RESUMEN
OBJECTIVE: To evaluate a multifaceted supermarket intervention promoting healthier alternatives to commonly purchased foods. DESIGN: Sales of 385 foods promoted between July and October, 2012 in the Eat Right-Live Well! intervention supermarket were compared with sales in a control supermarket. SETTING: Two supermarkets in geographically separate, low-income, urban neighborhoods. PARTICIPANTS: One control and 1 intervention supermarket. INTERVENTION: Product labeling, employee training, community outreach, and in-store promotions, including taste tests. MAIN OUTCOME MEASURES: Number of items sold; absolute and percent differences in sales. ANALYSIS: Difference-in-difference analyses compared absolute and percent changes between stores and over time within stores. Sub-analyses examined taste-tested items and specific food categories, and promoted items labeled with high fidelity. RESULTS: Comparing pre- and postintervention periods, within-store difference-in-differences for promoted products in the intervention store (25,776 items; 23.1%) was more favorable than the control (9,429 items; 6.6%). The decrease in taste-tested items' sales was smaller in the intervention store (946 items; 5.5%) than the control store (14,666 items; 26.6%). Increased sales of foods labeled with high fidelity were greater in the intervention store (25,414 items; 28.0%) than the control store (7,306 items; 6.3%). CONCLUSIONS AND IMPLICATIONS: Store-based interventions, particularly high-fidelity labeling, can increase promoted food sales.
Asunto(s)
Conducta Alimentaria , Abastecimiento de Alimentos/economía , Abastecimiento de Alimentos/estadística & datos numéricos , Promoción de la Salud , Fenómenos Fisiológicos de la Nutrición , Humanos , Pobreza , Salud UrbanaRESUMEN
OBJECTIVE: To determine the prevalence and incidence of low back pain (LBP) among workers in the aerospace and defense industry and in a specific company. METHODS: Claims and demographic data from the Truven Health MarketScan normative database representing more than 1 million workers were drawn from a group of 18 US benchmark companies and compared with one particular company, Lockheed Martin Corporation. RESULTS: The prevalence of LBP in the MarketScan normative group was 15.6% in the final study year (2012), whereas the incidence of new cases was 7.2% and 7.3% in years 2011 and 2012, respectively. Compared with the normative group, the company's prevalence and incidence rates were lower. Women and older workers were more likely to experience LBP compared with men and younger workers. CONCLUSIONS: The analysis was used to inform the company's leadership about the health burden of the condition and evaluate alternative treatment options to prevent the incidences and reduce the prevalence of clinical back pain among workers.
Asunto(s)
Aviación , Defensa Civil , Industrias , Dolor de la Región Lumbar/epidemiología , Enfermedades Profesionales/epidemiología , Adulto , Distribución por Edad , Bases de Datos Factuales , Femenino , Humanos , Incidencia , Masculino , Persona de Mediana Edad , Prevalencia , Distribución por Sexo , Encuestas y Cuestionarios , Estados Unidos/epidemiologíaRESUMEN
OBJECTIVE: To determine the ability of the Health Enhancement Research Organization (HERO) Scorecard to predict changes in health care expenditures. METHODS: 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. RESULTS: "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." CONCLUSIONS: 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.
Asunto(s)
Planes de Asistencia Médica para Empleados/economía , Costos de la Atención en Salud/tendencias , Gastos en Salud/tendencias , Salud Laboral/economía , Adolescente , Adulto , Femenino , Costos de la Atención en Salud/estadística & datos numéricos , Gastos en Salud/estadística & datos numéricos , Promoción de la Salud/economía , Humanos , Masculino , Persona de Mediana Edad , Análisis Multivariante , Servicios de Salud del Trabajador/economía , Reproducibilidad de los Resultados , Medición de Riesgo , Estados Unidos , Adulto JovenRESUMEN
PURPOSE: The study aim was to determine the utility of and satisfaction with a Centers for Disease Control and Prevention (CDC) Web-based employer tool, CDC's LEAN Works!, which provides evidence-based recommendations and promising practices for obesity prevention and control at worksites. DESIGN: This study examined employers' natural usage (i.e., without any study parameters on how, when, or how much to use the Web site and its resources) and impressions of the Web site. SETTING: Employers of varying sizes, industry types, and levels of maturity in offering obesity management programs and from both private and public sectors were recruited to participate in the study. PARTICIPANTS: A convenience sample of 29 employers enrolled to participate. METHOD: Participants were followed over a 12-month period. First impressions, bimonthly use of the Web site, and final assessments were collected using self-report surveys and individual interviews. Descriptive analyses were conducted. RESULTS: Almost all (96%) of participants reported a positive experience with the Web site, noting it provided a wealth of information. Most reported they planned to continue to use the Web site to develop (77%), implement (92%), and evaluate (85%) their obesity management programs. Aspects of the Web site that employers found valuable included a step-by-step implementation process, templates and toolkits, specific recommendations, and promising practices. CONCLUSION: CDC's LEAN Works! is a useful resource for employers wishing to develop and implement evidence-based workplace obesity prevention programs.
