Characteristics of self-selected responders to a health risk appraisal: generalizability of corporate health assessments.

Lynch, William T.; Golaszewski, Thomas; Clearie, Andrew F.; Vickery, Donald M.

doi:10.2105/ajph.79.7.887

Cited by 27 publications

(8 citation statements)

References 1 publication

(1 reference statement)

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“…Another limitation related to the difference in age and BMI between twins who agreed to participate and those who declined. This healthy participant bias, whereby participants in epidemiologic studies present with fewer risk factors than those who decided not to participate, has been described previously and does not necessarily affect the representativeness of results for the general population (65, 66). Importantly for our effort, there was no difference in the response rate between monozygotic and dizygotic twins.…”

Section: Discussionmentioning

confidence: 75%

Heritability of objectively assessed daily physical activity and sedentary behavior

Hoed¹,

Brage²,

Zhao³

et al. 2013

The American Journal of Clinical Nutrition

123

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Background: Twin and family studies that estimated the heritability of daily physical activity have been limited by poor measurement quality and a small sample size.Objective: We examined the heritability of daily physical activity and sedentary behavior assessed objectively by using combined heart rate and movement sensing in a large twin study.Design: Physical activity traits were assessed in daily life for a mean (±SD) 6.7 ± 1.1 d in 1654 twins from 420 monozygotic and 352 dizygotic same-sex twin pairs aged 56.3 ± 10.4 y with body mass index (in kg/m2) of 26.1 ± 4.8. We estimated the average daily movement, physical activity energy expenditure, and time spent in moderate-to-vigorous intensity physical activity and sedentary behavior from heart rate and acceleration data. We used structural equation modeling to examine the contribution of additive genetic, shared environmental, and unique environmental factors to between-individual variation in traits.Results: Additive genetic factors (ie, heritability) explained 47% of the variance in physical activity energy expenditure (95% CI: 23%, 53%) and time spent in moderate-to-vigorous intensity physical activity (95% CI: 29%, 54%), 35% of the variance in acceleration of the trunk (95% CI: 0%, 44%), and 31% of the variance in the time spent in sedentary behavior (95% CI: 9%, 51%). The remaining variance was predominantly explained by unique environmental factors and random error, whereas shared environmental factors played only a marginal role for all traits with a range of 0–15%.Conclusions: The between-individual variation in daily physical activity and sedentary behavior is mainly a result of environmental influences. Nevertheless, genetic factors explain up to one-half of the variance, suggesting that innate biological processes may be driving some of our daily physical activity.

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Section: Discussionmentioning

confidence: 75%

Heritability of objectively assessed daily physical activity and sedentary behavior

Hoed¹,

Brage²,

Zhao³

et al. 2013

The American Journal of Clinical Nutrition

123

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“…Patients who participate in an HRA are not necessarily representative of insured patients in general. Previous studies have found that HRA responders are younger and healthier than non-responders, and may be more likely to file health claims and incur greater healthcare costs (37,38). Second, we were unable to account for some potential factors such as race, socioeconomic status and total duration of membership in the health plan, as they were not available in our data.…”

Section: Discussionmentioning

confidence: 99%

Doctor shopping by overweight and obese patients is associated with increased healthcare utilization

Gudzune

Bleich

Richards

et al. 2013

Obesity

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Negative interactions with healthcare providers may lead patients to switch physicians or “doctor shop.” We hypothesized that overweight and obese patients would be more likely to doctor shop, and as a result, have increased rates of emergency department (ED) visits and hospitalizations as compared to normal weight non-shoppers. We combined claims data from a health plan in one state with information from beneficiaries’ health risk assessments. The primary outcome was “doctor shopping,” which we defined as having outpatient claims with ≥5 different primary care physicians (PCPs) during a 24-month period. The independent variable was standard NIH categories of weight by BMI. We performed multivariate logistic regression to evaluate the association between weight categories and doctor shopping. We conducted multivariate zero-inflated negative binominal regression to evaluate the association between weight-doctor shopping categories with counts of ED visits and hospitalizations. Of the 20,726 beneficiaries, the mean BMI was 26.3 kg/m2 (SD 5.1), mean age was 44.4 years (SD 11.1) and 53% were female. As compared to normal weight beneficiaries, overweight beneficiaries had 23% greater adjusted odds of doctor shopping (OR 1.23, 95%CI 1.04–1.46) and obese beneficiaries had 52% greater adjusted odds of doctor shopping (OR 1.52, 95%CI 1.26–1.82). As compared to normal weight non-shoppers, overweight and obese shoppers had higher rates of ED visits (IRR 1.85, 95%CI 1.37–2.45; IRR 1.83, 95%CI 1.34–2.50, respectively), which persisted during within weight group comparisons (Overweight IRR 1.50, 95%CI 1.10–2.03; Obese IRR 1.54, 95%CI 1.12–2.11). Frequently changing PCPs may impair continuity and result in increased healthcare utilization.

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“…Research indicates that employees who typically respond to heath risk assessments are different than nonresponders. 19,20 Consequently, efforts that are successful at increasing HRA participation rates will engage more individuals who otherwise would not have participated in health promotion activities and produce reports that are more representative of the whole employee population. Therefore, employers and health promotion providers continually seek to improve program participation.…”

mentioning

confidence: 99%

Incentives and Other Factors Associated With Employee Participation in Health Risk Assessments

Taitel

Haufle

Heck

et al. 2008

Journal of Occupational &Amp; Environmental Medicine

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Characteristics of self-selected responders to a health risk appraisal: generalizability of corporate health assessments.

Cited by 27 publications

References 1 publication

Heritability of objectively assessed daily physical activity and sedentary behavior

Heritability of objectively assessed daily physical activity and sedentary behavior

Doctor shopping by overweight and obese patients is associated with increased healthcare utilization

Incentives and Other Factors Associated With Employee Participation in Health Risk Assessments

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