将参加每月的网络研讨会，重点是改善工作环境，以支持PA和健康。在社会生态框架内，知觉控制、社会支持和创新扩散理论指导着个人、人际和中央层面的干预。FE部门的参与者将接受平行干预，以增强个人和中心层面的财务健康。主要结果将是加速度计测量的中等到剧烈PA的分钟数。主要和次要结果(饮食、人体测量学、心理社会变量和中心健康环境)将在基线、随访(6个月)和维持(18个月)进行评估。详细的过程评估、成本效益和冥想分析将被用来评估个人和中心层面的行为改变机制。

DESCRIPTION (provided by applicant): There are approximately 1.3 million US child care workers, most of who are hourly employees and classified as low-wage earners. In North Carolina, half of these workers are African American or Hispanic. Many have no health insurance, putting them at increased risk for many serious and chronic health conditions such as obesity, diabetes, and hypertension. Regular physical activity (PA) is known to decrease risk of many chronic diseases; unfortunately, most Americans, especially low-income individuals and minorities, fail to meet PA recommendations. A multi-level worksite-based PA intervention offered in child care is an innovative strategy to reach these low wage workers and address health disparities among this high-risk population. While the primary target of our intervention is worker PA, we expect that healthier and more physically active workers will be better role models and promoters of healthy lifestyles for children in their care. This two-arm, cluster RCT (n=104 centers, with 4 workers/center) will test the efficacy of a 6-month Care2bWell (CARE) intervention in increasing workers' PA compared to a Financial Empowerment (FE) control arm. The CARE intervention will include a kick-off workshop, where participants get tailored feedback about their health risks and set behavioral goals, followed by three 2-month long wellness campaigns, during which workers monitor PA, receive tailored feedback, and compete in teams for prizes. Center directors will take part in monthly webinars focused on improving the work environment to support PA and wellness. Within a social ecological framework, Perceptual Control, Social Support, and Diffusion of Innovation theories guide intrapersonal, interpersonal, and center- level intervention components. Participants in the FE arm will receive a parallel intervention to enhance financial health at the individual and center levels. The primary outcome will be accelerometer-measured minutes of moderate to vigorous PA. Primary and secondary outcomes (diet, anthropometrics, psychosocial variables, & center wellness environments) will be assessed at baseline, follow-up (6 mo), and maintenance (18 mo). Detailed process evaluation, cost-effectiveness, and meditational analysis will be used to assess mechanisms of behavior change at the individual and center levels.