Asunto(s)
Centers for Disease Control and Prevention, U.S. , Conducta Alimentaria , Promoción de la Salud/métodos , Internet , Actividad Motora , Obesidad/prevención & control , Salud Laboral , Estudios de Seguimiento , Humanos , Internet/estadística & datos numéricos , Estados UnidosRESUMEN
OBJECTIVE: To describe a 2010 initiative to encourage companies in South Africa to adopt workplace health promotion programs. METHODS: Data documenting organizational efforts to improve workers' health were collected from 71 participating employers and 11,472 workers completing health assessments. Organizational and employee health were scored on the basis of responses to the surveys that asked about facilities and programs offered, leadership support for health promotion, and employees' health status. RESULTS: In its first year, the initiative recruited 101 organizations and 71 qualified for the award. Results aggregated across these companies focus on elements constituting organizational and individual health, with specific measures that companies can review to determine whether they and their employees are "healthy." CONCLUSIONS: The Healthiest Company Index provided useful baseline data to support employers' efforts to develop and implement effective and impactful health promotion programs.
Asunto(s)
Promoción de la Salud/estadística & datos numéricos , Servicios de Salud del Trabajador/estadística & datos numéricos , Salud Laboral/estadística & datos numéricos , Adulto , Femenino , Conductas Relacionadas con la Salud , Promoción de la Salud/métodos , Estado de Salud , Encuestas Epidemiológicas , Humanos , Liderazgo , Masculino , Persona de Mediana Edad , Sudáfrica , Encuestas y Cuestionarios , Lugar de Trabajo/organización & administración , Lugar de Trabajo/estadística & datos numéricosRESUMEN
An underlying premise of the Affordable Care Act provisions that encourage employers to adopt health promotion programs is an association between workers' modifiable health risks and increased health care costs. Employers, consultants, and vendors have cited risk-cost estimates developed in the 1990s and wondered whether they still hold true. Examining ten of these common health risk factors in a working population, we found that similar relationships between such risks and total medical costs documented in a widely cited study published in 1998 still hold. Based on our sample of 92,486 employees at seven organizations over an average of three years, $82,072,456, or 22.4 percent, of the $366,373,301 spent annually by the seven employers and their employees in the study was attributed to the ten risk factors studied. This amount was similar to almost a quarter of spending linked to risk factors (24.9 percent) in the 1998 study. High risk for depression remained most strongly associated with increased per capita annual medical spending (48 percent, or $2,184, higher). High blood glucose, high blood pressure, and obesity were strongly related to increased health care costs (31.8 percent, 31.6 percent, and 27.4 percent higher, respectively), as were tobacco use, physical inactivity, and high stress. These findings indicate ongoing opportunities for well-designed and properly targeted employer-sponsored health promotion programs to produce substantial savings.
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Costos de Salud para el Patrón , Gastos en Salud , Promoción de la Salud/economía , Servicios de Salud del Trabajador/economía , Patient Protection and Affordable Care Act/economía , Adulto , Estudios de Cohortes , Femenino , Humanos , Masculino , Persona de Mediana Edad , Salud Laboral/economía , Sensibilidad y Especificidad , Estados Unidos , Adulto JovenRESUMEN
OBJECTIVE: To assess long-term changes in health risks for employees participating in Vanderbilt University's incentive-based worksite wellness program. METHODS: Descriptive longitudinal trends were examined for employees' health risk profiles for the period of 2003 to 2009. RESULTS: The majority of risk factors improved over time with the most consistent change occurring in physical activity. The proportion of employees exercising one or more days per week increased from 72.7% in 2003 to 83.4% in 2009. Positive annual, monotonic changes were also observed in percentage for nonsmokers and seat belt usage. Although the largest improvements occurred between the first two years, improvements continued without significant regression toward baseline. CONCLUSIONS: This 7-year evaluation, with high participation and large sample size, provides robust estimates of health improvements that can be achieved through a voluntary incentive-based wellness program.
