client report
EMPOWERED™ Outcomes Report
For Sample Company
06/30/14
Sample Company
EMPOWERED™ Outcomes Report
EMPOWERED™ HEALTH COACHING PRINCIPLES
EMPOWERED™ Health Coaching’s approach is based on the expectation that each
participant is able to achieve the health results that are important to them and allows them
to thrive. Using a participant-centered approach that includes aspects of motivational
interviewing, positive psychology, readiness to change, and social cognitive theories, the
Coaches support participants through a process of self-discovery, building confidence and
self-efficacy, applying knowledge and skills, and continuous learning.
PARTICIPATION AND DEMOGRAPHICS
Sample Company has a total population of 5,865. To be eligible for the EMPOWERED
program, participants had to take either a HRA or participate in a Screening. During
Program Year 1 and 2, 3,477 participants were eligible to participate in EMPOWERED (based
on completing a HRA or a Screening). During Program Year 1 and 2, 1,442 unique
individuals enrolled in the program (41.5% enrollment).
This EMPOWERED Health Coaching Outcomes Report summarizes Sample Company’s
participant health improvements made as a result of the EMPOWERED Health Coaching
Program.
This outcomes report is based on the aggregate results of those EMPOWERED
participants who completed a Health Risk Assessment (HRA) between 09/01/2011 and
08/31/2012 (Time 1), as well as between 09/01/2012 and 12/31/2012 (Time 2). A total of
1,987 participants completed both a Time 1 and a Time 2 HRA (33.9% participation rate
based on the total population). This included 572 EMPOWERED enrollees. The remaining
870 EMPOWERED enrollees either did not take a Time 1 HRA or did not take a Time 2 HRA
and therefore cannot be included in this analysis. The average time between tests was 1.6
years.
EMPOWERED Health Coaching is unique from other coaching programs in that a participant
may continue in the program as long as they are actively making progress on their lifestyle
behaviors and/or risks. Consequently, defining a “completer” in the program is slightly
different from “fixed time-frame” or “number-of-session” programs. Of those who took a
Time 1 and Time 2 HRA, 378 participants were classified as Enrolled and Completed, 194
were Enrolled and Not Completed, and 1,415 were Not Enrolled based on the following
definitions:
© 2013 Health Fitness Corporation
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EMPOWERED™ Outcomes Report

Enrolled and Completed – The Participant has completed both a Time 1 and a
Time 2 HRA and has at least four months of activity in the program OR has selected
at least one Focus Area and completed at least 6 coaching “interactions” over an 8week time period.

Enrolled and Not Completed – The Participant has completed both a Time 1 and a
Time 2 HRA. However, the participant was not in the program at least four months
OR has not selected at least one Focus area and has not completed at least 6
coaching “interactions” over an 8-week time period.

Not Enrolled – The person completed both a Time 1 and a Time 2 HRA but did not
enroll in EMPOWERED.
Table 1 summarizes the demographics of these groups of participants. The average age of
the Enrolled and Completed group was the oldest at 42.6 years old, while the Enrolled
and Not Completed and Not Enrolled groups were slightly younger at 41.3 and 40.1
years old. By gender, all groups had a higher representation by females, which matches the
overall eligibility for Sample Company. However, when looking at the percent of females in
each group, the Enrolled and Completed and Enrolled and Not Completed groups have
the highest percentages of females, indicating proportionately females are more likely to
enroll in the program.
TABLE 1: PARTICIPANT DEMOGRAPHICS
Enrolled and
Completed
(n=378)
Enrolled and
Not Completed
(n=194)
N
%
N
%
N
%
330
87.3%
162
83.5%
966
68.3%
48
12.7%
32
16.5%
449
31.7%
0
0.0%
0
0.0%
0
0.0%
20-29
46
12.2%
20
10.3%
222
15.7%
30-39
114
30.2%
73
37.6%
553
39.1%
40-49
119
31.5%
63
32.5%
389
27.5%
50-59
78
20.6%
35
18.0%
200
14.1%
60+
21
5.6%
3
1.5%
51
3.6%
Category
Not Enrolled
(n=1,415)
GENDER
Female
Male
AGE (Time 2)
Under 20
Average Age
© 2013 Health Fitness Corporation
42.6
41.3
40.1
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Sample Company
EMPOWERED™ Outcomes Report
DEFINITIONS OF HEALTH RISK FACTORS
Within the next sections of this EMPOWERED Outcomes Report, HealthFitness has utilized a
set of standard definitions for calculating risk and determining number of risk factors. The
table below (Table 2) describes the definitions and cut points utilized throughout the rest of
the report.
