Based on the results of previous worksite health promotion trials, this project will evaluate the impact of organizational-level health promotion activities and worksite characteristics on employee dietary and smoking behaviors. Based upon the organizational literature on adoption and institutionalization of innovative practices, a disseminable intervention protocol and materials (e.g., a guidebook for worksite health promotion steering committees) will be developed. This intervention will be evaluated in a randomized control trial comparing 13 treatment worksites to 13 delayed-treatment worksites on organizational health promotion practices (polices/environmental control, incentive programs, skills training activities, maintenance activities); employee smoking cessation and saturated fat consumption; and employee cholesterol levels. Following a two-year assessment, worksites in the delayed-treatment condition will receive a version of the intervention requiring less interventionist time. The effects of this streamlined intervention in these worksites will be evaluated relative to a third group of 13 quasi-experimental comparison worksites that enter the study at that time. The study will also evaluate the impact of organization characteristics and health promotion activities on employees at various stages of health related behavior change (awareness, intention to change, behavior change attempt, maintenance of behavior change). Process measures assessing program implementation and cost-effectiveness data will be collected. Finally, the long-term intervention effects (3-4 years following initial intervention) on organizational health promotion practices, employee dietary and smoking behaviors, and cholesterol levels will be assessed. In summary, this 5 year project will provide both a) knowledge about how to implement worksite health promotion interventions to promote employee ownership and maintenance, and b) disseminable intervention products (e.g., protocols and employee steering committee guidebooks).
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