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Promoción de la Salud/tendencias , Salud Laboral/tendencias , Universidades , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Ejercicio Físico , Femenino , Humanos , Estudios Longitudinales , Masculino , Persona de Mediana Edad , Factores de Riesgo , Cinturones de Seguridad/tendencias , Fumar/tendencias , Recursos Humanos , Lugar de Trabajo/estadística & datos numéricos , Adulto JovenRESUMEN
OBJECTIVE: To evaluate the relationship between modifiable health risks, and health and productivity related expenditures and predict cost savings from improvements in the health risk profile of a large US employer. METHODS: Information was collected on 11 modifiable health risks for active employees who completed a health assessment and enrolled in a noncapitated health plan. These risks were related to employer medical care costs and employee productivity. Multivariate analyses were performed to estimate costs associated with high risk, as well as potential savings from reducing risk prevalence among employees. RESULTS: Health risks with the greatest impact on total medical care costs included obesity, high blood pressure, high blood glucose, high triglycerides, and inadequate exercise. CONCLUSIONS: Modifiable health risks are associated with higher employer costs. Targeted programs that address these risks are expected to yield substantial savings.
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Eficiencia , Costos de la Atención en Salud , Indicadores de Salud , Costos y Análisis de Costo , Estudios Transversales , Femenino , Humanos , Masculino , Persona de Mediana Edad , Análisis Multivariante , Salud Laboral , Prevalencia , Factores de RiesgoRESUMEN
OBJECTIVE: To determine the effect of health promotion programs of Prudential Financial, Inc on biometric measures of blood lipids and glucose. METHODS: Using actual biometric and self-reported measures of blood lipids and glucose values for the employees of Prudential Financial, Inc, we examined 1) the extent to which self-reported lipid and blood glucose values correlate to laboratory data, 2) whether self-reported and measured lipid values differ for physically active and sedentary employees, and 3) whether participation in a disease management program affects employees' lipid measures. RESULTS: We found significant differences in self-reported and measured total cholesterol and low-density lipoprotein values, although these differences and those for all lipid and blood glucose values were not clinically meaningful. Supporting previous clinical studies, high-density lipoprotein values were significantly higher for fitness center users compared with sedentary employees. Finally, disease management participants showed a significant reduction in total cholesterol and low-density lipoprotein during a 3-year period compared with nonparticipants. CONCLUSIONS: On average, the employees of Prudential Financial, Inc were aware of and accurately reported their lipid and blood glucose levels. Results from this study support the value of evaluating corporate health promotion programs, using measured biometric outcomes.
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Glucemia , Conocimientos, Actitudes y Práctica en Salud , Promoción de la Salud/métodos , Hiperlipidemias/sangre , Salud Laboral , Adulto , HDL-Colesterol/sangre , LDL-Colesterol/sangre , Estudios de Cohortes , Centros de Acondicionamiento/estadística & datos numéricos , Humanos , Persona de Mediana Edad , Autoinforme , Triglicéridos/sangre , Adulto JovenRESUMEN
OBJECTIVE: Evaluate innovative, evidence-based approaches to organizational/supportive environmental interventions aimed at reducing the prevalence of obesity among Dow employees after 2 years of implementation. METHODS: A quasi-experimental study design compared outcomes for two levels of intervention intensity with a control group. Propensity scores were used to weight baseline differences between intervention and control subjects. Difference-in-differences methods and multilevel modeling were used to control for individual and site-level confounders. RESULTS: Intervention participants maintained their weight and body mass index, whereas control participants gained 1.3 pounds and increased their body mass index values by 0.2 over 2 years. Significant differences in blood pressure and cholesterol values were observed when comparing intervention employees with controls. At higher intensity sites, improvements were more pronounced. CONCLUSIONS: Environmental interventions at the workplace can support weight management and risk reduction after 2 years.
