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The Long-Term Impact of Johnson & Johnson’s Health & Wellness Program on Employee Health Risks
Abstract
To be viewed as successful, corporate health promotion and disease prevention programs must demonstrate that they can improve the risk profile of employees as a whole, and, in particular, those employees at highest risk. This study reports the effectiveness of Johnson & Johnson's newly configured Health & Wellness Program in reducing the health risks of 4586 employees who participated in two serial health screening programs, with a minimum of 1 year between screenings. The study also examines the impact of participation in a high-risk intervention program called Pathways to Change on health risk factors. McNemar chi-squared and z-test statistics were used to evaluate changes in health risks over time. Results indicate significant risk reduction in 8 of 13 risk categories examined for all employees who participated in two health risk assessments over an average of 2 3/4 years. When comparing Pathways to Change participants with non-participants, participants outperformed their non-participant counterparts in six categories but performed worse in five other categories that were not specifically targeted by the high-risk program. In two categories, no differences were found. The study underscores the ability of large-scale, well-attended, and comprehensive corporate health and productivity management programs to positively impact the health and well-being of workers.
... To summarize the previous literature, comprehensive, multiyear programs tend to lower prevalence in several health risk categories [20,[29][30][31], but the slope of such changes is relatively flat [28,29,32] and also includes negative findings [29][30][31]33]. Furthermore, the vast majority of studies report results of relatively short intervention periods from one to three years [11,20,28,[31][32][33], especially when considering the context of health risk accumulation as the population ages. ...
... To summarize the previous literature, comprehensive, multiyear programs tend to lower prevalence in several health risk categories [20,[29][30][31], but the slope of such changes is relatively flat [28,29,32] and also includes negative findings [29][30][31]33]. Furthermore, the vast majority of studies report results of relatively short intervention periods from one to three years [11,20,28,[31][32][33], especially when considering the context of health risk accumulation as the population ages. ...
... To summarize the previous literature, comprehensive, multiyear programs tend to lower prevalence in several health risk categories [20,[29][30][31], but the slope of such changes is relatively flat [28,29,32] and also includes negative findings [29][30][31]33]. Furthermore, the vast majority of studies report results of relatively short intervention periods from one to three years [11,20,28,[31][32][33], especially when considering the context of health risk accumulation as the population ages. ...
Research has shown that workplace health promotion (WHP) efforts can positively affect employees' health risk accumulation. However, earlier literature has provided insights of health risk changes in the short-term. This prospective longitudinal quasi-experimental study investigated trends in health risks of a comprehensive, eight-year WHP program (n = 523-651). Health risk data were collected from health risk assessments in applying both a questionnaire and biometric screenings. Health risk changes were investigated for three different time-periods using descriptive analyses, t-tests, and the Wilcoxon Signed Rank and McNemar's test, where appropriate. Overall health risk transitions were assessed according to low-, moderate-, and high-risk categories. Trend analyses observed 50-60% prevalence for low-, 30-35% for moderate-, and 9-11% high-risk levels across the eight years. In the overall health risk transitions of the three time-periods, 66-73% of participants stayed at the same risk level, 13-15% of participants improved, and 12-21% had deteriorated risk level across the three intervention periods. Our findings appear to indicate that the multiyear WHP program was effective in maintaining low and moderate risk levels, but fell short of reducing the total number of health risks at the population level.
... To summarize the available literature, comprehensive, multiyear programs tend to lower risks in several categories [20,28,33], but the slope of such changes is relatively at [28][29][30] and also includes negative ndings (28,(31)(32)(33). Furthermore, the vast majority of studies report results of relatively short intervention periods [11,20,29,30,32,33] -especially when considering the context of health risk accumulation as the population ages. ...
... To summarize the available literature, comprehensive, multiyear programs tend to lower risks in several categories [20,28,33], but the slope of such changes is relatively at [28][29][30] and also includes negative ndings (28,(31)(32)(33). Furthermore, the vast majority of studies report results of relatively short intervention periods [11,20,29,30,32,33] -especially when considering the context of health risk accumulation as the population ages. ...
... To summarize the available literature, comprehensive, multiyear programs tend to lower risks in several categories [20,28,33], but the slope of such changes is relatively at [28][29][30] and also includes negative ndings (28,(31)(32)(33). Furthermore, the vast majority of studies report results of relatively short intervention periods [11,20,29,30,32,33] -especially when considering the context of health risk accumulation as the population ages. ...
Background
This prospective longitudinal quasi-experimental study investigated trends in health risks of a multiyear comprehensive workplace health promotion (WHP) program.
Methods
A comprehensive, eight-year WHP program was implemented emphasizing lifestyle behaviors as key targets in 2010-2013 and environmental supports focused on stress management and mental health resources in 2014-2017. Health risk data was collected from health risk assessments, applying both a questionnaire and biometric screenings. Health risk trends were analyzed for the three time points 2010-2011, 2013-2014 and 2016-2017. Single health risk changes were investigated for three different cohorts using descriptive analyses, t-test, Wilcoxon Signed Rank and McNemar´s test where appropriate. Overall health risk transitions were assessed according to low, moderate and high risk categories.
Results
Trend analyses observed 50-60% prevalence for low, 30-35% for moderate and 9-11% high risk levels across the eight years. In the overall health risk transitions of the three cohorts, 66-73% of participants stayed at the same risk level, 13-15% of participants improved, and 12-21% deteriorated their risk level across the three intervention periods.
Conclusion
Our findings appear to indicate that the multiyear WHP program was effective in slowing the accumulation of measured health risks but fell short of reducing the number of health risks at the population level. In context of expected age-related health risk changes over time, this comprehensive multi-year WHP program was able to generate modest but important shifts in population health risk profiles.
... The frequency-based diet quality index was assessed using the Insight questionnaire (J&J Health Care Systems, Piscataway, NJ, USA) [33]. Participants reported frequency, in the previous week, of consuming foods high in sweet, fats and salt, as well as whole grains, fruits and vegetables ( Table 2). ...
... Pearson correlation (r) analysis was used to assess the associations between liking-based and frequency-based variables. Analysis of covariance (ANCOVA) was used to test for percent weight change differences across the groups defined by concordance or The frequency-based physical activity index was calculated from separate questions about the per week scores of mild, moderate, and vigorous physical activity by the categories of 0 days, 1-2 days, 3-4 days, and 5 or more days [33]. The specific descriptions for these physical activity categories included: mild-easy walking, bowling, mild yoga; moderate-brisk walking, slow bicycling, easy swimming; and vigorous-running, aerobics, fast bicycling. ...
In a secondary analysis, we assessed the ability of dietary and physical activity surveys to explain variability in weight loss within a worksite-adapted Diabetes Prevention Program. The program involved 58 overweight/obese female employees (average age = 46 ± 11 years SD; average body mass index = 34.7 ± 7.0 kg/m2 SD) of four long-term care facilities who survey-reported liking and frequency of dietary and physical activity behaviors. Data were analyzed using a latent variable approach, analysis of covariance, and nested regression analysis to predict percent weight change from baseline to intervention end at week 16 (average loss = 3.0%; range—6% gain to 17% loss), and follow-up at week 28 (average loss = 2.0%; range—8% gain to 16% loss). Using baseline responses, restrained eaters (reporting liking but low intakes of high fat/sweets) achieved greater weight loss at 28 weeks than those reporting high liking/high intake (average loss = 3.5 ± 0.9% versus 1.0 ± 0.8% S.E., respectively). Examining the dietary surveys separately, only improvements in liking for a healthy diet were associated significantly with weight loss (predicting 44% of total variance, p < 0.001). By contrasting liking versus intake changes, women reporting concurrent healthier diet liking and healthier intake lost the most weight (average loss = 5.4 ± 1.1% S.E.); those reporting eating healthier but not healthier diet liking (possible misreporting) gained weight (average gain = 0.3 ± 1.4% S.E.). Change in liking and frequency of physical activity were highly correlated but neither predicted weight loss independently. These pilot data support surveying dietary likes/dislikes as a useful measure to capture dietary behaviors associated with weight loss in worksite-based programs. Comparing dietary likes and intake may identify behaviors consistent (appropriate dietary restraint) or inconsistent (misreporting) with weight loss success.
