This study is designed to test the efficacy of a worksite model for promoting """"""""5-a-Day for Better Health"""""""". The intervention program uses the worksite as a channel to promote both individual dietary change and environmental support. The worksite intervention is based on the Treatwell Program, already tested and found to be efficacious in a 3-year NCI-funded study. This program adds a component not previously studied in worksite intervention programs: a focus on the role of family interaction and support in determining and promoting change in individual eating habits. Worksites already recruited to the study will be randomly assigned to one of three groups: (1) a minimal intervention control group; (2) an intervention group in which worker dietary change is promoted through worksite-based interventions; and (3) an intervention group in which worker dietary change is promoted through both worksite- based and family-focused interventions. A randomized controlled study design is used in which worksites are the unit of randomization, intervention and analysis. Change in worker consumption of fruits and vegetables will be assessed within the context of their total diets using the Semi-quantitative Food Frequency Questionnaire. In addition, a clearly specified set of secondary hypotheses will be assessed based on surveys of workers and of worksite representatives. The process evaluation will assess the extent to which the intervention was implemented and the costs associated with the intervention. This study is a unique working collaboration between several academic institutions and community organizations, and is based on long established ties between these groups. This partnership includes a comprehensive cancer center, a state health department, two schools of public health, and a cooperative extension system. The worksites are 24 community health centers, which are health clinics that offer comprehensive community- based care to high-risk and low-income communities. They not only represent small non-profit worksites; they also provide a setting for testing methods of reaching diverse ethnic and cultural groups because staff are generally hired from the ethnic or cultural communities they serve; almost half of the workers from participating health centers are from communities of color. Because one of the job responsibilities of CHC staff is health education, a 5-A-Day message is likely to be diffused to patients. In addition, we have established a partnership with several food industry groups. Two advisory committees have been established, including a community-based advisory group that will provide further linkages to the community, and a scientific advisory committee that will review the study design and evaluation. The Treatwell 5-a-Day Program will result in a program ready for dissemination through established community organizations such as health departments or cooperative extension systems, and will include an Educational Packet of program products for dissemination to other worksites.
