Initiation of health-behaviour change among employees participating in a web-based health risk assessment with tailored feedback

<p>Abstract</p> <p>Background</p> <p>Primary prevention programs at the worksite can improve employee health and reduce the burden of cardiovascular disease. Programs that include a web-based health risk assessment (HRA) with tailored feedback hold the advantage of simultaneously increasing awareness of risk and enhancing initiation of health-behaviour change. In this study we evaluated initial health-behaviour change among employees who voluntarily participated in such a HRA program.</p> <p>Methods</p> <p>We conducted a questionnaire survey among 2289 employees who voluntarily participated in a HRA program at seven Dutch worksites between 2007 and 2009. The HRA included a web-based questionnaire, biometric measurements, laboratory evaluation, and tailored feedback. The survey questionnaire assessed initial self-reported health-behaviour change and satisfaction with the web-based HRA, and was e-mailed four weeks after employees completed the HRA.</p> <p>Results</p> <p>Response was received from 638 (28%) employees. Of all, 86% rated the program as positive, 74% recommended it to others, and 58% reported to have initiated overall health-behaviour change. Compared with employees at low CVD risk, those at high risk more often reported to have increased physical activity (OR 3.36, 95% CI 1.52-7.45). Obese employees more frequently reported to have increased physical activity (OR 3.35, 95% CI 1.72-6.54) and improved diet (OR 3.38, 95% CI 1.50-7.60). Being satisfied with the HRA program in general was associated with more frequent self-reported initiation of overall health-behaviour change (OR 2.77, 95% CI 1.73-4.44), increased physical activity (OR 1.89, 95% CI 1.06-3.39), and improved diet (OR 2.89, 95% CI 1.61-5.17).</p> <p>Conclusions</p> <p>More than half of the employees who voluntarily participated in a web-based HRA with tailored feedback, reported to have initiated health-behaviour change. Self-reported initiation of health-behaviour change was more frequent among those at high CVD risk and BMI levels. In general employees reported to be satisfied with the HRA, which was also positively associated with initiation of health-behaviour change. These findings indicate that among voluntary participating employees a web-based HRA with tailored feedback may motivate those in greatest need of health-behaviour change and may be a valuable component of workplace health promotion programs.</p

Determinants of participation in a web-based health risk assessment and consequences for health promotion programs

Background: The health risk assessment (HRA) is a type of health promotion program frequently offered at the workplace. Insight into the underlying determinants of participation is needed to evaluate and implement these interventions. Objective: To analyze whether individual characteristics including demographics, health behavior, self-rated health, and work-related factors are associated with participation and nonparticipation in a Web-based HRA. Methods: Determinants of participation and nonparticipation were investigated in a cross-sectional study among individuals employed at five Dutch organizations. Multivariate logistic regression was performed to identify determinants of participation and nonparticipation in the HRA after controlling for organization and all other variables. Results: Of the 8431 employees who were invited, 31.9% (2686/8431) enrolled in the HRA. The online questionnaire was completed by 27.2% (1564/5745) of the nonparticipants. Determinants of participation were some periods of stress at home or work in the preceding year (OR 1.62, 95% CI 1.08-2.42), a decreasing number of weekdays on which at least 30 minutes were spent on moderate to vigorous physical activity (ORdayPA0.84, 95% CI 0.79-0.90), and increasing alcohol consumption. Determinants of nonparticipation were less-than-positive self-rated health (poor/very poor vs very good, OR 0.25, 95% CI 0.08-0.81) and tobacco use (at least weekly vs none, OR 0.65, 95% CI 0.46-0.90). Conclusions: This study showed that with regard to isolated health behaviors (insufficient physical activity, excess alcohol consumption, and stress), those who could benefit most from the HRA were more likely to participate. However, tobacco users and those who rate

Personalized prevention approach with use of a web-based cardiovascular risk assessment with tailored lifestyle follow-up in primary care practice - a pilot study

AIMS: The aim of this prospective implementation study is to evaluate feasibility of a personalized prevention approach with use of a web-based health risk assessment for cardiovascular diseases combined with tailored lifestyle feedback and interventions in the community setting. METHODS: A random sample of 800 inhabitants of Leidsche Rijn (a newly built residential area in the city of Utrecht) between 45 and 70 years old was invited by their general practitioner to participate in this study and sent a web-based health risk assessment containing a questionnaire, covering socio-demographic variables, family and personal medical history, lifestyle behaviour and psychological variables. The system generates an individual cardiovascular risk based on prognostic modelling. In the case of increased risk further biometric and laboratory evaluation is advised. All participants received tailored web-based feedback with an electronic referral to available medical, psychological and lifestyle interventions in the neighbourhood, or online interventions, and a follow-up questionnaire after six months. RESULTS: The participation rate was 29% (230/800) of which 39% (89/230) were at increased risk for cardiovascular disease and were advised to perform biometric measures, of which 36% (32/89) actually did. Of these respondents 25% (8/32) had increased blood pressure (≥140/90), 56% (18/32) increased total cholesterol (>6.0 mmol/l).One-third of the participants started changing their lifestyle, 20% indicated planning to do this later; 32% (41/129) increased their physical activity and 28% (36/129) were eating healthier. Seventy-nine per cent of the responders stated their participation was 'meaningful'. CONCLUSIONS: The personalized prevention approach offers a system for integrated risk profiling and individualized health management that was well received in general practice. The client-centred approach, which was embedded in a local community setting, using a web-based health risk assessment with tailored feedback and linkage to regional health management and lifestyle providers proved feasible, and successful. Participating in the health risk assessment elicited actual behaviour change among follow-up survey respondents