A Systematic Review of Employee Health Management Programs to Address Cardio-Metabolic Disorders Among Health Professionals

Abstract

Objective The main objective of this study was to examine peer reviewed literature on employee health management programs offered by health care organizations to address cardiovascular and metabolic conditions. Our objectives included understanding the types of interventions, measures reported, clinical and work-related outcomes, and quality of research. Study Design and Analysis Systematic review adhering to the PRISMA guidelines. Our research team included experts in health promotion, primary care, medical psychology, and library sciences. Analysis was based on evaluation guidelines for employee health management programs established by the Health Enhancement Research Organization and Population Health Alliance. We examined measures of physical health impact and work-related outcomes. Our review included a quality assessment based on National Heart, Blood, and Lung Institute criteria for case-control and before-after studies. Dataset We performed searches on PubMed, CINAHL, ABI/Inform, and PsycINFO and used backward citation tracking. Population English-language peerreviewed articles published in the US between 2000 to 2021 that reported outcomes of interventions aimed at improving employee cardiovascular and/or metabolic conditions. Interventions were randomized or non-randomized controlled trial or before-after design. A total of 2268 non-duplicate journal articles were retrieved. Two rounds of abstract screening excluded 2162 articles. A detailed evaluation of 106 full-text articles eliminated 21. Citation tracking resulted in 55 additional articles. Of the 140 articles, 22 were conducted within health care delivery organizations and included in this analysis. Results A variety of interventions were reported, most were 6 months or longer and included monetary incentives. All studies reported cardiometabolic outcomes: 20 measured blood pressure, 19 measured weight, 17 measured cholesterol, and 16 measured blood glucose. Few studies reported work-related outcomes. The majority of studies reported positive physical health outcomes. Of those reporting financial outcomes, most reported cost savings. Quality of research design varied. Major issues include high participant dropout rate, lack of sample size estimation, and lack of consistent intervention exposure. Conclusions Employer-sponsored interventions focused on improving cardiovascular and metabolic conditions may be one method to support the overall health and well-being of health professionals.