Workplace Wellness Initiatives to Combat Obesity

对抗肥胖的工作场所健康举措

• 批准号: 9081666
• 负责人: Jason Perry Block
• 金额: $ 16.93万
• 依托单位: HARVARD PILGRIM HEALTH CARE, INC.
• 依托单位国家: 美国
• 财政年份: 2013
• 资助国家: 美国
• 起止时间: 2013-08-15 至 2018-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9081666
• 关键词: Absenteeism; Academic Medical Centers; Academic advising; Address; Adherence; American; Back; Behavior; Behavioral; Behavioral trial; Beverages; Biometry; Body Weight decreased; Boston; Calories; Clinic; Clinical Trials Design; Contracts; Deposition; Development; Dietary intake; Diverse Workforce; Economics; Employee; Employee Health; Enrollment; Environment; Environmental Impact; Epidemic; Epidemiology; Evaluation; Faculty; Feedback; Fellowship; Focus Groups; Food; Food Services; Fostering; Frequencies; Goals; Health; Health Care Costs; Health Food; Hospital Restructuring; Hospitals; Hour; Individual; Intake; Interdisciplinary Study; Internal Medicine; Intervention; K-Series Research Career Programs; Lead; Learning; Learning Skill; Maintenance; Massachusetts; Measurement; Mentored Patient-Oriented Research Career Development Award; Mentors; Mentorship; Motivation; Natural experiment; Obesity; Occupational Health; Outcome; Overweight; Participant; Perception; Physicians; Physiological; Policy Maker; Primary Health Care; Protocol Compliance; Qualitative Research; Questionnaires; Randomized Controlled Trials; Reaction; Recording of previous events; Regrets; Research; Research Infrastructure; Research Personnel; Research Training; Resources; Risk; Sales; Series; Site; Time; Training; Training Activity; Trans Fats; Weight; Weight Gain; Woman; Work; Workplace; arm; base; behavior change; behavioral economics; career; career development; combat; cost; design; environmental intervention; experience; financial incentive; healthy weight; improved; information gathering; innovation; meetings; member; motivated behavior; novel; nutrition; obesogenic; population health; practical application; psychologic; response; saturated fat; service intervention; skills; success; weight loss intervention; weight maintenance

DESCRIPTION (provided by applicant): Dr. Jason Block is a general internal medicine physician committed to a research career focused on innovative interventions to combat obesity. This K23 Research Career Development Award will build upon his strong methodological skills obtained during a recently-completed population health research fellowship. With support from the K23, he will gain additional skills in advanced epidemiology, economics, qualitative research, analysis of quasi- and natural experiments, and randomized controlled trials. The goal of this K23 is for Dr. Block to learn these skills through coursework, mentorship and the practical application of these skills in Aims that evaluate workplace wellness initiatives to promote a healthy weight. Mentors with expertise in epidemiology, nutrition, biostatistics, behavioral economics, and economics will guide training and research for Dr. Block, and each mentor will meet with him at least monthly to provide training, feedback on projects and assessments of his career development. Dr. Block's department has a long history of supporting junior faculty members and developing them into independent investigators. The department will unequivocally protect 75% of Dr. Block's time for research during the K23 award period and will continue to provide institutional resources to support his work. The need for novel interventions to address the obesity epidemic in the US is the motivation for the Aims of Dr. Block's K23 proposal. Sustaining a healthy weight can be difficult because of the ubiquitous availability of low- cost, unhealthful foods and physiologic mechanisms that counteract weight maintenance. Intensive individual- level interventions, using behavioral counseling and educational initiatives that target one individual or a small group of individuals at a time, can lead to sustained weight loss but are costly and difficult to implement broadly. Environmental interventions, such as the restructuring of the menu in a workplace cafeteria, and financial incentives promoting weight maintenance are two strategies that might overcome the obesogenic environment and the physiological barriers to sustained weight loss. Workplaces are logical sites for these interventions because Americans spend much of their waking hours at work, and employers could gain financial benefits from a healthier and more productive workforce, especially through low cost interventions. An environmental food services intervention is one cited example of a relatively inexpensive intervention. Workplaces, especially those with existing infrastructure such as occupational health clinics and on-site primary care clinics, also are ideal settings to carry out low-cost, behavioral trials. Dr. Block proposes to evaluate two workplace wellness initiatives to reduce risk for overweight and obesity and to promote weight maintenance within Brigham and Women's Hospital, a large academic medical center in Boston, Massachusetts, with nearly 16,000 employees. The Aims are 1) to conduct focus groups among Brigham and Women's employees to gather their views on workplace wellness initiatives, their response to the environmental intervention in the cafeteria, including new menu, and their reaction to our proposal for a deposit contract weight maintenance trial; 2) to examine the extent to which a new cafeteria menu influences the sales of healthy and unhealthy food and beverages, decreases the calorie content of employees' meals in the cafeteria, and decreases the total daily calorie, trans fat, and saturated fat intake of employees, and 3) to determine the extent to which a deposit contract improves weight maintenance among employees who have lost 10 lbs during the prior year. These initiatives incorporate common behavioral economics principles, including the large effect of defaults on behaviors and the power of loss aversion, which is the natural inclination to avoid losses or regret, in motivating behavior change. Through the training activities, mentorship, and research experience provided by the K23, Dr. Block will become a successfully independent investigator, exploring mechanisms to combat obesity among Americans.

