The purpose of the proposed research is to evaluate whether principles for successful health promotion programs designed for large businesses can be adapted to small businesses in urban settings. For this research, we propose to develop a mobile team approach to worksite health promotion. The intervention will take a multi-risk factor approach. We will concentrate on identification and referral for preventive services for cardiovascular disease, cancer and smoking cessation. A package of health promotion and disease prevention activities will be developed that are based on the """"""""10 Steps to a Longer and Healthier Life"""""""", a New York City's Department of Health and Mental Hygiene initiative. The intervention will be offered free charge to 50 Fifty small businesses located in Harlem, New York City evaluated through a group-randomized trial. Businesses agreeing to participate will be randomized in to one of two conditions: 1) a comprehensive mobile team intervention or 2) a low intensity intervention with receipt of the full intervention to follow after a 3-month delay. The primary outcomes of the study increased use of appropriate preventive services that are available in the community for minimal or no fee and reduction in selected health risk factors. All employee data will be collected as part of the health profile assessment that will be an integral component of the intervention. Additional information will be collected to document worksite and employee participation rates, the fidelity of the intervention to principles of successful health promotion design, and the cost of the intervention. The first year of the study will be devoted to formative research to develop the intervention and confirm hypothesized prevention needs of the target population. The intervention will be conducted during the second and first half of the third year of the grant Analysis of project results will be conducted in year three of the grant.
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