CD07-004 Abstracts
1 R01 DP001169-01 -- High Impact Interventions for Employee Health Promotion
BUTTERWORTH, SUSAN W
DESCRIPTION (provided by applicant): The overarching objective of this application is to perform one of the most intensive analysis of factors related to reach, adoption, feasibility, fidelity, acceptability, compatibility and outcome of three of the most widely used worksite wellness interventions (health risk assessment, online tailored communications and health coaching) delivered under combinations of three of the most widely used recruitment and retention strategies (persuasive communications, incentives, and telephone outreach). These factors will be derived from the data from the current study on worksite wellness where a successful intervention was developed and implemented. The RE-AIM framework will be used to obtain study objectives. A total of 800 employees will be recruited from a random selection of the eligible pool of study participants from the original study. Members from the non-adopters, partial adapters, and full adopters of the program activities will be represented, as will the three intervention types. Incentives will be used to assist with recruitment efforts that include mail, email and telephone outreach. A mixed design will combine quantitative surveys delivered in person, by mail and telephone, and qualitative focus groups and semi-structured interviews delivered face-to-face. For the quantitative analysis, a range of statistical techniques will be used to analyze study outcomes. In all cases, the type of analysis will be determined by the question being answered and the type of data available. The range of measures (including both ordered categorical variables and continuous variables) and types of research questions (including basic outcome, change, and process to outcome) requires that diverse analytic techniques be used, including MANOVAs, ANCOVAs, chi-square analyses and logistic regression. Audiotapes from the focus groups and semi-structured interviews will be transcribed, analyzed and coded by multiple investigators. The constant comparative method of analysis will be used for the focus group and the `framework' system of qualitative data analysis will be used in the semi-structured interviews. In summary, the data generated will evaluate the public health impact of three health promotion interventions, influence worksite health policies and practices, identify evidence-based programs, and facilitate their translation from research to practice.
R01 OH009403-01 -- Evaluation of the Potential for Translation to Practice of a Sleep Disorders Management Program for Police
CZEISLER, CHARLES A
DESCRIPTION (provided by applicant): The need for 24/7 policing places high physical and psychological demands on police officers that contribute to a high level of fatigue. Frequent overnight shifts and long work weeks leads to acute and chronic partial sleep deprivation in addition to misalignment of circadian phase. As part of the CDC Health Protection Research Initiative: Evaluation of Workplace Health Promotion Research Projects, we have recently conducted a study entitled 'Sleep Disorders Management, Health and Safety in Police' that aimed to develop a novel sleep disorders detection and treatment program, 'Operation Healthy Sleep', on the health, safety, and productivity of police officers. The program included sleep health and hygiene education, caffeine-use education and a large- scale screening, diagnosis and treatment program for clinical sleep disorders. We have recently completed the program in two major police forces, the Massachusetts State Police and the Philadelphia Police Department, using a randomized clinical design to evaluate the overall impact of this health promotion program on officer health, workplace performance, and safety, as derived from police department databases. Approximately 2000 officers attended the educational component of the program. More than 1000 of these officers were also screened for sleep disorders and our results show that police officers have a particularly high prevalence of clinical sleep disorders, with obstructive sleep apnea and insomnia the most common conditions. In the current proposal, we will conduct a detailed evaluation of the Operation Healthy Sleep program and investigate the advantages and disadvantages of our approach though the RE-AIM (Reach, Effectiveness, Adoption, Implementation, and Maintenance) framework to health behavior interventions. We will take advantage of the excellent relationships that we have developed with the police departments, unions and officers during the course of implementing Operation Healthy Sleep to conduct a series of focus group interviews with the stake-holders in the program, in addition to analysis of quantitative data on participation in the various stages of the program. We will also evaluate the cost, feasibility and sustainability of the Operation Health Sleep program through cost-benefit analysis, including quantitative analysis of objective health, safety and productivity outcomes. Finally, we will evaluate the external validity and potential for translation of the Operation Healthy Sleep program nationally by comparing health, safety and productivity outcomes obtained from the primary police samples with those obtained from a nationwide sample of more than 4000 police officers participating in our concurrent web-based survey sleep disorders, fatigue, health and safety. If viable, our ultimate aim is to disseminate this program to practitioners, policymakers and researchers nationwide to reduce fatigue and stress in law enforcement officers, improve their workplace performance, enhance officers' health and safety and, consequently, improve public safety. The need for 24/7 policing, with frequent overnight shifts and long work weeks, places high physical and psychological demands on police officers that contribute leads to acute and chronic partial sleep deprivation and high levels of fatigue. Furthermore, we have shown that police officers have a high prevalence of clinical sleep disorders, particularly obstructive sleep apnea and insomnia. We have recently implemented Operation Healthy Sleep in the Massachusetts State Police and Philadelphia Police Department which includes sleep health and hygiene education, caffeine-use education and a large-scale screening, diagnosis and treatment program for clinical sleep disorders. In the current proposal, we will conduct a detailed evaluation of the Operation Healthy Sleep program and investigate the advantages and disadvantages of our approach with the view to developing a nationwide program to enhance the sleep, alertness and performance of police officers and ultimately both their and the public's health and safety.
