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Table 1 General Characteristics of the included studies

From: Impacts of chronic disease prevention programs implemented by private health insurers: a systematic review

Author, year

Country

Private Health Insurance company

Target population

Program

Duration of the intervention considered for the study

Study Sample

Study type

Outcome measure

Studies on financial incentives

 An et al., 2013

South Africa

Discovery

Members

Cash-back for healthy food program

Feb 2009 to Nov 2011

350,000 participants and non-participants

Retrospective cohort

Self-reported measures of food consumption and weight status (BMI)

 Patel et al., 2011

South Africa

Discovery

Members

Vitality health promotion program

2001–2006

N = 192,467 participants

Mean age = 44 years

% female = 35%

Retrospective cohort

Changes in the participation in activities on fitness, and hospital admissions

 Patel et al., 2010

South Africa

Discovery

Members

Vitality physical activity

1 year (2006)

948,974 members

cross-sectional

Hospital admissions

 Sturm et al., 2013

South Africa

Discovery

members

Cash-back for healthy food

Nov 2009 – March 2012

100,344 (intervention)

69,141 (control)

Case control

Changes in healthy food purchases

 Hubbert et al., 2003

USA

University of Alabama

at Birmingham’s (UAB)-owned HMO

Members

Financial incentives on a weight loss program

January 1998–February 2001

N = 125 participants

Mean age = 49 years

% female = 67%

Cohort with matched controls

Participation rate and weight loss

 Schwartz et al., 2014

South Africa

Discovery

Members

Financial incentives

January 1, 2012 to June 30, 2012

6570 households

Age and gender profile not provided

RCT

Healthy food purchases

 Ball et al., 2017

Australia

GMHBA

Members

the ACHIEVE (Active Choices IncEntiVE)

June-Nov 2015

80 participants

%female = 56%

Men age no provided

Cohort- Pre-post design

Changes in physical activity and sedentary behaviour

 Lambert et al., 2009

South Africa

Discovery

Members

Vitality – incentive based physical activity

1 year (2006)

948,976 members

Cross sectional

Hospital admissions and costs

 McGill et al., 2018

Australia

HCF and other two unknown insurers

Members

Australian weight loss and lifestyle modification program (Financial incentives)

18 weeks, 2015

130 and 28 participants for 2 samples from intervention

%female = 67.7 and 46.6%

Mixed method

Attitudes and views of participants

Studies on health coaching

 Adams et al., 2013

USA

Kaiser Permanente

Members

Health coaching

6 month period in 2011

N = 1410 members who had initial session between Jan 1, 2011, and Aug 23, 2011

Cross- sectional survey

patient satisfaction and perceived success

 Koocher et al., 2001

USA

Fallon community health care

Community

Medical crisis counselling

Not provided

20 participants (intervention)

18 (control)

Mean age = 57.5

Gender profile = not provided

RCT

Reductions in distress, hospital utilisation and costs

 Härter et al., 2013

Germany

KKH-Allianz

Members

Health coaching

3 months (2007)

834 participants

Mean age- = 66.2% female = 58.3%

Cross-sectional study

Evaluation of the coaching and process, effects on patient and physician communication

 Schwartz et al., 2010a

USA

Highmark Inc., Blue Cross Shield

Members

Online disease management program with coaching

2004–2006

413 participants (intervention)

360 (control)

Retrospective quasi experimental cohort

Medical costs and claims

 Scuffham et al., 2019

Australia

Bupa

Members

Health coaching for disease management (CAPICHe)

1 year (2012)

35,535 participants (intervention)

8883 (control)

Mean age = 72.7 (intervention & control)

%female = 46% (intervention)

46.2% (control)

RCT

Healthcare utilisation and costs

 Lawson et al., 2013

USA

Not provided

Members

Health coaching-telephonic

January 1, 2009 to December 31, 2010

570 participants

Cohort study

Health and behavioural outcomes

 Schmittdiel et al., 2017

USA

Kaiser Permanente

Members

Wellness coaching on weight loss

12 months (January 1 to August 232,011)

