Care2bWell: A Worksite Physical Activity & Wellness Program for Child Care Staff

美国大约有130万儿童保育员，其中大多数是小时工，被归类为 低收入者。在北卡罗来纳州，这些工人中有一半是非裔美国人或西班牙裔。许多人没有 医疗保险，使他们面临许多严重和慢性健康状况的风险增加，如 肥胖、糖尿病和高血压。众所周知，有规律的体力活动(PA)可以降低许多慢性疾病的风险 疾病；不幸的是，大多数美国人，特别是低收入个人和少数族裔，未能达到PA 建议。在儿童保育中提供基于工作场所的多层次PA干预是一种创新策略 接触到这些低薪工人，并解决这些高危人群之间的健康差距。而当 我们干预的主要目标是工人PA，我们预计更健康和更多的身体活动的工人将 为他们所照料的儿童做更好的榜样和健康生活方式的推动者。这种双臂、群集式RCT (n=104个中心，每个中心有4名工作人员)将测试为期6个月的Care2b Well(CARE)干预的有效性 与财务授权(FE)控制部门相比，提高了员工的PA。护理干预将 包括启动研讨会，参与者在那里获得关于他们健康风险的量身定制的反馈，并设置行为 目标，然后是三个为期两个月的健康活动，在此期间，工作人员监督PA，收到量身定做的 反馈，并以团队形式争夺奖品。中心主任将参加每月一次的网络研讨会，重点是 改善工作环境，以支持PA和健康。在社会生态框架内，感知 控制、社会支持和创新扩散理论指导着个人、人际和中心-- 水平干预组件。FE ARM的参与者将接受平行干预，以增强 个人和中心层面的财务健康状况。主要结果将由加速度计测量。 几分钟的适度到强烈的PA。主要和次要结果(饮食、人体测量学、心理社会 变量和中心健康环境)将在基线、跟踪(6个月)和维护时进行评估 (18mo)。将使用详细的过程评估、成本效益和冥想分析来评估 在个人和中心层面上的行为变化机制。

There are approximately 1.3 million US child care workers, most of who are hourly employees and classified as low-wage earners. In North Carolina, half of these workers are African American or Hispanic. Many have no health insurance, putting them at increased risk for many serious and chronic health conditions such as obesity, diabetes, and hypertension. Regular physical activity (PA) is known to decrease risk of many chronic diseases; unfortunately, most Americans, especially low-income individuals and minorities, fail to meet PA recommendations. A multi-level worksite-based PA intervention offered in child care is an innovative strategy to reach these low wage workers and address health disparities among this high-risk population. While the primary target of our intervention is worker PA, we expect that healthier and more physically active workers will be better role models and promoters of healthy lifestyles for children in their care. This two-arm, cluster RCT (n=104 centers, with 4 workers/center) will test the efficacy of a 6-month Care2bWell (CARE) intervention in increasing workers' PA compared to a Financial Empowerment (FE) control arm. The CARE intervention will include a kick-off workshop, where participants get tailored feedback about their health risks and set behavioral goals, followed by three 2-month long wellness campaigns, during which workers monitor PA, receive tailored feedback, and compete in teams for prizes. Center directors will take part in monthly webinars focused on improving the work environment to support PA and wellness. Within a social ecological framework, Perceptual Control, Social Support, and Diffusion of Innovation theories guide intrapersonal, interpersonal, and center- level intervention components. Participants in the FE arm will receive a parallel intervention to enhance financial health at the individual and center levels. The primary outcome will be accelerometer-measured minutes of moderate to vigorous PA. Primary and secondary outcomes (diet, anthropometrics, psychosocial variables, & center wellness environments) will be assessed at baseline, follow-up (6 mo), and maintenance (18 mo). Detailed process evaluation, cost-effectiveness, and meditational analysis will be used to assess mechanisms of behavior change at the individual and center levels.