Published results from the Illinois Workplace Wellness Study, a large randomized controlled trial of a wellness program at the University of Illinois at Urbana-Champaign, were disappointing, according to researchers, but researchers caution that the findings might not tell the whole story. Almost 5,000 employees volunteered to participate in the study.
More than 1,500 employees were randomly put in the control group, which essentially received no services. About 3,300 were invited to receive a biometric health screening and an online health risk assessment. They were then offered a number of wellness activities, including classes on weight loss, exercise, tai chi, smoking cessation, financial wellness and more. They were even offered financial incentives for completing screenings and participating in activities.
Although not everyone who is given an opportunity to engage in such activities will take it, but more than half of those offered the program participated. The researchers followed everyone, in both the control and intervention group, for a year to see how the program affected their activities, their health, their productivity and their medical spending. The results were disappointing; there seemed to be no causal effects.
Undaunted, the researchers also analyzed the data as if it were an observational trial. In other words, they took the 3,300 who were offered the wellness program, then analyzed them the way a typical observational trial would, comparing those who participated with those who didn’t. The results were very different from those of the controlled trial.
If we look only at the intervention group as an observational trial, the researchers say, it appears that people who didn’t make use of the program went to the campus gym 3.8 days per year, and those who participated in it went 7.4 times per year. Based on that, the program appears to be a success. But when the intervention group is compared with the control group as a randomized controlled trial, the differences disappear. Those in the control group went 5.9 times per year, and those in the intervention group went 5.8 times per year.
Researchers looked at whether people participated in a race, like a marathon, a 10-kilometer run or a five-kilometer run. The observational analysis, comparing nonparticipants with participants, showed a significant difference in running: 3.3 percent of people versus 9.2 percent. The randomized controlled trial, on the other hand, found 6.5 percent versus 6 percent.
Wellness programs sometimes claim to save money by reducing health care spending. The observational analysis supports this belief. It found that participants spent significantly less than nonparticipants on health care ($525 versus $657) and on hospital-related costs ($273 versus $387). The randomized controlled trial showed that the wellness program had little effect on spending compared with the control group in both overall spending ($576 versus $568) and hospital spending ($317 versus $297).
Why such stark differences? “The most likely explanation is that participants differ from nonparticipants in very important ways,” said Julian Reif, one of the study’s principal investigators. “Therefore, when a wellness program is offered, the differences seen between those who take advantage of it and those who don’t are due to differences in the people rather than differences from the program.”
Source: The New York Times, August 6, 2018