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Biomedical subjects

R Z Goetzel

Publications and source records attributed to R Z Goetzel.

16 recordsLinked to original sources
PubMed1998

Health care costs of worksite health promotion participants and non-participants.

Total and lifestyle-related medical care costs for employees of a major corporation participating in a worksite health promotion (WHP) program over a three-year period were compared with the costs for non-participants in a cross-sectional study. The study population consisted of 8,334 active employees based in the Cincinnati headquarters of The Procter & Gamble Company. Adjusting for age and gender, participants (n = 3,993) had significantly lower health care costs (29% lower total and 36% lower lifestyle-related costs) when compared with non-participants (n = 4,341) in the third year of the program. Similarly, in the third year of the program, participants had significantly lower inpatient costs, fewer hospital admissions, and fewer hospital days of care when compared with non-participants. No significant differences in costs were found between participants and non-participants during the first two years of the WHP program. Conclusions drawn from this study are that long-term participation in a WHP that includes high-risk screening and intensive one-on-one counseling results in lower total and lifestyle-related health care costs, as well as lower utilization of hospital services.

Adult↗
PubMed1998

Differences between descriptive and multivariate estimates of the impact of Chevron Corporation's Health Quest Program on medical expenditures.

This investigation focused on alternative methods for evaluating the impact of Chevron Corporation's Health Quest Fitness Center program on medical expenditures, comparing descriptive and multivariate research designs. Many uncontrolled studies of corporate health management programs base estimates of program effectiveness on descriptive analyses such as Student's tests. Unlike more sophisticated multivariate analyses, descriptive analyses often produce biased estimates of program cost savings. To test alternative research design methods, the investigators compared inpatient and pharmacy expenditures for program participants and non-participants over a 2.5-year period, using descriptive and multivariate regression analyses. Results showed that compared with non-participants, expenditures for participants were significantly lower for subjects who used a Health Quest fitness center at least twice weekly. Previous descriptive studies suggested a much broader impact. The results underscore the need to use multivariate analyses when evaluating the financial impact of corporate health management programs, especially when randomization cannot be used to assign participation status.

Adolescent↗
PubMed1998

The relationship between modifiable health risks and health care expenditures. An analysis of the multi-employer HERO health risk and cost database.

This investigation estimates the impact of ten modifiable health risk behaviors and measures and their impact on health care expenditures, controlling for other measured risk and demographic factors. Retrospective two-stage multivariate analyses, including logistic and linear regression models, were used to follow up 46,026 employees from six large health care purchasers for up to 3 years after they completed an initial health risk appraisal. These participants contributed 113,963 person-years of experience. Results show that employees at high risk for poor health outcomes had significantly higher expenditures than did subjects at lower risk in seven of ten risk categories: those who reported themselves as depressed (70% higher expenditures), at high stress (46%), with high blood glucose levels (35%), at extremely high or low body weight (21%), former (20%) and current (14%) tobacco users, with high blood pressure (12%), and with sedentary lifestyle (10%). These same risk factors were found to be associated with a higher likelihood of having extremely high (outlier) expenditures. Employees with multiple risk profiles for specific disease outcomes had higher expenditures than did those without these profiles for the following diseases: heart disease (228% higher expenditures), psychosocial problems (147%), and stroke (85%). Compared with prior studies, the results provide more precise estimates of the incremental medical expenditures associated with common modifiable risk factors after we controlled for multiple risk conditions and demographic confounders. The authors conclude that common modifiable health risks are associated with short-term increases in the likelihood of incurring health expenditures and in the magnitude of those expenditures.

Adolescent↗
PubMed1994

An evaluation of Duke University's LIVE FOR LIFE health promotion program on changes in worker absenteeism.

The effect of an employer-sponsored health promotion program on worker absenteeism is examined over a 4-year period in a group of 4972 Duke University hourly employees. Program participants experienced an average of 4.6 fewer absentee hours in the third year of program availability than did nonparticipants, after controlling for baseline absenteeism, gender, race, education, and age. These results suggest that employer-sponsored health promotion initiatives can have a favorable influence on absenteeism.

Absenteeism↗
PubMed1992

The impact of legislation on self-reported safety belt use in a working population.

To assess the impact of safety belt laws, we compared self-reported use of safety belts among employed residents of states with primary, secondary, and no laws in a group of 17,830 volunteer health profile participants. Failure to wear safety belts at least 80% of the time was reported by 22% of subjects covered by primary laws, 23% of those covered by secondary laws, and 39% of those not covered by any law.

Accidents, Traffic↗
PubMed1991

Prevalence and characteristics of employees reporting heavy or problem drinking.

