Effects of Physical Activity Calorie Expenditure (PACE) Food Labeling

描述（由申请人提供）：肥胖和缺乏身体活动每年导致40多万人死亡，并在很大程度上导致了美国医疗成本的上升。亟需有效的公共卫生干预措施来帮助遏制肥胖的流行。政策制定者正在寻求干预措施，比如《平价医疗法案》（Affordable Care Act）要求连锁餐厅在菜单上显示“清晰明显”的食物卡路里信息。然而，检查这种菜单标签的研究表明，它可能没有减少人们选择的食物的实际卡路里的预期效果。在更容易理解的背景下传达信息的标签可能更有效地激励行为改变。最近，我们在一项随机试验中发现，在假设的情况下，人们在看到体力活动卡路里消耗（PACE）食品标签时，会选择卡路里总量较少的食物。在这个项目中，我们现在将测试我们的PACE食品标签对实际的影响

DESCRIPTION (provided by applicant): Obesity and physical inactivity are responsible for more than 400,000 deaths per year and contribute substantially to rising healthcare costs in the US. Effective public health interventions are greatly needed to help curb the epidemic of obesity. Policymakers are looking toward interventions such as the mandate in the Affordable Care Act that chain restaurants display "clear and conspicuous" calorie information for the food on their menus. However, studies examining this type of menu labeling suggest that it may not have the intended effect of decreasing actual calories of meals that people choose. Labels that convey information in a more readily understandable context may be more effective at motivating behavior change. Recently, we found in a randomized trial using hypothetical scenarios that people select foods totaling fewer calories when shown physical activity calorie expenditure (PACE) food labels. In this project, we now will test the effect of our PACE food labels on actual point-of-decision food purchasing behavior as well as physical activity. We will partner with Blue Cross and Blue Shield of North Carolina to test the effects of our labels in three of their campus cafeterias that serve over 3600 employees. Primary outcomes will be amount of calories purchased by individuals in three cohorts (tracked by receipts and self-report) and physical activity as measured by accelerometry and gym use. As secondary measures, calories purchased and gym use will also be measured in aggregate (campus level). Secondary outcomes will also include changes in body mass index, blood pressure, glucose level, and cholesterol level among individuals in the cohorts. We will compare pre-intervention to post-intervention outcomes using interrupted time-series analysis as well as intervention to a control group. The groups will be followed for a total of 24 months. The results of this project will provide valuable evidence on the effectiveness of menu labeling and inform new policy intervention approaches which might in time lead to healthier Americans.