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

描述（由申请人提供）：吃大量的水果和蔬菜（F&V）与慢性疾病的风险较低有关，如许多癌症，心血管疾病和2型糖尿病。非常需要具有成本效益的营养教育方法，以帮助广大和不同的人口群体食用更多的F&V。工地是进行这种干预的一个很有希望的渠道。拟议的研究将研究创新的工作场所干预措施的有效性，以改善F&V消费的员工建立在一个成功的试点干预-新鲜倡议。这个试验计划是与一家私人食品和饮料配送公司、布朗大学、国际扶轮卫生部和国际扶轮工作场所健康理事会合作，定期向工作场所提供低成本的新鲜食品和饮料。将24个工作地点随机分配至三个实验组之一，如下所述。将在基线、6个月、12个月和18个月测量员工F&V消耗。本研究的主要具体目的是采用一组随机试验来研究以下干预措施的有效性：1以降低的价格在工作场所提供新鲜的F&V以增加员工的F&V消费（访问干预措施A）与比较（C）干预措施（A vs. C）相比; 2.改变工作场所信息和社会环境的干预措施（B）与单独的F&V交付干预措施（A）相结合，与比较干预措施相比，增加了员工的F&V消费（增强干预措施）。（A+B vs. C）; 3与单独的获取干预相比，增加员工F&V消费的强化干预。（A+B vs. A）。次要目标包括：1。实施广泛的实施过程评估，以确定成本，范围，保真度和剂量; 2。使用中介变量框架来研究重要的心理社会因素/决定因素与F&V消费变化之间的关系; 3.通过实验条件比较员工生产力从基线到6个月、12个月和18个月的变化; 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疗效; 5.比较比较、获取和强化干预措施与食品和蔬菜消费量变化相关的成本效益。公共卫生相关性：多吃水果和蔬菜（F&V）是一个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。拟议研究的目的是对24个工作场所进行随机研究，以比较不同干预措施对改善员工F&V消费的有效性。

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.