INTRODUCTION: This study examined the prevalence and demographic characteristics of chronic heavy drinkers, binge drinkers, those who report a problem with alcohol, and those at high risk for alcohol-related problems. METHODS: The sample comprised a worksite population of 18,053 employees. The study was based on responses to questions contained in a confidential health profile administered to employees at seven companies by an outside vendor (Johnson & Johnson Health Management, Inc.). RESULTS: Almost 1 in 4 participants (23.0%) was found to be at risk for alcohol-related problems. About 1 in 5 respondents (20.1%) reported binging, 1 in 10 reported chronic heavy drinking (9.8%), and 2.6% reported a drinking problem within the past month. Younger respondents were more likely to report binging but older respondents were more likely to report chronic heavy drinking. Men were more than twice as likely to report binging and almost four times as likely to report chronic heavy drinking, but only one and one-half times as likely to report a drinking problem within the past month. Other differential demographic associations with alternative measures of heavy drinking are described. CONCLUSION: The results suggest that a health profile administered at the worksite can be an effective screening tool for identifying employees at high risk for alcohol-related problems.

Adult↗
PubMed1991

Correlates of motor-vehicle safety behaviors in working populations.

To determine the prevalence and correlates in a working population of failure to wear seat belts, drinking and driving, and speeding, we examined the responses of 18,046 health-profile participants. Twenty-four percent of subjects reported failure to wear seat belts at least 80% of the time. Twenty-two percent reported speeding at least 10 miles per hour over the speed limit when traffic permits. Twenty-three percent reported traveling at least once a month with a driver who had two or more drinks. Correlates of high-risk behaviors included male gender and youth. Educational attainment was inversely associated with seat-belt nonuse but directly related to speeding and drinking/driving. Our findings suggest a substantial opportunity to help employees lower important risks for serious motor-vehicle injury.

Accidents, Traffic↗
PubMed1991

Utilization of preventive health services by an employed population.

To determine the utilization rates of selected preventive services in an employed population, we analyzed the responses of 18,053 health profile participants. Overall utilization rates for preventive services were high: 86.0% of respondents had their blood pressure checked, 94.0% of all women had a Pap smear and 81.3% had clinical breast examinations, 42.4% of respondents aged 40 and older had a rectal examination and 31.8% of those aged 50 and older had a test for occult blood in the stool, and 33.7% had a routine sigmoidoscopy. With the exception of blood pressure screening, the percentage of our respondents utilizing preventive services was considerably higher than the corresponding percentages in the US population as reported in the National Health Interview Survey. Nevertheless, the results suggest substantial opportunity for employers to encourage the appropriate use of preventive health services among employees.

Adult↗
PubMed1984

Attitudes towards cancer. Development of the cancer attitudes questionnaire.

A questionnaire evaluating attitudes towards cancer (the Cancer Attitudes Questionnaire) was constructed to compare the attitudes of first-year medical students before and after taking a clinical oncology program with those of students who did not participate in the program. A factor and reliability analysis revealed five underlying factors that explained 42% of the variance and reliabilities ranging from 0.55 to 0.79. An analysis of covariance revealed that students who participated in the clinical oncology program were more positively predisposed toward the outpatient functioning of cancer patients (P less than 0.04) at the conclusion of the year than students who did not take the course; the participating students were also somewhat less pessimistic toward the disease (P less than 0.07). Women (regardless of whether they had taken the course) assigned significantly greater importance to the patient's and family's attitudes in relation to outcome of disease (P = 0.03) than did male students. It appears that an early medical educational oncology experience emphasizing contact with ambulatory cancer patients can appreciably alter the attitudes of first-year medical students towards cancer.

Attitude to Health↗
PubMed1984

Evaluating self-help support groups for medical students.

Self-help support groups for medical students represent one strategy for dealing with the emotional stresses of medical training and the diminished human sensitivity of students that often accompanies that experience. Support groups at the Albert Einstein College of Medicine were evaluated by 26 students who completed a nine-part questionnaire. The respondents indicated that they were primarily drawn to these groups because of a desire for social affiliation and an opportunity to express their feelings in a "safe" environment. Members shared in the leadership responsibilities of the group and dealt with external personal problems of the students rather than with the internal group dynamics. The gains derived from participation in these groups included opportunities for nonprofessional contact with faculty members, getting help and support from fellow students, and participation in stimulating discussions about the medical field. Students rated the groups as "meaningful" and expressed a desire for more frequent meetings.

Adult↗
PubMed1984

Interdisciplinary training for medical and nursing students: learning to collaborate in the care of geriatric patients.

