Nonprofit Health Research Articles

A systematic approach to quantifying infection prevention staffing and coverage needs

This article describes a large nonprofit health care system's approach at quantifying the actual number of infection preventionist (IP) and relative support staff required to build and sustain effective infection prevention programs. A list of all physical locations within the organization requiring infection prevention coverage were identified via survey, including department-level detail for 34 hospitals, 583 ambulatory sites, and 26 in-home and long-term care programs across 5 states. Required IP activities for each physical location were also tallied by task. Type of activity, frequency (times per year), hours per activity, and total number of locations in which each activity should occur were determined. From this, the number of hours per week of infection prevention labor resources needed was calculated. Quantitative needs assessment revealed actual labor need to be 31%-66% above current benchmarks of 0.5-1.0 IP per 100 occupied beds. When aggregated across the organization, the comprehensive review results yielded a new benchmark of 1.0 infection prevention full-time equivalent per 69 beds if ambulatory, long-term care, or home care are included. Size, scope, services offered, populations cared for, and type of care settings all impact the actual need for IP coverage, making the survey benchmarks available in the literature invalid. A comprehensive assessment of health care organization composition and structure is necessary prior to determining the IP staffing needs for that organization.

Thermal medicine in Greece

The Hellenic Thermal Medicine Academy was founded in 2015 as a non-profit health organization dedicated to the development of thermal culture in Greece among professionals of medicine and consumers. The main purpose of the Academy includes representing and promoting world hydrotherapy, shared studies, research and experience in the sector, as well as new discoveries in Thermal Medicine and finally sponsoring high quality forums for education of medical professionals in the practice of thermal medicine. Thermal Medicine is a basic segment of Health Tourism and consists of a wide range of preventive, therapeutic and cosmetic applications using natural resources of seawater (thalassotherapy) for physical health, anti-aging and wellness for patients and non-patients in facilities called MediSpas (thermal centres under medical supervision). Academy’s vision for MediSpas is to provide competence and experience for qualified treatment, prevention and rehabilitation in a clean and healthy environment. Recently in Greece, the Complimentary Medicine was established by Hellenic Ministry of Health legislation and recognized as the main sector of health services since it combines medications with thermal springs compounds according to Hippocrates’ spirit. We are working on the cross-border health procedures trying to be adopted to the European health network in order to have similar therapeutic certified protocols. We are also developing research programmes of the therapeutic elements efficacy in order to establish the Thermal Medicine as evidence-based medicine, aiming to work altogether in common programmes of preventive medicine and antiaging according to high level education and practice. To sum up, Greece is a place devoted to enhancing overall well-being through a variety of professional services that encourages the renewal of mind, body and spirit, antiaging and prevention under medical supervision in the unique Hellenic climate

Utilization of Kenya’s free maternal health services among women living in Kibera slums: a cross-sectional study

IntroductionThis study was aimed at determining factors affecting utilization of public health facilities by pregnant Kenyan women living in Kibera slums, Nairobi since the implementation of the Free Maternal Service (FMS) Program in 2013.MethodsThis was a cross-sectional study done on 396 women who delivered between 2014 and 2015. Interview questions addressed socio-demographic characteristics, perception of quality of care in public health facilities, awareness of the FMS Program, antenatal care (ANC) and delivery service utilization.Results43.9% delivered in a public health facility, 30.3% in a private non-profit health facility (NGO), 22.7% in a private health facility and 3.0% at home. Of the 97% of the women who delivered in a health facility, only 43.9% delivered in a public health facility despite these facilities having free maternal services. Factors that favoured the Free Maternal Service uptake included a positive perception of the public health facility, living within close proximity, learning about the Program from a support group and a short waiting time before being examined by the doctor. On the other hand, safe delivery, quality of service, accessing a health facility on foot, ANC attendance at a private and a non-profit health facility were associated with low uptake of the free maternal services.ConclusionThe uptake of the Free Maternal Service program can improve if the Kenyan government directs its efforts towards changing women’s perception on quality of care in public health facilities and to improve access to health facilities in slum areas of Nairobi.

