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Workplace Digital Health Is Associated with Improved Cardiovascular Risk Factors in a Frequency-Dependent Fashion: A Large Prospective Observational Cohort Study.

Widmer RJ, Allison TG, Keane B, Dallas A, Bailey KR, Lerman LO, Lerman A - PLoS ONE (2016)

Bottom Line: DHI--mobile technology including online and smartphone interventions--has previously been found to be beneficial in reducing CVD outcomes and risk factors, however its use and efficacy in a large, multisite, primary prevention cohort has not been described to date.Regression analyses demonstrated that greater participation in the DHI (measured by log-ins) was significantly associated with older age (p<0.001), female sex (p<0.001), and Hispanic ethnicity (p<0.001).The current study demonstrates the success of DHI in a large, community cohort to modestly reduce CVD risk factors in individuals with high participation rate.

View Article: PubMed Central - PubMed

Affiliation: Division of Cardiovascular Diseases, Department of Internal Medicine, Mayo Clinic and College of Medicine, Rochester, MN 55905, United States of America.

ABSTRACT
Cardiovascular disease (CVD) is the leading cause of morbidity and mortality in the US. Emerging employer-sponsored work health programs (WHP) and Digital Health Intervention (DHI) provide monitoring and guidance based on participants' health risk assessments, but with uncertain success. DHI--mobile technology including online and smartphone interventions--has previously been found to be beneficial in reducing CVD outcomes and risk factors, however its use and efficacy in a large, multisite, primary prevention cohort has not been described to date. We analyzed usage of DHI and change in intermediate markers of CVD over the course of one year in 30,974 participants of a WHP across 81 organizations in 42 states between 2011 and 2014, stratified by participation log-ins categorized as no (n = 14,173), very low (<12/yr, n = 12,260), monthly (n = 3,360), weekly (n = 651), or semi-weekly (at least twice per week). We assessed changes in weight, waist circumference, body mass index (BMI), blood pressure, lipids, and glucose at one year, as a function of participation level. We utilized a Poisson regression model to analyze variables associated with increased participation. Those with the highest level of participation were slightly, but significantly (p<0.0001), older (48.3±11.2 yrs) than non-participants (47.7±12.2 yr) and more likely to be females (63.7% vs 37.3% p<0.0001). Significant improvements in weight loss were demonstrated with every increasing level of DHI usage with the largest being in the semi-weekly group (-3.39±1.06 lbs; p = 0.0013 for difference from weekly). Regression analyses demonstrated that greater participation in the DHI (measured by log-ins) was significantly associated with older age (p<0.001), female sex (p<0.001), and Hispanic ethnicity (p<0.001). The current study demonstrates the success of DHI in a large, community cohort to modestly reduce CVD risk factors in individuals with high participation rate. Furthermore, participants previously underrepresented in WHPs (females and Hispanics) and those with an increased number of CVD risk factors including age and elevated BMI show increased adherence to DHI, supporting the use of this low-cost intervention to improve CVD health.

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Predicted means of log-ins adjusted for age, gender, job type, employer, ethnicity, state, baseline weight, baseline systolic blood pressure, baseline glucose, and baseline lipid status.
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pone.0152657.g002: Predicted means of log-ins adjusted for age, gender, job type, employer, ethnicity, state, baseline weight, baseline systolic blood pressure, baseline glucose, and baseline lipid status.

Mentions: A Poisson regression model was used to investigate the association between total logins and gender, age, and ethnicity. We also adjusted for age, gender, job type, employer, ethnicity, state, baseline weight, baseline systolic blood pressure, baseline glucose, and baseline lipid status. From this, we note women, on average, tended to have 3.07 more total log-ins (p<0.001) at one year compared to men (Fig 2). Similarly, we found significant associations between older age, Hispanic ethnicities, and total logins as described in Table 3. Of note, employment type, white or African American ethnicity, lipid status, glucose had no predictive effect in terms of use of the program.


