""""""""Worksite Cancer Prevention: WellWorks-2"""""""" tests the effectiveness of a worksite cancer prevention model that integrates health protection and health promotion. WellWorks-2 is based on a recently completed study using a health protection/health promotion intervention that resulted in a significant and meaningful increase in smoking cessation rates. The ever-widening gap in disease risk by socio- economic status underlines the need for effective cancer control strategies for those less educated and in low status jobs, Worksite health promotion programs, however, have been less successful with blue collar workers and have traditionally failed to incorporate a major worker concern: the potential for exposure to occupational hazards. More than other workers, blue collar workers are exposed to occupational hazards. Workers exposed to hazardous work conditions may be more willing to attend to individual health behavior when employers are willing to dedicate resources to reduce exposure to work hazards. The proposed study provides a rigorous test of the integrated health protection-health promotion model by comparing the integrated intervention with a health promotion intervention, a design hat makes it possible to assess the added benefit of the integration component. Sixteen worksites will be randomly assigned either to a Health Promotion Only group or a Health Promotion plus Health Protection Group. The worksite is the unit of randomization, intervention, and analysis. Compared to the Health Promotion group, in the Health Promotion plus Health Protection group, the investigators expect greater increases in six-month continuous smoking cessation rates and consumption of fruits and vegetables, and greater decreases in the consumption of fat and exposure to chemical hazards. A clearly specified set of mediating and intermediate outcomes have been defined for three levels of influence: the worker, the organization (management, union), and environment. These levels provide structure for the interventions; resulting changes will be measured at he same levels. A state-of-he-art intervention tracking system is used to monitor the extent of implementation of the intervention and assess cost effectiveness. WellWorks-2 is submitted with a second application, Worksite Cancer Prevention: Partners in Health,: as part of a Collaborative Cancer Prevention Research Uni (CCPRU). This CCPRU responds directly to the challenge of the high concentration of cancer risk among less educated, blue collar workers by providing two tests of the integration of health promotion and health protection, implemented within fixed worksite settings (in WellWorks-2) and through a union structure to reach mobile workers (i.e., construction workers in the Partners Project). This integrated health protection/health promotion intervention model holds substantial promise for reducing cancer risk within this population and warrants the rigorous scientific examinations offered by this CCPRU.
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