Long-term Determinants Long-term Determinants of the Size of the Non-profit Sector Serving Households in the Visegrad Countries

The article investigates differences in socioeconomic determinants of the size of the nonprofit sector serving in the Visegrad Countries. The question is whether there are different power and direction of socioeconomic determinants of the size of the nonprofit sector serving households. The results are based on panel data regression in 2000-2014. GDP per capita is the significant determinant of the nonprofit sector in the country with no tax assignation. The different systems of care for the elderly have an impact on the determinants of the size of the nonprofit sector serving households (old-age dependency ratio, life expectation index). The government failure theory was established only in the Czech Republic where is an obvious competition between non-profit sector and health care system. In the most Visegrad countries, nonprofit organizations help governmental sector to cope with increasing number of refugees in need coming from war regions. DOI: http://dx.doi.org/10.5755/j01.ee.28.5.19254

The changing roles of community nurses: the case of health plan nurses in Israel

BackgroundIn Israel, approximately one-third of the country’s nurses work in community settings – primarily as salaried employees in Israel’s four non-profit health plans. Many health system leaders believe that the roles of health plan nurses have changed significantly in recent years due to a mix of universal developments (such as population aging and academization of the profession) and Israel-specific changes (such as the introduction of extensive quality monitoring in primary care).ObjectivesThe main objectives of the study were to identify recent changes in the roles of health plan nurses and their current areas of activity. It also explored the experience of front-line nurses with regard to autonomy, work satisfaction, and barriers to further role development.MethodsThe study integrated interviews and surveys of nurses and other professionals conducted across 4 years. Data generated from earlier study components were used to guide questions and focus for later components.In 2013, in-depth interviews were held with 55 senior nursing and medical professionals supplemented by interviews in mid-2017 with the head nurses in the four health plans. In addition, a national survey was conducted in 2014–5 among a representative sample of 1019 community nurses who work for the health plans and who are engaged in direct patient care. Six hundred ninety-two nurses responded to the survey, yielding a response rate of 69%. The survey sample consisted of an equal number of nurses from each health plan, and the observations were weighted accordingly.FindingsSenior professionals identified general themes associated with a shift in nursing roles, including a transition from reactive to initiated work, increased specialization, and a shifting of tasks from hospitals to community settings. They identified the current main areas of activity in the health plans as being: routine care, chronic care, health promotion, quality monitoring and improvement, specialized care (such as wound care), and home care.In the survey of front-line nurses, 38% of the nurses identified “caring for chronically ill patients” as their main area of activity aside from routine care; 30% did so regarding “health promotion”, and 26% did so regarding “a specific area of specialization” e.g., diabetes, wound care or women’s health). In response to a separate question, 77% reported “great” or “very great” involvement in quality measurement programs.Four out of five front-line nurses were satisfied with their work to a great or very great extent, and approximately three out of four of them (73%) felt that they had autonomy at work to a great or very great extent. About half of the nurses take into account, to a great or very great extent, the financial concerns of the health plans that employ them.A large majority of the nurses (85%) indicated that the nature of their work had changed substantially in recent years, with an increase in autonomy noted as one of the key changes. Perceived barriers to further role development include attitudes on the part of some physicians and nurses, an insufficient number of dedicated nursing positions, and insufficiently attractive wage levels.ConclusionsThe findings, gathered over 4 years, indicate alignment between universal and Israel-specific trends in health care and the evolving roles of nurses in Israel’s health plans.The findings provide support for ongoing efforts in the health plans to give nurses more authority and responsibility in the management of chronically ill patients, a more central role in health promotion efforts, more advanced training - both inter-professional and nurse-specific, and more opportunity to focus on the roles and tasks that require nursing professionals.

