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The Bank of America Study

J. Paul Leigh, PhD; Nancy Richardson, MD; Robert Beck; Clark Kerr, PhD; Harry Harrington; Charles L. Parcell; James F. Fries, MD

Arch Intern Med. 1992;152(6):1201-1206.

Abstract
The initial results of a 12-month controlled trial of a health promotion program in 5686 Bank of America retirees, randomized into full program, questionnaire only, and insurance claims only groups, were analyzed to determine whether the health promotion program was effective. Comparisons were between program and questionnaire only groups for self-reported health habit changes, health risk scores, medical care utilization, and days confined to home, and between all groups for insurance claims data. The intervention, or full program, included health habit questionnaires administered every 6 months, individualized time-oriented health risk appraisals, personal recommendation letters, self-management materials, and a health promotion book. Twelve-month changes in health habits, health status, and economic variables favored the full program group in 31 of 32 comparisons and were statistically significant at the.05 level in two-tailed tests in 19 comparisons and at the.01 level in two-tailed tests in 13 comparisons. Over 12 months, overall computed health risk scores decreased by 4.3% in the full program experimental group and increased by 7.2% in the questionnaire only control group. Total direct and indirect costs decreased by 11% in the experimental group and increased by 6.3% in the questionnaire only control group. Analysis of claims data confirmed these trends. A low-cost health promotion program for retirees was effective in changing health behaviors and has potential to decrease health care utilization.

(Arch Intern Med. 1992;152:1201-1206)

Author Affiliations
From the Department of Economics, San Jose (Calif) State University (Dr Leigh); Blue Shield of California, San Francisco (Dr Richardson and Messrs Harrington and Parcell); Bank of America, San Francisco (Dr Kerr and Mr Beck); and the Department of Medicine, Stanford (Calif) University School of Medicine (Dr Fries).

Footnotes
Accepted for publication December 16, 1991.

Reprint requests to Department of Economics, San Jose State University, San Jose, CA 95192-0114 (Dr Leigh).

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