A medicine clerkship for students at the Albert Einstein College of Medicine provided the setting for a pilot program in interdisciplinary geriatric training with nursing students from the College of Mount Saint Vincent. The program's objectives were to provide opportunities for interdisciplinary collaboration and to increase appreciation for the role of each discipline in caring for the aged. Additionally, it sought to foster a holistic approach to the aging and a recognition of the psychosocial influences on their lives. Teams of one medical and two nursing students conducted patient work-ups and presented cases to an interdisciplinary group of health care professionals. Analysis of pretest-posttest responses of ten medical and ten nursing students to a Role Assessment Questionnaire (RAQ) found that the program significantly increased medical students' perceptions of the nurse's role in caring for hospitalized elderly patients (P less than 0.05). Despite this gain, however, there continued to be substantial discrepancies between medical and nursing students' perceptions of the extent to which nurses are "essential" in caring for the elderly. In evaluating the program, all participants concurred that working with students in another health profession was a valuable learning experience. While nursing students felt that the program achieved all its goals, responses of medical students were more variable, with volunteers having more positive perceptions of program impact than those who were assigned. The program demonstrated both the need for and the effect of interdisciplinary training, and that teaching and clinical experiences centering around the hospitalized older person can provide a natural setting for such training.

Aged↗
PubMed1984

Methodological update.

Explore the source record for details and available documents.

Attention Deficit Disorder with Hyperactivity↗
PubMed1982

A content validity analysis of neoplastic items of the National Board of Medical Examiners Part II Examination.

As part of its evaluation of the Clinical Cancer Education Program (CCEP) at the Albert Einstein College of Medicine, the Office of Educational Research and Evaluation analyzed student performance on neoplastic items of the National Board of Medical Examiners (NBME) Examination Part II. The evaluation provided a successful application of the American Association for Cancer Education (AACE) coding schema for analysis of neoplastic items. Two examinations were analyzed in order to determine the frequency with which specific disease sites, treatment modalities, and question emphasis items appeared. With reference to disease site, the greatest number of questions on both examinations dealt with gynecological issues while the fewest dealt with lung and hematologic-related disease. A breakdown of questions into various treatment modalities indicated that of items that could be categorized, most dealt with surgical treatment, while other therapeutic modalities were given little or no emphasis. Looking at question emphases, the most frequently asked questions referred to diagnostic tests and stratagems, whereas the least amount of emphasis was placed on rehabilitative and psychosocial aspects of the disease. These findings corroborate those reported by Ruckdeschel and his associates and point out several limitations to the content validity of the neoplastic items on NBME Part II.

Achievement↗
PubMedDate not supplied

The relationship between perceived stress and self-reported illness-related absenteeism.

PURPOSE: To investigate the association between perceived stress and illness-related work absenteeism. DESIGN: A standardized health profile questionnaire developed by Johnson & Johnson Advanced Behavioral Technologies, Inc., was used to collect demographic and personal health data between June 1988 and January 1993. Chi-square, odds ratio, and stepwise regression tests were used to analyze perceived stress and self-reported absenteeism data. SETTING: Worksite health promotion programs in 250 U.S. companies. SUBJECTS: Subjects consisted of 79,070 employees. MEASURES: Stress data, grouped as low, moderate, and high, were correlated with absenteeism data grouped by annual days missed (None, 1 to 2, 3 to 4, and 5+). RESULTS: Significant relationships were found (p < or = .05) between high stress and absenteeism for both genders. Female workers reported higher stress levels and absenteeism than men. Those with high stress were 2.22 more likely to be absent 5+ days per year than those with low stress. Work, finances, and family were the highest stress sources. Greatest absenteeism predictors were health, legal, social, and financial stress. CONCLUSIONS: These data primarily represented self-selected white workers and may not apply to all employees. However, if high stress relates to absenteeism, these data may provide valuable information for program design in stress management.

Absenteeism↗
PubMedDate not supplied

A review of health-related outcomes of multi-component worksite health promotion programs.

PURPOSE: The purpose of this article is to critically review evaluation studies of the health-related effects (i.e., health risk modification and reduction in worker absenteeism) of multicomponent worksite health promotion programs. SEARCH METHOD: A comprehensive literature search conducted under the auspices of the Centers for Disease Control and Prevention identified 36 articles that examined health-related outcomes of multi-component programs. The authors identified 11 additional articles through manual searches of recent journal issues and through personal contacts with worksite health promotion researchers. Forty-seven studies describing the results of 35 worksite health promotion programs were reviewed. IMPORTANT FINDINGS: The worksite health promotion programs reviewed for this article varied tremendously in the comprehensiveness, intensity, and duration of the intervention activities. All of the programs provided health education to employees. In a majority of the programs, opportunities to learn and practice new skills were also offered. A smaller number of programs incorporated modifications in organizational policy or the physical work environment. Results from well-conducted randomized trials suggest that providing opportunities for individual risk reduction counseling for high risk employees within the context of comprehensive programming may be the critical component of an effective worksite health promotion program. Just offering low intensity, short duration programs aimed at increasing awareness of health issues for the entire employee population may not be sufficient to achieve desired outcomes. MAJOR CONCLUSIONS: The results of the studies reviewed provide both cautious optimism about the effectiveness of these worksite programs and some general guidance as to the critical components and characteristics of successful programs. Overall, the evidence suggests that a rating of indicative/acceptable may best characterize this literature.

Absenteeism↗