Absence of conflict of interest.
Citation
Highlights
-
The study’s objective was to examine the impact of iThrive, a workplace wellness program developed at the University of Illinois at Urbana-Champaign, on employment, productivity, employer benefits receipt, and health and safety.
-
This study is a randomized controlled trial. The authors used a statistical model to compare the outcomes of treatment and control group members, using data from multiple sources including university administrative records, health insurance claims, online survey data from baseline and follow-up surveys, and health screening data.
-
The study found that the iThrive program significantly increased health screening rates at both 12 and 30 months after random assignment. The authors also found a statistically significant increase in perception of management’s priority on health and safety at 12—but not 30—months after random assignment. They did not find statistically significant changes in individuals’ medical spending, participation in runs, or number of campus gym visits.
-
The quality of causal evidence presented in this report is high for most outcomes because it was based on a well-implemented randomized controlled trial. This means we are confident that the estimated effects are attributable to iThrive and not to other factors. The quality of causal evidence is moderate for the long-term perception of management’s priority on health and safety outcome because attrition was high and could have led to imbalances across the experimental groups. This means we would be somewhat confident that any estimated effects would be attributable to iThrive, but other factors might also have contributed. However, the study did not find statistically significant effects on this outcome.
Intervention Examined
IThrive
Features of the Intervention
iThrive is a workplace wellness program developed and implemented at the University of Illinois at Urbana-Champaign. The program was designed to incorporate expert-recommended components of successful wellness programs, including a biometric screening, a health risk assessment (HRA), wellness activities, monetary incentives, and paid time off.
The iThrive program was administered in two steps over one academic year. Authors ran the program twice over the span of two academic years with the same study participants. Step 1 included a five-week time frame for participants to schedule a biometric health screening at multiple locations on campus. After the screening, participants received an email invitation to complete an online HRA. They then received a scorecard that recommended areas of improvement based on the two assessments. Only participants who completed both assessments were eligible for the second step. In Step 2, iThrive invited individuals to participate in one wellness activity for the fall semester and one for the spring semester. Participants were encouraged to take paid time off to attend the wellness programs. Wellness activities included in-person classes on chronic disease management, weight management, tai chi, physical fitness, financial wellness, and healthy workplace habits as well as a tobacco quitline and an online wellness challenge. Depending on the treatment group participants were assigned to, they received a monetary reward of either $0, $100, or $200 for completing the biometric screening and the HRA and either $25 or $75 for each wellness activity completed. The total reward ranged from $50 to $350.
Features of the Study
The study is a randomized controlled trial. The authors invited 12,459 benefit-eligible employees from the University of Illinois at Urbana-Champaign to participate in the iThrive wellness program. A total of 4,834 individuals enrolled by completing a 15-minute online survey on baseline health and wellness measures. Individuals received a $30 gift card upon completion. The authors randomly assigned 3,300 participants to six treatment groups and 1,534 to a control group. Treatment groups differed only in the amount of the monetary reward participants received, with rewards ranging from $50 to $350 per year of participation, and analysis was conducted by pooling across treatment groups. The authors used a statistical model to compare the outcomes of treatment and control group members at 12 and 30 months after random assignment. The analysis used data from multiple sources, including university administrative records; data from the Illinois marathon, 10k, and 5k runs; health insurance claims; baseline and follow-up surveys; health screening data; health questionnaire data; and online HRA and wellness activities data.
Findings
-
Health and safety. The iThrive program showed a statistically significant increase in employees’ health screening rates at both 12 months and 30 months after random assignment. The program also showed a statistically significant increase in perception of management’s priority on health and safety at 12 months, but results at 30 months were insignificant. There were no statistically significant impacts on any or amount of medical spending, participation in runs, or number of campus gym visits at 12 or 30 months.
-
Employment. The iThrive program showed statistically insignificant impacts on job promotion and job termination at both 12 months and 30 months after random assignment.
-
Employer benefits receipt. The iThrive program showed statistically insignificant impacts on days of sick leave taken at both 12 months and 30 months after random assignment.
Considerations for Interpreting the Findings
Random assignment was conducted within strata defined by type of employee (faculty, staff, or civil service), age, sex, race, and annual salary. The probability of assignment to each experimental group was equal across participants.
In a separate analysis, the authors examined whether those who participated in iThrive differed from those who were invited to participate but did not. They found that participants had lower medical spending and healthier behaviors than non-participants before the intervention.
Causal Evidence Rating
The quality of causal evidence presented in this report is high for most outcomes because it was based on a well-implemented randomized controlled trial. This means we are confident that the estimated effects are attributable to iThrive and not to other factors. The quality of causal evidence is moderate for the long-term perception of management’s priority on health and safety outcome because attrition was high and could have led to imbalances across the experimental groups. This means we would be somewhat confident that any estimated effects would be attributable to iThrive, but other factors might also have contributed.