This proposal addresses significant goals of CDC's Health Protection Research Initiative (RFA-CD-04). The overarching objective is to compare high impact health promotion programs with employees at each stage of change on multiple behavior changes, cost effectiveness, quality of life, and productivity. This population-based project utilizes a 3 x 3 x 4 repeated measures design crossing 3 interventions (Motivational Interviewing (MI), tailored communications and control) x 3 recruitment strategies (email and regular mail; mail plus incentives; mail, incentives and proactive telephone calls) x 4 assessment occasions (0, 6,12 and 18 months). Multiple behavior risks (smoking, stress, diet and exercise) are targeted in of 2250 employees in a major health care system.
The specific aims are: 1. To compare the two interventions and control groups on the number of health behavior risks that are effectively changed over time; 2. To compare the three recruitment strategies on the number of health behavior risks effectively changed over time; 3. To compare impacts (recruitment x efficacy x number of behaviors changed) of the three intervention conditions across the three recruitment approaches; 4. To compare the impacts of the three intervention conditions across the three recruitment approaches on cost effectiveness, quality of life, and productivity; and 5. To compare the impacts of the three intervention conditions across the three recruitment approaches on employee's utilization of and support for the worksite's current multilevel health promotion offerings, such as use of the employee's walking paths and new exercise facility, choice of healthy foods in the cafeteria and support for policies like smoking bans in buildings. The tailored communications are based on the Transtheoretical Model and have been found to produce multiple behavior changes in populations of employees, primary care patients, parents and patients with Type 2 diabetes. A series of three tailored communications are delivered at 0, 3 and 6 months along with a stage-based multiple behavior change manual at baseline. The MI coaching involves a 45-minute individual session at baseline and two proactive coaching calls at 3 and 6 months. A defined population of 2250 employees will be recruited from across employee groups of a major medical center. The population based health promotion programs have the potential to produce unprecedented impacts on multiple risks in a cost-effective manner that can also increase employee productivity and quality of life.
| Lipschitz, Jessica M; Paiva, Andrea L; Redding, Colleen A et al. (2015) Co-occurrence and coaction of stress management with other health risk behaviors. J Health Psychol 20:1002-12 |
| Prochaska, James O; Butterworth, Susan; Redding, Colleen A et al. (2008) Initial efficacy of MI, TTM tailoring and HRI's with multiple behaviors for employee health promotion. Prev Med 46:226-31 |