... 10 Previous research has shown that companies that implement health promotion programs can effectively reduce employee risk status, particularly when those programs target high-risk individuals. [11][12][13][14][15][16][17][18] In a quasi-experimental study by Gold et al, 11 the authors assessed the long-term effectiveness of a telephonic wellness coaching (TWC) program on improving seven targeted health risks in two groups: self-selected at-risk TWC participants and risk-eligible nonparticipants. Using data from two health-risk assessments (HRAs) approximately 24 months apart, the authors reported that participants were 1.8 to 3.5 times as likely than nonparticipants to reduce their targeted risk in 6 of 7 risk categories (those related to back care, eating habits, exercise, stress management, tobacco use, and weight control). ...
... Moreover, the authors noted that interventions focusing on one primary area of change (eg, physical activity only or healthy eating only) were associated with greater mean effect sizes. In a longitudinal study by Goetzel et al, 15 the researchers compared the outcomes of 2301 participants enrolled in Johnson & Johnson's Health and Wellness program referred to as Pathways to Change 1 , with the outcomes of 2285 nonparticipants. Participants in this pre-event management program achieved significantly better results as compared with the nonparticipants, in six health-risk categories related to high dietary fat intake, high body weight, too little aerobic exercise, diabetes risk, high total cholesterol, and high blood pressure. ...
Objective:
To assess the relationship between wellness program participation and employee health risks.
Methods:
Data from 173,901 health-risk appraisals and wellness program participation records were used to assess changes in seven health risks (blood pressure, body weight, cholesterol level, nutrition, physical inactivity, stress, and tobacco use).
Results:
Controlling for baseline covariates, high-risk members who completed only a coaching program were significantly more likely to lower five out of seven health risks than were high-risk members in the comparison group. Participation in multiple wellness activities (eg, biometric screening) increased the odds that risks would be reduced.In addition, the number of risk levels that improved was greater than the total that worsened.
Conclusions:
This study provides evidence that wellness program participation was associated with significant risk reduction, particularly among individuals who participated in more than one program.
... Secondly, in order to display corporate social responsibility, corporations need to increase company accountability to enhance reputation among employees, suppliers and investors, which is also a favorable way to attract more investors, increase company confidentiality, stimulate their technological innovation, ensure the loyalty of talented employees to corporations, bring a great number of investment opportunities and intensify contradictions between competitors (McElhaney, 2009). A vivid example is from Johnson & Johnson Company (Goetzel et al., 2002). Johnson & Johnson Company saved approximately $250 million in investing in employee health care programs (Goetzel et al., 2002). ...
... A vivid example is from Johnson & Johnson Company (Goetzel et al., 2002). Johnson & Johnson Company saved approximately $250 million in investing in employee health care programs (Goetzel et al., 2002). This would report Johnson & Johnson as a high sense of responsibility for employees, which can not only enhance corporate image but also arouse the enthusiasm of employees. ...
Corporate social responsibility is becoming a very popular tool for companies in outlining their own strategies ( Stancu, Grigore, & Rosca, 2011 ). Different approaches have been developed to perform corporate social responsibility due to increased market competition. The purpose of this essay is to analyze the importance of carrying out corporate responsibility by demonstrating three different approaches: value creation, risk management, and corporate philanthropy. This will include a particular focus on the advantages and disadvantages of these approaches to extended performance reporting, followed by recommendations and suggestions with an emphasis on the importance of corporate social responsibility. Finally, with detailed analysis, it will be demonstrated that there is not a perfect approach which can meet all the requirements from companies. The approaches to Corporate Extended Performance Reporting for realizing corporate social responsibility still lack sophistication and maturity.
... This meta-analysis review found evidence suggesting that employer-based wellness initiatives may not only improve health, but may also result in substantial savings offering a promising avenue for improving employee physical health, well-being, and productivity. The preponderance of wellness program research literature indicates that leader choices that offer, support, and promote participation opportunities positively impact long-term employee physical health and well-being (Baicker et al., 2010;Goetzel et al., 2002;Gold et al., 2000;Gray, 2011;Heaney & Goetzel, 1997;Merrill, Aldana et al., 2011;Merrill, Anderson et al., 2011;Ozminkowski et al., 2000). ...
The philosophy of lean is creating value for the customer through organization-wide continuous improvement, reducing resource consumption (i.e., waste), and improving flow times across value stream processes while maintaining respect for people. Despite numerous studies identifying lean practice contributions to improvements in operating performance metrics, the body of literature devoting attention to the human aspect of lean reveals contradictory effects on the physical and mental health and well-being of employees. Stress management interventions (SMIs) have been shown to offer benefits for physical and mental health well-being. The objectives of this manuscript are to (1) identify the gap in the extant lean literature between the physical and mental health benefits of lean research, (2) review the relevant SMI research, and (3) utilize this review to identify and synthesize evidence-based actionable guidelines that advance transformational excellence with respect for people. These objectives proffer a significant contribution to the existing body of lean knowledge.
... The importance and effectiveness of follow-up management are well known from previous studies. In many studies, the risk factors for cardiocerebrovascular diseases, such as smoking, drinking, exercise, eating habits, blood pressure, and blood sugar, were improved in the group with specific follow-up management, compared to the group without it [5][6][7]. However, in the past studies in Korea, only 35.5% of people who needed a follow-up confirmation examination after the initial examination followed through with the confirmation examination [8]. ...
(1) Background: Follow-up management of workers’ general health examination (WGHE) is important, but it is not currently well done. Chatbot, a type of digital healthcare tool, is used in various medical fields but has never been developed for follow-up management of WGHE in Korea. (2) Methods: The database containing results and explanations related to WGHE was constructed. Then, the channel, which connects users with the database was created. A user survey regarding effectiveness was administered to 23 healthcare providers. Additionally, interviews on applicability for occupational health services were conducted with six nurses in the agency of occupational health management. (3) Results: Chatbot was implemented on a small scale on the Amazon cloud service (AWS) EC2 using KaKaoTalk and Web Chat as user channels. Regarding the effectiveness, 21 (91.30%) rated the need for chatbots as very high; however, 11 (47.83%) rated the usability as not high. Of the 23 participants, 14 (60.87%) expressed overall satisfaction. Nurses appreciated the chatbot program as a method for resolving accessibility and as an aid for explaining examination results and follow-up management. (4) Conclusions: The effectiveness of WGHE and the applicability in the occupational health service of the chatbot program for follow-up management can be confirmed.
... The nutrition that organizations provide to their employees is one example of a growing trend toward promoting healthy behaviors in workplace settings (e.g., employee wellness programs, lucrative benefits packages, access to gyms; Centers for Disease Control and Prevention 2017; Vardaman et al. 2016). These types of initiatives have demonstrable physiological benefits for employees (e.g., reduced blood pressure, lower cholesterol, increase health promotion behaviors; Goetzel et al. 2002; Task Force on Community Preventive Services 2007), which translates to financial benefits for organizations (e.g., decreasing healthcare and turnover costs and increasing productivity, employee morale, and company loyalty; Arnett et al. 2002;Berry et al. 2012;Goetzel and Ozminkowski 2008;Loeppke et al. 2009). However, the psychological mechanisms that may explain these effects have not been investigated. ...
Although providing employees with food options onsite is an increasingly common practice in contemporary workplaces, there is a relative lack of research that focuses on the psychological impact this food, and particularly the nutritiousness of this food, has on employees. In two complementary studies, we consider onsite cafeteria food nutrition in the context of social exchange theory and hypothesize that nutritious food acts as a signal of organizational support, which in turn predicts positive employee attitudes. In Study 1, participants randomly assigned to a hypothetical work situation in which relatively healthy food was provided in the onsite cafeteria reported higher perceived organizational support and, in turn, higher satisfaction and lower turnover intentions. In Study 2, we replicate this pattern in a sample of employees who reported on the nutritiousness of the food in their own workplace cafeterias. Furthermore, Study 2 included a measure of food nutrient characteristics, to complement mere perceptions of food healthiness. Together, these studies provide initial evidence that improved organizational cafeteria nutrition can be related to improved psychological attitudes among employees.
