Relationships between multiple appraisals of health risk and indices of physical and psychological health

Research has shown a continual increase in the rate of mortality in the United States due to illnesses deemed preventable; estimates suggest that as many as 50% of all U.S. deaths are attributable to preventable behaviors. Due to the cost to American businesses resulting from absenteeism, morale, health care claims, workers comp and other health-related factors, worksite health promotion and prevention programs (WHP) are increasingly financially prudent. A core component of many WHP are health risk appraisals (HRA) used to gather data related to level of health risk for individual employees. However, HRAs vary in manner of data collection, feedback, and repeated administration. A literature review of studies examining the efficacy of HRAs reveals significant shortcomings in efficacy research. ^ Participants were recruited from a large manufacturing plant as part of a four-year longitudinal project designed to investigate the influence of health protection and preventive interventions on numerous dimensions of employee health. The present study sought to address two issues: whether those participants who returned for multiple assessments were healthier initially than those participants who engaged in a single HRA, and whether engaging in multiple assessments over a four-year period was associated with improvement in indices of health. Health status was measured by self-assessment, anthropometric indices, and blood lipid assays. ^ Repeated measures analysis of covariance revealed no significant differences between the group of participants that engaged in a single HRA and the group that returned multiple times. Also, comparisons of health status over time revealed very minor improvements in several biometric measures (LDL, HDL, total cholesterol) and no significant improvements in self-reported health status and behaviors. ^ Results of this study suggest that information-based interventions, such as the repeatedly administered HRA here, are not powerful change agents alone in promoting improved health over time. Recommendations for future studies include more thoroughly incorporating the intervention into the fabric of the company at individual and organizational levels, point-of-purchase information, signage to remind workers of pro-health behaviors, and intervention process evaluation measuring with sensitivity the actual exposure of each participant to the intervention.