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

• 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
• 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

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 糖甜床（例如，苏打水，运动饮料，“水果”饮料，瓶装茶，咖啡） 成为肥胖症和2型糖尿病的关键饮食危险因素。我们提出了双重的 多级工作场所干预的对照试验结合了员工赞助的SSBS销售禁令 通过简短的动机咨询，以支持减少的消费。卫生系统和学校是 越来越多地采用SSB的销售禁令，并用更健康的选择来代替它们。基于雇主的简报 咨询干预措施，dospite是低成本，可以减少酒精和烟草的效率 作为减少SSB消费的策略，受到了有限的关注。两者结合的多层次干预 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 尽管渴望，但销售禁令却消除了与SSB相关的可用性和工作场所的提示。我们的飞行员 数据强烈支持结合这些干预措施和SSB的中介作用的基本原理 渴望。 拟议的试验测试这种多层次干预措施，称为工作场所代谢健康改善 计划（MHIP），与位于北加州的学术医疗系统合作，Sutter Health （在n = 16个医院校园内注册n = 700名员工）。第一个随机化将分配医院 校园对员工赞助的SSB（8个站点）与控制（8个站点）的销售禁令。第二个 随机化将把员工分配给简短的咨询干预与控制，并平均分配 销售禁令和控制网站。我们在基线和12个月时评估人类学和血液。主要 结果是中央肥胖症的变化（例如腰围）。次要结果包括SSB的变化 消费，体重指数（BMI），血清胰岛素敏感性（稳态模型评估[HOMA]）和 脂质。使用自动化自动管理24-对饮食和卧室组成进行远程评估 小时召回（ASA-24）在基线，6和12个月。 这项研究的第一个目的是评估简短咨询干预的独立影响 以及工作场所SSB销售禁止主要和次要结果的变化。第二个目的是测试 合并简短干预和SSB销售禁令对结果的多层次效果。第三个探索性目标 检查SSB渴望的减少是否介导多级干预对预后的影响。 如果有效，员工赞助的多层次干预将为有效，可扩展的策略提供 预防数百万美国工作成年人的肥胖和代谢疾病。