... However, to be effective, we must reach those who are overweight and don't naturally engage in exercise and those that suffer most from stress but don't engage in stress management. Many workplace health promotion studies, such as the well-known Johnson & Johnson Health & Wellness programme, used a design in which voluntary participants were compared before and after the intervention or participants were compared to nonparticipants [10]. In these studies, selection bias, i.e. selection of more favourable participants into the study, could explain the results. ...
... The solution to these significant barriers may lie in our engagement with additional stakeholders in workplace health. Companies continue to increase resources in order to improve employee health and wellbeing, as they increasingly understand the relationship between productivity and health status [108][109][110]. However, workplace health promotion programs are often not informed by evidence, and a recent review suggests that programs that are informed by research have more potential to yield positive results [111]. ...
Sedentary behaviour is associated with poor health outcomes, and office-based workers are at significant health risk, as they accumulate large proportions of their overall sitting time at work. The aim of this integrated systematic review was to collate and synthesize published research on sedentary behaviour interventions in the workplace that have reported on at least one an aspect of the reach, effectiveness, adoption, implementation, and maintenance (RE-AIM) framework. Studies were included if they involved adult office workers, were conducted in an office setting, and changes in sedentary behaviour had been measured as a primary outcome. Five electronic databases were searched yielding 7234 articles, with 75 articles (61 individual interventions) meeting the inclusion criteria. Reach indicators were the most frequently reported RE-AIM dimensions, which were reported on average 59% of the time. Efficacy/effectiveness was the second most reported dimension at 49% reporting across all of the indicators. Implementation indicators were reported an average of 44% of the time, with indicators of adoption and maintenance reported as the lowest of all indicators at 13% and 8%, respectively. Recommendations are provided to improve reporting across all RE-AIM dimensions, which is an important first step to enable the effective translation of interventions into real world settings.
... He concluded that the main reason for low growth in Europe is the inflexible labour market, which is linked with welfare cost 17 . Goetzel R. et al (2002) did a research on the long term impact of Johnson & Johnson's health & wellness program onemployee health risks they mainly did a study because they believed that corporate health promotion and disease prevention program can improve the employee's risk profile18 . ...
... L arge businesses, such as Johnson & Johnson and Texas Instruments, recognized as far back as the 1970s, that a healthy workforce offers a competitive advantage. 1,2 Fast forward to 2016, and an analysis of publicly traded companies showed that those companies that had exemplary health and safety programs outperformed the average Standard and Poor's 500 Index in terms of their stock price. 3 Health systems have additional goals than simply increasing shareholder returns, however. ...
Objectives:
To determine whether the CDC Worksite Health ScoreCard (ScoreCard) is an effective vehicle for measuring workplace health promotion programs and causing change in a large employer with multiple entities defined by different physical environments and types of workers.
Methods:
Johns Hopkins Medicine (JHM) representatives completed a baseline ScoreCard for each of their entities. In the subsequent year, improvement of the ScoreCard was tied to leadership performance evaluation. JHM year over year scores were analyzed, along with comparisons to national benchmarks.
Results:
Eleven of the 12 JHM entities improved their overall score from year one to year two and the JHM enterprise surpassed national benchmarks in year two.
Conclusions:
Organizations can use the ScoreCard as an effective measurement tool and as a method to improve the number of evidenced-based health promotion strategies provided to their employees.
... 26 The WM+ program was originally based on the employee health and wellness program offered at Johnson & Johnson. [27][28][29] This program has been offered at Duke for the past 15 years and is well established and supported within the institution. Participants in the WM+ program have (1) monthly meetings with a health coach (in person at months 1, 4, 8, and 12, and the rest via telephone), (2) optional meetings at months 2 and 5 with an exercise physiologist, (3) quarterly biometric feedback, (4) targeted health education materials, and (5) information and active linking with various Duke programs and wellness resources. ...
To present the short-term follow-up findings of the Steps to Health study, a randomized trial to evaluate the effectiveness of two employee weight management programs offered within Duke University and the Health System.
A total of 550 obese (body mass index, ≥30 kg/m) employees were randomized 1:1 between January 2011 and June 2012 to the education-based Weight Management (WM) or the WM+ arm, which focused on behavior modification. Employees were contacted to complete a follow-up visit approximately 14 months after baseline.
There were no clinically, or statistically, meaningful differences between arms, but there were modest reductions in body mass index, and positive, meaningful changes in diet and physical activity for both arms.
The modest positive effects observed in this study may suggest that to achieve weight loss through the workplace more intensive interventions may be required.
... type 2 diabetes or heart disease (Wolfe et al. 1994, PriceWaterhouseCooper 2007. Programs may be targeted at those at risk of developing or who already have conditions such as high blood pressure or high cholesterol levels (Goetzel et al. 2002) while other initiatives may be aimed at people who would like to improve their lifestyle habits in general (Aldana et al. 2005). ...
Research has shown that employee well-being is associated with a range of positive outcomes such as reduced stress and improved productivity. The aim of this study was to assess the awareness of Australian HR Managers of a broader range of concepts related to wellbeing and of the nature and prevalence of well-being programs in Australian organisations. An email invitation was sent to 3471 HR professionals in Australia of whom 319 responded to the online survey (9.2%). Findings indicate that Australian HR professionals offer a range of services related to emotional, intellectual, social and physical well-being, but only a minority include services related to spiritual well-being. Most respondents consider that the benefits of well-being programs outweigh the costs. However, the low response rate may suggest that many organisations do not yet recognise the importance of promoting well-being at work.
... 79 Based on our criteria in determining a promising practice (Table 1), we identified 17 studies 79-95 that evaluated the effectiveness of behavioral practices with incentives ( Table 2). With at least one study 82 in the greatest study design suitability and one limitation (Table 8), these studies [79][80][81][82][83][84][85][86][87][88][89][90][91][92][93][94][95] provide sufficient evidence that behavioral practices with incentives are promising in the worksite setting for the prevention and control of obesity as measured by change in weight. ...
Background: Obesity affects nearly 60 million adults in the United States. Obesity is linked to many co-morbid conditions resulting in increased health care costs. It is estimated that employers spend $13 billion annually on the total cost of obesity. To help employers respond to this epidemic, we identified promising worksite strategies for obesity prevention and control.
Methods: Using a methodology that closely parallels and broadens the Community Guide review process; we conducted a systematic review to identify worksite interventions addressing environmental and policy, informational and educational, and behavioral strategies. Our review included studies such as randomized control trials, before and after, time series, and other designs with concurrent comparison groups. Studies were evaluated based on suitability of study design, quality of execution, sample size, and effect size. Changes in weight-related outcomes were used to assess effectiveness.
Results: Six promising strategies were identified: 1) enhanced access to physical activity with health education: -3.24% (n=5 studies) 2) exercise prescription alone: -2.45% (n=14 studies) 3) multi-component educational interventions which incorporated exercise prescriptions, nutrition prescriptions, and/or small media in addition to health education sessions: -2.24% (n=25 studies) 4) weight-loss competitions: -2.66% (n=17 studies) 5) behavioral strategies with incentives: -3.46% (n=17 studies) 6) behavioral strategies without incentive: -1.89% (n=46 studies)
Conclusion: These promising strategies can help employers build effective interventions for their employees. Our review allows us to identify research gaps and acknowledges the need for further evaluation of promising worksite strategies for obesity prevention and control.
... 27 Therefore, and despite the trend away from randomized controlled workplace trials over the past 30 years), 27,47,48 highquality observational studies such as ours can track both employee health status and employer health care expenditures over extended periods. 49,50 We add further evidence for the effectiveness of such comprehensive programs. 51 The fact that, in the 12 months after cessation of this program, hospitalization rates returned to their former levels after cessation of the program, and PMPM claims costs jumped 8.3%, raises the issue that an intensive, proactive employee wellness program is only effective while operational, and does not have a sustaining effect after program cessation. ...