TABLE 2: HIGH RISK DEFINITIONS UTILIZED IN ANALYSIS
Risk Factor
Alcohol
High Risk Definition
Drinks per Week
Male
>21
Female
>14
Sys≥140 and/or Dias≥ 90
Blood Pressure
(or both ≥130/85 and medicated)
If personal history of diabetes=yes, Sys≥130 and/or Dias≥80
Cholesterol
TC:HDL Ratio
≥ 4.4
Total Cholesterol
> 240
Depression
Glucose
Health Perception
Yes to both the “Hopeless” and “No Pleasure” questions
Fasting: ≥ 126
Non-Fasting: ≥ 200
“Poor”
Job Satisfaction
“Very Dissatisfied”
Life Satisfaction
“Very Dissatisfied”
Obesity
BMI ≥ 30
Physical Activity
0-89 Moderate Minute Equivalents Per Week
Seat Belts
Never, Occasionally, Half the Time (<75%)
Stress
Tobacco
Vegetables and Fruit
© 2013 Health Fitness Corporation
Evaluated Score of 4 or 5 - "Heavily" or "Excessive"
Any Tobacco Use
Fruits + Vegetables < 3 servings per day
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EMPOWERED™ Outcomes Report
HEALTH RISK FACTORS – MULTIPLE HIGH RISKS
Chronic diseases are often associated with common, modifiable risk factors, such as an
unhealthy diet, physical activity, tobacco use, high cholesterol, diabetes, and high blood
pressure. While having even one of these risk factors can negatively affect your health,
having multiple risk factors can be more serious. People who have multiple risk factors for
chronic diseases are at a significantly higher risk of illness and death from chronic diseases
than those with just one risk factor.
The following table (Table 3) depicts the participant distribution based on number of high
health risks in Time 1 compared to Time 2. As shown in the “Summary of Risk
Stratification” section, the Enrolled and Completed group had the largest reduction in
High Risk (five or more high risk factors) with a starting rate of 11.9% at High Risk, which
dropped to 8.5% at High Risk during Time 2.
TABLE 3: MULTIPLE HIGH RISK SUMMARY
# of High Risk
Factors
Enrolled and
Completed
(n=378)
Enrolled and
Not Completed
(n=194)
Not Enrolled
(n=1,415)
T1%
T2%
Change
T1%
T2%
Change
T1%
T2%
Change
0
11.9%
14.3%
+2.4%
11.3%
11.9%
+0.6%
14.3%
17.0%
+2.7%
1
20.4%
27.5%
+7.1%
15.5%
20.6%
+5.1%
21.0%
21.7%
+0.7%
2
27.0%
23.3%
-3.7%
23.2%
24.2%
+1.0%
25.3%
24.2%
-1.1%
3
18.0%
17.7%
-0.3%
25.8%
24.2%
-1.6%
20.1%
19.0%
-1.1%
4
10.8%
8.7%
-2.1%
14.9%
12.4%
-2.5%
10.4%
10.7%
+0.3%
5
7.7%
5.0%
-2.7%
5.2%
5.2%
0.0%
5.2%
4.8%
-0.4%
6
1.1%
1.9%
+0.8%
1.0%
1.0%
0.0%
2.7%
2.1%
-0.6%
7+
3.2%
1.6%
-1.6%
3.1%
0.5%
-2.6%
0.9%
0.5%
-0.4%
59.3%
65.1%
+5.8%
50.0%
56.7%
+6.7%
60.6%
62.9%
+2.3%
28.8%
26.5%
-2.3%
40.7%
36.6%
-4.1%
30.5%
29.7%
-0.8%
11.9%
8.5%
-3.4%
9.3%
6.7%
-2.6%
8.8%
7.4%
-1.4%
Summary by
Risk
Stratification
Low Risk
(0-2 High Risks)
Moderate Risk
(3-4 High Risks)
High Risk
(5+ High Risks)
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EMPOWERED™ Outcomes Report
As shown in Graph 1, the average number of high risk factors decreased or stayed the same
for all three groups. Calculated as a percentage of loss, the Enrolled and Completed
group made the largest reduction in average number of risks (12.5%).
