Be Well at Work-Plus: Engaging low-wage workers in the design and implementation of a depression and physical activity intervention.

工作顺利+：让低薪工人参与抑郁症和体育活动干预的设计和实施。

• 批准号: 10191407
• 负责人: Jessica Lauren McCurley
• 金额: $ 19.46万
• 依托单位: MASSACHUSETTS GENERAL HOSPITAL
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-08-15 至 2026-07-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10191407
• 关键词: Address; Adult; Behavior Therapy; Behavioral; Behavioral Sciences; Blood Pressure; Body mass index; Cardiometabolic Disease; Cardiovascular Diseases; Caring; Chronic; Clinical; Cognitive Therapy; Coping Behavior; Data; Development Plans; Diabetes Mellitus; Ecological momentary assessment; Economics; Educational Curriculum; Educational workshop; Effectiveness; Employee; Employee Health; Employment; Evidence based intervention; Feedback; Financial Hardship; Food; General Hospitals; Goals; Grant; Health; Health Promotion; Health behavior; High Prevalence; Hospitals; Housing; Impairment; Individual; Industry; Information Dissemination; Intervention; Intervention Trial; Interview; Low Income Population; Low income; Massachusetts; Mental Depression; Mentorship; Methods; Moods; Obesity; Occupations; Outcome; Participant; Phase; Physical activity; Pilot Projects; Population; Positioning Attribute; Prevalence; Preventive care; Process; Provider; Publications; Randomized; Randomized Controlled Trials; Research; Research Personnel; Risk; Risk Factors; Scientist; Sleep; Suggestion; Technology; Telephone; Testing; Text; Text Messaging; Time; Training; Wages; Waiting Lists; Wellness Program; Work; Workplace; Writing; adverse outcome; arm; base; cardiometabolic risk; cardiometabolism; care coordination; career; career development; clinically relevant; cost; depressive symptoms; design; disability; efficacy trial; evidence base; exercise intervention; feasibility testing; health equity; implementation science; improved; innovation; low socioeconomic status; mHealth; physical inactivity; pilot trial; poor sleep; preference; pressure; primary outcome; programs; randomized trial; scale up; secondary outcome; skill acquisition; sleep quality; social; social determinants; social disadvantage; social health determinants; text messaging intervention; therapy design; trial comparing; trial design; uptake

Depression and physical inactivity are leading contributors to cardiometabolic diseases such as obesity, diabetes, and cardiovascular disease. Low-wage workers, who comprise one-third of all workers in the U.S. and are essential to many industries, are more likely to be physically inactive and to have cardiometabolic conditions and depression, yet they are half as likely as higher wage workers to utilize preventive care. Targeted workplace initiatives have been successful in improving employee health, but low-wage workers are difficult to engage, in part due to a high burden of social disadvantage (e.g., food and housing insecurity, time and financial constraints). Currently, to our knowledge, there are no workplace interventions for depression that specifically target low-wage workers and their unique social risk factors. This study was conceptualized using a planned adaptation approach that involves low-wage workers in the design of the intervention to increase engagement and feasibility in this population. The proposed study will adapt an evidence-based 8-session telephone-delivered depression intervention for working adults, Be Well at Work, and add critical enhancements for low-wage workers: assessment and referrals for social determinants of health, physical activity promotion, and personalized text message behavioral support via ecological momentary assessment and intervention. The adapted intervention, Be Well at Work-PLUS, will be developed and tested in three phases: (1) qualitative interviews with low-wage workers to understand social determinants of health, barriers and facilitators of engagement, and intervention preferences (Aim 1); (2) a single-arm pilot (N=10) with exit interviews to refine the intervention content and delivery (Aim 2); (3) a pilot randomized controlled trial comparing Be Well at Work-PLUS to a waitlist condition (N=60; Aim 3). This iterative process will yield results on feasibility, acceptability, and preliminary clinical outcomes of Be Well at Work-PLUS and provide data to apply for an R01 efficacy trial. To compliment these research aims, Dr. McCurley has designed a training plan to gain expertise in (1) implementation science, including planned adaptation of evidence-based interventions and participatory design methods for improving reach and engagement in low-income groups, (2) mobile health, specifically, text messaging for increased intervention feasibility and uptake; and (3) randomized controlled trial design. The career development plan involves regular mentorship with experts in implementation science, mobile health, randomized behavioral intervention trials, as well as didactic courses and workshops in these topics, dissemination of results through presentations and publications, and support for grant writing and additional skill development to advance Dr. McCurley’s career as an independent behavioral scientist. This K23 proposal will position Dr. McCurley to become an independent investigator developing interventions that fuse technology and behavioral science to address depression, health behavior, social determinants of health, and cardiometabolic diseases in low-income populations.

抑郁症和身体不活动是肥胖症等心脏代谢疾病的主要因素， 糖尿病和心血管疾病。低薪工人，包括美国所有工人的三分之一 并且对于许多行业至关重要，更有可能在身体上不活跃并且具有心脏代谢 条件和抑郁症，但是他们使用预防性护理的工资工人的可能性较高。 有针对性的工作场所计划已成功改善员工健康，但低薪工人是 很难参与，部分原因是社会灾难的烧毁（例如，食物和住房不安全感，时间 和财务限制）。据我们所知，目前尚无抑郁症的工作场所干预措施 特别针对低薪工人及其独特的社会风险因素。这项研究是使用 计划的适应方法涉及低薪工人在干预的设计中增加 该人群的参与和可行性。拟议的研究将调整基于证据的8条。 为成年人提供电话交付的抑郁干预，工作良好，并增加关键 低薪工人的增强：对健康的社会决定者的评估和推荐 通过生态瞬时评估，活动促进和个性化的文本消息行为支持 和干预。适应的干预措施在工作加上良好 阶段：（1）与低薪工人的定性访谈，以了解健康的社会决定者，障碍 以及参与和干预偏好的促进者（目标1）； （2）带出口的单臂飞行员（n = 10） 采访以完善干预内容和交付（AIM 2）； （3）试点随机对照试验 在工作加上良好的情况与候补名单条件进行比较（n = 60; aim 3）。这个迭代过程将产生结果 关于可行性，可接受性和初步临床结果在工作加上良好 申请R01效率试验。为了补充这些研究的目的，麦克库利博士设计了一个培训计划 获得（1）实施科学方面的专业知识，包括计划基于证据的干预措施 以及参与设计方法，用于改善低收入组的覆盖范围和参与度，（2）移动 健康，特别是文本消息传递，以增加干预性和吸收； （3）随机 对照试验设计。职业发展计划涉及与专家的定期精神训练 实施科学，移动健康，随机行为干预试验以及教学课程 以及这些主题的讲习班，通过演示和出版物传播结果以及支持 授予写作和额外技能发展，以推动麦克库利博士作为独立的职业生涯 行为科学家。该K23提案将使麦考利博士成为独立研究者 开发干预措施，将技术和行为科学融合以解决抑郁症，健康行为， 低收入人群中健康的社会决定者和心脏代谢性疾病。