The Association between Social Determinants of Health, Risk Factors, Job Performance and Healthcare Costs in an Employed Population.

OBJECTIVE: To compare employees of a US school district based on their social determinants of health (SDoH). METHODS: Employees (N = 5006) were categorized into low, medium, or high need SDoH tiers. Of them, N = 2469 also participated in a health risk appraisal in 2019. Subjects' average healthcare costs, health risk factors, and self-rated job performance were compared by SDoH tier and race. RESULTS: Significant differences were observed among the SDoH comparison groups regarding age, gender, race, and marital status. SDoH was associated with health care costs, number of health risk factors, and self-rated job performance differently for Black and White employees. CONCLUSIONS: SDoH are complex and multi-faceted. Black employees in the high need SDoH group had higher average healthcare costs, lower self-rated job performance, and more average health risk factors than subjects in the lower need tiers.

Evaluation of a multimedia outreach campaign for a multi-target stool DNA test for colorectal cancer screening among non-medicare employer population in the United States.

Regular and timely screenings for colorectal cancer (CRC) can improve survival through early cancer detection. The current prospective intervention study assessed the effectiveness of a CRC screening outreach campaign via a multi-media campaign featuring articles in a multi-topic benefits newsletter that was both printed/mailed to homes and emailed to Metro Nashville Public Schools (MNPS) employees and their dependents in the United States. Individuals were included if they were between 45 and 64 years old. The mailed newsletter was sent to 5631 active employees, 868 under 65 retirees, and 4046 retirees with Medicare. The open rate was the highest for the third email (n = 3018; 53.3%). The click-through rate was also the highest for the third email (n = 203;6.7%). Among those who opened at least one of the emails or received a mailed newsletter, 119 members completed the assessment (conversion rate = 3.9%). Among this population, the mt-sDNA completion rate was 64.5% (69 orders completed out of 107 ordered mt-sDNA kits). All 6 patients with a positive mt-sDNA result underwent a follow-up colonoscopy (FU-CY) with the mean (±SD) days to FU-CY among those with positive mt-sDNA test results was 49 (±27) days (median = 42 days). Using emails in conjunction with other targeted interventions to outreach and educate members regarding CRC screening may be an effective strategy to enhance mt-sDNA completion rates.

Migraine Headache in an Employed Population: Demographics, Health Risks, Pharmaceutical Utilization, and Productivity Loss.

OBJECTIVE: Demographics, health risks, pharmaceutical utilization, and other characteristics of adults with and without migraine who were employed by a school district in the southern United States were compared. METHODS: A total of 4528 employees completed a health risk appraisal. A diagnosis of migraine was reported by 11%. Employees with and without migraine were compared on several measures. RESULTS: Demographic and health risk differences were observed among the comparison groups. One-fifth of migraineurs had a prescription for an opioid, which was associated with very high average annual health care costs ($17,791) compared with migraineurs without opioid ($3907). CONCLUSIONS: Migraine is common in the workforce. Employers may want to educate employees with migraine about evidence-based treatments. Benefit plan design should be consistent with current accepted treatment guidelines for opioid use.

Results of a Virtual Migraine Education Program in an Employed Population.

OBJECTIVE: Migraine affects about 15% of the world's population and disproportionately affects adults who are working age. It is associated with higher healthcare costs, absenteeism, and lost productivity. A metropolitan school district in the southern United States offered a virtual migraine education program to their teaching employees. METHODS: Seventy-nine employees completed a migraine questionnaire at both baseline and 3-month follow-up. The program included webinars, educational videos, and other intranet-based resources. RESULTS: Results found that program participants reported a significant improvement in the frequency and severity of migraine as well as a reduction in lost on-the-job productivity. A majority of participants reported making positive changes to reduce triggers and better manage stress. CONCLUSIONS: An employer-offered migraine education program distributed virtually to remote workers has the potential to improve migraine symptoms and treatment as well as productivity.

Evaluating Outreach Methods for Multi-Target Stool DNA Test for Colorectal Cancer Screening Among an Employer Population.

INTRODUCTION/OBJECTIVES: Despite compelling evidence of clinical and economic benefits, adherence to colorectal cancer (CRC) screening remains low. Increasing public awareness through various outreach methods may improve screening uptake. The objective of this study was to evaluate the uptake of non-invasive multi-target stool DNA (mt-sDNA) by different outreach methods in an average-risk employer population. METHODS: This retrospective observational study included CRC screening-eligible individuals aged ≥50 years insured by the Metropolitan Nashville Public Schools (MNPS) employee healthcare plan. The study intervention arms included population-based outreach and office visit-based interaction. The mt-sDNA completion rate (proportion of individuals who return the mt-sDNA kit after consenting to have it shipped to their home), proportion of patients who performed follow-up colonoscopy after a positive test, and time to follow-up colonoscopy were assessed. RESULTS: A total of 167 mt-sDNA kits were shipped to eligible participants (aged 50-64 years) in the population-based outreach arm. In the office visit-based interaction arm, a total of 132 mt-sDNA kits were shipped to eligible participants (aged ≥50 years). The mt-sDNA completion rate was significantly higher for office visit-based interaction as compared to population-based outreach (76.8% vs 53.5%; P < .001) among those aged 50 to 64 years. While all patients aged 50 to 64 years with a positive mt-sDNA result received a follow-up colonoscopy in both arms, the median time to follow-up colonoscopy was shorter among the population-based outreach (55 vs 136 days; P < .05). CONCLUSIONS: Office visit-based interaction was associated with a higher mt-sDNA completion rate as compared to the population-based outreach among average-risk, CRC screening-eligible individuals aged 50 to 64 years old.