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A review and analysis of the clinical- and cost-effectiveness studies of comprehensive health promotion and disease management programs at the worksite, 1998–2000 update
Abstract
PURPOSE: This article is the fifth in a series of critical reviews of the clinical effectiveness and cost-effectiveness studies of comprehensive, multifactorial health promotion and disease management programs conducted in worksites. As with the previous reviews, the purpose of this article is to review and assess the randomized control trials that have focused on both clinical and cost outcomes of worksite health promotion and disease management programs. For this current review, a new category of quasi-experimental studies has been added because this represents a major new trend in such interventions over the last 2 years. Comprehensive worksite programs are those that provide an ongoing, integrated program of health promotion and disease prevention that integrates specific components into a coherent, ongoing program that is consistent with corporate objectives and includes program evaluations of both clinical and cost outcomes. DATA SOURCES: A comprehensive search was conducted using a multistage process that included MEDLINE, ERIC, ADI, EDGAR, CARL, Inform, and Lexis-Nexis databases and direct inquiries to worksite researchers. INCLUSION AND EXCLUSION CRITERIA: The search identified 27 new studies to which the following inclusion criteria were applied: research conducted in the United States; results published in English; methodological quality of nonexperimental (pre- and postmeasures but no comparison group); quasi-experimental to randomized control trials; and both clinical and cost outcomes. Exclusion criteria were studies outside of the United States; non-English publications; and clinical or cost outcomes only. Fifteen studies remained for this review. FINDINGS EXTRACTION METHODS: Findings extraction and analysis of the 15 studies was done by extracting the relevant population, intervention design, clinical results, and cost outcomes from the published article. As in previous reviews, findings are summarized in a table format that extracts and describes each study by the following: (1) study author(s); (2) corporate site; (3) purpose of the evaluation; (4) employee population; (5) percentage of program participants; (6) number of employees included in the evaluation; (7) brief description of the intervention; (8) evaluation design; (9) evaluation period; (10) outcomes; (11) research rating; and (12) findings. FINDINGS SYNTHESIS: Based on these 15 studies, a methodological critique was conducted with brief reference to appropriate prior studies. Conclusions regarding study quality and new trends over the time period of 1998 to 2000 are discussed. MAJOR CONCLUSIONS: Results from randomized clinical trials and quasi-experimental designs suggest that providing individualized risk reduction for high risk employees within the context of comprehensive programming is the critical element of worksite interventions. Despite the many limitations of the current methodologies of the 15 new studies, the vast majority of the research to date indicates positive clinical and cost outcomes.
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“businesses that encourage healthy lifestyle practices among their employees are likely to gain reduced health insurance costs and possibly a more loyal workforce (Aldana, 2001; Pelletier, 2001; Whitmer et al., 2003).”
From Central effects of stress hormones in health and disease: understanding the protective and damaging effects of stress and stress mediators (2008) · cites this paper as Pelletier, 2001
In the citing paper
“In sum, these studies provide relatively consistent evidence that such programs improve health behaviors and related clinical risk factors (Table 6).”
From Population Approaches to Improve Diet, Physical Activity, and Smoking Habits: A Scientific Statement From the American Heart Association (2012) · cites this paper as [275]
In the citing paper
“Examples of findings include improved diet (increased consumption of fruits and vegetables, reduced consumption of saturated fat and fatty meats), increased daily activity and walking, reduced smoking (14% reduction), reduced systolic blood pressure (≈7 mm Hg reduction) and body fat (9% reduction), and lower estimated global CVD risk (≈13% reduction).”
From Population Approaches to Improve Diet, Physical Activity, and Smoking Habits: A Scientific Statement From the American Heart Association (2012) · cites this paper as [275]
In the citing paper
“Interventions targeting higher-risk employees appear especially effective.”
From Population Approaches to Improve Diet, Physical Activity, and Smoking Habits: A Scientific Statement From the American Heart Association (2012) · cites this paper as [275]
In the citing paper
“Examples of findings include improved diet (increased consumption of fruits and vegetables, reduced consumption of saturated fat and fatty meats), increased daily activity and walking, reduced smoking (14% reduction), reduced systolic blood pressure (≈7 mm Hg reduction) and body fat (9% reduction), and lower estimated global CVD risk (≈13% reduction).”
