Given the prevalence of overweight and obesity, worksite-based health promotion programs have been recommended due to their potential reach and social support impact. Within worksite contexts, many strategies to prevent and treat obesity have focused on educational programs delivered in person or to small groups that target knowledge acquisition, and strategies targeted at individuals to improve dietary and activity practices. These programs have been criticized because they typically reach a small percentage of workers-and seldom those that could benefit most, are of short duration, and have small, temporary effects. They have also typically been conducted in large worksites that have the greatest resources. The lack of success of these programs may be due to: 1) inadequate intervention intensity, 2) implementation challenges, and 3) a lack of theoretical models as the bases for intervention development. To overcome the limitations of previous research we will conduct a 3 group RCT to determine the reach and effectiveness of an extensive intervention that: a) is based upon sound theory, b) is delivered primarily through scalable interactive technologies, and c) leverages the organizational and environmental context of the workplace. We will test the utility of a social ecological theory, individually-targeted internet-based intervention with monetary incentives to reduce the weight of overweight and obese employees (INCENT) when compared to a health risk appraisal and stress management control (HRA). Participants in INCENT will receive frequent e-mail supports that facilitate goal setting, regular assessments of body weight, and incentives based on percent of original body weight lost at the end of each quarter over the 12-month program. The e-mail supports will target improving perceptions of self-efficacy and outcome expectations related to weight loss or maintaining a healthy weight in addition e-mail support will facilitate participant problem solving and identification of resources for healthful eating and physical activity at home, in their neighborhoods, and at their worksite. Given the well-documented rate of recidivism following weight loss programs, a secondary study aim, is to determine the effectiveness of a weight maintenance intervention delivered after the original 12-months of intervention. The weight maintenance intervention will target regular physical activity, healthful food choices, and identification of local resources to support maintaining a healthful weight. It will be delivered via automated interactive voice response (IVR) telephone counseling, based on social ecological theory and support weight loss (i.e., for those who are not yet < BMI of 25) or weight maintenance (i.e., for those with a BMI <=25). In a 3 group worksite cluster randomized design, 48 small to medium sized worksites, with a heterogeneous ethnic (i.e., >20 percent Latino) and economic diversity will be randomized to receive HRA (n=1Q worksites), INCENT (n=19 worksites), or INCENT+IVR (n=19 worksites). ? ? ?

Agency
National Institute of Health (NIH)
Institute
National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)
Type
Research Project (R01)
Project #
1R01DK071664-01A2
Application #
7274046
Study Section
Psychosocial Risk and Disease Prevention Study Section (PRDP)
Program Officer
Kuczmarski, Robert J
Project Start
2007-07-23
Project End
2012-06-30
Budget Start
2007-07-23
Budget End
2008-06-30
Support Year
1
Fiscal Year
2007
Total Cost
$607,337
Indirect Cost
Name
Virginia Polytechnic Institute and State University
Department
Nutrition
Type
Schools of Earth Sciences/Natur
DUNS #
003137015
City
Blacksburg
State
VA
Country
United States
Zip Code
24061
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Almeida, Fabio A; You, Wen; Harden, Samantha M et al. (2015) Effectiveness of a worksite-based weight loss randomized controlled trial: the worksite study. Obesity (Silver Spring) 23:737-45
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Davy, Brenda M; You, Wen; Almeida, Fabio et al. (2014) Impact of individual and worksite environmental factors on water and sugar-sweetened beverage consumption among overweight employees. Prev Chronic Dis 11:E71
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You, Wen; Almeida, Fabio A; Zoellner, Jamie M et al. (2011) Who participates in internet-based worksite weight loss programs? BMC Public Health 11:709
Allen, Kacie; Zoellner, Jamie; Motley, Monica et al. (2011) Understanding the internal and external validity of health literacy interventions: a systematic literature review using the RE-AIM framework. J Health Commun 16 Suppl 3:55-72

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