Tailored Worksite Weight Control Programs

鉴于超重和肥胖的普遍性，基于工作场所的健康促进计划已被 由于其潜在的影响力和社会支持的影响，建议。在工作场所，许多 预防和治疗肥胖症的策略集中在亲自或向小 以知识获取为目标的团体，以及以个人为目标的改善饮食和 活动实践。这些计划一直受到批评，因为他们通常达到一个小的百分比， 工人，很少是那些可以受益最多的人，持续时间短，影响小，暂时的。 它们通常也在拥有最多资源的大型工地进行。缺乏 这些项目的成功可能是由于：1）干预强度不足，2）实施 3）缺乏理论模型作为干预措施开发的基础。克服 鉴于以往研究的局限性，我们将进行一项3组随机对照试验，以确定 广泛的干预措施：a）基于合理的理论，B）主要通过可扩展的 互动技术，以及c）利用工作场所的组织和环境背景。 我们将测试社会生态理论的效用，以个人为目标的基于互联网的干预， 与之相比，减轻超重和肥胖员工体重的货币激励措施（INCENT） 健康风险评估和压力管理控制（HRA）。INCENT的参与者将经常获得 电子邮件支持，促进目标设定，定期评估体重，并根据 在为期12个月的计划中，每个季度末的原始体重下降百分比。电子邮件 支持将针对改善自我效能感和与减肥相关的结果预期， 保持健康的体重，此外，电子邮件支持将有助于参与者解决问题， 在家里、社区和其他地方确定健康饮食和体育活动的资源 他们的工地。考虑到减肥计划后的累犯率， 研究的目的是确定在最初的体重维持干预后进行体重维持干预的有效性。 12-数月的干预。体重维持干预将针对定期的身体活动，健康 食物的选择，并确定当地资源，以支持保持健康的体重。将 通过自动交互式语音应答（IVR）电话咨询提供，基于社会生态 理论和支持减肥（即，对于那些尚未< BMI 25的人）或体重维持（即，为 BMI <=25）。采用3组随机整群设计， 工作场所，具有不同种族（即，>20%拉丁裔）和经济多样性将被随机分配到 接受HRA（n= 10个工作地点）、INCENT（n=19个工作地点）或INCENT+IVR（n=19个工作地点）。

Given the prevalence of overweight and obesity, worksite-based health promotion programs have been recommended due to their potential reach and social support impact. Within worksite contexts, many strategies to prevent and treat obesity have focused on educational programs delivered in person or to small groups that target knowledge acquisition, and strategiestargeted at individuals to improve dietary and activity practices. These programs have been criticized because they typically reach a small percentage of workers¿and seldom those that could benefit most, are of short duration, and have small, temporary effects. They have also typically been conducted in large worksites that have the greatest resources. The lack of success of these programs may be due to: 1) inadequate intervention intensity, 2) implementation challenges, and 3) a lack of theoretical models as the bases for intervention development. To overcome the limitations of previous research we will conduct a 3 group RCT to determine the reach and effectiveness of an extensive intervention that: a) is based upon sound theory, b) is delivered primarily through scalable interactive technologies, and c) leverages the organizational and environmental context of the workplace. We will test the utility of a social ecological theory, individually-targeted internet-based intervention with monetary incentives to reduce the weight of overweight and obese employees (INCENT) when compared to a health risk appraisal and stress management control (HRA). Participants in INCENT will receive frequent e-mail supports that facilitate goal setting, regular assessments of body weight, and incentives based on percent of original body weight lost at the end of each quarter over the 12-month program. The e-mail supports will target improving perceptions of self-efficacy and outcome expectations related to weight loss or maintaining a healthy weight in addition e-mail support will facilitate participant problem solving and identification of resources for healthful eating and physical activity at home, in their neighborhoods, and at their worksite. Given the well-documented rate of recidivism following weight loss programs, a secondary study aim, is to determine the effectiveness of a weight maintenance intervention delivered after the original 12-months of intervention. The weight maintenance intervention will target regular physical activity, healthful food choices, and identification of local resources to support maintaining a healthful weight. It will be delivered via automated interactive voice response (IVR) telephone counseling, based on social ecological theory and support weight loss (i.e., for those who are not yet < BMI of 25) or weight maintenance (i.e., for those with a BMI <=25). In a 3 group worksite cluster randomized design, 48 small to medium sized worksites, with a heterogeneous ethnic (i.e., >20% Latino) and economic diversity will be randomized to receive HRA (n=1Qworksites), INCENT (n=19 worksites), or INCENT+IVR (n=19 worksites).