Nonprofit health plan makes inroads in integrating behavioral, primary care

Nonprofit health plan makes inroads in integrating behavioral, primary care

A Study of Outcomes Determination Strategy in Non-profit Health and Welfare Programs Evaluation

This article considers the findings of a survey of evaluators practising in Australian health and welfare organisations to learn about strategy in outcomes evaluation design. Outcomes evaluation is identified as an opportunity for health and welfare programs to learn if and how different practice interventions are contributing to the achievement of desired outcomes, for the purpose of building an evidence base for advancing the wellbeing of people. Results indicate that current strategy to determine client outcomes in these sectors is typified by reliance on program logic models and funding specifications, with limited translation of best practice evidence or client wellbeing preferences. We suggest that clarity of purpose is an important consideration for non-profit programs embarking on evaluation design, bringing attention to the need for skill development and better resourcing of non-profit organisations to support the production of evaluations capable of contributing to best practice evidence.

Satisfaction of French rehabilitation nurses about practice: Observational study

Job satisfaction is a public health issue that can lead to uneasiness and career change. Very few French studies deal with the experience of rehabilitation nurses. We carried out a qualitative study about the satisfaction of French rehabilitation nurses on their practice. A survey was sent by Google forms to French rehabilitation nurses, through the association “infirmiers de rééducation réadaptation” (AIRR). Four topics were broached: socio-professional criteria, workplace, specifics on their professional activity, and a satisfaction assessment on the professional practice in rehabilitation. Two hundred and five French nurses answered the questionnaire. Nurses were predominately woman with 89.4%. The average age is 37. Most nurses work in non-profit health institutions (70% vs. 30% in hospital centers). A total of 80% of nurses choose the rehabilitation specialty. The average satisfaction is 6.7/10, of which 88.4% are satisfied or very satisfied (EVA > 6/10). The average satisfaction on exchanges with the healthcare team is over 90% and exchanges with the medical team are 70%. Relationship with the patient and teamwork are viewed as satisfactory factors. The lack of involvement in the rehabilitation project is viewed as harmful by nursing teams. Two highlighted factors affect satisfaction on professional practice from rehabilitation nurses. Seeing as most nurses choose the rehabilitation specialty, the risk of leaving the sector after 10 years is reduced by 65% (the risk of leaving rehabilitation after 10 years decreases by 58%). Moreover, according to our study, having an important part in the therapeutic project increases satisfaction. The same results were found in the Norwegian study of Begat et al. It also showed that a good management of nursing teams reduces their stress and anxiety. Previous studies on nurses’ job satisfaction have highlighted the benefit of a good work environment. Roets-Merken et al have described a program in order to improve the nurses’ autonomy with seniors with sensory deficit's care. These nursing empowerment programs will be able to improve nursing teams’ self-valorization and increase their practice's satisfaction.

Strategic Use of Diversification and Centralization in High and Low Performance Healthcare Firms

To what extent does related diversification and extent of centralization explain financial performance? And are there strategic differences in related diversification and extent of centralization that distinguish high performing firms from low performing firms? These questions are addressed through the development of two structural equation models (SEM) representing two different loci of hierarchical authority and strategic decision making – centralized and decentralized. A sample of nonprofit health care provider firms is used to test hypotheses distinguishing high performing firms from low performing firms. Results suggest that related diversification explains 9 percent of the variance in financial performance for centralized firms and 13 percent of the variance in financial performance for decentralized firms. Strategic use of related diversification by high performing firms include: exhibiting consistency among business units, extent of centralization and revenue sources; determining when to own and w...

Network development for non-state health providers: African Christian health associations

ABSTRACTSubstantial effort has been put into forming and strengthening national networks of non-state, non-profit health providers in lower- to middle-income contexts. Christian health associations (national umbrella networks of faith-inspired health providers) were first established in the 1950s, and are currently present in an estimated 23 of the 54 countries in Africa. The establishment of CHAs was equally encouraged by faith-based health providers, governments, and external stakeholders. CHAs look different in each context, but perform similar roles: networking diverse institutions and facilities together into a loose system; and establishing a more cohesive sector to simplify and strengthen advocacy and engagement with the government.