1 R01 DP001170-01 -- Translatability of Wellness Programs for Older Workers
HUGHES, SUSAN L
DESCRIPTION (provided by applicant): Our current HPRI R01 is examining the cost-effectiveness of two evidence-based health promotion interventions for older workers, whose participation in the workforce is anticipated to increase by 60% between now and 2015. The proposed study will build upon and expand our ongoing and completed work to explore its potential for translation. We will use the RE-AIM model as a guiding framework for our work (Glasgow et al., 1999). This model assesses five dimensions: Reach, Efficacy, Adoption, Implementation and Maintenance that can operate at both the individual and clinic, organization, or community level and interact to determine the public health or population-based impact of a program or policy. The proposed activities will enable us to learn how to enhance translation of these programs, including ways to package and market programs and address barriers and facilitators to adoption, implementation, and maintenance. We will conduct focus groups with participants in both of our study arms (COACH and RealAge) to learn more about the processes that impact behavior change in each treatment condition. Five participant focus groups will be conducted. Four will be conducted with high vs. low users in each intervention arm and one will be conducted with persons who contacted us about participation and decided not to follow through. We will also conduct a web-based survey with a random sample of staff over the age of 40 who never contacted us about study participation to assess their degree of interest in either of the two interventions or in other health promotion opportunities at UIC. Key informant interviews will be conducted with Human Resource (HR) staff and high-level UIC managers to explore the possibilities for large scale implementation of the interventions within UIC that would be supported and maintained by the University. Finally, key informant interviews and a systematic survey will be conducted with business leaders and businesses in the greater Chicago area to explore the characteristics of existing health promotion efforts for older workers, the attractiveness of the COACH and RealAge interventions, and facilitators and barriers to the adoption, implementation, and maintenance of the COACH and RealAge programs and other programs like them.
R01 DP001171-01 -- Implementing Evidence-Based Health Promotion through Health and Welfare Funds
SORENSEN, GLORIAN C
DESCRIPTION (provided by applicant): The purpose of this study is to prepare for the dissemination of an evidence-based intervention promoting smoking cessation and weight management among blue- collar workers through the joint labor-management health and welfare funds that insure them. This study builds from our current research funded under the CDC Health Protection Research Initiative; we are testing a tailored, telephone-delivered intervention to promote smoking cessation and weight management among blue-collar workers. Tobacco use and overweight are major contributors to mortality in the U.S., and are especially elevated among blue-collar workers. Our current study specifically addresses the elevated risks of motor freight workers, including truck drivers and dockworkers, using a quasi-experimental design, in collaboration with the International Brotherhood of Teamsters. Our baseline data indicated that 29% of these workers were smokers, and 41% were obese. The proposed study relies on a solid body of evidence, including through our prior research and forthcoming results from our ongoing study. As a next logical step in this research, the proposed study puts into place several necessary steps toward building for dissemination of this intervention through health and welfare funds (H&W funds). Labor-management H&W funds provide health insurance to 10 million unionized workers, retirees, and their dependents through some 1,600 separate funds in the U.S. In collaboration with the Teamsters and a collaborating H&W funds, we will adapt the tested program products and intervention protocol for implementation on a larger scale. Modifications to the current intervention are necessary to bring it to a scale that can be broadly delivered in a cost-efficient manner. We will additionally work with the Teamsters and collaborating H&W fund to design strategies to promote this intervention effectively through H&W fund channels. In addition, we will conduct a pilot study to evaluate the implementation of the adapted program through this channel. This quasi-experimental study will assess reach, intervention implementation, and participant outcomes. We will additionally assess organizational readiness among Teamsters-affiliated H&W funds through a series of key informant interviews. We believe this pilot study provides an essential developmental step that will help us better understand the process and outcomes of dissemination through this channel a step which we believe will increase the likelihood of eventual program adoption and sustainability.
1 R01 DP001168-01 -- Financial Incentives for Smoking Cessation
VOLPP, KEVIN G
DESCRIPTION (provided by applicant): Smoking is the leading cause of preventable mortality in United States, accounting for approximately 435,000 deaths each year in the United States. Most smokers make multiple attempts to quit smoking, but only 2-3% succeed each year. This proposal builds on a successful CDC-funded study "Financial incentives for smoking cessation" which is a 2-arm randomized control trial (RCT) of financial incentives for smoking cessation among employees at General Electric (GE) worksites throughout the United States. Eligible smokers were randomized to receive either usual care (information about local community-based smoking cessation resources) or usual care plus a package of financial incentives that includes $100 for completion of a community-based tobacco cessation program, $250 for tobacco cessation within the first 6 months following enrollment, and $400 for continuous tobacco cessation for the following 6 months (biochemically confirmed). We have found highly significant differences in smoking cessation program completion (9.6% vs. 0.9%, p<0.0001) and smoking cessation in the first 6 months (23.4% vs. 13.6%, p=0.0002). The current proposal has 3 Specific Aims: 1. To evaluate the public health impact of this program and the perceived barriers and facilitators of success, using the RE-AIM framework; 2. To examine the business case for adoption of this program based on within-trial data on cost- effectiveness as well as projections from the literature; 3. To assess the attitudes, information needs, and organizational factors that might impede or facilitate adoption of this program among corporate medical directors (CMOs) of large employers or insurers; The first aim will be achieved through a detailed process evaluation, which will involve focus groups of GE employees; interviews of local health champions at the largest worksites and those worksites most and least successful in recruiting; and careful assessment of the data from our RCT. The second aim will be achieved through a rigorous cost-effectiveness analysis in which we will examine the "business case" for this incentives program using both trial data at 12 months (final incentive payment) and 18 months (after incentive payments have ceased). The third aim will be achieved through structured interviews with the CMOs of the nation's largest employers and insurers to examine their level of interest and potential barriers to implementation of this intervention. We will be assisted in setting up these interviews by members of our Advisory Board, which includes the Chief of Health Benefits worldwide for GE, Bob Galvin, and the CMO of Aetna, Troy Brennan. Careful evaluation of our financial incentives intervention and its potential external validity will be an important next step to realizing the potential for this approach to substantially reduce the economic and health burden of smoking-related disease and disability among a large portion of the American population.
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Page last modified: July 22, 2008
Content source: Office of the Chief Science Officer (OCSO)
