WORKSITE CANCER SCREENING AND NUTRITION INTERVENTION FOR HIGH-RISK AUTO WORKERS - DESIGN AND BASE-LINE FINDINGS OF THE NEXT STEP TRIAL

Background. This article describes the design and baseline findings of The Next Step Trial, a health promotion intervention targeting automo bile industry employees at increased colorectal cancer risk. The inter vention encouraged colorectal cancer screening participation and adopt ion of low-fat, high-fiber diets. Methods. Twenty-eight worksites (n = 5,042) were randomized to control (a company-sponsored screening prog ram) or intervention (an enhanced screening program including a person alized educational booklet and motivational telephone call and diet-ch ange program including nutrition classes, self-help materials, and com puter-generated personalized feedback). Outcomes included screening co mpliance and fat and fiber intake. Results. Pretrial data indicated ta rgeted employees were predominantly older, well educated, married, Cau casian men, Sixty-one percent (SE = 2) participated in the screening p rogram in the preceding 2 years, and 24% (SE = 1) reported a history o f colorectal polyps or cancer. Fifty-eight percent of the cohort respo nded to the baseline questionnaire; respondents were older and more ed ucated; more were married, retired, and Caucasian than nonrespondents. Mean dietary intakes were 36.9% energy from fat (SE = 0.21), 8.8 g fi ber/1,000 kcal (SE = 0.07), and 3.4 servings of fruits and vegetables per day (SE = 0.04). Conclusions. Baseline data show moderate screenin g participation and dietary intakes that did not meet guidelines; henc e intervention efforts were warranted. Data from this trial will suppo rt a rigorous test of whether this high-risk employee population is re sponsive to targeted health promotion, early cancer detection, and pre vention interventions. (C) 1997 Academic Press.