Interventions to Control Obesity in Community Colleges

描述(由申请者提供)：尽管肥胖症是一种流行病，美国雇主每年估计花费785亿美元；但全国数据显示，只有不到25%的雇主提供疾病管理计划来解决肥胖问题。有效的减肥计划需要适应繁忙的工作环境，并保持员工的兴趣，但这些计划几乎没有进行过严格的测试。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以及州教师和员工医疗计划合作，进行一项为期三年的团体随机减肥干预研究，在13所社区大学中嵌套的1300名超重/肥胖员工将被随机分配到三种有前途的、最先进的、与理论相关的干预措施中：环境/日常护理(E)、基于网络的减肥计划+环境(Web+E)或网络+环境+激励(Web+E+I)。高校是随机干预的单位，员工是分析的单位。经过第一年的形成性研究，以适应社区大学员工的干预措施，我们将严格测试这些干预措施对12个月体重减轻(主要结果)的影响。体重将在基线、3、6、9和12个月时测量；大多数次要结果(减肥行为、中等强度的体力活动；总卡路里、体脂百分比、水果/蔬菜摄入量、缺勤、生产力、医疗费用和生活质量)将在基线、6个月和12个月时进行评估；以及减肥结果的潜在中介/调节因素。过程跟踪数据将衡量保真度、提供/接收的剂量以及对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。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有力的合作伙伴关系将有助于指导整个社区学院校园系统采用项目和制度化/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.