Objective:
A 12-month wellness program was provided for employees of a major employer in the Orlando area.
Methods:
The program involved screening and measurement of baseline indices, educational sessions, telephonic support, quarterly laboratory monitoring, and provision of glucometers and test strips.
Results:
For the 73 enrolled employees with prediabetes, serum hemoglobin A1c levels-mean (standard deviation)-decreased from 6.10% (0.53%) to 5.42% (0.51%) (P < 0.0001). For the 151 enrolled employees with diabetes, mean serum hemoglobin A1c levels-mean (standard deviation)-decreased from 8.03% (1.91%) to 7.48% (1.52%) (P < 0.0001). In the 12 months before, during, and after the program, 27, 15, and 27 diabetic employees required hospitalization, respectively. Health insurance per member per month claims costs for employees with diabetes rose only 1.2% over the prior 12 months, and self-reported presenteeism increased (P < 0.0001).
Conclusions:
This employer-endorsed program achieved favorable outcomes for employees with prediabetes and diabetes.
... The same kind of analysis can be done at company level considering that non-perfect health status (e.g. having a chronic condition or being obese) has been demonstrated to produce the following direct cash and opportunity costs for companies: a) increased costs for health insurance (in those countries where employers pay all or part of this insurance); b) productivity loss due to absenteeism and presenteeism; c) lower average productivity as reflected by wages due to lower capacities [122][123][124][125][126][127][128][129][130][131][132][133][134][135][136][137][138][139][140][141]. Even from this perspective there are large gains to be obtained through public health intervention and also through health promotion programmes for employees directly financed by the employers. ...
... Ello va asociado a un aumento del costo del examen, sin embargo, debería considerarse el costo a largo plazo. Al respecto, está demostrado el costo-beneficio de los programas de promoción y prevención de la salud a largo plazo (7,8,9,10). Otra ventaja es que el examen médico pre-ocupacional puede aportar información sobre las necesidades de salud del postulante, mejorando la relación trabajador-empresa. ...
... En la literatura se encuentra relación directa entre el status de riesgo y los costos de salud, es decir aquellos trabajadores con mayores riesgos de salud presentarían mayores costos de salud (4,7,8,9). En nuestro país no se encuentra una investigación similar. ...
Objetivo: Hallar la relación entre Factores de Riesgo de Salud (FRS) y costos médicos directos en una población trabajadora peruana. Materiales y Métodos: Se realizó un estudio en una población de trabajadores del área de minería; se incluyeron a todos los trabajadores que habían realizado el examen médico anual 2003. Se utilizó la herramienta de valoración de estado de salud (HRA) del servicio de Medicina Ocupacional donde se atienden los trabajadores, en el cual se consignan datos generales y además se evalúan 7 FRS: 1. Consumo de tabaco; 2. Consumo de alcohol; 3.Presión arterial >125/90; 4.Glucosa en sangre >110; 5.Colesterol > 240; 6. Indice de masa corporal (IMC)>25 y 7. Diagnóstico y prescripción de medicamentos durante el año de estudio para ansiedad o depresión. Se relacionaron los costos médicos directos promedios anuales con el número de FRS, además de comparar los costos y la presencia o no de FRS específico. El análisis estadístico se realizó con un modelo multivariado usando regresión lineal. Resultados: En el análisis se encontró a una asociación positiva con la edad, tiempo de trabajo en la empresa, presencia de FRS y número de FRS con mayores costos médicos directos. Conclusión: En esta población trabajadora peruana el número de factores de riesgo de salud correlaciona directamente con mayores costos directos de salud (Rev Med Hered 2006;17:90-95).
... If the employee was below the threshold for the risk factor, they were given a score of zero. The risk factors and threshold included in the calculation for total risk included age (≥ 45 years for men and ≥ 55 years for women), having a Body Mass Index (BMI) more than 24.9 kg/m 2 [20], blood pressure greater than 140/90 mmHg [21], and a total cholesterol reading greater than 5.2 mmol/l [22]. Lifestyle behaviors for risk classification included consuming less than five servings of fruit and vegetables [23] per day and being a smoker [24]. ...
The global increase in the prevalence of NCD's is accompanied by an increase in risk factors for these diseases such as insufficient physical activity and poor nutritional habits. The main aims of this research study were to determine the extent to which insufficient physical activity (PA) clustered with other risk factors for non-communicable disease (NCD) in employed persons undergoing health risk assessment, and whether these risk factors were associated with higher healthcare costs.
Employees from 68 companies voluntarily participated in worksite wellness days, that included an assessment of self-reported health behaviors and clinical measures, such as: blood pressure (BP), Body Mass Index (BMI), as well as total cholesterol concentrations from capillary blood samples. A risk-related age, 'Vitality Risk Age' was calculated for each participant using an algorithm that incorporated multiplicative pooled relative risks for all cause mortality associated with smoking, PA, fruit and vegetable intake, BMI, BP and cholesterol concentration. Healthcare cost data were obtained for employees (n = 2789).
Participants were 36 +/- 10 years old and the most prevalent risk factors were insufficient PA (67%) and BMI >= 25 (62%). Employees who were insufficiently active also had a greater number of other NCD risk factors, compared to those meeting PA recommendations (chi2 = 43.55; p < 0.0001). Moreover, employees meeting PA guidelines had significantly fewer visits to their family doctor (GP) (2.5 versus 3.11; p < 0.001) than those who were insufficiently PA, which was associated with an average cost saving of ZAR100 per year (p < 0.01). Furthermore, for every additional year that the 'Vitality Risk Age' was greater than chronological age, there was a 3% increased likelihood of at least one additional visit to the doctor (OR = 1.03; 95% CI = 1.01 - 1.05).
Physical inactivity was associated with clustering of risk factors for NCD in SA employees. Employees with lower BMI, better self-reported health status and readiness to change were more likely to meet the PA guidelines. These employees might therefore benefit from physical activity intervention programs that could result in improved risk profile and reduced healthcare expenditure.
... Employees complete specific requirements and goals within each option in order to earn their rebate payment (Hand, 2009). Johnson and Johnson's Health and Wellness Program targets health habit improvements, early disease detection, and chronic disease management and provides a $500 medical benefit plan credit to participants (Goetzel et al., 2002). ...
This article presents evidence on the effectiveness of worksite health promotion programs and the correspondingly low participation rates in such programs. To address this gap, Boyatzis's Intentional Change Theory (ICT) is offered as an integrative theory for increasing good health practices. Generally accepted health promotion guidelines are applied to each of the five discoveries of ICT to assist employees in finding their own fit with fitness and thus increase their individual participation in health promotion. To explain the differing contexts for ICT engagement, complexity theory is used to contrast the Positive Emotional Attractor (PEA) and the Negative Emotional Attractor (NEA). The physiological changes that occur when people are in either the PEA or NEA condition are also identified. Last, the elements of each condition are examined, the health promotion applications for each of ICT's five discoveries are summarized, and specific employee actions for each discovery that ignite sustained, desired change are identified.
The purpose of this article is to conceptualize a novel theoretical occurrence—team physical activity (PA)—and its relevance for researchers and organizations. By building a testable model of the consequences and contingencies of team PA, we integrate the science of teamwork with the scholarly domain of employee health and well-being. Hence, we clarify the construct of team PA, present a three-dimensional typology, and outline a model drawing on neuroscience, positive organizational behavior, and teams research. Our propositions and subsequent discussion proffer an outline of potential benefits for organizations when they increase the utility and frequency of team PA. We also suggest ways in which researchers can advance scholarship in this area.
Objective:
To determine if scientifically based social network (Facebook) lifestyle interventions reduce 10-year cardiovascular disease (CVD) risk.
Methods:
Financial sector employees (n = 300) were equally randomly assigned: Facebook plus Health Professionals (FB+HP), Facebook (FB), or control (C). We report changes in 10-year Framingham risk score (FRS) for CVD (%) and risk factors over 12 months.
