ENHANCING WORKSITE CANCER PREVENTION THROUGH THE HOME

该项目的重点是下一代癌症预防和 控制工地的工作。这是我们的巅峰 自1984年以来一直由NCI资助的程序性研究，进展 从理论上讲，以及现有的经验证据。重点放在规模较小的 到研究不足、服务不足的中等规模工作场所 蓝领和受教育程度较低的工人的人口，以及 以符合成本效益的方式改善对公众健康的影响。下一个 干预措施的产生需要是积极、持续和量身定制的 因地制宜，多种风险因素，并将个人和 环境变化。归根结底，干预必须是 制度化地融入工地文化的结构。这项研究 需要科学严谨、操作实用性和可传播性 合理的成本。迄今在工作场所健康促进方面所做的最好努力 产生了适度的影响，这是由于中等的疗效和覆盖范围 干预措施。为了提高影响和成本效益，一种以家庭为基础的 干预可以加强和补充工作现场渠道。一位专家 系统允许重复、主动、交互和高度个性化 (量身定做)在工作现场并非总是可行的干预措施。 这项建议将评估主要影响和相加效应。 针对多种危险因素的工作场所和家庭干预渠道 癌症预防(膳食脂肪、纤维、吸烟、紫外线照射和锻炼) 在从定义的地理位置招聘的40个中等规模的工作地点中 区域。工地是作业和分析的单位 现场与控制评估。个人被随机分配 在工作场所内，以家庭为基础或评估控制条件。最终 在基线、12个月、24个月和36个月时测量结果。工地 干预持续24个月，以便对 在36个月内维持和制度化。个人和 组织计划、过程和中期结果数据 收集以阐明调解机制(诱因、使能 和干预)基于理论驱动的模型和假设。一个 经过现场测试的复杂计算机跟踪系统用于收集 在预期的基础上进行计划评估和成本数据。通径分析 而过程到结果的分析将揭示 对定义的服务不足产生较大影响的行动 工人的人口。结果将推动工作场所癌症领域的发展 通过评估下一步的成本效益来控制研究 生成工作现场和基于家庭的干预措施。

This project focuses on the next generation of cancer prevention and control efforts at the worksite. It is the culmination of our programmatic research funded continuously by NCI since 1984, the advances in theory, and the available empirical evidence. The focus is on smaller to moderate-sized worksites that are under-researched, underserved populations of blue collar and less educated workers, and the challenge of improving the public health impact in a cost-effective manner. The next generation of interventions need to be proactive, sustained, and tailored to local needs, multiple risk factor, and integrating individual and environmental change. Ultimately, the intervention must be institutionalized into the fabric of the worksite culture. This research requires scientific rigor, operational practicality and disseminability at reasonable cost. The best efforts to date in worksite health promotion have produced modest impact due to moderate efficacy and reach of interventions. To improve the impact and cost-efficiency, a home-based intervention can enhance and complement a worksite channel. An expert system allows for repeated, proactive, interactive and highly personalized (tailored) interventions that are not always possible at the worksite. This proposal will evaluate the main effects and additive effects of worksite and home-based intervention channels on multiple risk factors for cancer prevention (dietary fat, fiber, smoking, UV exposure, and exercise) in 40 worksites of moderate size recruited from a defined geographic region. The worksites are the unit of assignment and analysis for the worksite versus control evaluation. Individuals are randomly assigned within worksites to home-based or assessment control conditions. Final outcomes are measured at baseline, 12, 24 and 36 months. The worksite intervention is sustained for 24 months, allowing for an evaluation of maintenance and institutionalization at 36 months. Both individual and organizational program, process and intermediate outcome data are collected to shed light on mediating mechanisms (predisposing, enabling and intervening) based on theory-driven models and hypotheses. A sophisticated and field-tested computer tracking system serves to collect program evaluation and cost data on a prospective basis. Path analyses and process-to-outcome analyses will shed light on the mechanisms of action that produce greater versus lesser impact on defined underserved populations of workers. Results will advance the field of worksite cancer control research by evaluating the cost-effectiveness of the next generation of both worksite and home-based interventions.