Wellness that Works
Peer-reviewed study shows long-term impact of UR Medicine Employee Wellness Program in reducing risk of cardiovascular disease
Tuesday, November 26, 2019
Although employee wellness programs have become increasingly prevalent in recent years, there has been little research to emerge showing their effectiveness in improving the long-term health of participants.
A new study by researchers at the University of Rochester Medical Center (URMC) showed that the UR Medicine Employee Wellness Program has made statistically significant improvement in reducing the risk for cardiovascular disease (CVD) in participants.
The study, published in the Journal of Population Health Management, looked at the health outcomes for more than 16,000 employees at the University of Rochester over a five-year period and found that nearly 50 percent of those who were at moderate to very high risk for CVD at the start of the program and participated in the program for at least one year were able to lower their 10-year CVD risk, with nearly one-third improving by an entire risk category.
“Beyond the significant and positive outcomes of the program’s impact, this study provides a national, peer-reviewed validation of the UR Medicine Employee Wellness Program. That’s really the meaningful implication of this study,” said the paper’s lead author, Irena Pesis-Katz, PhD, senior director for population health informatics at URMC and associate professor of clinical nursing at the UR School of Nursing. “To the best of our knowledge, there is no program out there with parallel outcomes published in a peer-reviewed journal. That’s a big accomplishment for the program.”
“This important study validates that rigorous wellness programs delivered in the workplace can improve the cardiovascular health of those who participate,” said URMC CEO Mark B. Taubman, MD. “Employer-based wellness can be a useful element of a population health strategy.”
CVD is the biggest killer in the U.S., accounting for more than one-third of all deaths. Our risk for developing CVD increases as we age but is also affected by factors that individuals can control or modify. High blood pressure, high cholesterol, obesity and smoking are not only risk factors for CVD, but they are also associated with cancer, diabetes and other chronic respiratory diseases which account for two-thirds of all deaths globally. The UR Medicine Employee Wellness Program’s integrated approach to wellness helps address CVD risk and the overall health of participants by helping individuals achieve sustainable improvements among modifiable risk factors.
More than 9,000 employees at the University of Rochester participated in the program for at least a year from 2013 to 2017 and each were assigned a 10-year CVD risk score based on the participant’s age, sex, marital status, and health measures such as cholesterol, smoking history, and blood pressure. Eighty-four percent of participants fell in the minimal risk category, while 16 percent were classified in one of the three remaining categories (moderate, high, or very high). Of those 1,462 individuals, 48 percent improved their 10-year risk score over what was predicted without the program. Thirty-three percent dropped into a lower risk category.
“When we developed the program, we recognized the need to have a meaningful, data-driven method that would allow us to objectively assess our effectiveness in improving people’s health,” said Renu Singh, MS, CEO of the UR Employee Wellness Program and senior associate dean for operations at the UR School of Nursing. “We decided that focusing on the Framingham model of assessing CVD risk was the right choice given that it’s evidence-based, widely used, and recognized internationally. It incorporates several key objective measures that are reliable indicators of an individual’s health risks. If we can reduce those risks, we improve health and quality of life.”
“Our CVD risk increases as we get older, so we have to intervene as early as we can to help people make the modifications that are necessary to keep them at low risk,” said Lisa Norsen, PhD, RN, ACNP-BC, professor of clinical nursing and UR Medicine chief wellness officer. “We controlled for the non-modifiable risk factors – we can’t modify age, we can’t modify sex, we can’t modify ethnicity – so one of the things that this study tells us is that modifying behavior really works.”
The UR School of Nursing developed a comprehensive wellness program for the University of Rochester and its employees in 2012. The nurse-driven program consists of an online personal health assessment filled out by the employee; a biometric screening, which gives real-time results of clinical measurements such as blood pressure, weight, and cholesterol levels; and personalized wellness coaching delivered by the nurse during the screening. The results, with permission, can then be shared with the employee’s primary care provider, connecting the workplace program with the employee’s ongoing care plan.
The program has expanded its operations rapidly over the past seven years. It now serves 55 companies and more than 40,000 employees in the Greater Finger Lakes region.
“We chose UR Medicine’s Employee Wellness Program because it’s about the complete care of the person,” said Sharon Napier, chair and founder of Partners + Napier, an integrated creative agency headquartered in Rochester. “Health screening services can often seem transactional, but UR offers an experience that looks to understand and support employees before, during and after their screenings—so they are more likely to achieve their health and wellness goals.”
“We’re not a ‘one-and-done’ type program. We have a fully rounded program that not only assesses what your risks are but can also intervene and help coach you, monitor you, and be integrated with your health care provider,” said Singh. “I think that’s why we’re able to make the impact that we are.”
The UR Medicine Employee Wellness Program also offers condition management programs in areas such as asthma, diabetes, and lower back pain to help employees manage chronic conditions. The URMC study found that employees who participated in a condition management program increased their odds of improving their CVD risk by 36 percent.
“The deeper your engagement with the program, the more likely you are to change,” said Pesis-Katz. “It seems obvious, but we were able to prove it empirically.”
“This is a perfect example of the impact nurses have on improving health through awareness and personal empowerment,” Norsen said. “Wellness is at the very core of what nurses do every day.”