From Population Approaches to Improve Diet, Physical Activity, and Smoking Habits: A Scientific Statement From the American Heart Association (2012) · cites this paper as [275]
In the citing paper
“Examples of findings include improved diet (increased consumption of fruits and vegetables, reduced consumption of saturated fat and fatty meats), increased daily activity and walking, reduced smoking (14% reduction), reduced systolic blood pressure (≈7 mm Hg reduction) and body fat (9% reduction), and lower estimated global CVD risk (≈13% reduction).”
From Population Approaches to Improve Diet, Physical Activity, and Smoking Habits: A Scientific Statement From the American Heart Association (2012) · cites this paper as [275]
In the citing paper
“Examples of findings include improved diet (increased consumption of fruits and vegetables, reduced consumption of saturated fat and fatty meats), increased daily activity and walking, reduced smoking (14% reduction), reduced systolic blood pressure (≈7 mm Hg reduction) and body fat (9% reduction), and lower estimated global CVD risk (≈13% reduction).”
From Population Approaches to Improve Diet, Physical Activity, and Smoking Habits: A Scientific Statement From the American Heart Association (2012) · cites this paper as [275]
In the citing paper
“Examples of findings include improved diet (increased consumption of fruits and vegetables, reduced consumption of saturated fat and fatty meats), increased daily activity and walking, reduced smoking (14% reduction), reduced systolic blood pressure (≈7 mm Hg reduction) and body fat (9% reduction), and lower estimated global CVD risk (≈13% reduction).”
From Population Approaches to Improve Diet, Physical Activity, and Smoking Habits: A Scientific Statement From the American Heart Association (2012) · cites this paper as [275]
In the citing paper
“Examples of findings include improved diet (increased consumption of fruits and vegetables, reduced consumption of saturated fat and fatty meats), increased daily activity and walking, reduced smoking (14% reduction), reduced systolic blood pressure (≈7 mm Hg reduction) and body fat (9% reduction), and lower estimated global CVD risk (≈13% reduction).”
From Population Approaches to Improve Diet, Physical Activity, and Smoking Habits: A Scientific Statement From the American Heart Association (2012) · cites this paper as [275]
In the citing paper
“However, limitations were noted, including inconsistent methodology across trials, often relatively small sizes (N<400), and short durations of follow-up (typically <6 months, with a few studies having a follow-up of 12 to 18 months).”
From Population Approaches to Improve Diet, Physical Activity, and Smoking Habits: A Scientific Statement From the American Heart Association (2012) · cites this paper as [275]
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- Pelletier, K. R.
- Affiliations
- University of Maryland, Baltimore (US)
- Corresponding author
- Pelletier, Kenneth R.
- Venue
- American Journal of Health Promotion
- Publisher
- SAGE Publications
- Published
- 2001-11
- Volume
- 16
- Issue
- 2
- Pages
- 107-116
- ISSN
- 0890-1171 (ISSN-L)
- 2168-6602
- OpenAlex
- W2003668646
- Cited by
- 341
- References
- 91
- Citations by year
- 2025: 2 · 2024: 3 · 2022: 3 · 2021: 5 · 2020: 3 · 2019: 5 · 2018: 3 · 2017: 6 · 2016: 10 · 2015: 13 · 2014: 22 · 2013: 19 · 2012: 23
- FWCI
- 36.15
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- American Journal of Health Promotion (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Workplace Health and Well-being
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Occupational Health and Safety in Workplaces
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Health Promotion and Cardiovascular Prevention
- Keywords
- workplace health promotion, disease management programs, occupational health, cost-effectiveness, clinical effectiveness, quasi-experimental design, randomized controlled trials, methodological quality, health promotion program evaluation, disease prevention, corporate wellness programs, health care costs, methodological critique
- MeSH terms
- Cost-Benefit Analysis, Health Promotion, Health Services Research, Humans, Occupational Health Services, United States, Workplace, Disease Management
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