Steps to Health: Targeting Obesity in the Health Care Workplace

健康之路：针对医疗保健工作场所的肥胖问题

基本信息

批准号：
8699275
负责人：
TRULS OSTBYE
金额：
$ 41.5万
依托单位：
DUKE UNIVERSITY
依托单位国家：
美国
项目类别：
财政年份：
2010
资助国家：
美国
起止时间：
2010-06-01 至 2016-05-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/8699275
关键词：
Steps Health Targeting Obesity Care

项目摘要

DESCRIPTION (provided by applicant): Overweight and obesity increase the risk of diabetes, heart disease, and cancer. Nearly two thirds of the US population is overweight or obese, accounting for 9-10% of health care expenditures. Worksite obesity interventions to date have not typically been characterized by strong methodological designs or assessed the long-term impact of intervention strategies - neither in terms of the benefits to the participants, i.e., meeting weight and health goals, nor in terms of benefits to employers, including increased productivity and decreased health care costs. The NIOSH WorkLife Initiative encourages further research in this area. The primary objective of this proposal is to compare the effectiveness of two individually tailored, integrated worksite weight management programs - Steps to Health (STH: "usual standard of care") and Steps to Health Plus! (STH+) using a randomized controlled trial design (n=500) and follow-up at 12, 24, and 36 months. The primary endpoint will be weight loss at 36 months, with additional analysis to determine role of social-cognitive and behavioral (diet and physical activity) factors in intervention success. Further analysis will compare reductions in workplace injuries, health care utilization and claims costs, and absenteeism/presenteeism in the two trial arms during the two years following the intervention. For these outcomes, participants will also be compared, in a prospective (non-randomized) fashion, with individuals in an observational comparison group, who meet eligibility criteria but do not take part in either of the two interventions. Finally, we will estimate the costs of the interventions relative to their effectiveness and savings, including changes in absenteeism and presenteeism, workers' compensation claims, and health claim reimbursements. The proposal takes advantage of an existing comprehensive occupational surveillance system which will permit evaluating the impact of the intervention on health care reimbursements. The study will build upon and enhance a well-established institutional employee wellness program, most of the intervention costs will be provided in kind by the institution, and the multidisciplinary research team has broad experience with behavioral interventions, obesity and the workplace, and cost effectiveness analysis. The interventions will be evaluated in a health-care worksite with a population of mixed ethnicity and socioeconomic status, allowing greater generalizability. The results of this study should be of great value to worksites considering interventions encouraging healthy weight. The intervention site is especially pertinent in that health care institutions can be models for other workplaces, and health care workers can be models for their families and patients. The workplace may be an ideal setting for reaching large populations of overweight and obese adults with weight control programs; several federal agencies have called for further pursuit of this opportunity to improve public health. Steps To Health aims to 1) help workers meet and maintain healthy weight goals through healthy eating and increased physical activity, 2) reduce the rate of work-related injuries, and 3) decrease health care expenditures associated with obesity.

描述（由申请人提供）：超重和肥胖会增加患糖尿病、心脏病和癌症的风险。近三分之二的美国人口超重或肥胖，占医疗保健支出的 9-10%。迄今为止，工作场所肥胖干预措施通常没有以强有力的方法设计为特征，也没有评估干预策略的长期影响——无论是对参与者的好处，即达到体重和健康目标，还是对雇主的好处，包括提高生产力和降低医疗保健成本。 NIOSH WorkLife Initiative 鼓励该领域的进一步研究。该提案的主要目标是比较两个单独定制的综合工作场所体重管理计划的有效性 - Steps to Health（STH：“通常的护理标准”）和 Steps to Health Plus！ (STH+) 采用随机对照试验设计 (n=500) 并在 12、24 和 36 个月进行随访。主要终点是 36 个月时体重减轻，并进行额外分析以确定社会认知和行为（饮食和身体活动）因素在干预成功中的作用。进一步的分析将比较干预后两年内两个试验组的工作场所伤害、医疗保健利用率和索赔成本以及缺勤/出勤的减少情况。对于这些结果，参与者还将以前瞻性（非随机）方式与观察对照组中符合资格标准但不参加这两种干预措施中任何一种的个人进行比较。最后，我们将估计干预措施相对于其有效性和节省的成本，包括缺勤和出勤、工人赔偿索赔和健康索赔报销的变化。该提案利用了现有的综合职业监测系统，该系统将允许评估干预措施对医疗保健报销的影响。该研究将建立在完善的机构员工健康计划的基础上并加强该计划，大部分干预成本将由机构以实物形式提供，多学科研究团队在行为干预、肥胖和工作场所以及成本效益方面拥有丰富的经验分析。这些干预措施将在具有混合种族和社会经济地位的人群的医疗保健工作场所进行评估，从而具有更大的普遍性。这项研究的结果对于考虑鼓励健康体重的干预措施的工作场所应该具有很大的价值。干预现场尤其具有针对性，因为医疗机构可以成为其他工作场所的榜样，医护人员可以成为其家人和患者的榜样。工作场所可能是向大量超重和肥胖成年人提供体重控制计划的理想环境；一些联邦机构呼吁进一步利用这一机会来改善公共卫生。 Steps To Health 的目标是 1) 通过健康饮食和增加体力活动帮助工人达到并保持健康的体重目标，2) 降低工伤发生率，3) 减少与肥胖相关的医疗保健支出。

项目成果

期刊论文数量（7）

专著数量（0）

科研奖励数量（0）

会议论文数量（0）

专利数量（0）

Perceived Barriers to Healthy Eating and Physical Activity Among Participants in a Workplace Obesity Intervention.

工作场所肥胖干预参与者认为健康饮食和身体活动存在的障碍。

DOI：
10.1097/jom.0000000000001092
发表时间：
2017
期刊：
Journal of occupational and environmental medicine
影响因子：
3.2
作者：
Stankevitz,Kayla;Dement,John;Schoenfisch,Ashley;Joyner,Julie;Clancy,ShaynaM;Stroo,Marissa;Østbye,Truls
通讯作者：
Østbye,Truls

Association Between Exercise Frequency and Health Care Costs Among Employees at a Large University and Academic Medical Center.

大型大学和学术医疗中心员工的运动频率与医疗保健费用之间的关联。

DOI：
10.1097/jom.0000000000000882
发表时间：
2016
期刊：
Journal of occupational and environmental medicine
影响因子：
3.2
作者：
Caretto,DavidC;Ostbye,Truls;Stroo,Marissa;Darcey,DennisJ;Dement,John
通讯作者：
Dement,John

The steps to health employee weight management randomized control trial: rationale, design and baseline characteristics.

健康员工体重管理随机对照试验的步骤：基本原理、设计和基线特征。

DOI：
10.1016/j.cct.2013.04.007
发表时间：
2013
期刊：
Contemporary clinical trials
影响因子：
2.2
作者：
Østbye,Truls;Stroo,Marissa;Brouwer,RebeccaJN;Peterson,BercedisL;Eisenstein,EricL;Fuemmeler,BernardF;Joyner,Julie;Gulley,Libby;Dement,JohnM
通讯作者：
Dement,JohnM

The Effects of Two Workplace Weight Management Programs and Weight Loss on Health Care Utilization and Costs.

两种工作场所体重管理计划和减肥对医疗保健利用和成本的影响。