The Working Well Trial is a cooperative agreement between investigators at NCI, study centers at the University of Florida, Dana-Farber Cancer Institute, M. D. Anderson Cancer Center, Brown University, and a coordinating center at Fred Hutchinson Cancer Research Center. The Trial randomized 114 worksites to a cancer prevention program designed to reduce smoking, and increase fiber and decrease fat consumption, or to the control condition. Attainment of study goals made it necessary to extend the Trial's theoretical structure and amount of data collected. These enhancements make analyses possible that go considerably beyond merely comparing the results in control and intervention worksites. They make it possible to investigate the processes that affect the translation of the intervention into behavior change in a depth that has not been done previously. This continuation will examine the relationships among factors that make employees receptive to health promotion activities, factors that may make it easier for employees to achieve and maintain behavioral change, the intervention dose, the persistence of intervention programs that encourage smoking cessation and the adoption of a high fiber, low fat diet in the intervention sites, and the diffusion of cancer prevention activities to the control sites. Investigation of the persistence and diffusion hypotheses requires re-surveying the organizational informants two years after completion of the intervention. All of the Working Well Trial investigators will collaborate in the continuing investigation proposed. Accomplishment of the goals presented above will be met by the analysis of data that will have been collected in the Working Well Trial, and by re-surveying organizational informants. These investigations can be completed at modest cost in comparison to the cost of the Working Well Trial.