GRAPH 1: AVERAGE NUMBER OF HIGH RISK FACTORS (T1/T2)
T1
Average # of Risks
3.0
2.5
2.0
1.5
1.0
T2
2.54
2.40
2.10
2.27
2.23
2.10
%
Change:
-12.5%
%
Change:
-10.6%
%
Change:
-5.8%
Enrolled and Completed*
Enrolled and Not
Completed*
Not Enrolled*
0.5
0.0
*Statistically significant changes based on a t-test (p<0.05)
© 2013 Health Fitness Corporation
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Sample Company
EMPOWERED™ Outcomes Report
HEALTH RISK FACTORS – HIGH RISK FACTOR SUMMARY
Based on all participants who took a Time 1 and Time HRA, the most prevalent conditions
for Sample Company employees are: Physical Activity (52.3% Time 1; 46.9% Time 2),
Obesity (40.4% Time 1; 42.7% Time 2), and Vegetable and Fruit Consumption (39.3%
Time 1; 32.3% Time 2). The table below (Table 4) summarizes the high risk changes made
by the three groups included in this report.
TABLE 4: HIGH RISK FACTOR SUMMARY
Enrolled and
Completed
(n=378)
Enrolled and
Not Completed
(n=194)
Not Enrolled
(n=1,415)
High Risk
Factor
T1%
T2%
Change
T1%
T2%
Change
T1%
T2%
Change
Alcohol
0.8%
0.3%
-0.5%
0.0%
0.5%
+0.5%
0.9%
0.6%
-0.3%
Blood Pressure
9.8%
10.3%
+0.5%
6.2%
8.2%
+2.0%
8.8%
9.5%
+0.7%
Cholesterol
24.6%
23.0%
-1.6%
28.4%
27.8%
-0.6%
26.9%
25.7%
-1.2%
Depression
22.5%
15.9%
-6.6%
24.7%
14.9%
-9.8%
16.4%
13.4%
-3.0%
Glucose
1.1%
1.3%
+0.2%
2.1%
0.0%
-2.1%
2.5%
2.0%
-0.5%
Health
Perception
3.2%
2.6%
-0.6%
3.6%
3.1%
-0.5%
2.0%
2.0%
0.0%
Job Satisfaction
3.4%
5.0%
+1.6%
3.1%
4.6%
+1.5%
4.9%
5.7%
+0.8%
Life Satisfaction
3.7%
5.6%
+1.9%
5.2%
4.6%
-0.6%
4.9%
5.0%
+0.1%
Obesity
46.3%
48.7%
+2.4%
49.0%
52.1%
+3.1%
37.6%
39.9%
+2.3%
Physical Activity
57.7%
44.7%
-13.0%
61.3%
51.0%
-10.3%
49.7%
46.9%
-2.8%
Seat Belts
8.5%
10.6%
+2.1%
9.3%
13.4%
+4.1%
12.4%
11.7%
-0.7%
Stress
4.2%
4.8%
+0.6%
7.2%
4.1%
-3.1%
2.9%
3.9%
+1.0%
Tobacco
16.4%
11.1%
-5.3%
11.9%
8.2%
-3.7%
13.3%
10.2%
-3.1%
Vegetables and
Fruit
37.6%
26.2%
-11.4%
41.8%
34.0%
-7.8%
39.4%
33.7%
-5.7%
Changes colored in blue had a statistically significant reduction in high risk prevalence (good).
Changes colored in red had a statistically significant increase in high risk prevalence (bad).
Statistical testing based off the McNemar Test (significant is defined as p<0.05).
The Enrolled and Completed group made statistically significant improvements in four
areas (Depression, Physical Activity, Tobacco, and Vegetables and Fruit) and made progress
in many other areas, though not statistically significant (including Alcohol, Cholesterol, and
Health Perception).
© 2013 Health Fitness Corporation
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Sample Company
EMPOWERED™ Outcomes Report
The Enrolled and Not Completed group made four statistically significant improvements
(Depression, Glucose, Physical Activity, and Vegetables and Fruits). The Not Enrolled
group made statistically significant improvements in three areas (Depression, Tobacco, and
Vegetables and Fruits). The Not Enrolled group also made a statistically significant
regression in the area of Obesity, as well as slight regressions (though not statistically
significant) in several other areas. It is important to note that the Not Enrolled group had
the largest sample size of the three groups so it was more likely for changes in high risk to
be significant.
