Tilley B C, Vernon S W, Glanz K, Myers R, Sanders K, Lu M, Hirst K, Kristal A R, Smereka C, Sowers M F
Division of Biostatistics and Research Epidemiology, Henry Ford Health Sciences Center, Detroit, Michigan 48202, USA.
Prev Med. 1997 Mar-Apr;26(2):227-35. doi: 10.1006/pmed.1996.0132.
This article describes the design and baseline findings of The Next Step Trial, a health promotion intervention targeting automobile industry employees at increased colorectal cancer risk. The intervention encouraged colorectal cancer screening participation and adoption of low-fat, high-fiber diets.
Twenty-eight worksites (n = 5,042) were randomized to control (a company-sponsored screening program) or intervention (an enhanced screening program including a personalized educational booklet and motivational telephone call and diet-change program including nutrition classes, self-help materials, and computer-generated personalized feedback). Outcomes included screening compliance and fat and fiber intake.
Pretrial data indicated targeted employees were predominantly older, well educated, married, Caucasian men. Sixty-one percent (SE = 2) participated in the screening program in the preceding 2 years, and 24% (SE = 1) reported a history of colorectal polyps or cancer. Fifty-eight percent of the cohort responded to the baseline questionnaire; respondents were older and more educated; more were married, retired, and Caucasian than nonrespondents. Mean dietary intakes were 36.9% energy from fat (SE = 0.21), 8.8 g fiber/1000 kcal (SE = 0.07), and 3.4 servings of fruits and vegetables per day (SE = 0.04).
Baseline data show moderate screening participation and dietary intakes that did not meet guidelines; hence intervention efforts were warranted. Data from this trial will support a rigorous test of whether this high-risk employee population is responsive to targeted health promotion, early cancer detection, and prevention interventions.
本文介绍了“下一步试验”的设计及基线研究结果,该试验是一项针对患结直肠癌风险增加的汽车行业员工的健康促进干预措施。该干预措施鼓励员工参与结直肠癌筛查并采用低脂、高纤维饮食。
28个工作场所(n = 5042)被随机分为对照组(公司赞助的筛查项目)或干预组(强化筛查项目,包括个性化教育手册和激励性电话,以及饮食改变项目,包括营养课程、自助材料和计算机生成的个性化反馈)。结果包括筛查依从性以及脂肪和纤维摄入量。
审前数据表明,目标员工主要是年龄较大、受过良好教育、已婚白种男性。61%(标准误 = 2)的员工在过去两年中参加了筛查项目,24%(标准误 = 1)报告有结直肠息肉或癌症病史。58%的队列成员回复了基线调查问卷;回复者年龄更大、受教育程度更高;与未回复者相比,已婚、退休和白种人的比例更高。平均饮食摄入量为脂肪提供36.9%的能量(标准误 = 0.21),每1000千卡含8.8克纤维(标准误 = 0.07),每天摄入3.4份水果和蔬菜(标准误 = 0.04)。
基线数据显示筛查参与率中等,饮食摄入量未达到指南要求;因此有必要进行干预。该试验的数据将支持对这一高风险员工群体是否对有针对性的健康促进、早期癌症检测和预防干预措施有反应进行严格测试。