Stand & Move at Work II: Effectiveness and Implementation

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• 批准号: 10524183
• 负责人: Matthew P Buman
• 金额: $ 11.73万
• 依托单位: ARIZONA STATE UNIVERSITY-TEMPE CAMPUS
• 依托单位国家: 美国
• 财政年份: 2020
• 资助国家: 美国
• 起止时间: 2020-08-10 至 2025-07-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10524183
• 关键词: Address; Adherence; Adult; Behavior Therapy; Behavioral; Body Weight; Cardiovascular Diseases; Chronic Disease; Competence; Costs and Benefits; Dimensions; Effectiveness; Effectiveness of Interventions; Employee; Evidence based intervention; Government; Health; Health Benefit; Health Promotion; Health Services; Industry; Internet; Intervention; Interview; Investments; Knowledge; Maintenance; Malignant Neoplasms; Manufacturer Name; Measures; Musculoskeletal Pain; Non-Insulin-Dependent Diabetes Mellitus; Nonprofit Organizations; Occupations; Promoting Action on Research Implementation in Health Services framework; Public Health; Quality of life; Randomized; Reporting; Research; Risk; Risk Factors; Role; Societies; Speed; Testing; Time; Translating; Variant; Vendor; Work; Workplace; arm; base; behavioral health; cost; effectiveness evaluation; effectiveness implementation study; effectiveness testing; effectiveness trial; efficacy trial; flexibility; follow-up; implementation cost; implementation facilitation; implementation fidelity; implementation outcomes; implementation questions; implementation strategy; implementation trial; improved; innovation; intervention cost; intervention effect; mortality; post implementation; preservation; prevent; primary outcome; programs; public health intervention; public health priorities; randomized trial; sedentary; sedentary lifestyle; social; therapy design; treatment arm; trend; trial design; work-study

Project Summary Sedentary behavior (i.e., sitting) has emerged as an important risk factor for type 2 diabetes, cardiovascular disease, some cancers, and mortality. Working adults with desk-bound occupations accumulate large volumes of daily sedentary time. Sit-stand workstations are now the fastest growing employee benefit, yet evidence-based interventions are not being implemented to support their use. Our team has completed the largest and most definitive efficacy trial on the impact of an intervention to support use of sit-stand workstations and reduce sedentary behavior in the workplace. Stand & Move at Work (SMW) is a multicomponent, social-ecological behavioral intervention tested in 24 industry, government, and academic worksites (N=630 workers). Intervention effects included: (a) reductions in sedentary time at 12 months (~60 min/8 h workday) that were retained at 24- month follow-up (~30 min/8 h workday); (b) reduced body weight and improved chronic disease risk factors among those with high baseline risk; and (c) reduced musculoskeletal pain. We are now proposing a new trial that tests the role of expert-based facilitation to enhance effectiveness and implementation of the SMW intervention. We use the Integrated - Promoting Action on Research Implementation in Health Services (iPARIHS) framework to inform our new trial through: (a) organizing our implementation outcomes from our efficacy trial; (b) conducting industry-based discovery interviews; and (c) piloting our enhanced implementation strategy in new worksites. We propose a 2-arm group-randomized hybrid effectiveness-implementation (type 2) trial to test the effectiveness of SMW for reducing sedentary time in the workplace, and to test an implementation strategy (i.e., expert facilitation) for improving implementation fidelity. Worksites (N=24) will be observed over 3 months of sit-stand workstation use only, and will then be randomized to 12 months of either: (a) SMW (web- delivered); or (b) SMW+ (web-delivered + expert facilitation). Our dual primary outcomes will be reductions in objectively-measured sedentary time (effectiveness) and intervention fidelity (implementation) over 12 months. Because facilitation increases intervention cost, we will also assess incremental cost benefit of our interventions (secondary aim). Finally, we will explore fidelity as a driver of effectiveness, examine within-worksite differences in sedentary time pre- and post- implementation, and measure organizational sustainability of effectiveness and implementation at 24 months. The potential health benefits of sit-stand workstations and associated worksite health promotion programs will not be realized in the workforce at large until we test the most effective and efficient way to implement evidence-based interventions. This project is among the first initiatives to address this growing trend in worksite health, and will answer important questions related to effectiveness, implementation, and cost benefit. Optimal strategies for delivering the SMW intervention will be identified and new knowledge will be generated on how facilitation can enhance implementation fidelity of workplace health initiatives, both of which will increase the public health impact of evidence-based interventions.

项目概要 久坐行为（即坐着）已成为 2 型糖尿病、心血管疾病的重要危险因素 疾病、某些癌症和死亡率。从事办公桌工作的成年人积累了大量的数据 每天久坐的时间。坐站两用工作站现在是增长最快的员工福利，但也是有证据支持的 没有实施干预措施来支持其使用。我们的团队完成了规模最大、最多的 关于支持使用坐站工作站并减少干预措施影响的明确功效试验 工作场所的久坐行为。工作中站立和移动 (SMW) 是一个多组成部分、社会生态学 在 24 个工业、政府和学术工作场所（N = 630 名工作人员）进行了行为干预测试。干涉 效果包括：(a) 12 个月时久坐时间减少（工作日约 60 分钟/8 小时），但 24 个月时仍保持不变。 一个月的随访（~30 分钟/8 小时工作日）； (b) 减轻体重并改善慢性病危险因素 属于高基线风险人群； (c) 减少肌肉骨骼疼痛。我们现在提议一项新的试验 测试专家协助在提高最低最低工资的有效性和实施方面的作用 干涉。我们采用综合促进卫生服务研究实施行动 (iPARIHS) 框架，通过以下方式为我们的新试验提供信息：(a) 组织我们的实施结果 疗效试验； (b) 进行基于行业的发现访谈； (c) 试行我们的强化实施 新工作地点的战略。我们提出了 2 臂组随机混合有效性实施（类型 2） 测试 SMW 减少工作场所久坐时间的有效性的试验，并测试实施情况 提高实施保真度的策略（即专家协助）。工地 (N=24) 将被观察超过 3 天 仅使用坐站工作站几个月，然后将被随机分配到 12 个月： (a) SMW（网络- 发表）; (b) SMW+（网络交付+专家协助）。我们的双重主要成果将是减少 12 个月内客观测量的久坐时间（有效性）和干预保真度（实施）。 由于便利会增加干预成本，我们还将评估干预措施的增量成本效益 （次要目标）。最后，我们将探讨保真度作为有效性的驱动因素，检查工作场所内的差异 在实施前和实施后的静坐时间内，衡量组织的有效性和可持续性 24个月后实施。坐站工作站和相关工作场所的潜在健康益处 在我们测试最有效和最有效的方法之前，健康促进计划不会在广大劳动力中实现。 实施循证干预措施的有效方法。该项目是解决这一问题的首批举措之一 工作场所健康的增长趋势，并将回答与有效性、实施、 和成本效益。将确定实施 SMW 干预的最佳策略，并获得新知识 就促进如何提高工作场所健康举措的实施保真度产生疑问，这两者 将增加循证干预措施对公共卫生的影响。