Promoting Employee Health Through The Worksite Food Environment

通过工作场所食品环境促进员工健康

• 批准号: 9063084
• 负责人: Anne N Thorndike
• 金额: $ 83.52万
• 依托单位: MASSACHUSETTS GENERAL HOSPITAL
• 依托单位国家: 美国
• 财政年份: 2015
• 资助国家: 美国
• 起止时间: 2015-05-05 至 2020-01-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9063084
• 关键词: Address; Adopted; Adult; Affordable Care Act; Architecture; Behavior; Blood Pressure; Body Weight Changes; Body Weight decreased; Choices and Control; Cholesterol; Control Groups; Data; Dietary intake; Eating Behavior; Effectiveness; Electronic Mail; Electronics; Employee; Employee Health; Environment; Epidemic; Feedback; Food; Food Analysis; Food Labeling; Future; General Hospitals; Glycosylated hemoglobin A; Goals; Health; Health Food; Healthy Eating; Individual; Institution; Intervention; Knowledge; Label; Lead; Letters; Life Style; Light; Link; Massachusetts; Measures; Modeling; Motivation; Obesity; Outcome; Outcome Study; Phase; Physical activity; Pilot Projects; Population; Prevalence; Randomized; Randomized Controlled Trials; Research; Research Design; Social Change; Social Network; Study Subject; System; Testing; Time; United States; Weight; Weight Gain; Work; Workplace; arm; behavioral economics; cardiovascular health; cardiovascular risk factor; energy balance; environmental change; financial incentive; follow-up; food environment; group intervention; healthy lifestyle; improved; indexing; innovation; novel; nutrition; peer; prevent; primary outcome; programs; secondary outcome; skills; social norm; trafficking; weight gain prevention

 DESCRIPTION (provided by applicant): Adults in the United States gain an average of 1-2 pounds a year. Interventions to prevent weight gain at the population level are needed to reverse the rising prevalence of obesity. Although individual-level interventions can result in large weight changes among small groups of individuals, achieving changes in the population will require long-term strategies that create healthier food environments, establish new social norms, and improve motivation and skills for healthy lifestyle behaviors. The worksite is ideal for interventions to address weight and lifestyle behaviors because a majority of adults are employed, and provisions in the Affordable Care Act encourage worksite wellness. Our research team at Massachusetts General Hospital (MGH) has demonstrated that behavioral economics strategies, including traffic-light labels, choice architecture, social norms, and financial incentives, improve employees' healthy food choices. The proposed project will address the critical next phase of this research to determine if a worksite intervention delivered through the food environment can prevent weight gain and reduce cardiovascular risk of employees. This project builds on the established traffic- light labeling system at MGH and tests an intervention that aims to increase nutrition knowledge, motivate change in lifestyle behaviors, and promote socially normative behavior for healthier lifestyles among employees. The intervention will be integrated into the flow of the work day, thus lowering burden to employees and the employer. Study Design: In a randomized controlled trial, 600 MGH employees will be assigned to: 1) an intervention arm with automated, personalized feedback about (a) worksite food purchases and calorie and physical activity goals (weekly emails) and (b) social norm feedback plus small financial incentives for healthy food purchases (monthly letters) or 2) a control arm (standardized monthly letters). Study outcomes will be assessed at 1 year (end of intervention) and 2 year follow-up. The primary outcome is change in weight at 1 year. Secondary outcomes are cardiovascular risk factors, worksite food purchases, and dietary intake (as measured by the Healthy Eating Index). A novel exploratory outcome will be healthy food purchases of co- workers who are socially connected to study subjects. Aim 1 is to determine if employees assigned to the intervention have less weight gain and lower cardiovascular risk factors than the control group at 1 year and 2- year follow-up. Aim 2 is to determine if employees assigned to the intervention group make healthier food choices than the control group at 1 year and 2-year follow-up. Exploratory Aim 3 is to determine if employees socially connected to the intervention group make healthier worksite food choices over 1 year than employees connected to the control group. Implications: This innovative strategy utilizing personalized feedback, social norms, and financial incentives will provide a scalable and sustainable model that could be adopted in other worksite, institutional, and retail settings to prevent obesity at the population level.

 描述（由申请人提供）：美国成年人平均每年增加 1-2 磅，但需要在人群层面采取干预措施来防止体重增加，以扭转肥胖患病率上升的趋势。由于小群体体重变化较大，实现人口变化需要长期战略，以创造更健康的饮食环境，建立新的社会规范，并提高健康生活方式行为的动力和技能。该工作场所是理想的选择。 由于大多数成年人都有工作，因此需要采取干预措施来解决体重和生活方式行为问题，而且《平价医疗法案》中的条款鼓励工作场所健康。拟议的项目将解决该研究的下一阶段的关键问题，以确定通过食品环境进行的工作场所干预是否可以防止员工体重增加并降低心血管风险。该项目建立在现有交通灯的基础上麻省总医院的标签系统并测试了一项干预措施，旨在增加营养知识、改变生活方式行为的动机，并促进员工健康生活方式的社会规范行为。该干预措施将融入工作日流程中，从而减轻员工的负担。研究设计：在一项随机对照试验中，600 名 MGH 员工将被分配到：1) 干预组，提供有关 (a) 工作场所食品购买、卡路里和身体活动目标（每周电子邮件）和 ( b) 社会规范反馈加购买健康食品的小额经济激励（每月信件）或 2）对照组（标准化每月信件） 研究结果将在 1 年（干预结束）和 2 年随访时进行评估 主要结果是体重变化。次要结果是心血管危险因素、工作场所食品购买和饮食摄入量（通过健康饮食指数衡量）。一个新颖的探索性结果是与研究对象有社会联系的同事购买健康食品。 1 是确定目标 2 是确定分配到干预组的员工是否比对照组的员工选择更健康的食物。探索性目标 3 是确定与干预组有社会联系的员工在一年内是否比与对照组有联系的员工做出更健康的工作场所食物选择。社会规范，以及财政激励措施将提供一个可扩展且可持续的模式，可在其他工作场所、机构和零售环境中采用，以预防人口层面的肥胖。