Division of Health Policy and Management, University of Minnesota, Minneapolis, MN, United States.
Division of Health Policy and Management, University of Minnesota, Minneapolis, MN, United States.
Prev Med. 2017 Dec;105:135-141. doi: 10.1016/j.ypmed.2017.09.002. Epub 2017 Sep 8.
Wellness programs are a popular strategy utilized by large U.S. employers. As mobile health applications and wearable tracking devices increase in prevalence, many employers now offer physical activity tracking applications. This longitudinal study evaluates the impact of engagement with a web-based, physical activity tracking program on changes in individuals' biometric outcomes in an employer population. The study population includes active employees and adult dependents continuously enrolled in an eligible health plan and who have completed at least two biometric screenings (n=36,882 person-years with 11,436 unique persons) between 2011 and 2014. Using difference-in-differences (DID) regression, we estimate the effect of participation in the physical activity tracking application on BMI, total cholesterol, and blood pressure. Participation was significantly associated with a reduction of 0.275 in BMI in the post-period, relative to the comparison group, representing a 1% change from baseline BMI. The program did not have a statistically significant impact on cholesterol or blood pressure. Sensitivity checks revealed slightly larger BMI reductions among participants with higher intensity of tracking activity and in the period following the employer's shift to an outcomes-based incentive design. Results are broadly consistent with the existing literature on changes in biometric outcomes from workplace initiatives promoting increased physical activity. Employers should have modest expectations about the potential health benefits of such programs, given current designs and implementation in real-world settings.
健康计划是美国大型雇主常用的策略。随着移动健康应用和可穿戴跟踪设备的普及，许多雇主现在提供身体活动跟踪应用程序。本纵向研究评估了在雇主群体中，参与基于网络的身体活动跟踪计划对个体生物标志物结果变化的影响。研究人群包括在 2011 年至 2014 年间持续参加符合条件的健康计划的活跃员工和成年受抚养人，并且至少完成了两次生物标志物筛查（n=36882 人年，11436 个独特个体）。使用差分法（DID）回归，我们估计了参与身体活动跟踪应用程序对 BMI、总胆固醇和血压的影响。与对照组相比，参与该计划后 BMI 平均降低了 0.275，代表从基线 BMI 下降 1%。该计划对胆固醇或血压没有统计学上的显著影响。敏感性检查显示，在跟踪活动强度较高的参与者和在雇主转向基于结果的激励设计之后的时期，BMI 降低幅度略大。结果与现有文献中关于促进增加身体活动的工作场所倡议对生物标志物结果变化的研究结果基本一致。鉴于当前的设计和在现实环境中的实施，雇主对这些计划可能带来的健康益处应持适度的期望。
