The purpose of the proposed study is to develop, implement and evaluate a comprehensive health promotion/cancer prevention program called """"""""WorkWell"""""""" designed specifically for rural, blue-collar energy transmission workers. Matched worksites will be randomized to receive either a comprehensive or a minimal intervention. Changes in the tobacco and nutrition behaviors of the """"""""WorkWell"""""""" sites will be compared to matched comparison sites using an experimental design with the worksite serving as the unit of analysis. Six organizations (5 natural gas pipeline companies and the National Rural Electric Cooperative Association) are participating in the study, comprising a total of 73 worksites. The intervention will seek to reduce tobacco-use and improve dietary behaviors and is directed at three components of each worksite: 1) the organizational and administrative characteristics of the employer, 2) the immediate work environment, and 3) the individual worker and his family, Diffusion theory, social learning theory and the trans-theoretical model, provide the conceptual foundation for the interventions. This integrated approach will serve the needs of individuals in all stages of the change process--from those who are intransigent about their behavior to those who have entered the action stage. Measurement and evaluation procedures will determine: 1) a reduction in the use of tobacco products and fat consumption and an increase in dietary fiber, 20 change from baseline in organizational policies and practices, 30 environmental incentives and support, and 40 the extent of program implementation. It is expected that this study will result in a program and process that will be generalizable for use in all worksites, and especially for those with blue-collar hard-to-reach workers. The findings of the study will contribute to applied social science, both to the theoretical foundations of individual change and also to an understanding of organizations and environments that promote and enable positive health behavior change, particularly in blue-collar populations.
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