Older Workers Benefit from High-Tech, High-Touch Health Promotion
[Writer] This is research news from U-I-C – the University of Illinois at Chicago.
Today, Susan Hughes, professor of community health sciences and co-director of UIC’s Center for Research on Health and Aging, talks about her research that found older workers benefit most from a high tech, high touch wellness program.
Here’s Professor Hughes:
[Hughes] This is Sue Hughes and I am a professor in the School of Public Health at the University of Illinois at Chicago where I also co-direct the Center for Research on Health and Aging. My colleagues and I recently completed a randomized trial of a worksite wellness intervention, actually compared two worksite wellness interventions, to a no treatment control group at UIC.
One of the innovative things about this study is that we actually used staff at UIC as participants in the study who are over age 40. The other unique thing about this study is we examined the effects of a workplace wellness program, or programs, for people who are over age 40. There have not been that many studies of programs for older adult workers to date. So this was a pretty important initiative.
We compared two programs. The first was what we call COACH; and that was an adapted version of a program called Enhanced Wellness that was developed by Senior Centers of Seattle. It was tested initially with people who are retirees in senior centers. We adapted it for use in the workforce, or he workplace, by using instead of having teams of a nurse/social worker working with people to inventory their health status/health action plan, we used an MPH-educated health educator.
The thing that we compared it to was RealAge. RealAge is a completely computerized program that is available – anybody can go on the internet and access RealAge – and take the RealAge test. And the RealAge test gives you a health profile and then it directs you to a number of different modules for different chronic conditions if you want to access them.
So we were very interested in what the comparative uptake of these two programs were. The first one which we call COACH, combines kind of an in-person coach who follows up the results with people and works with them on the plan, so that if the plan, the action plan, that they put together, if they run into problems with it, the coach is in touch with them on a weekly basis until they get to what we call action or maintenance, with respect to the health behavior.
The health behaviors that we were interested in were physical activity, diet, stress reduction, and smoking cessation.
RealAge differs from COACH because it is totally Web-based and it’s really up to the individual to stick with the program and figure out how much or how little interaction she wants with it.
So we compared the two programs. We recruited 450 people, about, at UIC staff. We measured them at baseline, at six months and 12 months.
And to make a long story short, what we found is that there were real differences in uptake between the two groups.
Ninety-five percent of people in the COACH program actually used the COACH intervention, as compared to 59 percent of people in the RealAge arm.
So [in] the RealAge arm, we assigned them to RealAge, we sent them a reminder a week later after assignment that they were supposed to access their Web site, and so on and so forth. We did not really want to bug them to use it because then the RealAge intervention would have more closely mirrored the COACH intervention and we wanted to maintain those differences in approach.
The outcomes that we found were at six months and 12 months the people in the COACH program improved with respect to improved consumption of fruits and vegetables, and also improved involvement in physical activity, yet they had a marginally significant improvement in reduced consumption of fat from vegetables at six months that became significant at 12 months. So there were about five significant improvements. And the nice thing is to see the maintenance of the improvement out to 12 months.
In contrast, the RealAge group experienced one significant outcome. But it is an interesting one. It was all on waist circumference and improvement. And it diminished waist circumference. So of course we’re all curious to understand kind of how that happened. That’s another puzzle. We kind of have to go back and look at the data, try to figure out whether we can come up with an explanation for that.
I think the other thing that’s worth noting is this was intervention light, in both cases for worksite interventions. The number of people, older adult workers, is growing dramatically especially with the recession and other things that are going on. It’s a whole area that really has been understudied — whether programs need to be tailored or adapted in any way for this population. But it’s a unique opportunity, we think, to be able to reach people in a opportunistic setting when they’re all together in the worksite, to be able to bring these programs to them in an efficient way. And if you can get people to adopt behavior change at that point there’s a potential that they would then bring that with them into retirement with the potential for decreased Medicare costs.
So we think the results are very promising. There are lots of other worksite interventions out there that are more multi-faceted, might have as many as twelve different components including direct referrals of people for special clinics for treatment of specific issues, and so on and so forth; memberships in gyms, reduced premiums for health insurance, and so on and so forth. So compared to some of those more multi-faceted interventions, both of these were relatively modest. But the good thing is that they were modest and we did see benefits. And it looks like the heavier the dose, the more contact, that’s our lesson from looking at this. COACH had more interaction, followed up with people, basically got better results than leaving people on their own to negotiate a Web site. So I guess that’s not too surprising.
[Writer] Susan Hughes is professor of community health sciences and co-director of the Center forResearch on Health and Aging at UIC’s Institute for Health Research and Policy.
For more information about this research, go to www.today.uic.edu, click on “news releases,” and look for the release dated April 14, 2011.
This has been research news from U-I-C – the University of Illinois at Chicago.
