In Reply Dr Raymond and colleagues offer potential reasons that our randomized evaluation of a workplace wellness program1 did not find greater effects. They suggest that a higher participation rate, clinician involvement, larger incentives, and a longer follow-up might have produced more positive findings for the program.

We of course agree that a different kind of wellness program might have produced different results; there are limits to the external generalizability of any single study. Our goal was not to study the most intensive or highly incentivized program possible, but rather one that was fairly representative of typical programs, with common features and an on-site component. The optimal wellness program might look different, and future research assessing the effectiveness of different program features might prove fruitful. We also agree that effects may vary over time (potentially either accumulating or attenuating), and we are currently working on a follow-up study of this randomized clinical trial through 3 years of the wellness program.

中文翻譯：

工作場(chǎng)所健康計(jì)劃和健康成果-答復(fù)

在答復(fù)中，雷蒙德博士及其同事提供了可能的原因，即我們對(duì)工作場(chǎng)所健康計(jì)劃1的隨機(jī)評(píng)估沒(méi)有發(fā)現(xiàn)更大的影響。他們認(rèn)為更高的參與率，臨床醫(yī)生的參與，更大的激勵(lì)措施以及更長(zhǎng)的隨訪(fǎng)可能為該計(jì)劃帶來(lái)了更多積極的發(fā)現(xiàn)。

我們當(dāng)然同意，不同種類(lèi)的保健計(jì)劃可能會(huì)產(chǎn)生不同的結(jié)果。任何一項(xiàng)研究的外部可概括性都有其局限性。我們的目標(biāo)不是研究可能最密集或最受激勵(lì)的計(jì)劃，而是研究一個(gè)具有典型特征，具有共同特征和現(xiàn)場(chǎng)組成部分的典型代表。最佳健康計(jì)劃可能看起來(lái)有所不同，并且未來(lái)評(píng)估不同計(jì)劃功能有效性的研究可能會(huì)碩果累累。我們還同意，效果可能隨時(shí)間而變化（可能會(huì)累積或減弱），并且我們目前正在通過(guò)這項(xiàng)為期3年的健康計(jì)劃進(jìn)行這項(xiàng)隨機(jī)臨床試驗(yàn)的隨訪(fǎng)研究。

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Workplace Wellness Programs and Health Outcomes—Reply,JAMA
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