Community-Based User Experience: Evaluating the Usability of Health Insurance Information with Immigrant Patients

User experience (UX), a common practice in corporate settings, is new for many nonprofit organizations. This case study details a community-based research project between nonprofit staff at a community health center and UX professionals to improve the design and usability of a document designed to help immigrant patients sign up for health insurance. UX professionals may need to adapt and be flexible with their efforts, but can offer valuable skills to community partners. Research questions : (1) What are the information needs and barriers faced by immigrant populations signing up for health insurance? (2) How does a usability study, adapted to meet the needs of immigrant populations, inform the design of a supplemental guidebook about health insurance? (3) What are the challenges and opportunities when engaging in community-based UX research projects? Situating the case : Other community-based research projects in technical communication and UX point to the need for a clear conceptualization of participation, a strong partnership with nonprofits, and the need to develop meaningful and actionable insights. Furthermore, when conducting studies with immigrant populations, the role of the translator on the research team is crucial. Methodology : As a community-based research project focused on the collaborative generation of practical knowledge, we conducted a usability study with 12 participants in two language groups, Chinese and Vietnamese, to evaluate the design and usability of a guidebook designed to provide guidance about enrolling in a health insurance plan. Data were analyzed to identify usability concerns and used to inform a second iteration of the guidebook. About the case : Immigrant populations struggle to sign up for health insurance for a variety of reasons, including limited English and health insurance literacy. As a result, a nonprofit community health center developed a guidebook to support immigrant populations. Version 1 of this guidebook was evaluated in a usability study, with results showing that users struggled to correctly choose a plan, determine their eligibility, and interpret abstract examples. As a result, Version 2 was designed to support the in-person experience, reduce visual complexity, and support patients’ key questions. Conclusions : Community-based UX collaborations can amplify the expertise of UX and nonprofit professionals. However, UX methods may need to be adapted in community-based projects to better incorporate local knowledge and needs.

Effect of a low-dose, high-frequency training approach on stillbirths and early neonatal deaths: a before-and-after study in 12 districts of Uganda

BackgroundPost-partum haemorrhage and neonatal asphyxia are the leading causes of maternal and newborn deaths, respectively, in Uganda. However, proven interventions that can save the lives of women and children are not being widely practised. Here, we assess the effects of two onsite training programmes for interventions to reduce deaths from post-partum haemorrhage and neonatal asphyxia, plus three different levels of performance support after the training in health-care facilities in 12 districts of Uganda.MethodsWe invited all public and some private non-profit health facilities that deliver babies in western and eastern regions of Uganda to participate. At all study sites, training in the Helping Mothers Survive and Helping Babies Breathe interventions was given to all health-care providers who attend births—medical doctors, clinical officers, midwives, nurses, and nurse assistants. The training consisted of low-dose, high-frequency onsite training followed by 20 weeks of provider-led practise with low-cost simulators. At all intervention sites, a midwife was designated as a clinical mentor or peer leader of simulation-based practice. We used a cluster randomised design to match districts for volume of births and presence of an operating theatre, and then randomly allocated districts to one of three training follow-up groups. A full-support group had onsite training supported with a peer practice coordinator and weekly practice sessions, supplemented with mobile messages to remind providers to practise. A partial-support group had an onsite training programme supported with a peer practice coordinator; and a control group received onsite training only. We collected routine monthly service-delivery statistics from the government Integrated Maternity Register (IMR) and introduced a supplemental maternity register to capture indicators not present in the IMR. Outcomes of interest were fresh stillbirths and neonatal deaths within 24 h at baseline and 6 months after the intervention. We had also aimed to study post-partum haemorrhage retained placenta, but no baseline data were available.FindingsBetween May, 2013, and May, 2016, training was delivered at 125 participating health facilities: 11 hospitals, 21 level IV health centres, 79 level III health centres, and 14 level II health centres. The control and partial-support groups had three hospitals each, but the full group had five hospitals, including the only regional referral hospital. The partial-support group had more level III and II (n=35) hospitals than did the full-support and control groups (n=29 each). The proportion of adverse birth outcomes (combined fresh stillbirths and neonatal deaths within 24 h), appeared to decrease significantly in all the study groups from baseline to 6 months post intervention: from 26·5 to 9·6 per 1000 livebirths (p<0·001) in the full support group, from 24·2 to 7·8 per 1000 livebirths (p<0·001) in the partial-support group, and from 17·2 to 9·5 per 1000 livebirths in the control group (p=0·008). We also noted a 47% reduction in retained placenta and a 17% reduction in post-partum haemorrhage between the intervention period and 6–9 months after the intervention.InterpretationFacility-based simulation training is feasible and can be effective in reducing adverse birth outcomes.FundingSaving Lives at Birth: a partnership of USAID, Norwegian Ministry of Foreign Affairs, Bill & Melinda Gates Foundation, Grand Challenges Canada and UK Aid.