Results:
FRS did not change within and between groups. Overweight (-7.4% vs -5.6%, P = 0.005) and diabetes risk (-10.7% vs 0.2%, P = 0.011) reduced significantly in FB+HP versus FB and C, respectively. Inadequate fruit/vegetable intake (-9.4% vs 3.6%, P = 0.011) and smoking (-0.7% vs 14.9%) reduced significantly in FB versus C. No significant changes in physical activity, central obesity, hypertension, and hypercholesterolemia between groups.
Conclusions:
Scientifically based social network lifestyle intervention programs could be included in workplace health promotional programmes to improve certain non-communicable disease risk factors.
Objectives:
The aim of this study was to understand the relationship between employees' perception of work load, group interactional quality, and their effects on employee's psychological strain (need for recovery after work and fatigue) and job accidents.
Methods:
Questionnaire was used to collect data form 401 employees in the transport service industry in Taiwan.
Results:
(1) Workload was positively related with need for recovery after work; (2) Group interaction quality was negatively related with need for recovery after work; (3) Need for recovery after work was positively related with fatigue; (4) Fatigue was positively related with job accidents.
Conclusions:
The findings highlight the importance for organizations to provide adequate work design and build a supportive working environment, which may ultimately contribute to decreased psychological strain and fewer job accidents.
Employee's safety has become the most vital concern for the organization in the present technological complex work environment. Business organizations have to provide benefits to its employees so as to their concerned safety and welfare facilities. In fact it is not possible to smoothly function an organization without offering safety and welfare needs of the employees. The overall research objective was to analyze the work place safety and welfare scheme of some selected pharmaceutical organization located in Uttarakhand and assess whether these practices help organization in motivating the employee for greater retention. Structured questionnaire covering different dimension of safety and welfare practices was prepared on the basis of review of secondary literatures. Results indicate the following: Safety Training and Awareness measures, Work Place Safety, Social Security and welfare, Sanitation condition and Medical facility had an impact on employee retention. The present study also contributed to the current understanding of how the six factors(Safety preparing and Awareness measures, Work Place Safety, Working Environment and condition, Social Security and welfare, Sanitation condition and Medical office) out of 32 distinguished elements of wellbeing and welfare rehearses are the most affecting components prompting worker inspiration and maintenance. From relapse model, the investigation set up that Safety preparing and Awareness measures, Work Place Safety and Social Security and welfare had solid positive effect on worker maintenance when contrasted with different practices. It was likewise reasoned that worker security and welfare rehearses have the noteworthy impact on representative inspiration and maintenance while working condition and condition and medicinal office demonstrated a powerless effect on representative maintenance.
Background:
Attending work when sick for fear of losing the job is common among workers. Presenteeism is a rising problem, which has called the attention of researchers from different fields; being difficult to notice, it also raised concerns among managers.
Objective:
To establish the prevalence of presenteeism at a food industrial company.
Method:
Cross-sectional epidemiological study conducted with 1,224 workers, with application of Stanford Presenteeism Scale (SPS-6) as method to investigate presenteeism.
Results:
Presenteeism was adopted by 30.6% of the analyzed workers along the previous 12 months. The prevalence of presenteeism detected through SPS-6 was 50.9% for the full sample. Significant association was found between presenteeism and sedentarism, overweight and some self-reported symptoms.
Conclusion:
The detected high prevalence of presenteeism and its association with sedentary lifestyle and musculoskeletal symptoms confirm the relevance of presenteeism and its negative impact on the health of workers.
Health promotion at the worksite has become increasingly more popular and these programs are sometime also called “workplace health programs” or “worksite wellness programs” or “workplace wellness programs”. These workplace health promotion initiatives can help to improve the health of employees and, correspondingly, healthy employees are thought to be more productive and have less absenteeism. It is believed that this program facilitate to create a culture of health. Historically, worksite health promotion has focused on promoting worker health through reduction of risk-related behaviors and lack of exercise. This may be coordinated with Employee Assistance Programs (EAP), clinical prevention services, or disease management programs, etc.
A 2012 American Association of Occupational Health Nurses, Inc. (AAOHN) web-based membership survey of 5,138 members was designed to identify occupational health and safety issues facing members. A total of 2,123 members responded to the survey (41% response rate). Of the AAOHN members who responded to this survey, 61% reported health risk appraisal (HRA) priorities for 2012. HRA priority areas are identified among various subgroups of the AAOHN responders in this article. The top three HRA priority areas identified were weight management/nutrition/healthy eating, physical activity, and mental health/stress management. These priority areas were consistent across three industry sectors, three occupational health nurse job titles, and the smallest and largest employers. These results suggest that occupational health nurses should consider prioritizing their employee wellness efforts in these areas.
Occupational health nurses use their knowledge and skills to improve the health and safety of the working population; however, companies increasingly face budget constraints and may eliminate health and safety programs. Occupational health nurses must be prepared to document their services and outcomes, and use quantitative tools to demonstrate their value to employers. The aim of this project was to create and pilot test a quantitative tool for occupational health nurses to track their activities and potential cost savings for on-site occupational health nursing services. Tool development included a pilot test in which semi-structured interviews with occupational health and safety leaders were conducted to identify current issues and products used for estimating the value of occupational health nursing services. The outcome was the creation of a tool that estimates the economic value of occupational health nursing services. The feasibility and potential value of this tool is described.
Chronic disease rates have become more prevalent in the modern American workforce, which has negative implications for workplace productivity and healthcare costs. Offering workplace health interventions is recognized as an effective strategy to reduce chronic disease progression, absenteeism, and healthcare costs as well as improve population health. This review documents intervention and evaluation strategies used for health promotion programs delivered in workplaces. Using predetermined search terms in 5 online databases, we identified 1,131 published items from 1995 to 2014. Of these items, 27 peer-reviewed articles met the inclusion criteria; reporting data from completed U.S.-based workplace interventions that recruited at-risk employees based on their disease or disease-related risk factors. A content rubric was developed and used to catalogue these 27 published field studies. Selected workplace interventions targeted obesity (n=13), cardiovascular diseases (n=8), and diabetes (n=6). Intervention strategies included instructional education/counseling (n=20), workplace environmental change (n=6), physical activity (n=10), utilization of technology (n=10), and incentives (n=13). Self-reported data (n=21), anthropometric measurements (n=17), and laboratory tests (n=14) were utilized most often in studies with outcome evaluation. This is the first literature review to focus on interventions for employees with elevated risk for chronic diseases. The review has the potential to inform future workplace health interventions by presenting strategies related to implementation and evaluation strategies in workplace settings. These strategies can help determine optimal worksite health programs based on the unique characteristics of work settings and the health risk factors of their employee populations.
As workplaces become sites where health issues are addressed, organizations have an ever-increasing presence in the personal lives of workers. The purpose of this chapter is to illustrate how workplace health promotions (WHPs) violate four types of boundaries: (a) cultural, (b) privacy, (c) confidentiality, and (d) ethical, all of which are managed through communication. We apply Petronio’s (2002) communication privacy management theory to frame health-related boundary negotiations between employee and employer. This chapter concludes with a call for more research on WHPs from interpretive, critical, feminist, and postcolonial approaches.
The health care system in the United States is in crisis, and the implications for businesses and their employees are profound. As employers struggle with unrelenting double-digit health-insurance cost increases, some firms have decided to drop coverage entirely, and many others have shifted costs to employees. Meanwhile, the quality of the health care being paid for by companies and their workers remains highly uneven. On its own, business cannot solve the health care crisis in all its aspects, but that doesn't mean it can't do a lot to improve the system. Some companies are taking more active control over the issue and getting better results on both cost and quality. To learn from such companies and from those who influence and deliver health care services, the authors conducted in-depth interviews with thought leaders in business, health care and related sectors. The overriding lesson from their research: Companies must build bridges to other players in the system to address the systemic problems that transcend even the most powerful corporations. They propose a partnership-based health care agenda for business that will benefit not only companies and employees but also health care overall by strengthening the market mechanism and encouraging fruitful collaboration.