954 participants (intervention)

19,080 (control)

Mean age = 52%female = 83%

Cross sectional

Changes in weight loss

   Harmar et al., 2010

Germany

A German private insurance company

Members

Telephonic coaching in Chronic care management program

January 2, 2008 to January 1, 2009

17,319 participants (intervention)

5668 (control)

Mean age 71.2 (intervention)

Mean age = 72.5 (control)

% Female = 50.8 (intervention)

% female = 45.6

Retrospective quasi experimental cohort

Hospital admission rate

 Morello et al., 2016

Australia

An Australian Private Health Insurer

Members

Telephonic Complex Care Program

6 months (2012)

273 participants (intervention)

232 (control)

Mean age = 79 for both groups

% female = 57.5% (Intervention)

% female = 59.1% (control)

Case control

Hospital use and benefits paid

Studies on wellness programs

 Harris, 2011

USA

Blue shield

Members

Wellness program (Healthy Lifestyle rewards program)

2 years (2006 and 2007)

8003 (intervention)

187,631 (control)

observational cohort study

Medical utilisation, health claims, health risk behaviours

 King et al., 2012

USA

Not provided a particular name

Members

Health-plan sponsored fitness centers

2012

Ranged from 618 to 4766 participants

1413 to 9035 for control

Systematic review

Changes in physical activity and positive health outcomes, health utilisation

 Maeng et al., 2013

USA

Geisinger Health Plan

Members

MyHealth Rewards (health plan-driven employee health and wellness program)

2007–2011

Geisinger health plan employees as intervention and members as control

Cohort

Impact on cardiovascular event rate and health costs

 Henry et al., 2016

USA

Kaiser Permanente

Members

Internet based health promotion

from December 2014 to March 2015

838,638 participants

Mean age = 49.5% female = 48.9%

Retrospective cohort

Reducing care gaps on haemoglobin A1c testing, pneumonia vaccination, and cancer screenings

 Frost et al., 2018

USA

Kaiser Permanente

Community

Physical activity

2014–2015

148 participants

No gender profile at individual level

% female at school level = 50%

Pre and post evaluation study

Participation in physical activity and changes in physical activity

 Cheadle et al., 2018

USA

Kaiser Permanente

Community

Healthy eating, Active living

2011–2015

1300 residents from HEAL Zones (intervention)

1300 residents from outside of HEAL Zone (Control)

Cohort -pre and post design

Changes in food and physical activity behaviours

 McGill et al., 2020

Australia

Not specified (In PHI setting)

Members

The Healthy Weight for Life (HWFL)

August 2019–August 2020

490 participants

Cohort- Pre and Post design

Changes in anthropometric and lifestyle risk behaviours

 Coombes, 1998

USA

Kaiser Permanente and Oxford health Plan

Members

Malnutrition screening

Not provided

Not provided

cross-sectional survey

Identification of risk patients

 Schwartz et al., 2010b

USA

An independent licensee of the Blue Cross and Blue Shield Association (Hawaii Medical Service Association)

Member

wellness and disease prevention program (HealthPass)

2002–2005

11,883 participants (intervention)

154,327 (control)

Mean age = 51.7

50.7 (control)

%female = 58.3% (intervention)

52.3% (control)

Retrospective cohort

Healthcare costs

Studies on group medical appointments

 Beck et al., 1997

USA

Kaiser Permanente

Members

Group outpatient medical appointment

1 year

321 participants with chronic diseases (intervention groups = 160 and usual care = 161)

Mean age = 72 (intervention)

Mean age = 75 (control)

RCT

Health service utilisation and cost, self-reported health status, and satisfaction

 Hinchman et al., 2006

USA

Kaiser Permanente

Community

Childhood obesity

8 weeks to 6 months (2001–2003)

135 participants

% Female = 55%

Mean age not provided

Aged from 11 to 17 years

Retrospective cohort

Body fat reduction, waist size, BMI