WORKSITE INTERVENTIONS TO REDUCE OBESITY AND DIABETES RISK IN LOW SES POPULATIONS

 描述（由申请人提供）：达到和保持健康的体重是预防糖尿病的主要公共卫生目标。虽然强化的生活方式干预措施在减肥和降低糖尿病风险方面取得了成功，但社会经济地位低的人群肥胖负担更高，很难通过卫生系统或基于人群的减肥干预措施达到。工作场所为针对低社会经济地位人群的健康促进计划提供了一个潜在的有效环境。拟议的研究小组汇集了国家认可的研究团队，他们在社区肥胖预防和工作场所健康和安全干预方面具有互补的专业知识，以测试针对低SES工人的工作场所干预计划。该项目与拥有许多低工资工人的大型医疗保健雇主BJC HealthCare合作，将评估可改变的工作环境和个人层面的健康饮食和活动障碍和促进因素（Aim 1）。在这项形成性工作的指导下，研究小组将调整现有的群体和个人层面的干预模式，以促进工人的健康体重。我们将开发和测试一种创新的多层次干预措施，其中包括使用短信的互动式肥胖治疗计划（iOTA）（Aim 2B）。这种创新的移动健康干预措施被嵌入到一个新描述的健康工作场所规划计划中，该计划将员工参与决策，以产生可接受的，有效的和可持续的工作场所环境变化（目标2A）。这些嵌套干预措施将通过一项大型延迟开始的随机分组试验进行测试。这项研究将严格测试易于扩展的干预措施，这些干预措施可以转化为其他工作环境，以降低低SES工人（这些疾病的高风险群体）的肥胖和糖尿病风险。这项实用的临床试验将 推动长远目标，使雇主和雇员能够减少肥胖和与肥胖有关的疾病，包括糖尿病。

 DESCRIPTION (provided by applicant): Attaining and maintaining healthy weight is a major public health goal for preventing diabetes. While intensive lifestyle interventions are successful in weight loss and reducing risk of diabetes, low socioeconomic status (SES) populations, which have a higher burden of obesity, are difficult to reach with health system or population-based weight loss interventions. The workplace offers a potentially effective setting for health promotion programs aimed at low SES populations. The proposed study team brings together nationally recognized research teams with complementary expertise in community-based obesity prevention and in workplace health and safety interventions to test a workplace intervention program targeted at low SES workers. Working in partnership with BJC HealthCare, a large health care employer with many low-wage workers, this project will evaluate modifiable work environment and individual-level barriers and facilitators of healthy eating and activity (Aim 1). Guided by this formative work, the study team will adapt existing group- and individual-level intervention models to promote healthy weight among workers. We will develop and test an innovative multi-level intervention that includes an interactive obesity treatment program (iOTA) using SMS text messaging (Aim 2B). This innovative mHealth intervention is embedded in a newly described Healthy Workplace Participatory Program, which incorporates employee participation in decision making to produce changes in the workplace environment that are acceptable, effective, and sustainable (Aim 2A). These nested interventions will be tested a large delayed-start group-randomized trial. This study will rigorously test readily scalable interventions that can be translated to other work settings to reduce obesity and diabetes risk among low SES workers, a group at high risk for these disorders. This pragmatic clinical trial will advance the long- term goal of enabling employers and employees to reduce obesity and obesity-associated illnesses including diabetes.