Program Evaluation Summary

Vanderbilt’s Go for the Gold program has resulted in significant improvements in health and productivity over a 5-year period. The incentive for annual participation has resulted in a cohort of 4,512 participants who have completed the health risk assessment every year for 5 years. The evaluation of both these paired data from the cohort and the unpaired data from the set of participants who completed the HRA in each year provides strong evidence regarding the effectiveness of the program. As an academic medical research organization with physicians and a biostatistician integrated into the program, the evaluation is scientifically and statistically rigorous, using state-of-the-art methods such as data reduction methods, recursive partitioning, proportional odds logistic regression, and propensity score analysis to account for selection bias, as well as modern graphical methods, such as restricted cubic splines to assess nonlinear associations.

Program Evaluation Highlights

• 87.5% of the current benefits-eligible faculty and staff have participated in the program and completed the health risk assessment at least once during the past 3 years.
• In 2007, 80.0% were low risk, defined as 0 to 2 risk factors, using the factors defined by Edington.
• A cohort of 4,512 has participated in all of the previous 5 years (2003-2007). This is the major strength of this wellness program since it allows for an unbiased assessment of the true changes on an annual basis.
• The slope of health care cost per employee was reduced in the 5-year period after the program began, with an estimated savings of $214.87 per employee, per year. In addition to health care savings, there are other savings (including workers’ compensation, absenteeism and presenteeism) estimated to be twice this amount.
• The program has succeeded with participation across a broad spectrum of socioeconomic levels and job categories, including physicians, faculty members, nurses, and staff.
• Major improvements were seen between the first and second year of the program, with incremental but consistent improvements in years three through five.

The specific goals for the program were based on Healthy People 2010.5 In addition, progress in relation to both national and state data has been tracked to evaluate trends. Ongoing evaluation provides feedback for quality improvement and information about populations that require additional support for participation.

Overview of Evaluation Methods

The evaluation includes annual de-identified data from health risk assessments, Wellness Actions Logs, the Healthy Steps coaching program, workers’ compensation data, health care claims data, and absenteeism data. To protect the confidentiality of employees, there is an extensive de-identification and data security system.

The program has received direction and professional assistance from outside consultants and internal advisors from across the University. The Go for the Gold team includes two physicians, a faculty-level biostatistician, two health educators, a registered dietitian, an exercise specialist, a health promotion coordinator, a registered nurse, a CPA/nurse practitioner, and four fitness associates to ensure high-quality planning, implementation, and evaluation.