Should Cancer Centers start their own specialty pharmacy? Quality and economic data from the oral chemotherapy program at Smilow Cancer Hospital and Yale New Haven Health System.

108 Background: Recent focus has shown that oral chemotherapy is high risk for medical error. Our QOPI certification process identified that oral oncologic processes were marked by: lack of documentation in the EMR, patients receiving refills from third party pharmacies after prescription discontinuation, incorrect self-administration of medications due to lack of education, delivery delays, high copays, and underuse of available patient assistance programs. Methods: A multidisciplinary task force developed a program to expedite drug access, standardize consent, and ensure clinical support including education, adherence and toxicity monitoring. We expanded an existing health-system pharmacy to provide specialty services. Treatment protocols were created for every oral oncologic drug, which are routed to a clinical oncology pharmacist and the specialty pharmacy. Nursing and pharmacist verify all orders. Medication Assistance Program for copay support. Day 1, 5 and 21 pharmacist to patient calls. Multidisciplinary flow sheet documentation. Results: Today, 80% of our patients receive medication within 72 hours. Specialty pharmacists monitor toxicity even for patients whose prescriptions are filled by other pharmacies. Pharmacists have prevented more than 400 prescription errors. Today, monthly revenue before cost for the oral chemotherapy program is nearly than $4 million. The total revenue since initiation in February 2015 is over $44 million, yielding an approximately $9 million margin after costs. Funding through the medication assistance program exceeded $1 million thus far in 2016, with an average of 140 patients receiving assistance each month. Conclusions: A patient-centered multidisciplinary model integrating clinical, operational, financial, and IT resources optimized care for patients receiving oral oncologic therapy. This project transferred revenue from for-profit third party pharmacies to our non-profit health system, and revenue is used to provide enhanced education, monitoring, and patient assistance. Our collaborative improvement model can be adapted to many practice settings.

Janusian, anomic, agent, and steward: How employees perceive the identity of healthcare organizations

We suggest that healthcare organizations (HCOs) develop a hybrid identity that can be described in a typology made up of four identities: janusian, anomic, agent, and steward. These hybrid identity types result from the combination of two seemingly incompatible identities: utilitarian or business oriented versus normative or community care oriented. We also posit that the perception of HCOs’ identity is related with members’ patient-focused behaviour and organizational identification. To explore these possibilities, we surveyed a sample of 732 members from three very different HCOs: a non-profit mental health provider, a haemodialysis for-profit company, and a state-owned acute hospital. Results show that our typology of HCOs’ identity discriminates between organizations, between occupations and, more importantly, that patient-focused behaviours and organizational identification are higher when members perceive their organizations as janusian, i.e. rate their organizations high in both utilitarian and normative identities, orientations that do not usually go together. Implications for the management of janusian HCO are discussed.

For Super-Utilizers, Integrated Care Offers A New Path.