Purpose
– The purpose of this paper is to examine the literature assessing the return-on-investment (ROI) of healthy workplace programs.
Design/methodology/approach
– Used a narrative review to summarize and evaluate findings.
Findings
– Although substantial ROI data now exist, methodological and logical weaknesses limit the conclusions that can be drawn.
Practical implications
– A strategy for monetizing the benefits of healthy workplaces that draws on both human resource accounting and strategic human resource management is described.
Social implications
– The promotion of healthy workplaces is an important goal in its own right. To the extent that ROI estimates are important in advancing this goal, these estimates should be based on clear logic and strong methodology.
Originality/value
– The paper suggests the need for stronger research designs but also note the difficulties in monetizing outcomes of the healthy workplace.
The Center for Healthcare Research & Transformation (CHRT) sponsors research and public information to promote evidence-based care delivery, improve population health, and expand access to care. Housed at the University of Michigan, CHRT is a nonprofit partnership between U-M and Blue Cross Blue Shield of Michigan to test the best ideas for improving the effectiveness and efficiency of the health care system. mericans obtain health insurance coverage in a variety of ways, but most do so through their employer. As a result, it is in the interest of employers to promote a healthy, productive workforce as well as to moderate health care spending. Recently, many employers that provide health insurance coverage have turned to wellness programs to try to achieve both goals. Indeed, the percentage of firms of any size offering at least one wellness program grew from 58 percent in 2009 to 77 percent in 2013. 1, 2 The Patient Protection and Affordable Care Act (ACA) also includes several provisions to further encourage small and large employers to offer such programs.
Occupational health nurses use their knowledge and skills to improve the health and safety of the working population; however, companies increasingly face budget constraints and may eliminate health and safety programs. Occupational health nurses must be prepared to document their services and outcomes, and use quantitative tools to demonstrate their value to employers. The aim of this project was to create and pilot test a quantitative tool for occupational health nurses to track their activities and potential cost savings for on-site occupational health nursing services. Tool developments included a pilot test in which semi-structured interviews with occupational health and safety leaders were conducted to identify currents issues and products used for estimating the value of occupational health nursing services. The outcome was the creation of a tool that estimates the economic value of occupational health nursing services. The feasibility and potential value of this tool is described.
Background: The utility of employee wellness programs (EWPs) in cancer prevention and control is not well established. Purpose: This project is to determine the potential value of EWPs in preventing cancer by examining the characteristics of EWP participants and their prevalence of cancer risk factors. Methods: A secondary data analysis of health risk assessment (HRA) participants' data in the 2009 Kansas state EWP. Results: Among the 60,006 eligible participants, 9,202 (15.3%) completed an HRA. The prevalence of cancer risk factors were 59.7% for family cancer history, 7.7% for smoking, and 69.7% for overweight or obesity. Non-adherence rates in colorectal cancer screening, breast cancer screening, and cervical cancer screening were 28%, 12.2%, and 12.6%, respectively. Discussion: Overall, 94.4% of all HRA participants had at least one cancer risk factor. The majority of HRA participants were at risk for cancer, indicating the potential high impact of EWP-based cancer prevention programs. However, the low HRA participation rate and related self-selection bias of healthy workers severely undermines the utility of EWPs in cancer prevention. Translation to Health Education Practice: More health education and intervention programs should be implemented in employee communities to promote higher HRA participation rates to reduce this bias and realize the full potential impact of EWPs.
The cost of health care and the rate of uninsurance in the United States continue to rise as American firms struggle to contain the cost of health coverage. Workplace Wellness programs may be a way to mitigate the rising cost of insurance by improving employee health, reducing demand for medical services, lowering the cost of insurance for firms, and by decreasing the cash firms lose to unhealthy employees by increasing productivity and reducing absenteeism. This paper assesses the potential benefits of Workplace Wellness Programs by presenting the shortcomings as well as the potential impact of current evaluation literature given programs such as Healthy Workforce 2010, and gives recommendations for producing statistically rigorous research to make HHS advice more applicable to a broader range of firms. Rachel Silberman is a second year masters student at the LBJ School of Public Affairs and Co-Editor in Chief of the LBJ Journal. She is an alumnus of Skidmore College in upstate New York, and taught fourth and fifth grade in Edinburg, Texas with Teach For America. Rachel is especially interested in quantitative and economic analysis. Her policy interests include local economic development, health care, and education.
Objective:
To determine the relationship between the availability of wellness facilities at worksites and self-reported employee health behaviors (physical activity [PA] and nutrition [NUT]).
Methods:
Employers (n = 71) and employees (n = 11472) participated in the South African Healthy Company Index survey. The survey included self-reported clinical measures and lifestyle behaviors. A facility score was calculated, ranging from 0 to 100. Hierarchical linear models were used to calculate the relationship between facility scores and whether employees met PA and NUT guidelines.
Results:
The mean total facility score was 58.5 ± 25.5. The number of facilities at each worksite accounted for 5.4% of the variance in PA among employees (r = 0.054; P = 0.036). Higher facility scores were associated with better NUT habits among employees.
Conclusions:
Employers providing wellness facilities are likely to have employees with better PA and NUT habits.
We leverage conservation of resources theory to explain possible dynamics through which a holistic wellness program results in positive longer-term outcomes. Specifically, we hypothesize that wellness self-efficacy at the end of a wellness program will create a positive resource gain spiral, increasing psychological availability (a sense of having cognitive, physical, and emotional resources to engage oneself) 6 months later, and career satisfaction, 1 year later. To test these hypotheses, using a time-lagged with control group design, we gathered questionnaire data from 160 Episcopal priests who participated in a 10-day off-site wellness program. We developed a scale measuring self-efficacy in the 4 wellness areas the program was designed to improve: physical, spiritual, financial, and vocational. Our findings provide evidence from a field setting of a relatively untested tenet of conservation of resources theory, resource gain spirals. The wellness program that we studied served as an opportunity for participants to gain new resources in the form of wellness self-efficacy, which in turn helped participants experience positive outcomes over time. We discuss theoretical and practical implications of the findings. (PsycINFO Database Record (c) 2014 APA, all rights reserved).
Purpose
– The leadership lifestyle lived by academic leaders is characterized by fast pace, high responsibility, and little personal time. This lifestyle may be unattractive for professionals seeking high-level academic leadership positions. The purpose of this paper is to discover the meaning of wellness for leaders in higher education and better understand how they achieve and maintain wellness in their lives.
Design/methodology/approach
– This study used a qualitative methodology and specifically a grounded theory approach. Grounded theory was the chosen methodological approach due to its applicability to academic and non-academic audiences as well as its ability to better understanding the processes associated with certain phenomenon such as wellness.
Findings
– The results yielded a grounded theory called wellness maturity with four supporting axial categories: intention, gauge of wellness, reflection, and adaptation. Wellness maturity, depicted as a continuum, represents an optimal wellness destination with constant movement toward the destination for each leader.
Practical implications
– The results of this study offer greater insight into practical applications and considerations necessary for the achievement or maintenance of wellness while working in a higher education environment.
Originality/value
– This is critical as the future of higher education suggests a large number of vacancies of leadership posts. With the increasing pressures for administrators, the need to create a desirable and attractive climate for potential leaders is necessary.
To determine the ability of the Health Enhancement Research Organization (HERO) Scorecard to predict changes in health care expenditures.
Individual employee health care insurance claims data for 33 organizations completing the HERO Scorecard from 2009 to 2011 were linked to employer responses to the Scorecard. Organizations were dichotomized into "high" versus "low" scoring groups and health care cost trends were compared. A secondary analysis examined the tool's ability to predict health risk trends.
"High" scorers experienced significant reductions in inflation-adjusted health care costs (averaging an annual trend of -1.6% over 3 years) compared with "low" scorers whose cost trend remained stable. The risk analysis was inconclusive because of the small number of employers scoring "low."
