Multi-Level Trial of a Workplace Sales Ban of Sugary Beverages and Brief Motivational Counseling Intervention on Adiposity

工作场所销售含糖饮料禁令的多层次试验和肥胖的简短动机咨询干预

基本信息

批准号：
10467924
负责人：
Elissa S. Epel
金额：
$ 66.98万
依托单位：
UNIVERSITY OF CALIFORNIA, SAN FRANCISCO
依托单位国家：
美国
项目类别：
财政年份：
2022
资助国家：
美国
起止时间：
2022-04-15 至 2027-02-28
项目状态：
未结题

来源：
https://reporter.nih.gov/project-details/10467924
关键词：
Adopted Adult Alcohols American American diet Attention Behavior Therapy Beverages Blood Blood specimen Body mass index California Calories Central obesity Clinical Trials Coffee Consumption Counseling Cues Data Diabetes Mellitus Employee Enrollment Exposure to Fruit Health Health Care Costs Health Food Health system Healthcare Systems Home Hospitals Hour Incentives Individual Intake Intervention Knowledge Lipids Liquid substance Low income Magic Mediating Mediation Metabolic Metabolic Diseases Modeling Motivation Non-Insulin-Dependent Diabetes Mellitus Obesity Occupational Status Outcome Participant Pilot Projects Policies Prevention Public Health Randomized Randomized Controlled Trials Research Risk Risk Factors Role Sales Schools Science Self Administration Serum Site Source Sports Tea Testing Tobacco Work Workplace base behavior change brief intervention cost craving dietary drinking effectiveness evaluation ethnic minority experience food environment high risk high risk population insulin sensitivity obesity prevention primary outcome programs randomized trial remote delivery secondary outcome soft drink sugar sweetened beverage synergism therapy design waist circumference

项目摘要

ABSTRACT Sugar-sweetened beverages (SSBs, e.g., sodas, sports drinks, “fruit” drinks, bottled teas, coffees) have emerged as a key dietary risk factor for obesity and type 2 diabetes. We propose a double-randomized controlled trial of a multilevel workplace intervention that combines an employer-sponsored sales ban on SSBs with brief motivational counseling to support reduced consumption. Health systems and schools are increasingly adopting sales bans of SSBs and replacing them with healthier options. Employer-based brief counseling interventions, despite being low-cost and highly efficacious for alcohol and tobacco reduction, have received limited attention as a strategy to reduce SSB consumption. A multilevel intervention combining both strategies may be the most effective: the brief counseling intervention can increase motivation to reduce SSBs despite cravings while the sales ban removes SSB-related availability and cues from the workplace. Our pilot data strongly support the rationale for combining these interventions and for the mediating role of SSB cravings. The proposed trial tests this multilevel intervention, called the workplace Metabolic Health Improvement Program (MHIP), in partnership with a Northern California-based academic healthcare system, Sutter Health (enrolling N=700 employees on N=16 hospital campuses). The first randomization will assign hospital campuses to the employer-sponsored sales ban on SSBs (8 sites) versus control (8 sites). The second randomization will assign employees to the brief counseling intervention versus control, split equally across sales ban and control sites. We assess anthropometrics and blood at baseline and 12 months. The primary outcome is change in central obesity (e.g., waist circumference). Secondary outcomes include changes in SSB consumption, Body Mass Index (BMI), serum insulin sensitivity (homeostatic model assessment [HOMA]), and lipids. Dietary and beverage composition is assessed remotely using the Automated Self-Administered 24- Hour recall (ASA-24) at baseline, 6 and 12 months. The first aim of this research is to assess the independent effects of the brief counseling intervention and workplace SSB sales ban on changes in primary and secondary outcomes. The second aim is to test the multilevel effects of combining the brief intervention and SSB sales ban on outcomes. A third, exploratory aim examines whether reductions in SSB cravings mediate the effects of the multilevel intervention on outcomes. If effective, the employer-sponsored multilevel intervention will offer an efficient, scalable strategy for preventing obesity and metabolic disease in millions of American working adults.

抽象的含糖饮料（SSB，例如苏打水、运动饮料、“水果”饮料、瓶装茶、咖啡）已成为肥胖和 2 型糖尿病的关键饮食危险因素，我们提出了双随机研究。多层次工作场所干预的对照试验，其中结合了雇主资助的 SSB 销售禁令通过简短的动机咨询来支持减少消费。越来越多地采用 SSB 销售禁令，并用基于雇主的更健康的选择取而代之。尽管咨询干预措施成本低且对减少酗酒和吸烟非常有效，但作为减少 SSB 消耗的策略，将两者结合起来的多层次干预受到的关注有限。策略可能是最有效的：简短的咨询干预可以增加减少 SSB 的动力尽管销售禁令消除了工作场所中与 SSB 相关的可用性和线索，但我们仍然渴望这样做。数据有力地支持了结合这些干预措施以及 SSB 的中介作用的基本原理渴望。拟议的试验测试了这种多层次的干预措施，称为工作场所代谢健康改善计划 (MHIP)，与北加州学术医疗保健系统 Sutter Health 合作（在 N=16 个医院园区招募 N=700 名员工）第一次随机分组将分配医院。校园对雇主发起的 SSB（8 个站点）销售禁令与控制（8 个站点）的影响。随机化将分配员工进行简短的咨询干预与控制，平均分配我们对基线和 12 个月的人体测量学和血液进行了评估。结果是中心性肥胖的变化（例如腰围）。次要结果包括 SSB 的变化。消耗量、体重指数 (BMI)、血清胰岛素敏感性（稳态模型评估 [HOMA]）和使用自动自我管理 24- 远程评估饮食和饮料成分。基线、6 个月和 12 个月时的小时回忆 (ASA-24)。本研究的首要目的是评估简短咨询干预的独立效果和工作场所 SSB 销售禁令对主要和次要结果的变化进行测试。短期干预和 SSB 销售禁令相结合对结果的多层次影响第三个是探索性目标。研究了 SSB 渴望的减少是否介导了多层次干预对结果的影响。如果有效，雇主资助的多层次干预措施将为企业提供高效、可扩展的战略。预防数百万美国职业成年人的肥胖和代谢疾病。