Randomized Controlled Study of a Retiree Health Promotion Program

Abstract

The initial results of a 12-month controlled trial of a health promotion program in 5686 Bank of America retirees, randomized into full program, questionnaire only, and insurance claims only groups, were analyzed to determine whether the health promotion program was effective. Comparisons were between program and questionnaire only groups for self-reported health habit changes, health risk scores, medical care utilization, and days confined to home, and between all groups for insurance claims data. The intervention, or full program, included health habit questionnaires administered every 6 months, individualized time-oriented health risk appraisals, personal recommendation letters, self-management materials, and a health promotion book. Twelve-month changes in health habits, health status, and economic variables favored the full program group in 31 of 32 comparisons and were statistically significant at the .05 level in two-tailed tests in 19 comparisons and at the .01 level in two-tailed tests in 13 comparisons. Over 12 months, overall computed health risk scores decreased by 4.3% in the full program experimental group and increased by 7.2% in the questionnaire only control group. Total direct and indirect costs decreased by 11% in the experimental group and increased by 6.3% in the questionnaire only control group. Analysis of claims data confirmed these trends. A low-cost health promotion program for retirees was effective in changing health behaviors and has potential to decrease health care utilization.

Effect of a Workplace Wellness Program on Employee Health and Economic Outcomes

“…Observational studies have often been limited by a lack of valid control groups, selection bias, and small samples . Experimental studies of comprehensive wellness programs have been scarce and have produced mixed results, with most of the more rigorous studies now dated . Other experimental studies have focused on certain components of wellness, such as smoking cessation and weight loss, using an intervention of limited duration .…”

“…[6][7][8] Experimental studies of comprehensive wellness programs have been scarce and have produced mixed results, with most of the more rigorous studies now dated. 9,10 Other experimental studies have focused on certain components of wellness, such as smoking cessation and weight loss, using an intervention of limited duration. [11][12][13][14] A recent rigorous randomized study used individual-level rather than workplacewide randomization, making it difficult to assess the effects of the tools used by many programs aiming to improve workplace culture or harness peer effects.…”

“…b Number of observations for each outcome (range, 864-1013 [36.2%-42.4% of those employed at worksites in June 2016]). 0-100) were normalized (mean [SD], 50[10]) in the general US population.Higher scores indicate better self-reported health-related quality of life. g SE is shown in parentheses.…”

Can health promotion programs save Medicare money?

“…Of the seven studies that calculated cost-benefit ratios, financial returns averaged $3.48 for every dollar expended. Studies often cited with the strongest research designs and large numbers of subjects included those performed at Johnson and Johnson (Bly et al 1986; Breslow et al 1994), Citibank (Ozminkowski et al 1999), Dupont (Bertera 1990), the Bank of America (Leigh et al 1992; Fries et al 1993), Tenneco (Baun et al 1986), Duke University (Knight et al 1994), the California Public Employee Retirees System (CalPERS) (Fries et al 1994), Procter and Gamble (Goetzel, Jacobsen, et al 1998), and Chevron Corporation (Goetzel, Dunn, et al 1998). Even accounting for certain inconsistencies in design and results, most produced positive cost outcomes.…”