Innovative approaches to increase F&V intake thru worksites: The Fresh Initiative

描述(由申请人提供)：食用充足的水果和蔬菜(F&V)与患慢性病的风险较低有关，如许多癌症、心血管疾病和2型糖尿病。迫切需要成本效益高的营养教育方法，帮助广大和多样化的人口吃更多的F&V食物。工地是进行此类干预的一个很有希望的渠道。这项拟议的研究将在一个成功的试点干预措施--Fresh倡议的基础上，研究创新工作场所干预措施的有效性，以改善员工的餐饮消费。这项试点是与私营F&V分销公司布朗大学、国际扶轮卫生部和国际扶轮工地健康委员会合作，定期向工作地点提供低成本、新鲜的F&V。24个工作地点将被随机分成三个试验组之一，如下所述。员工的F&V消费将在基线、6个月、12个月和18个月进行衡量。这项拟议研究的主要具体目标是采用一组随机试验来研究以下干预措施的有效性：1以更低的价格在工作场所提供新鲜的F&V食品以增加员工的F&V消费(获取干预A)与对照(C)干预(A与C)相比；2.改变工作场所的信息和社会环境的干预措施(B)结合单独F&V提供的干预措施(A)与对照干预相比增加员工的F&V消费(强化干预)。(A+B vs C)；3与单纯的准入干预相比，加强了对增加员工F&V消费的干预。(A+B对A)。第二个目标包括：1.实施广泛的实施过程评估，以确定成本、覆盖范围、忠诚度和剂量；2.使用中介变量框架来检验重要的心理社会因素/决定因素与F&V消费变化的关系；3.通过实验条件比较从基线到6、12和18个月员工生产力的变化；4.在积极干预期结束后6个月(基线后18个月)比较上述干预措施的效果；5.比较与F&V消费变化相关的比较、获得和强化干预的成本效益。与公共健康相关：多吃水果和蔬菜(F&V)是一项主要的国家饮食建议，因为它可以降低许多癌症、心血管疾病和2型糖尿病的风险。然而，许多美国人没有吃足够的F&V食品。这项拟议的研究的目的是对24个工作场所进行随机研究，比较不同干预措施在改善员工F&V消费方面的效果。

DESCRIPTION (provided by applicant): Eating ample amounts of fruits and vegetables (F&V) is associated with a lower risk of chronic diseases such as many cancers, cardiovascular diseases, and type 2 diabetes. Cost-effective nutrition education approaches to help large and diverse segments of the population to eat more F&V are greatly needed. The worksite is a promising channel for such interventions. The proposed research will study the efficacy of innovative worksite interventions to improve F&V consumption of employees by building upon a successful pilot intervention - the Fresh Initiative. This pilot is a partnership with a private F&V distribution company, Brown University, the RI Department of Health and the Worksite Wellness Council of RI to regularly deliver low-cost, fresh F&V to the worksite. Twenty four worksites will be randomized to one of three experimental groups as discussed below. Employee F&V consumption will be measured at baseline, 6, 12 and 18 months. The primary Specific Aims of this proposed research are to employ a group randomized trial to study the efficacy of: 1 An intervention to deliver fresh F&V at reduced prices for purchase at worksites on increasing employees' F&V consumption (Access intervention A) compared to a Comparison (C) intervention (A vs. C.); 2. Interventions to change the information and social environments at the worksite (B) combined with the F&V delivery intervention alone (A) on increasing employees' F&V consumption (Enhanced intervention) compared to a Comparison intervention. (A+B vs. C); 3 The Enhanced intervention on increasing employees' F&V consumption compared to the Access intervention alone. (A+B vs. A). Secondary aims include: 1. To implement extensive implementation process evaluation to determine costs, reach, fidelity and dose; 2. To use a mediating variable framework to examine relationships among important psychosocial factors/determinants with changes in F&V consumption; 3. To compare changes in employee productivity from baseline to 6, 12, and 18 months by experimental condition; 4. To compare the efficacy of the above interventions 6 months after the active intervention period ends (18 months after baseline); 5. To compare the cost effectiveness of the Comparison, Access and Enhanced interventions related to change in F&V consumption. PUBLIC HEALTH RELEVANCE: Eating more fruits and vegetables (F&V) is a major national dietary recommendation because it reduces risk for many cancers, cardiovascular diseases and type 2 diabetes. However, many Americans are not eating adequate F&V. The purpose of the proposed research is to conduct a randomized study with 24 worksites to compare the effectiveness of different interventions on improving employees' F&V consumption.