Many health systems continue to experiment with the best way to care for those patients who end up in the hospital most frequently.

Advocacy coalitions involved in California's menu labeling policy debate: Exploring coalition structure, policy beliefs, resources, and strategies

Advocacy coalitions often play an important role in the state health policymaking process, yet little is known about their structure, composition, and behavior. In 2008, California became the first state to enact a menu labeling law. Using the advocacy coalition framework, we examine different facets of the coalitions involved in California's menu labeling policy debate. We use a qualitative research approach to identify coalition members and explore their expressed beliefs and policy arguments, resources, and strategies by analyzing legislative documents (n = 87) and newspaper articles (n = 78) produced between 1999 and 2009. Between 2003 and 2008, six menu labeling bills were introduced in the state's legislature. We found the issue received increasing media attention during this period. We identified two advocacy coalitions involved in the debate—a public health (PH) coalition and an industry coalition. State organizations acted as coalition leaders and participated for a longer duration than elected officials. The structure and composition of each coalition varied. PH coalition leadership and membership notably increased compared to the industry coalition. The PH coalition, led by nonprofit PH and health organizations, promoted a clear and consistent message around informed decision making. The industry coalition, led by a state restaurant association, responded with cost and implementation arguments. Each coalition used various resources and strategies to advance desired outcomes. PH coalition leaders were particularly effective at using resources and employing advocacy strategies, which included engaging state legislators as coalition members, using public opinion polls and information, and leveraging media resources to garner support. Policy precedence and a local policy push emerged as important policymaking strategies. Areas for future research on the state health policymaking process are discussed.

“You just can’t trust everybody”: the impact of sexual risk, partner type and perceived partner trustworthiness on HIV-status disclosure decisions among HIV-positive black gay and bisexual men

HIV remains an intractable public health concern in the USA, with infection rates notably concentrated among Black gay and bisexual men. Status disclosure by HIV-positive individuals can be an important aspect of risk reduction but doing so poses dilemmas concerning privacy, stigma and self-protection, especially among populations subjected to multiple types of stigmatisation. Understanding the factors related to the disclosure process can help to inform prevention efforts. Using exploratory in-depth interviews, this qualitative study examines the disclosure process among a sample of twenty HIV-positive Black gay and bisexual men (mean age = 40) recruited through a non-profit health centre in a mid-western city in the USA. Data were analysed using a thematic analysis approach with HIV-disclosure as an a priori sensitising concept. Fears of stigma and secondary disclosure within social networks were critical barriers to talking about HIV with sexual partners and disclosure decisions involved a complex process centred on three primary themes: degree of sexual risk, partner type and perceived partner trustworthiness. The unique combinations of these contextual factors resulted in increased or decreased likelihood of disclosure. A conceptual model explicating a potential process by which these contextual factors influence disclosure decisions is presented.

PP091 A Follow Up Study On Transcatheter Aortic Valve Implantation (TAVI)

