Ron Z. Goetzel

Promising practices in employer health and productivity management efforts: findings from a benchmarking study.

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.

Design characteristics of worksite environmental interventions for obesity prevention.

Objective: This paper describes the design characteristics of the National Heart, Lung, and Blood Institute (NHLBI)‐funded studies that are testing innovative environmental interventions for weight control and obesity prevention at worksites.

The impact of rheumatoid arthritis on medical expenditures, absenteeism, and short-term disability benefits

Objectives: The objectives of this study were to estimate medical expenditures, absenteeism, and short-term disability costs for workers with rheumatoid arthritis (RA) and to estimate the relative costs of RA over a 12-month period. Methods: Using data from nine U.S. employers, direct and indirect costs for 8502 workers with RA were compared with costs for a matched group without RA. Regression analyses controlled for factors that were different even after propensity score matching. Results: Average total costs for workers with RA were

Assessing management support for worksite health promotion: Psychometric analysis of the leading by example (LBE) instrument

4244 (2003 dollars) greater than for workers without RA. RA was the fourth most costly chronic condition per employee compared with cancers, asthma, bipolar disorder, chronic obstructive pulmonary disease, depression, diabetes, heart disease, hypertension, low back disorders, and renal failure. Conclusions: RA is a costly disorder and merits consideration as interventions are considered to improve workers’ health and productivity.

The Savings Gained From Participation in Health Promotion Programs for Medicare Beneficiaries

Purpose. Describe the development of the leading by example (LBE) instrument. Methods. A total of 135 responses from employees of a private corporation working at 11 different worksites were factor analyzed in 2005. Exploratory factor analysis was used to obtain an initial factor structure. Factor validity was evaluated using confirmatory factor analysis methods. A second sample was collected in 2006 from the same population (N = 178) and was used to confirm the factor structure via confirmatory factor analysis. Cronbachs α and item-total correlations provided information on the reliability of the factor subscales. Results. Four subscales were identified: business alignment with health promotion objectives, awareness of the health-productivity link, worksite support for health promotion, and leadership support for health promotion. Factor by group comparisons revealed that the initial factor structure was effective in detecting differences in organizational support for health promotion across different employee groups. Conclusions. Management support for health promotion can be assessed using the LBE, a brief self-report questionnaire. Researchers can use the LBE to diagnose, track, and evaluate worksite health promotion programs.

Using formative research to develop environmental and ecological interventions to address overweight and obesity.

Objective: The objective of this study was to estimate savings to Medicare associated with participation in one or more health promotion programs offered to 59,324 retirees from a large employer and their aged dependents. Methods: Propensity score and multiple regression techniques were used to estimate savings adjusted for demographic and health status differences between elderly retirees and dependents who used one or more health promotion services and nonparticipants. Results: Participants who completed a health risk assessment saved from

Estimating Risk Reduction Required to Break Even in a Health Promotion Program

101 to

Health promotion in later life: it's never too late.

648 per person per year. Savings were generally higher as more programs were used, but differences were not always statistically significant. Conclusion: Using the health risk assessment as a guide for health promotion programs can yield substantial savings for the elderly and the Medicare program. The federal government should test health promotion programs in randomized trials and pay for such programs if the results suggest cost savings and better health for Medicare beneficiaries.

Emerging trends in health and productivity management

Objective: This paper presents the formative research phase of a large multi‐site intervention study conducted to inform the feasibility of introducing environmental and ecological interventions.

Prescription to over-the-counter switching of drugs: Methodological issues and implications for non-sedating antihistamines

Purpose. To illustrate a formula to estimate the amount of risk reduction required to break even on a corporate health promotion program. Design. A case study design was implemented. Base year (2001) health risk and medical expenditure data from the company, along with published information on the relationships between employee demographics, health risks, and medical expenditures, were used to forecast demographics, risks, and expenditures for 2002 through 2011 and estimate the required amount of risk reduction. Setting. Motorola. Subjects. 52,124 domestic employees. Measures. Demographics included age, gender, race, and job type. Health risks for 2001 were measured via health risk appraisal. Risks were noted as either high or low and related to exercise/eating habits, body weight, blood pressure, blood sugar levels, cholesterol levels, depression, stress, smoking/drinking habits, and seat belt use. Medical claims for 2001 were used to calculate medical expenditures per employee. Results. Assuming a