Interventions to Control Obesity in Community Colleges

描述（由申请人提供）：尽管肥胖是流行病的比例，并花费美国雇主估计每年785亿美元;国家数据表明，只有不到25%的雇主提供疾病管理计划，以解决肥胖问题。有效的减肥计划，是适应忙碌的工作环境，并保持员工的兴趣是必要的，但很少有严格的测试，这些计划已经尝试。我们将与北卡罗来纳州社区学院系统、北卡罗来纳州蓝十字蓝盾和州教师和雇员医疗计划合作，进行一项为期三年的分组随机减肥干预研究，其中1300名超重/肥胖雇员将被随机分配到13所社区学院，接受三种有前途的、最先进的、理论相关的干预措施之一：环境/卫生保健（E）;基于网络的减肥计划+环境（WEB+E）或网络+环境+激励措施（WEB+E+I）。学院是随机化和干预的单位;员工是分析的单位。在第一年的形成性研究，以适应社区学院员工的干预措施后，我们将严格测试这些干预措施对12个月减肥的影响（主要结果）。将在基线、3、6、9和12个月时测量体重;并将在基线、6和12个月时评估大多数次要结局（体重减轻行为、中度-剧烈体力活动、总热量、体脂百分比、水果/蔬菜摄入、缺勤、生产力、医疗支出和生活质量）;沿着体重减轻结局的潜在中介/调节因子。过程跟踪数据将衡量保真度、输送/接收的剂量以及干预措施的可接受性/满意度。将进行广泛的成本和成本效益分析，包括投资回报分析。如果被证明是有效的，社区学院，国家健康计划和研究团队之间的这种强大的伙伴关系，将有助于指导整个社区学院校园系统的计划采用和制度化/传播。

DESCRIPTION (provided by applicant): Despite the fact that obesity is at epidemic proportions and costs US employers an estimated $78.5 billion annually; national data indicate that less than 25% of employers are offering disease management programs to address obesity. Effective weight loss programs that are adaptable to busy work environments and maintain employee interest are needed, but few rigorous tests of these programs have been attempted. In collaboration with the North Carolina Community College System, NC Blue Cross Blue Shield, and the State Teachers and Employee Medical Plan, we will conduct a three year group-randomized weight loss intervention study where 1300 overweight/obese employees nested within 13 community colleges will be randomly assigned to receive one of three promising, state-of-the-art, theory-linked interventions: Environment/Usual Care (E); Web-based Weight Loss Program + Environment (WEB+E) or Web + Environment +Incentives (WEB+E+I). College is the unit of randomization and intervention; employee is the unit of analysis. After formative research in Year 1 to adapt interventions for community college employees, we will rigorously test the effects of these interventions on 12-month weight loss (primary outcome). Weight will be measured at baseline, 3, 6, 9 and 12 months; and most secondary outcomes (weight loss behaviors, moderate-vigorous physical activity; total calories, percent body fat, fruit/vegetable intake, absenteeism, productivity, medical expenditures, and quality of life) will be assessed at baseline, 6 and 12 months; along with potential mediators/moderators of weight loss outcomes. Process tracking data will measure fidelity, dose delivered/received and acceptability/satisfaction with the interventions. Extensive cost- and cost-effectiveness analysis, including return on investment, will be undertaken. If proven effective, this strong partnership between community colleges, the State Health Plan, and the research team, will help guide program adoption and institutionalization/dissemination throughout the community college campus system.