Healthy Clinical Trial
Official title:
Revising Employee Benefits for the Sake of Health
This study will explore ways in which employee benefits may be designed to improve people's
health, through examining the viewpoints and preferences of low-income people. A person's
health is affected not only by being able to receive health care but also by several factors
such as income and education. People with lower incomes have been found to be not as healthy
as those with higher incomes. While the governments of many countries in the Organization for
Economic Cooperation and Development are currently working on public policy to address this
topic, the likelihood is small that the United States, given its market-based economy, will
do the same. However, owing to the heavy reliance in the United States on employer-sponsored
health insurance, it would be useful to explore the possibility of insuring some of the
measures that people can take to improve their health, and to do that through employee
benefit packages. Solutions might include extended unemployment insurance, more education,
job training, exercise programs, help for housing, disability insurance, and extra retirement
benefits.
Adults who have a minimum of a sixth-grade reading level, have low incomes, are English
speaking may be eligible for this study. For recruitment, 400 people who live and work in the
Washington, D.C, area will be invited to participate, and about12 people will take part in
each session. Unless people in the study participate during working hours, they will each be
paid $75 at the conclusion of the session.
The study consists of one phase, in which participants will engage in a group exercise that
lasts for approximately 2-1/2 hours. During that time, participants will have the chance to
say what employee benefits they would choose, if the opportunity arose, to improve their
health. They will first make those choices by themselves and then make choices along with
other people in the group. While group members talk, the discussion will be recorded on a
tape recorder. Participants will be asked to give information about themselves and their
opinions but will not be asked for any information that identifies them personally, except
for data needed to pay participants with a paycheck. They will also get to use a computer and
will be shown how to use it, if necessary. If videotaping or photographs are done during the
exercise, the investigators of the study will ask for separate signed permission to do so.
Participants will be asked to respect the privacy of others in the group and to not discuss
the opinions of others after leaving the session.
An individual's health is affected not only by access to health care but also by a number of
determinants such as income and education. Individuals with low incomes are not as healthy as
those with higher incomes. Thus it seems important to explore possible avenues for improving
the health of low income individuals with an eye toward ameliorating the complicated
determinants of health status, aside from health insurance. Many countries in the
Organization for Economic Cooperation and Development (OECD) are currently developing public
policy to address this issue. In the U.S., however with its market based economy, the
likelihood of adopting this public policy approach is small. Given that reality, is it
possible to explore other avenues such as designing employee benefit packages with the aim of
ameliorating the socio-economic determinants of health?
Objective: The goal of this project is to explore the feasibility of designing employee
benefits in a manner that may improve their health, by ascertaining the perspectives and
preferences of low income employees regarding employee benefits designed to ameliorate the
social determinants of health. Four hundred male and female low-income individuals recruited
from clinical, community, and employment settings will participate in small group exercises
in which a facilitated discussion will take place using a previously tested group decision
tool (CHAT: Choosing Health plans All Together) that has been modified for this project. Data
will be anonymously collected regarding socio-demographic characteristics, attitudes toward
health, preferences for possible employee benefits and assessment of the exercise. Group
discussions will be audio-taped. Data will be analyzed quantitatively to determine
preferences of employee benefits and socio-demographic factors associated with these
preferences. Discussions will undergo qualitative analysis go explore the underlying reasons
for participant preferences. Participants will receive $75 dollars as compensation for their
participation unless they participate during working hours.
Risks and Benefits: Given the anonymous nature of the data collection we anticipate no risks
other than those entailed in discussion of poor health outcomes associated with lack of
insurance and low income. Participants may benefit from learning about factors that improves
health status.
Outcome and Meaning to the Field: Study results will yield information about what employee
benefits would be of utmost priority to low income employees. This is unique information that
may contribute to efforts to find affordable strategies for ameliorating the socio-economic
determinants of health for the low-income working population in the US.
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