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Obesidad/prevención & control , Servicios de Salud del Trabajador , Conducta de Reducción del Riesgo , Adulto , Índice de Masa Corporal , Estudios de Casos y Controles , Industria Química , Femenino , Estudios de Seguimiento , Humanos , Masculino , Persona de Mediana Edad , Pérdida de PesoRESUMEN
OBJECTIVE: To determine the accuracy of self-reported health care utilization and absence reported on health risk assessments against administrative claims and human resource records. METHODS: Self-reported values of health care utilization and absenteeism were analyzed for concordance to administrative claims values. Percent agreement, Pearson's correlations, and multivariate logistic regression models examined the level of agreement and characteristics of participants with concordance. RESULTS: Self-report and administrative data showed greater concordance for monthly compared with yearly health care utilization metrics. Percent agreement ranged from 30% to 99% with annual doctor visits having the lowest percent agreement. Younger people, males, those with higher education, and healthier individuals more accurately reported their health care utilization and absenteeism. CONCLUSIONS: Self-reported health care utilization and absenteeism may be used as a proxy when medical claims and administrative data are unavailable, particularly for shorter recall periods.
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Absentismo , Atención a la Salud/estadística & datos numéricos , Autorrevelación , Adulto , Intervalos de Confianza , Estudios Transversales , Femenino , Humanos , Masculino , Persona de Mediana Edad , Reproducibilidad de los ResultadosRESUMEN
OBJECTIVE: To examine the impact of the New York City Department of Health and Mental Hygiene's Wellness at Work program on health risks of employees from 10 New York City organizations at 26 worksites. METHODS: Employer sites were matched and assigned to receive either moderate or high intensity health promotion interventions. Changes from time 1 to time 3 in employees' risk status on 12 health risks were examined using chi and t tests for a cohort group (N = 930). Comparisons between moderate and high intensity groups used multivariate methods, controlling for confounders. RESULTS: From time 1 to time 3, both moderate and high intensity sites demonstrated significant risk reductions. Nevertheless, comparisons by intervention intensity did not reveal significant differences between treatment conditions. CONCLUSIONS: Private-public partnerships to promote employee health in the workplace have the potential to reduce health risks that are precursors to chronic disease.
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Conducta Cooperativa , Promoción de la Salud/organización & administración , Sector Privado , Sector Público , Lugar de Trabajo , Adulto , Estudios de Cohortes , Recolección de Datos , Femenino , Humanos , Masculino , Ciudad de Nueva York , Medición de RiesgoRESUMEN
OBJECTIVE: Certain modifiable risk factors lead to higher health care costs and reduced worker productivity. A predictive return-on-investment (ROI) model was applied to an obesity management intervention to demonstrate the use of econometric modeling in establishing financial justification for worksite health promotion. METHODS: Self-reported risk factors (n = 890) were analyzed using chi2 and t test methods. Changes in risk factors, demographics, and financial measures comprised the model inputs that determined medical and productivity savings. RESULTS: Over 1 year, 7 of 10 health risks decreased. Of total projected savings ($311,755), 59% were attributed to reduced health care expenditures ($184,582) and 41% resulted from productivity improvements ($127,173), a $1.17 to $1.00 ROI. CONCLUSIONS: Using an ROI model to project program savings is a practical way to provide financial justification for investment in worksite health promotion when risk reduction data are available.
Asunto(s)
Promoción de la Salud/economía , Modelos Económicos , Obesidad/terapia , Salud Laboral , Evaluación de Resultado en la Atención de Salud/economía , Lugar de Trabajo , Adulto , Análisis Costo-Beneficio/economía , Femenino , Humanos , Masculino , Persona de Mediana Edad , Conducta de Reducción del RiesgoRESUMEN
OBJECTIVE: To identify key success factors related to employer-based health and productivity management (HPM) programs. METHODS: Data regarding promising practices in HPM were gathered via literature review, discussions with subject matter experts, online inventory, and site visits. RESULTS: Promising practices in HPM include 1) integrating HPM programs into the organization's operations; 2) simultaneously addressing individual, environmental, policy, and cultural factors affecting health and productivity; 3) targeting several health issues; 4) tailoring programs to address specific needs; 5) attaining high participation; 6) rigorously evaluating programs; and 7) communicating successful outcomes to key stakeholders. CONCLUSION: Increased efforts should be directed at disseminating the experiences of promising practices. However, more research is needed in this area, so that additional public and private funding is made available for applied research in "real-life" business settings. Finally, employers should be provided effective tools and resources to support their HPM efforts.