The primary aim of this proposal is to implement and evaluate the effects of a comprehensive worksite cancer prevention model that integrates message about nutrition, smoking, and occupational health. Occupational health and health promotion have rarely been integrated in a single program. This project proposes to develop and test an innovative interdisciplinary model that addresses broad health concerns of workers and worksites. Using a randoniized control this study will assess the impact of a standardized intervention protocol on individual behavior change, including intake of fa and fiber smoking cessation, and on-the worksite environment, including a low fat, high fiber foods in worksite cafeterias and vending machines, exposure to environmental tobacco smoke and exposure to occupational caranogens.
Major aims of the proposed intervention are (1) to address the objectives of both health promotion and (occupational health and safety programs in a single coordinated and (2) to develop a model that can bi readily incorporated into a statewide system by collaborating with the Massachusetts Department of Public Health. Twenty-four worksites already recruited to the study will be matched and randomized to intervention and comparison conditions. Comparison sites will receive intervention assistance from the Massachusett Department of Public Health the conclusion of the study. The intervention model is based on principles of community organization and social marketing and includes the following steps: (1) mobilize -worker to promote program activities and risk factor messages through participection in an employee advisory board in each worksite; 2) tailor intervention programming to individual worksites based on recommendations from these boards; (3) implement-intervention programming aimed at individual workers that will have maximum penetration worksite-wide to increase readiness-to change health behaviors, and that will build skills those ready to make behavior changes; (4) promote environmental changes -supportive of risk on, including cafeteria and vending machine modifications, implementation of effective nonsmoking policys, and reduction of exposures to occupational carcinogens; and (5) plan for incorporation of the program in participating worksites an statewide beyond the study period. Process objective have been estiblished for each phase. Components of the evaluation include assessment of: the intervention on the defined impact objective; achievement of the process objectives; the intervention delivery; potential competing explanations for observed changes; and the cost of the intervention. Products of the study will include: a tested model of a worksite intervention program that integrates nutrition, smoking cessation, and occupational health, including an implementation manual with program materials for use in other worksites; a system of dissemination of model through state health departments, implemented on a pilot basis through the Massachusetts Department of Public Health; a tested food service food frequency questionnaire to assess the availability of low fat, high fiber foods in cafeterias and vending machines; a tested method and protocol for quantitative, specific assessmen of changes in environmental tobacco smoke as a result of worksite smoking policies; and an assessment of the cost effectiveness of the tested model.
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