Aetna, Inc. Critique
This is a broad, well funded program with data showing marked effectiveness. Strengths are the integrated approach, comprehensive programming and evaluation, improved health, behavior change, and cost-effectiveness. A great strength is the variety of health improvement and preventive health services including consumer education, self help, the lactation program, fitness complements, and more. It is obvious that a great deal of creative energy, manpower, and money were spent in developing the plethora of opportunities that are described.
Reviewer concerns were that there was not the ability to exclude self-selection bias even in these well done pre-post comparisons. There are no "intention to treat" results. Cost data were only available for 345 out of 5500 employees participating in the fitness program, making extrapolation to the total population a bit of the uncertain. Follow-ups for the survey were quite low. In contrast, there is excellent documentation on the fitness cost-effectiveness study although it could have benefited from more complete statistical analysis.
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