Promoting Activity and Changes in Eating (PACE) to Reduce Obesity
Condition: Obesity; Cardiovascular Diseases; Heart Diseases
MeSH terms: Cardiovascular Diseases; Heart Diseases; Obesity
Study type: Interventional

Summary: 
      Reducing the prevalence of obesity in the population is one of the Healthy People 2010 goals.
      Increased vigilance is required in all age groups in preventing and reversing overweight and
      obesity. On an individual level, behavioral factors that influence body weight include eating
      choices leading to excess calorie intake and physical activity patterns leading to diminished
      calorie expenditure. An imbalance between the two over time leads to increased weight. On a
      population basis, the prevalence of overweight is associated with a myriad of influences,
      including social, behavioral, cultural, and environmental factors as well as genetic and
      physiological factors. For a majority of overweight individuals, restoring a balance between
      energy intake and expenditure is difficult, and therefore there is an increasing emphasis on
      preventing obesity on a population level. The long-term goal of this research is to prevent
      further increase in rates of obesity in the population. In the adult population of working
      age, a majority of the day is spent in the worksite, suggesting that interventions at the
      worksite level may offer the opportunity for success in this age group. It is anticipated
      that this project will yield important contributions to the understanding of obesity
      prevention.
    

Detailed description: 
      BACKGROUND:

      More than half of American adults are overweight or obese, and this proportion is increasing.
      The health risks associated with obesity include diabetes, cardiovascular disease, arthritis,
      and some cancers. It is well established that on an individual level, weight gain is caused
      by taking in more calories than are expended. On a population basis, the prevalence of
      overweight and obesity is associated with a myriad of influences, including genetic and
      physiological factors as well as social, behavioral, cultural, and environmental factors.
      Behavioral factors that contribute to weight gain include eating choices that lead to
      increased energy intake and physical activity choices that lead to decreased energy
      expenditure. For a majority of overweight individuals, restoring the balance between energy
      intake and expenditure is difficult.

      DESIGN NARRATIVE:

      This study will develop and test a comprehensive intervention involving simple messages that
      will integrate changes in dietary intake with changes in energy expenditure, while
      simultaneously modifying structural and environmental factors to promote social support and
      opportunities for behavioral change. The study will recruit and randomize 48 worksites to a
      2-year intervention in which the following will be carried out: build a physical activity
      intervention combining increased daily physical activity and regular, structured exercise;
      build a dietary intervention that will promote lower calorie intake; and increase worksite
      access to both healthy foods and physical activity. The primary aim is to evaluate the
      effectiveness of the intervention in reducing or maintaining body mass index in a randomized
      controlled trial of worksites. The study will compare changes in body mass index in
      intervention versus control worksites using two cross-sectional surveys at baseline and
      follow-up. Additional assessments using biomarkers and fitness measures will be performed in
      a subset of employees. The research team has considerable experience with interventions at
      the worksite level and substantial expertise in obesity prevention.
    

Intervention name(s): Diet; Exercise; Environment
Intervention type(s): Behavioral; Behavioral; Behavioral
Intervention description(s): A dietary intervention that will promote lower calorie intake; A physical activity intervention combining increased daily physical activity and regular, structured exercise; Increase worksite access to both healthy foods and physical activity
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Single (Outcomes Assessor)
Primary purpose: Prevention