Measuring Participation in Employer-Sponsored Health and Well-Being Programs: A Participation Index and Its Association With Health Risk Change

PURPOSE

To develop an index of participation in workplace health and well-being programs and assess its relationship with health risk status.

DESIGN

Study design comprised a retrospective longitudinal analysis of employee health risk assessment (HRA) and program participation data.

SETTING

Data from 6 companies that implemented health and well-being programs from 2014 to 2016.

PARTICIPANTS

Employee participants (n = 95 318) from 6 companies who completed an HRA in 2014 to 2016. After matching those who completed the HRA in all 3 years, the longitudinal file included 38 789 respondents.

MEASURES

Participation indicators were created for 9 different program components. The sum of these 9 components established the total participation index.

ANALYSIS

Descriptive and correlation analyses were conducted on all participation measures. Repeated-measures analysis of variance was used to assess the impact of participation level on health risk over time.

RESULTS

Higher levels of participation were associated with a greater reduction in risks, with each participation dose yielding a reduction of 0.038 risks (P < .001).

CONCLUSION

Results suggest that employees who participate more in workplace health and well-being programs experience more health risk improvement. The study also supports a more granular definition of participation based on the number of interactions and type of program.

Background and method of the Striving to be Strong study a RCT testing the efficacy of a m-health self-management intervention

BACKGROUND

Osteoporosis is a prevalent and debilitating condition affecting >50% of post-menopausal women. Yet, a low percentage of women regularly engage in health promoting behaviors associated with osteoporosis prevention. Complex, multidimensional, m-Health interventions hold promise to effect engagement in health behavior change related to calcium and vitamin D intake, balance, core and leg strength, and physical activity.

METHODS

Striving to be Strong study (R01NR013913-01) tests the efficacy of a research and theory based, patient centered, dynamically tailored intervention delivered via smart phone apps. Ecological Momentary Assessments (EMAs) enhance immediate feedback and complement traditional measures. The desired outcomes are the maintenance of osteoporosis self-management behaviors and a decrease in the loss of bone density over time. The Individual and Family Self-management Theory provided the conceptual foundation for the study. The sample consists of 290 healthy women between the ages of 40 and 60 with an anticipated attrition of 33%. This three group repeated measures Randomized Clinical Trial spans a 12-month time period. Data collected occurs via web site, smart-phone app, self-report, observation, and measures. Proximal (engagement in osteoporosis health behaviors) and distal (serum vitamin D, DXA, and body composition) outcomes are collected for testing of the efficacy of the intervention and theory evaluation.

DISCUSSION

Active and rigorous quality management processes continually evaluate enrollment and retention goals, functionality of the automated intervention delivery and data collection systems, EMAs, and dispersion of incentives.

The Influence of Worksite and Employee Variables on Employee Engagement in Telephonic Health Coaching Programs: A Retrospective Multivariate Analysis

Purpose.

This study assessed 11 determinants of health coaching program participation.

Design.

A cross-sectional study design used secondary data to assess the role of six employee-level and five worksite-level variables on telephone-based coaching enrollment, active participation, and completion.

Setting.

Data was provided by a national provider of worksite health promotion program services for employers.

Subjects.

A random sample of 34,291 employees from 52 companies was selected for inclusion in the study.

Measures.

Survey-based measures included age, gender, job type, health risk status, tobacco risk, social support, financial incentives, comprehensive communications, senior leadership support, cultural support, and comprehensive program design.

Analysis.

Gender-stratified multivariate logistic regression models were applied using backwards elimination procedures to yield parsimonious prediction models for each of the dependent variables.

Results.

Employees were more likely to enroll in coaching programs if they were older, female, and in poorer health, and if they were at worksites with fewer environmental supports for health, clear financial incentives for participation in coaching, more comprehensive communications, and more comprehensive programs. Once employees were enrolled, program completion was greater among those who were older, did not use tobacco, worked at a company with strong communications, and had fewer environmental supports for health.

Conclusion.

Both worksite-level and employee-level factors have significant influences on health coaching engagement, and there are gender differences in the strength of these predictors.

Randomized controlled trial of the effectiveness of genetic counseling and a distance, computer-based, lifestyle intervention program for adult offspring of patients with type 2 diabetes: background, study protocol, and baseline patient characteristics

Relatives of type 2 diabetic patients are at a high risk of developing type 2 diabetes and should be regarded as target of intervention for diabetes prevention. However, it is usually hard to motivate them to implement preventive lifestyle changes, because of lack of opportunity to take advises from medical professionals, inadequate risk perception, and low priority for preventive behavior. Prevention strategy for them therefore should be highly acceptable and suited for them. The parallel, three-group trial is now being conducted to investigate the effects of genetic counseling and/or a computerized behavioral program on the prevention of type 2 diabetes in that population. The preventive strategies used in this study could provide a novel solution to the numbers of genetically high-risk individuals, if found to be effective. The objective of this paper is to describe the background, protocol, and baseline patient characteristics of the trial.