Also of interest, the Enrolled and Completed group showed the most progress in reducing
high risk for all of the following, although only three were a significant change: Alcohol
(0.5% decrease), Cholesterol (1.6% decrease), Health Perception (0.6% decrease), Physical
Activity (13.0% decrease – statistically significant), Tobacco (5.3% decrease – statistically
significant), and Vegetables and Fruits (11.4% decrease – statistically significant).
© 2013 Health Fitness Corporation
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Sample Company
EMPOWERED™ Outcomes Report
PROGRAM INTENSITY AND RESULTS
Based on the number of weeks participants were active within the EMPOWERED program,
Table 5 describes the average number of high risks in Time 1 compared to Time 2 for those
Enrolled and Completed and those Enrolled and Not Completed. As shown below,
participants who were Enrolled and Completed for a longer period of time made the
largest changes to their average number of High Risks.
TABLE 5: RESULTS BY PROGRAM INTENSITY
Sample
Size
Average # of
Risks in T1
Average # of
Risks in T2
194
2.54
2.27
Enrolled and Completed - 4-5 Months
142
2.56
2.43
Enrolled and Completed - 6+ Months
236
2.31
1.91
# of Months Active
Enrolled and Not Completed –
Less Than 4 Months
Change
-0.27
(-10.6%)
-0.13
(-5.1%)
-0.40
(-17.3%)
An interesting group is the Enrolled and Not Completed participants who were in the
program less than 4 months. This group reduced their average number of risks by
10.6%. It is unknown why these participants didn’t “complete” the program, but they may
have been self-motivated to move throughout the EMPOWERED program on their own,
without working with a coach.
© 2013 Health Fitness Corporation
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Sample Company
EMPOWERED™ Outcomes Report
CONCLUSION AND SUMMARY
When looking at all areas provided within this analysis, the Enrolled and Completed group
made the most significant improvements. This group had the largest impact in their High
Risk stratification (five or more high risk factors) by decreasing their High Risk prevalence
from 11.9% to 8.5%. This corresponded with the largest decrease in average number of
risk factors (2.40 in Time 1 to 2.10 in Time 2, which was a 12.5% change). Additionally this
group showed statistically significant changes in the areas of Depression, Physical Activity,
Tobacco, and Vegetables and Fruits. Other areas showed improvement, though not
significant.
The other two groups Enrolled and Not Completed and Not Enrolled had less positive
outcomes, which helps substantiate the importance of not only enrollment, but also
engagement, within any program. Both of these groups showed high risk change (10.6%
and 5.8% respectively), though the improvements were much less than those of the
Enrolled and Completed group.
© 2013 Health Fitness Corporation
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Sample Company
EMPOWERED™ Outcomes Report
APPENDIX A
Filters Utilized in Report Creation
Criteria
Value
Time 1
Start Date = 09/01/2011
End Date = 08/31/2012
Time 2
Start Date = 09/01/2012
End Date = 12/31/2012
EMPOWERED Eligibility
HRA or Screening
Completed HRA Only
2
Other Filters
n/a
© 2013 Health Fitness Corporation
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Sample Company
EMPOWERED™ Outcomes Report
APPENDIX B
This supplement to the EMPOWERED™ Outcomes Report includes definitions for terms found
in the report.
DEFINITIONS
EMPOWERED™ OUTCOMES REPORT
TERM
DEFINITION
Program year
The time period for the Health Management Program
determined by the client. For example, a client’s
program year 1 may be 01/01/2008 to 12/31/2008.
Program year 2 may be 01/01/2009 to 12/31/2009.
The relevant program year dates are displayed on page
2 of the report.
Any individual who enrolled in the EMPOWERED Health
Coaching Program during the time period.
EMPOWERED Participant
Total population
Eligible population
Percent enrolled in EMPOWERED
Time 1
Time 2
© 2013 Health Fitness Corporation
Other Filters: Please see Appendix A within the report
to view any additional filter criteria utilized.
The total number of employees, spouses, dependents
and/or retirees as defined by the client. This number is
based on the eligibility file as of the report date, with
those marked as inactive removed from the total.
(Marked_Inactive must equal FALSE.)
Other Filters: Please see Appendix A within the report
to view any additional filter criteria utilized.
The number of those eligible to enroll in EMPOWERED
as defined by the client. This may include employees,
spouses, dependents and/or retirees. Eligibility may
also be based on HRA or Screening participation, as
defined by the client.
Other Filters: Please see Appendix A within the report
to view any additional filter criteria utilized.
Total number of participants divided by the eligible
population.
