Cancer risk, represented by low intake of fruits and vegetables, high consumption of saturated fat, physical inactivity, and exposures to occupational hazards, is increasingly concentrated among those with lower levels of education and low status jobs. This project tests a worksite cancer prevention intervention specifically designed for working class, """"""""blue collar"""""""" workers. The intervention will be tested in small manufacturing business, in which over half of the work force, includes high proportions of multiethnic working class workers. The comprehensive intervention integrates health protection, aimed at reducing exposure to occupational hazards, and health promotion within a single intervention. Small manufacturing businesses will be recruited from inner city neighborhoods of Boston. Based on community demographics, we anticipate that over half of the workers employed in these worksites will represent ethnic workers. This study uses a randomized controlled design, in which 24 worksites will be randomly assigned to either an integrated intervention or a minimal intervention control condition. The impact of the intervention will be evaluated using a nested design which controls for worksite.
The specific aims of this proposal are to: 1) determine if this integrated' health promotion/health protection intervention for small businesses yields greater mean improvements in the primary outcomes (increased fruit and vegetable intake, decreased saturated fat consumption, and increased moderate and vigorous physical activity), compared to the minimal intervention control condition; 2) estimate the effects of this health promotion/health protection intervention on reductions in exposure to known or suspected occupational carcinogens; 3) assess worksite acceptance of this health promotion/health protection intervention in small business, as indicated by program adoption rate; extent of implementation of the intervention; and worker participation in programs in intervention worksites; 4) assess the role of the social context and other modifying conditions and mediating mechanisms, including motivation, self-efficacy, and social support, in changes in the primary outcomes; and 5) assess the cost effectiveness of the study in order to assess the replicability of the project and provide data for the Cancer Prevention Policy Model. Thus, this project addresses the social contexts in which people live and work through: (1) interventions that target social networks at the workplace, workplace management, and workers' families; (2) the use of interventions designed with sensitivity for cultural differences and limitations in material resources; and (3) the integration o f health protection with health promotion as a means of responding to workers' priorities.
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