The HERO Scorecard predicts health care cost trends among employers. More research is needed to determine how well it predicts health risk trends for employees.
In an effort to reduce the rising costs of health care many local governments are turning to alternative and innovative strategies to mitigate the problem. One solution has been to offer a wellness program for employees. The article reviews the research on employee assistance programs and differentiates between them and the current wellness programs that are in place today. Wellness programs have proved to be cost effective and the return on investment has been well worth the initial cost. A recent study is reviewed to show the current profile of wellness programs in the Dallas-Fort Worth Metroplex. More local governments in this area have initiated wellness programs and the results so far have been encouraging. The article argues that, though wellness programs at the local level of government are not new, they have been repackaged as a positive alternative to reduce costs. A win/win situation arises for the public employee when their health is promoted and they are being productive stewards of tax payer dollars.
Educating employees on health risks and related behavior has always been a company’s challenge. Convincing them to adopt the company’s health strategies is long, difficult and culturally sensitive. As some health risks are emerging or re-emerging, such as pandemics, vector borne diseases or HIV, fortunately employee self-education has never been as much a trend as shown by the frantic use of wikis, blogs or Google®. Some companies have understood that new web-based technology allow them to develop tools to raise employees awareness of risk exposure and management.
In the context of a pandemic, a company's ability to limit infections within the workplace would depend on the cooperation of all staff and their adherence to plans. Similarly, employees working in malaria endemic areas would need to understand the rationale for chemoprophylaxis and mosquito bite prevention. This basically all relies upon the understanding of the risk and the personal feeling of responsibility.
We present how Employee Education and Awareness Packages allow companies to meet their duty of care by ensuring that every targeted / exposed group has benefited from the same health education commitments quickly and effectively.
Online Learning Courses are accessible via the web or the company HSE intranet. Some are used as a stand-alone campaign or integrated into a regular schedule of staff training. They usually consist of several lessons, downloadable summaries, and test questions. An online manager can achieve traceability of training through the administration of courses.
The purpose of this paper is to review the effectiveness and the benefits of this promising type of interventions in the field of pandemic preparedness and malaria education. The objective is to see how it can fit into a holistic learning environment among other traditional employee education strategies.
Health and Wellness continues the vision to optimize the health, well-being, and productivity of Johnson & Johnson employees. The mission is simple: we will deliver leading-edge, best-value health and wellness service that achieve excellence in customer satisfaction and promote prevention, education, and self-responsibility. Investing in our employee's health and well-being is justified by our conviction that one of Johnson & Johnson's most important competitive advantages is the quality of our people and their organizational capability. Given enough time and effort, others can mimic or duplicate our products or design around our patents. We believe it is far more difficult to duplicate our organizational strength and the potential of our healthy employees.
Purpose. To assess the relationship between modifiable health risks and total health care expenditures for a large employee group. Design. Risk data were collected through voluntary participation in health risk assessment (HRA) and worksite biometric screenings and were linked at the individual level to health care plan enrollment and expenditure data from employers' fee-for-service plans over the 6-year study period. Setting. The setting was worksite health promotion programs sponsored by six large private-sector and public-sector employers. Subjects. Of the 50% of employees who completed the HRA, 46,026 (74.7%) met all inclusion criteria for the analysis. Measures. Eleven risk factors (exercise, alcohol use, eating current and former tobacco use, depression, stress, blood pressure, cholesterol, weight, and blood glucose) were dichotomized into high-risk and lower-risk levels. The association between risks and expenditures was estimated using a two-part regression model, controlling for demographics and other confounders. Risk prevalence data were used to estimate group-level impact of risks on expenditures. Results. Risk factors were associated with 25% of total expenditures. Stress was the most costly factor, with tobacco use, overweight, and lack of exercise also being linked to substantial expenditures. Conclusions. Modifiable risk factors contribute substantially to overall health care expenditures. Health promotion programs that reduce these risks may be beneficial for employers in controlling health care costs.
We need effective ways of getting adults to exercise if we are to meet the Surgeon General's 1990 health goals for the nation. This study reports a comprehensive effort to evaluate the sustained effect of a public health intervention model to achieve these health goals. Employees at four companies (N=2,600) were exposed to a health promotion program, while employees at three comparison companies (N=1,700) were offered an annual health screen. Daily energy expenditure in vigorous activity increased 104% among employees at companies offering the health promotion program, compared with a 33% increase among employees at comparison companies. Changes in exercise habits were corroborated by estimates of maximal oxygen uptake. Exercise and physical fitness improvements were distributed throughout the work force. Meaningful population changes in exercise and physical fitness can be produced at the work site and are of a magnitude that makes it possible to meet the 1990 goals for exercise and physical fitness.
(JAMA 1986;255:921-926)
This study explores the relationship between exposure to a comprehensive worksite health promotion program and health care costs and utilization. The experience of two groups of Johnson & Johnson employees (N=5192 and N=3259) exposed to Live for Life, a comprehensive program of health screens, life-style improvement programs, and worksite changes to support healthier life-styles, was compared with that of a control group (N=2955) over a five-year period. To account for baseline differences, analyses of covariance produced adjusted means for inpatient hospital costs, admissions, hospital days, outpatient costs, and other health costs. Mean annual inpatient cost increases were $43 and $42 for two Live for Life groups vs $76 for the non-Live for Life group. Live for Life groups also had lower rates of increase in hospital days and admissions. No significant differences were found for outpatient or other health care costs.(JAMA 1986;256:3235-3240)
A 2-year study was conducted to evaluate the effect of a health promotion program on the work-related attitudes of employees. The study employed a quasi-experimental design with nonequivalent control groups. The change in employee attitudes at companies that participated in the program was significantly greater and more favorable than that found at nonparticipating companies. Significant change was found on attitudes toward organizational commitment, supervision, working conditions, job competence, pay and fringe benefits, and job security.
This paper reports on a study of the absenteeism experience of two groups of Johnson & Johnson employees over a 3-year period. Employees at four company sites (n = 1406) where LIVE FOR LIFE, a comprehensive health promotion program, had been introduced, were compared with employees at five company sites (n = 487) without the health promotion program. Analyses of covariance were employed to control for differences between the two study groups with respect to age, gender, job classification (wage or salaried), as well as baseline levels of absenteeism. Adjusted mean levels of absenteeism among wage earners in the LIVE FOR LIFE groups were found to decline over the study period, and were significantly lower (P less than .01) than mean levels for the non-LIVE FOR LIFE wage employees in the final year of the study. No significant differences were found for salaried personnel.
Worksite health promotion, a rapidly growing form of preventive health service, may include health risk appraisal with communication of findings to the individuals tested. It may also assist in achieving and maintaining physical and mental fitness, controlling alcohol use, avoiding or quitting tobacco and other drugs, and otherwise maintaining health protective habits, while providing opportunities to control high blood pressure, and reduce elevated blood cholesterol, obesity, and other health hazards. This article presents a synopsis of the evolution of that movement and reviews the experience of one industrial firm that has endeavored to document and evaluate its effort. Such a review may be helpful in consolidating the various findings to date and in indicating the complexity of assessing the health and economic consequences of such an endeavor in private companies.
Smoking-cessation programs at the worksite hold the potential to reduce the national prevalence of smoking. This article presents the 2-year results of a broad-spectrum smoking-cessation initiative that was part of the comprehensive Johnson & Johnson LIVE FOR LIFE wellness program. In a quasi-experimental design, four companies offered the complete LIVE FOR LIFE program to their employees, and three comparison companies offered only annual health screen assessments. Smoking status was assessed by self-report and serum thiocyanate at baseline and at a 2-year follow-up. At the LIVE FOR LIFE companies, 22.6% of all smokers quit versus 17.4% of smokers at the health screen only companies. The LIVE FOR LIFE program was particularly effective with smokers at high risk for coronary heart disease: 32% of all high-risk smokers quit at the LIVE FOR LIFE companies versus 12.9% at the health screen only companies. These results demonstrate that a company-wide smoking-cessation initiative can produce significant changes in smoking behavior.