The assessment period in which participants completed
the first HRA. If a participant completed multiple HRAs
during Time 1, only the earliest test is used. See
Appendix A in the report for the dates used as Time 1.
This may also be referred to as “T1”.
The period of time in which participants completed the
second HRA within the given time frame. If a
participant completed multiple HRAs during Time 2,
only the latest test is used. See Appendix A in the
report for the dates used as Time 2. This may also be
referred to as “T2”.
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EMPOWERED™ Outcomes Report
TERM
DEFINITION
Time 1 / Time 2 HRA participant
The number of people who completed the HRA at least
once within the Time 1 Assessment period AND at least
once within the Time 2 Assessment period. Unless
filtered out, this could include both active and inactive
participants as shown in the current eligibility file on
the date the report was generated.
For example, if Time 1 was 01/01/2007 to 12/31/2007
and Time 2 was 01/01/2008 to 12/31/2008, then the
participant would need to complete one HRA between
01/01/2007 and 12/31/2007 AND another HRA
between 01/01/2008 and 12/31/2008.
Multiple Tests: If a person completed multiple HRAs in
either of the specified time periods, they would only be
counted once. Additionally, if the person completed
multiple HRAs in Time 1, their first HRA would be
included for Time 1. If the person completed multiple
HRAs in Time 2, their last HRA would be included for
Time 2.
Completeness Criteria: A client is able to set up
“RiskCalc Completeness Criteria”, which designates
required questions within the HRA that must be
answered for the HRA to be considered complete. The
client then has the option to receive a report only on
complete HRAs based on those criteria. If the report is
generated based on completeness criteria, this
information would display in Appendix A.
Other Filters: Please see Appendix A within the report
for any additional filter criteria.
HRA completion
Time 1 / Time 2 HRA participation
rate
© 2013 Health Fitness Corporation
This may also be referred to as “two-time participants”.
The individual has started the HRA (either online or
submitted a paper HRA) during the time period and has
entered at least height and weight.
Completeness Criteria: A client is able to set up
“RiskCalc Completeness Criteria”, which designates
required questions within the HRA that must be
answered for the HRA to be considered complete. The
client then has the option to receive a report only on
complete HRAs based on those criteria. If the report is
generated based on completeness criteria, this
information would display in Appendix A.
Total number of unique individuals that completed a
Time 1 and Time 2 HRA divided by the total population.
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EMPOWERED™ Outcomes Report
TERM
DEFINITION
Average time between tests
The average of the difference between the number of
months that passed between the Time 1 HRA and Time
2 HRA.
A participant who has completed both a Time 1 and a
Time 2 HRA and was active in the program for at least
four months OR has selected at least one Focus Area
(Action-stage only, indicating that they are ready to
make a change in the area, and does not include those
in Preparation) and has completed at least 6 coaching
“interactions” over an 8-week time period.
The Participant has completed both a Time 1 and a
Time 2 HRA. However, the participant was not in active
in the program at least four months OR has not
selected at least one Focus area (within Action stage
which identifies the participant is ready to make a
change) and has not completed at least 6 coaching
“interactions” over an 8-week time period.
The person completed both a Time 1 and a Time 2 HRA
but did not enroll in EMPOWERED.
A participant accumulates time active in the program
based on the following. First, participants within their
first three months of the program and have not opted
out are considered to be active. Second, after the first
three months, those who have logged into the website
or interacted with their coach are considered active. If
a participant becomes inactive or opts out but then reengages in the program, the length of time in the two
separate periods are added together (it is accumulative
total for the year).
A specific behavioral area within EMPOWERED which
participants are able to choose/open. Examples include:
Aerobic Exercise, Overeating and Stress Management.
An interaction between a coach and a participant,
including phone calls or messages on the message
board sent by the participant.
Risk reduction is measured based on various factors.
The one area that is focused on most is the change in
the average number of high risks (Graph 1). To
calculate the reduction in average number of high risks,
the following numbers were used: the average number
of high risks in Time 1, in which you subtract the
average number of high risks in Time 2. Take that
number and divide it by the average number of high
risks in Time 1 to obtain the percent reduction in
average number of high risks. Risk factor definitions
can be found in Table 2.
A participant’s highest priority or primary reason for
participating in health coaching. The participant
chooses this priority when they enroll in EMPOWERED.
Enrolled and completed
Enrolled and not completed
Not enrolled
Length active in the program
Focus area
Coaching interaction
Risk reduction
Primary intention
© 2013 Health Fitness Corporation
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