INTRODUCTION:Severe aortic stenosis with symptoms or left ventricular dysfunction has commonly a poor prognosis. Aortic valve replacement is usually performed for these patients aiming at improving their functional class and survival rate. Transcatheter aortic valve implantation (TAVI) is often presented as an option in patients with high surgical risk for conventional surgical valve replacement.(1) Nonetheless, in this group of patients, the literature has yielded conflicting evidence suggesting that benefits of TAVI for patients of high or intermediate surgical risk is not consistent.(2,3)METHODOLOGY:This retrospective study aimed to evaluate the mortality rate from a cohort of patients after the correction of aortic valve dysfunction with TAVI. It consisted of a convenience sample of patients at high risk for open surgery for the correction of aortic valve dysfunction treated with TAVI from 2013 to 2016. All included patients were being provided healthcare assistance by a private nonprofit health maintenance organization (HMO) operating in Belo Horizonte, Brazil. Since TAVI is not currently covered by the Brazilian supplementary healthcare system, reimbursements were enforced by lawsuits. Data was extracted from an administrative database, using the software Oracle Business Intelligence®. Continuous variables were expressed as mean and standard deviation. The Kaplan-Meier method was used to adjust the 1-year survival curve using the software STATA 13.1 (Stata Corp, College Station, TX, USA). This historical cohort resulted in no interventions, neither during the course of the instituted treatment nor after the observed outcome. Privacy of subjects and the confidentiality of their personal information were handled in accordance to the ethical principles of the Declaration of Helsinki.RESULTS:Overall, seventeen patients with a mean age of 80.5 years (68-91) underwent TAVI; 59 percent were women. Peri-operative mortality rate was 23.5 percent (n = 4) and accumulated overall one-year mortality was 35.3 percent (n = 6). Mean length of hospital stay was 26.9 ± 16.6 days. Prolonged hospital stay (≥ 7 days) occurred in 14/17 cases (82.3 percent), with a maximum of 51 days.CONCLUSIONS:In similarity to our findings, other authors described a high early and late mortality rate in patients undergoing TAVI. The strategy to use TAVI as an alternative in patients at high risk for open surgery is still under debate and should be carefully discussed taking into consideration the local team expertise as well as local healthcare available recourses.

Evaluation recommendations for nonprofit social marketing campaigns: An example from the Louisiana Campaign for Tobacco-Free Living

Nonprofit organizations with limited capacity and resources must be strategic when designing, implementing, and evaluating social marketing campaigns. The Louisiana Campaign for Tobacco-Free Living, a nonprofit public health program, implemented a mass media campaign in 2012, with the goal of increasing advocacy for policy change around the smoke-free movement. The campaign was accompanied by a mixed–quantitative evaluation that was grounded in the diffusion of innovations theory. The evaluation consisted of unique, yet complementary, analytical components, employing traditional survey methods to measure population exposure to the campaign and Google Analytics to segment campaign website visitors into actionable categories for future programmatic efforts. Results from this study demonstrate that the 2012 Tobacco-Free Living mass media campaign was moderately effective in reaching its target audience and highly effective in using Google Analytics to identify a group of activists (i.e., innovators) in support of the smoke-free policy change. This study offers several recommendations for nonprofit organizations to consider when implementing and evaluating similar social marketing campaigns.

Concordance Between Life Satisfaction and Six Elements of Well-Being Among Respondents to a Health Assessment Survey, HealthPartners Employees, Minnesota, 2011.

IntroductionWe assessed and tracked perceptions of well-being among employees of member companies of HealthPartners, a nonprofit health care provider and health insurance company in Bloomington, Minnesota. The objective of our study was to determine the concordance between self-reported life satisfaction and a construct of subjective well-being that comprised 6 elements of well-being: emotional and mental health, social and interpersonal status, financial status, career status, physical health, and community support.MethodsWe analyzed responses of 23,268 employees (of 37,982 invitees) from 6 HealthPartners companies who completed a health assessment in 2011. We compared respondents’ answers to the question, “How satisfied are you with your life?” with their indicators of well-being where “high life satisfaction” was defined as a rating of 9 or 10 on a scale of 0 (lowest) to 10 (highest) and “high level of well-being” was defined as a rating of 9 or 10 for 5 or 6 of the 6 indicators of well-being.ResultWe found a correlation between self-reported life satisfaction and the number of well-being elements scored as high (9 or 10) (r = 0.62, P < .001); 73.6% of the respondents were concordant (high on both or high on neither). Although 82.9% of respondents with high overall well-being indicated high life satisfaction, only 34.7% of those indicating high life satisfaction reported high overall well-being.ConclusionThe correlation between self-reported life satisfaction and our well-being measure was strong, and members who met our criterion of high overall well-being were likely to report high life satisfaction. However, many respondents who reported high life satisfaction did not meet our criterion for high overall well-being, which suggests that either they adapted to negative life circumstances or that our well-being measure did not identify their sources of life satisfaction.