Evaluating Workforce Mental Health and Well-Being: A Review of Assessments.

OBJECTIVE: Given the importance of mental health and well-being assessments to employers' efforts to optimize employee health and well-being, this paper reviews mental health assessments that have utility in the workplace. DATA SOURCE: A review of publicly available mental health and well-being assessments was conducted with a primary focus on burnout, general mental health and well-being, loneliness, psychological safety, resilience, and stress. INCLUSION CRITERIA: Assessments had to be validated for adult populations; available in English as a stand-alone tool; have utility in an employer setting; and not have a primary purpose of diagnosing a mental health condition. DATA EXTRACTION: All assessments were reviewed by a minimum of two expert reviewers to document number of questions, subscales, fee structure, international use, translations available, scoring/reporting, respondent (ie, employee or organization), and the target of the assessment (ie, mental health domain and organizational or individual level assessments. DATA SYNTHESIS & RESULTS: Sixty-six assessments across the six focus areas met inclusion criteria, enabling employers to select assessments that meet their self-identified measurement needs. CONCLUSION: This review provides employers with resources that can help them understand their workforce's mental health and well-being status across multiple domains, which can serve as a needs assessment, facilitate strategic planning of mental health and well-being initiatives, and optimize evaluation efforts.

Measuring Participation in Employer-Sponsored Health and Well-Being Programs: A Participation Index and Its Association With Health Risk Change.

PURPOSE: To develop an index of participation in workplace health and well-being programs and assess its relationship with health risk status. DESIGN: Study design comprised a retrospective longitudinal analysis of employee health risk assessment (HRA) and program participation data. SETTING: Data from 6 companies that implemented health and well-being programs from 2014 to 2016. PARTICIPANTS: Employee participants (n = 95 318) from 6 companies who completed an HRA in 2014 to 2016. After matching those who completed the HRA in all 3 years, the longitudinal file included 38 789 respondents. MEASURES: Participation indicators were created for 9 different program components. The sum of these 9 components established the total participation index. ANALYSIS: Descriptive and correlation analyses were conducted on all participation measures. Repeated-measures analysis of variance was used to assess the impact of participation level on health risk over time. RESULTS: Higher levels of participation were associated with a greater reduction in risks, with each participation dose yielding a reduction of 0.038 risks (P < .001). CONCLUSION: Results suggest that employees who participate more in workplace health and well-being programs experience more health risk improvement. The study also supports a more granular definition of participation based on the number of interactions and type of program.

Association Between Sleep and Productivity Loss Among 598 676 Employees From Multiple Industries.

PURPOSE: To examine the relationship between sleep habits and employee productivity. DESIGN: Cross-sectional health risk assessment analysis. SETTING: Employer-sponsored health and well-being programs. PARTICIPANTS: A total of 598 676 employed adults from multiple industries. MEASURES: Self-reported average hours of sleep, fatigue, absence days, and presenteeism. ANALYSIS: Bivariate analyses to assess the relationships between self-reported hours of sleep and self-reported fatigue and mean and median absence and presenteeism. RESULTS: The relationship between sleep hours and both measures of productivity was U-shaped, with the least productivity loss among employees who reported 8 hours of sleep. More daytime fatigue correlated with more absence and presenteeism. Median absence and presenteeism was consistently lower than mean absence and presenteeism, respectively, for the various hours of sleep and levels of fatigue. CONCLUSION: Organizations looking to expand the value of their investment in employee health and well-being should consider addressing the employee sleep habits that may be negatively impacting productivity.

Impact of a comprehensive population health management program on health care costs.

OBJECTIVE: Assess the influence of participation in a population health management (PHM) program on health care costs. METHODS: A quasi-experimental study relied on logistic and ordinary least squares regression models to compare the costs of program participants with those of nonparticipants, while controlling for differences in health care costs and utilization, demographics, and health status. Propensity score models were developed and analyses were weighted by inverse propensity scores to control for selection bias. RESULTS: Study models yielded an estimated savings of $60.65 per wellness participant per month and $214.66 per disease management participant per month. Program savings were combined to yield an integrated return-on-investment of $3 in savings for every dollar invested. CONCLUSIONS: A PHM program yielded a positive return on investment after 2 years of wellness program and 1 year of integrated disease management program launch.

Effectiveness of a worksite telephone-based weight management program.