描述（由申请人提供）：Jason Block博士是一名普通内科医师，致力于研究研究职业，重点是对抗肥胖的创新干预措施。这项K23研究职业发展奖将基于他在最近完成的人口健康研究奖学金中获得的强大方法论能力。在K23的支持下，他将获得高级流行病学，经济学，定性研究，准和自然实验的分析以及随机对照试验的其他技能。该K23的目的是让Block博士通过课程，指导以及这些技能的实际应用来学习这些技能，以评估工作场所健康计划以促进健康的体重。具有流行病学，营养，生物统计学，行为经济学和经济学方面的专业知识的导师将指导Block博士的培训和研究，每位导师将至少每月与他会面，以提供培训，有关项目的反馈以及对其职业发展的评估。 Block博士的部门在支持初级教师并将其发展成为独立调查员方面有很长的历史。该部门将在K23颁奖典礼期间明确保护Block博士的研究时间的75％，并将继续提供机构资源来支持他的工作。在美国解决肥胖症流行的新颖干预措施的需求是Block博士K23提案的目标的动机。由于可抵消体重维持的低成本，不健康的食物和生理机制，因此保持健康体重可能很困难。使用行为咨询和一次针对一个人或一小部分人的行为咨询和教育计划的密集级别干预措施可能会导致持续的体重减轻，但昂贵且难以实施。环境干预措施，例如工作场所自助餐厅中菜单的重组以及促进体重维持的经济激励措施是两种策略，这些策略可能会克服肥胖环境和生理障碍，以持续体重减轻。工作场所是这些干预措施的逻辑网站，因为美国人在工作中花费了大部分时间，雇主可以从更健康，更有生产力的劳动力中获得经济利益，尤其是通过低成本干预措施。环境食品服务干预是相对便宜的干预措施的一个引用的例子。工作场所，尤其是那些具有现有基础设施的人，例如职业健康诊所和现场初级保健诊所，也是进行低成本，行为试验的理想环境。 Block博士建议评估两项工作场所健康计划，以降低超重和肥胖的风险，并在马萨诸塞州波士顿的一个大型学术医疗中心，北方妇女医院内的体重维持，并拥有近16,000名员工。目的是1）在杨百翰和妇女雇员之间进行焦点小组，以收集他们对工作场所健康计划的看法，他们对自助餐厅的环境干预的反应，包括新菜单，以及他们对我们对存款合同体重维持试验的提议的反应； 2）检查新的自助餐厅菜单在多大程度上影响健康和不健康的食物和饮料的销售，减少自助餐厅员工餐食的卡路里含量，并减少每日卡路里，反式脂肪，trans脂肪和饱和的员工脂肪的摄入量， 3）确定押金合同在多大程度上改善了上一年损失10磅的员工的体重维持。这些举措纳入了共同的行为经济学原则，包括违约对行为的巨大影响和损失厌恶的力量，这是避免损失或遗憾的自然倾向，激励行为改变。通过K23提供的培训活动，指导和研究经验，Block博士将成为一名成功的独立研究者，探索与美国人之间肥胖作斗争的机制。