The impact of the Citibank, NA, health management program on changes in employee health risks over time.
ABSTRACT This study estimated the impact of the Citibank Health Management Program on changes in health risks among Citibank employees. McNemar chi-squared tests compared the probability of being at high risk for poor health when the first and last health-risk appraisal surveys were taken. Logistic regression controlled for baseline differences in subsequent analyses when those who participated in more intensive program features were compared with those who participated in less intensive features. Declines in risk were noted for 8 of 10 risk categories. Most changes were small, except those related to exercise habits, seatbelt use, and stress levels. For nine health risk categories, those who participated in more intensive program services were significantly more likely than others to reduce their health risks. Thus, the Citibank Health Management Program was associated with significant reductions in health risk.
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ABSTRACT: In the largely successful preventive approach to reduction in cardiovascular disease prevalence, three classic stages of investigation were used. First, an hypothesis was raised that diet and cholesterol levels were a cause of heart disease. Second, multiple longitudinal observational studies, led by the Framingham group, documented a strong association between these health risks and heart disease mortality. Finally, randomized controlled trials of cholesterol-lowering drugs established proof of causality. Our understanding of the Successful Aging phenomenon has followed the same sequence. The Compression of Morbidity hypothesis sets forth a new and promising paradigm. Multiple longitudinal and cross-sectional observational studies show strong associations consistent with the hypothesis. Finally, randomized controlled trials of healthy aging interventions prove our ability to successfully intervene in this most important of all contemporary health problems: the health of seniors .Clinics in Geriatric Medicine 09/2002; 18(3):371-82. DOI:10.1016/S0749-0690(02)00021-6 · 3.19 Impact Factor
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ABSTRACT: To analyze the impact of worksite wellness programs on health and financial outcomes, and the effect of incentives on participation. Sources were PubMed, CINAHL and EconLit, Embase, Web of Science, and Cochrane for 2000-2011. We examined articles with comparison groups that assessed health-related behaviors, physiologic markers, healthcare cost, and absenteeism. Data on intervention, outcome, size, industry, research design, and incentive use were extracted. A total of 33 studies evaluated 63 outcomes. Positive effects were found for threefourths of observational designs compared with half of outcomes in randomized controlled trials. A total of 8 of 13 studies found improvements in physical activity, 6 of 12 in diet, 6 of 12 in body mass index/weight, and 3 of 4 in mental health. A total of 6 of 7 studies on tobacco and 2 of 3 on alcohol use found significant reductions. All 4 studies on absenteeism and 7 of 8 on healthcare costs estimated significant decreases. Only 2 of 23 studies evaluated the impact of incentives and found positive health outcomes and decreased costs. The studies yielded mixed results regarding impact of wellness programs on healthrelated behaviors, substance use, physiologic markers, and cost, while the evidence for effects on absenteeism and mental health is insufficient. The validity of those findings is reduced by the lack of rigorous evaluation designs. Further, the body of publications is in stark contrast to the widespread use of such programs, and research on the effect of incentives is lacking.The American journal of managed care 02/2012; 18(2):e68-81. · 2.17 Impact Factor