Environmental Intervention for Weight Gain Prevention

描述（由申请人提供）：肥胖在美国是一个快速增长的健康问题，目前没有有效的治疗和预防措施。现在人们普遍认为，鼓励饮食和阻碍体育活动的环境因素是造成肥胖问题的重要因素，有人建议，可能需要环境干预来减少人口肥胖。这项拟议的研究将评估多组分环境干预在预防工作成年人体重增加方面的功效。8个工作地点将被随机分为干预组和不进行治疗的对照组。干预措施将包括：1)改变在工作场所出售给员工的食品和饮料的供应、份量和价格，鼓励他们选择更健康的食品；2)通过实施步行计划和增加楼梯间通道和吸引力，增加工地体力活动机会的可用性；3)在工作环境中放置体重秤，鼓励员工监测体重，并使员工能够为自己的体重设定目标；4)向所有员工提供教育材料，使他们意识到环境干预和行为实践可能有效防止体重增加。每个工作地点的一组员工的体重、饮食行为和身体活动将在基线和两年内进行测量。还将通过直接观察和管理记录获得行为的综合衡量标准。假设干预工作场所的员工在两年内会减少能量摄入，增加能量消耗，减少体重增加。预计干预对行为和体重的影响将与干预活动的暴露程度有关。

DESCRIPTION (provided by applicant): Obesity is a rapidly growing health problem in the US for which neither effective treatment nor preventive measures are currently available. It is now widely accepted that environmental factors that encourage eating and discourage physical activity are important contributors to the problem, and it has been suggested that environmental interventions may be needed to achieve reductions in population obesity. The proposed study will assess the efficacy of a multi-component environmental intervention in preventing weight gain among working adults. Eight worksites will be randomized to either an intervention or a no-treatment control group. Intervention will be comprised of 1) changing the availability, portion sizes, and prices of foods and beverages sold to employees in their worksites in ways that encourage healthier food choices; 2) increasing the availability of physical activity opportunities at the worksite by implementing walking programs and increasing stairwell access and attractiveness; 3) placing scales in the work environment to encourage body weight monitoring and to enable workers to set goals for their weight; and 4) to provide educational materials to all employees to make them aware of the environmental interventions and of behavioral practices likely to be effective in preventing weight gain. Body weight, eating behavior, and physical activity will be measured at baseline and two years in a cohort of employees from each worksite. Aggregate measures of behavior will also be obtained through direct observation and management records. It is hypothesized that employees in intervention worksites will decrease energy intake, increase energy expenditure, and reduce weight gain compared to those in comparison sites over two years. It is also anticipated that the effects of the intervention on behavior and weight will be related to degree of exposure to intervention activities.