Workplace Digital Health Is Associated with Improved Cardiovascular Risk Factors in a Frequency-Dependent Fashion: A Large Prospective Observational Cohort Study.

Widmer RJ, Allison TG, Keane B, Dallas A, Bailey KR, Lerman LO, Lerman A - PLoS ONE (2016)

Predicted means of log-ins adjusted for age, gender, job type, employer, ethnicity, state, baseline weight, baseline systolic blood pressure, baseline glucose, and baseline lipid status.
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4836693&req=5

pone.0152657.g002: Predicted means of log-ins adjusted for age, gender, job type, employer, ethnicity, state, baseline weight, baseline systolic blood pressure, baseline glucose, and baseline lipid status.
Mentions: A Poisson regression model was used to investigate the association between total logins and gender, age, and ethnicity. We also adjusted for age, gender, job type, employer, ethnicity, state, baseline weight, baseline systolic blood pressure, baseline glucose, and baseline lipid status. From this, we note women, on average, tended to have 3.07 more total log-ins (p<0.001) at one year compared to men (Fig 2). Similarly, we found significant associations between older age, Hispanic ethnicities, and total logins as described in Table 3. Of note, employment type, white or African American ethnicity, lipid status, glucose had no predictive effect in terms of use of the program.

Bottom Line: DHI--mobile technology including online and smartphone interventions--has previously been found to be beneficial in reducing CVD outcomes and risk factors, however its use and efficacy in a large, multisite, primary prevention cohort has not been described to date.Regression analyses demonstrated that greater participation in the DHI (measured by log-ins) was significantly associated with older age (p<0.001), female sex (p<0.001), and Hispanic ethnicity (p<0.001).The current study demonstrates the success of DHI in a large, community cohort to modestly reduce CVD risk factors in individuals with high participation rate.

View Article: PubMed Central - PubMed

Affiliation: Division of Cardiovascular Diseases, Department of Internal Medicine, Mayo Clinic and College of Medicine, Rochester, MN 55905, United States of America.

ABSTRACT
Cardiovascular disease (CVD) is the leading cause of morbidity and mortality in the US. Emerging employer-sponsored work health programs (WHP) and Digital Health Intervention (DHI) provide monitoring and guidance based on participants' health risk assessments, but with uncertain success. DHI--mobile technology including online and smartphone interventions--has previously been found to be beneficial in reducing CVD outcomes and risk factors, however its use and efficacy in a large, multisite, primary prevention cohort has not been described to date. We analyzed usage of DHI and change in intermediate markers of CVD over the course of one year in 30,974 participants of a WHP across 81 organizations in 42 states between 2011 and 2014, stratified by participation log-ins categorized as no (n = 14,173), very low (<12/yr, n = 12,260), monthly (n = 3,360), weekly (n = 651), or semi-weekly (at least twice per week). We assessed changes in weight, waist circumference, body mass index (BMI), blood pressure, lipids, and glucose at one year, as a function of participation level. We utilized a Poisson regression model to analyze variables associated with increased participation. Those with the highest level of participation were slightly, but significantly (p<0.0001), older (48.3±11.2 yrs) than non-participants (47.7±12.2 yr) and more likely to be females (63.7% vs 37.3% p<0.0001). Significant improvements in weight loss were demonstrated with every increasing level of DHI usage with the largest being in the semi-weekly group (-3.39±1.06 lbs; p = 0.0013 for difference from weekly). Regression analyses demonstrated that greater participation in the DHI (measured by log-ins) was significantly associated with older age (p<0.001), female sex (p<0.001), and Hispanic ethnicity (p<0.001). The current study demonstrates the success of DHI in a large, community cohort to modestly reduce CVD risk factors in individuals with high participation rate. Furthermore, participants previously underrepresented in WHPs (females and Hispanics) and those with an increased number of CVD risk factors including age and elevated BMI show increased adherence to DHI, supporting the use of this low-cost intervention to improve CVD health.

Show MeSH
Related in: MedlinePlus