This study explores the relationship between exposure to a comprehensive worksite health promotion program and health care costs and utilization. The experience of two groups of Johnson & Johnson employees (N = 5192 and N = 3259) exposed to Live for Life, a comprehensive program of health screens, life-style improvement programs, and worksite changes to support healthier life-styles, was compared with that of a control group (N = 2955) over a five-year period. To account for baseline differences, analyses of covariance produced adjusted means for inpatient hospital costs, admissions, hospital days, outpatient costs, and other health costs. Mean annual inpatient cost increases were $43 and $42 for two Live for Life groups vs $76 for the non-Live for Life group. Live for Life groups also had lower rates of increase in hospital days and admissions. No significant differences were found for outpatient or other health care costs.
We need effective ways of getting adults to exercise if we are to meet the Surgeon General's 1990 health goals for the nation. This study reports a comprehensive effort to evaluate the sustained effect of a public health intervention model to achieve these health goals. Employees at four companies (N = 2,600) were exposed to a health promotion program, while employees at three comparison companies (N = 1,700) were offered an annual health screen. Daily energy expenditure in vigorous activity increased 104% among employees at companies offering the health promotion program, compared with a 33% increase among employees at comparison companies. Changes in exercise habits were corroborated by estimates of maximal oxygen uptake. Exercise and physical fitness improvements were distributed throughout the work force. Meaningful population changes in exercise and physical fitness can be produced at the work site and are of a magnitude that makes it possible to meet the 1990 goals for exercise and physical fitness.
This investigation estimates the impact of ten modifiable health risk behaviors and measures and their impact on health care expenditures, controlling for other measured risk and demographic factors. Retrospective two-stage multivariate analyses, including logistic and linear regression models, were used to follow up 46,026 employees from six large health care purchasers for up to 3 years after they completed an initial health risk appraisal. These participants contributed 113,963 person-years of experience. Results show that employees at high risk for poor health outcomes had significantly higher expenditures than did subjects at lower risk in seven of ten risk categories: those who reported themselves as depressed (70% higher expenditures), at high stress (46%), with high blood glucose levels (35%), at extremely high or low body weight (21%), former (20%) and current (14%) tobacco users, with high blood pressure (12%), and with sedentary lifestyle (10%). These same risk factors were found to be associated with a higher likelihood of having extremely high (outlier) expenditures. Employees with multiple risk profiles for specific disease outcomes had higher expenditures than did those without these profiles for the following diseases: heart disease (228% higher expenditures), psychosocial problems (147%), and stroke (85%). Compared with prior studies, the results provide more precise estimates of the incremental medical expenditures associated with common modifiable risk factors after we controlled for multiple risk conditions and demographic confounders. The authors conclude that common modifiable health risks are associated with short-term increases in the likelihood of incurring health expenditures and in the magnitude of those expenditures.
Purpose:
The purpose of this article is to critically review evaluation studies of the health-related effects (i.e., health risk modification and reduction in worker absenteeism) of multicomponent worksite health promotion programs.
Search method:
A comprehensive literature search conducted under the auspices of the Centers for Disease Control and Prevention identified 36 articles that examined health-related outcomes of multi-component programs. The authors identified 11 additional articles through manual searches of recent journal issues and through personal contacts with worksite health promotion researchers. Forty-seven studies describing the results of 35 worksite health promotion programs were reviewed.
Important findings:
The worksite health promotion programs reviewed for this article varied tremendously in the comprehensiveness, intensity, and duration of the intervention activities. All of the programs provided health education to employees. In a majority of the programs, opportunities to learn and practice new skills were also offered. A smaller number of programs incorporated modifications in organizational policy or the physical work environment. Results from well-conducted randomized trials suggest that providing opportunities for individual risk reduction counseling for high risk employees within the context of comprehensive programming may be the critical component of an effective worksite health promotion program. Just offering low intensity, short duration programs aimed at increasing awareness of health issues for the entire employee population may not be sufficient to achieve desired outcomes.
Major conclusions:
The results of the studies reviewed provide both cautious optimism about the effectiveness of these worksite programs and some general guidance as to the critical components and characteristics of successful programs. Overall, the evidence suggests that a rating of indicative/acceptable may best characterize this literature.
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.
Evaluate the long-term impact of telephone-based interventions that target high risk, ready-to-change individuals.
Quasi-experimental design with pre/post comparisons of lifestyle-related health risks between participants and nonparticipants.
Six organizations from the private and public sectors.
Subjects were 607 intervention participants who were compared with a control group of 1134 eligible nonparticipants.
Health risk assessment at baseline and at an average of 2 years later measured risk in 13 lifestyle areas.
Programs were offered in seven areas: back care, cholesterol control, eating habits, exercise and activities, stress management, tobacco use, and weight control. Each program was conducted by a trained health educator who provided information and counseling to facilitate change in the area selected by the participant. All counseling was done by telephone and included three to five contacts over a 1-year period.
Binary logistic regression models controlling for gender and age revealed both specific and general effects. Participants were 1.8 to 3.5 times as likely as nonparticipants to reduce the targeted risk in six of seven risk areas. In addition, participants were 1.7 to 3.5 times as likely as nonparticipants to reduce their risks in nine of 13 areas not targeted by the intervention (i.e., general effect). Overall, participants significantly reduced their number of risks, whereas nonparticipants significantly increased their risk (difference of .85 risks).
Results show that at-risk participants make long-term improvements in health risks directly related to the intervention in which they participate. Results also suggest that this intervention may help individuals develop behavior-change skills they can apply to other lifestyle issues.
The purpose of this review is to summarize the literature on the ability of health promotion programs to reduce employee-related health care expenditures and absenteeism. SEARCH PROCESS: Using key words in a literature-searching program, a comprehensive search was conducted on the following databases: MEDLINE, Embase, HealthSTAR. SPORTDiscus, PsycINFO, SciSearch, ERIC, and ABI Inform.
All data-based studies that appeared in peer reviewed journals in the English language. Theses, dissertations, or presentation abstracts that were not published in peer reviewed journals were excluded. The initial search identified 196 studies, but only 72 met the inclusion criteria and were included in the review.
Summary tables were created that include design classification, subject size, results, and other key information for each study.
Both the nature of the findings and the overall quality of the literature were evaluated in an attempt to answer two questions: Do individuals or populations with high health risks have worse financial outcomes than individuals or populations with low health risks? Do health promotion programs improve financial outcomes?
There are good correlational data to suggest that high levels of stress, excessive body weight, and multiple risk factors are associated with increased health care costs and illness-related absenteeism. The associations between seat belt use, cholesterol, diet, hypertension, and alcohol abuse and absenteeism and health care expenditures are either mixed or unknown. Health promotion programs are associated with lower levels of absenteeism and health care costs, and fitness programs are associated with reduced health care costs.
The long-term impact of corporate health and wellness programs is largely unknown, because most evaluations focus on impact in just 1 or 2 years after program initiation. This project estimated the longer-term impact of the Johnson & Johnson Health & Wellness Program on medical care utilization and expenditures. Employees were followed for up to 5 years before and 4 years after Program implementation. Fixed-effects regression models were used to control for measurable and unmeasurable factors that may influence utilization and expenditures. Results indicated a large reduction in medical care expenditures (approximately $224.66 per employee per year) over the 4-year Program period. These benefits came from reduced inpatient use, fewer mental health visits, and fewer outpatient visits compared with the baseline period. Most benefits occurred in years 3 and 4 after Program initiation. We conclude that programs designed to better integrate occupational health, disability, wellness, and medical benefits may have substantial health and economic benefits in later years.
Financial impact of health promotion programs: a comprehensive review of the literature Heaney CA, Goetzel RZ. A review of health-related outcomes of multicomponent worksite health promotion programs
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Aldana SG. Financial impact of health promotion programs: a comprehensive review of the literature. Am J Health Promot. 2001;15:296 –320. 11. Heaney CA, Goetzel RZ. A review of health-related outcomes of multicomponent worksite health promotion programs. Am J Health Promot. 1997;11: 290 –308.