Ward Dianne S, Vaughn Amber E, Hales Derek, Viera Anthony J, Gizlice Ziya, Bateman Lori A, Grummon Anna H, Arandia Gabriela, Linnan Laura A
Department of Nutrition, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, 245 Rosenau Hall, CB 7461, Chapel Hill, NC 27599-7461, USA; Center for Health Promotion and Disease Prevention, University of North Carolina at Chapel Hill, 1700 Martin L. King Jr. Blvd., Chapel Hill, NC 27599-7426, USA.
Center for Health Promotion and Disease Prevention, University of North Carolina at Chapel Hill, 1700 Martin L. King Jr. Blvd., Chapel Hill, NC 27599-7426, USA.
Contemp Clin Trials. 2018 May;68:116-126. doi: 10.1016/j.cct.2018.02.018. Epub 2018 Mar 1.
Low-wage workers suffer disproportionately high rates of chronic disease and are important targets for workplace health and safety interventions. Child care centers offer an ideal opportunity to reach some of the lowest paid workers, but these settings have been ignored in workplace intervention studies.
Caring and Reaching for Health (CARE) is a cluster-randomized controlled trial evaluating efficacy of a multi-level, workplace-based intervention set in child care centers that promotes physical activity and other health behaviors among staff. Centers are randomized (1:1) into the Healthy Lifestyles (intervention) or the Healthy Finances (attention control) program. Healthy Lifestyles is delivered over six months including a kick-off event and three 8-week health campaigns (magazines, goal setting, behavior monitoring, tailored feedback, prompts, center displays, director coaching). The primary outcome is minutes of moderate and vigorous physical activity (MVPA); secondary outcomes are health behaviors (diet, smoking, sleep, stress), physical assessments (body mass index (BMI), waist circumference, blood pressure, fitness), and workplace supports for health and safety.
In total, 56 centers and 553 participants have been recruited and randomized. Participants are predominately female (96.7%) and either Non-Hispanic African American (51.6%) or Non-Hispanic White (36.7%). Most participants (63.4%) are obese. They accumulate 17.4 (±14.2) minutes/day of MVPA and consume 1.3 (±1.4) and 1.3 (±0.8) servings/day of fruits and vegetables, respectively. Also, 14.2% are smokers; they report 6.4 (±1.4) hours/night of sleep; and 34.9% are high risk for depression.
Baseline data demonstrate several serious health risks, confirming the importance of workplace interventions in child care.
低薪工人患慢性病的比例过高，是工作场所健康与安全干预措施的重要目标人群。儿童保育中心为接触一些收入最低的工人提供了理想机会，但这些场所却在工作场所干预研究中被忽视。
关爱健康（CARE）是一项整群随机对照试验，评估在儿童保育中心开展的多层次、基于工作场所的干预措施的效果，该干预措施旨在促进工作人员的身体活动及其他健康行为。各中心被随机（1:1）分为健康生活方式（干预组）或健康财务（注意力对照组）项目。健康生活方式项目为期六个月，包括启动活动和三次为期八周的健康活动（杂志、目标设定、行为监测、个性化反馈、提示、中心展示、主任指导）。主要结局指标是中等强度和剧烈身体活动（MVPA）的分钟数；次要结局指标是健康行为（饮食、吸烟、睡眠、压力）、身体评估（体重指数（BMI）、腰围、血压、体能）以及工作场所对健康与安全的支持。
总共招募并随机分配了56个中心和553名参与者。参与者主要为女性（96.7%），非西班牙裔非裔美国人（51.6%）或非西班牙裔白人（36.7%）。大多数参与者（63.4%）肥胖。他们每天的MVPA累计时间为17.4（±14.2）分钟，每天分别摄入1.3（±1.4）份和1.3（±0.8）份水果和蔬菜。此外，14.2%的人吸烟；他们报告每晚睡眠6.4（±1.4）小时；34.9%的人有抑郁高风险。
基线数据显示了几种严重的健康风险，证实了在儿童保育场所开展工作场所干预措施的重要性。