PURPOSE: Examine the long-term impact of a telephone-based weight management program among participants recruited from worksite settings. DESIGN: Pre/post quasi-experimental design comparing weight loss and related behaviors between program completers and noncompleters. SETTING: Ten large private-sector and public-sector employers. SUBJECTS: Overweight or obese participants (n  =  1298) enrolled in a telephone-based weight management program. INTERVENTION: Individually tailored telephone-based weight management coaching program that included up to five calls over a median of 250 days. MEASURES: Weight, body mass index, and lifestyle behaviors assessed via health risk assessment at baseline and 1-year follow-up. ANALYSIS: Chi-square and one-way analysis of variance procedures were used to assess between-group differences in weight and associated behaviors, with criterion for significance set at p < .05. RESULTS: Among weight management program participants, 48% of program completers and 47% of noncompleters lost weight, but program completers averaged 2.6 times more weight loss than noncompleters. Improvements in physical activity, eating habits, and overall health status were reported for completers. CONCLUSION: The weight loss attained among participants who lost weight, along with the improvements in physical activity and nutrition practices, suggests that a telephone-based weight management program of modest intensity can have a positive impact on the health of obese or overweight worksite participants.

A comparison of the effectiveness of a telephone coaching program and a mail-based program.

Many health promotion interventions have been developed and tested in recent years. Practitioners and researchers must continue to explore how various program delivery modalities can be used effectively and efficiently to optimize program outcomes. A sample of 6,055 participants was drawn from 10 large employers. Participants self-selected into a mail or telephone intervention. This study compared the demographics of those who selected each modality and assessed differences in program success relative to the modalities chosen. Telephone participants were more likely to be older, female, and salaried. Telephone participants were also more ready, confident, and motivated to make a behavior change, when compared to those in the mail program. Researchers found both the telephone and mail programs to be effective in reducing participants' health risk status, though the telephone program was slightly more effective. These findings demonstrate the importance of offering a variety of interventions when promoting healthy changes. More research is needed to investigate the role of participant choice and the combinations of learning experiences that best facilitate sustainable behavior change.

The role of incentive design, incentive value, communications strategy, and worksite culture on health risk assessment participation.

PURPOSE: To examine the impact of financial incentives, communications strategy, and worksite culture on health risk assessment (HRA) participation rates. DESIGN: A cross-sectional study design was used to examine factors that influence employee participation, including incentive value, incentive design, communications strategy, and worksite culture. SETTING: Large private-sector and public-sector employers. PARTICIPANTS: Thirty-six employers (n = 559,988 employees) that provided financial incentives to promote employee HRA participation. INTERVENTION: Organizations implemented the HRA as part of a more comprehensive worksite health promotion strategy that included follow-up interventions and a variety of other components. The primary outcome of interest was employee HRA participation. MEASURES: Information on program design and structure, as well as on HRA eligibility and participation, was collected for each organization via standard client report and semistructured interviews with account managers. General linear regression models were used to examine the extent to which factors influence HRA participation independently and when controlled for other factors. RESULTS: Incentive value (r2 = .433; p < .000), benefits-integrated incentive design (r2 = .184; p = .009), culture (r2 = .113; p = .045), and communications strategy (r = .300; p = .001) had positive bivariate associations with HRA participation rates. When all factors were included in the model, incentive value (p = .001) and communications strategy (p = .023) were significantly associated with HRA participation. Variance accounted for by all factors combined was R12 = .584. CONCLUSION: This study suggests that incentive value, incentive type, supportive worksite culture, and comprehensive communications strategy may all play a role in increasing HRA participation.

Association between nine quality components and superior worksite health management program results.

OBJECTIVE: To assess the prevalence of "best practice" program components across a select sample of organizations, and to explore differences in engagement rates and health risk reduction between organizations using "best-practice" and "common-practice" health management approaches. METHODS: Using a retrospective approach, researchers assigned organizations to a "best practice" or "common-practice" group based on well-defined criteria. The study examined group differences in employee health assessment participation rates, health coaching program participation and completion rates, and organizational-level health risk reduction. RESULTS: Best-practice organizations achieved higher levels of engagement than common-practice organizations in both health assessment and health coaching programs. Population-level and intervention-level health risk reduction was 2.35 and 1.08 times higher, respectively, among best-practice organizations compared with common-practice organizations. CONCLUSIONS: This study demonstrates the contribution of quality program components to superior program engagement rates and health outcomes.