Date of Award


Document Type

Scholarly Project

Degree Name

Doctor of Physical Therapy (DPT)


Physical Therapy

First Advisor

Peggy Mohr


Occupational Health; Preventive Health Services -- utilization


Background and Purpose: The purpose of this study was to determine perception of the utilization of preventive health screenings as compared to actual utilization for benefitted University of North Dakota employees. The research was designed to determine the perception of compliance and barriers to receiving recommended health screenings for benefitted employees. The significance was that the University of North Dakota has created a Well ness Center and has begun the creation of a worksite well ness program for its employees. While there are a variety of worksite well ness program designs, very little has been done to ascertain utilization or barriers to utilization of preventive health screenings.

Subjects: A stratified sample of 400 employees was selected from the 5,301 benefitted faculty and staff employed at UNO. As staff members at the University of North Dakota comprised 75% of the workforce (n = 3969) and faculty were the minority of the workforce (25% of the overall population at UNO (n = 1332)), a 3 to 1 ratio was set for target employees, staff to faculty. Of the 400 survey participants selected by random sample, a total of 102 survey instruments were returned, yielding a response rate of 26%. All University of North Dakota benefitted employees were included in the NDPERS health insurance utilization data analysis for years 1998 through 2002.

Methods: Data were obtained through the use of survey instruments distributed to the random sample of benefitted employees of the University of North Dakota. Actual utilization preventive health screening data for the years 1998 through 2002 were provided by NDPERS.

Results: While numerous provider and patient barriers have been reported in literature, it is also reported that patients with a primary care provider, insurance benefits, and sick leave are the most likely to receive the appropriate preventive health screenings. Of the surveyed University of North Dakota benefitted employees, 86% indicated they have a primary care provider. All benefitted employees have 100% paid coverage for preventive health screenings and paid sick leave, yet utilization for the USPSTF screenings are nowhere near expected compliance levels. Returned survey data indicate that over 49% of benefitted employees believe they are receiving the recommended preventive healths screenings. The preventive health screenings are recommended yearly, every two years, or every five years. Actual health insurance utilization data for a five-year period, 1998- 2002, indicates that overall compliance for all annual screenings is less than 30%; for screenings recommended every two years, overall compliance is less than 5%; and for screenings recommended every five years, overall compliance for years 1998-2002 is less than 2%.

Conclusion and Discussion: Lack of awareness of screenings and costs as well as the general sense of being healthy and not needing to be seen by a physician are the leading causes of low participation in receiving the appropriate health screenings. The findings indicated a need to re-examine patient barriers which have a negative effect on the use of recommended preventive services. As the University of North Dakota is breaking ground for a new Wellness Center and recognizes the workplace is an ideal site for the establishment of a wellness program, it is more important than ever to re-examine existing benefits and barriers to preventive health screenings. Ultimately, ownership of our health belongs in the hands of each individual. Knowledge and empowerment are tools which worksite well ness can harness to assist the individual employee in taking that responsibility.