245:
software were distributed to users who requested it, and approximately 70 copies of the code were provided to for-profit companies that were interested in developing proprietary products. This proliferation coincided with the rapid growth in interest in corporate health promotion programs as awareness developed on health risks and for-profit vendors monetized the programs.
1492:
213:, creating the first computerized health risk assessment. Within a year, he had programmed 12 health assessments on single topics such as nutrition, fitness, weight, and stress. In 1979, when personal desktop computers became readily available, he packaged all 12 assessments together on a floppy disk and marketed it as a comprehensive health risk assessment.
248:
The Carter Center's interest shifted to Africa and Dr. Hutchins founded the
Healthier People Network (HPN) in 1991 to continue the work. HPN raised funds to support the HRA, but additional funding was not forthcoming from government sources. As a result, the Carter Center and HPN could not underwrite
273:
for employers and organizations. These reports include demographic data of participants, highlight health risk areas and often include cost projections and savings in terms of increased healthcare, absence and productivity. Organization-level reports can then be used to provide a first step by which
336:
There is also recent evidence to suggest that taking a HRA alone can have a positive effect on health behavior change and health status. However, it is generally accepted that HRAs are most effective at promoting behavior change when they form part of an integrated, multi-component health promotion
282:
The delivery of HRAs has changed over the years in conjunction with advances in technology. Initially distributed as paper-based, self-scoring questionnaires through on-site workplace health promotion sessions, HRAs are now most commonly implemented online. Other delivery methods include telephone,
58:
A health risk assessment (HRA) is a health questionnaire, used to provide individuals with an evaluation of their health risks and quality of life. Commonly a HRA incorporates three key elements – an extended questionnaire, a risk calculation or score, and some form of feedback, i.e.
126:
In the US, HRAs used as part of the
Medicare Annual Wellness Visit help identify issues important to a senior's health and well-being. HRAs used as part of Medicaid enrollment help identify individuals with health problems that need immediate attention. The Community Preventive Services Task Force
244:
to create a mainframe product that could be used on an international basis. The HRA was managed as a not-for-profit product. Copies were distributed to every state health department, and liaisons were assigned to each to work with their staffs to evaluate related data. Over 2,000 copies of the
265:
Once an individual completes a HRA, they usually receive a report, detailing their health rating or score, often broken down into specific sub scores and areas such as stress, nutrition and fitness. The report can also provide recommendations on how individuals can reduce their health risks by
127:(CPSTF) recommends the use of HRAs in workplace settings when used in combination with health education, having found there is strong or satisfactory evidence that they help improve the following behaviors among employees:
998:
1081:
Anderson DR, Whitmer RW, Goetzel RZ, et al. (2000). "The relationship between modifiable health risks and group-level health care expenditures. Health
Enhancement Research Organization (HERO) Research Committee".
634:
256:
programs has been most prevalent in the United States, with comparatively slower growth elsewhere. However, there has been recent strong growth in corporate wellness outside the US, particularly in Europe and Asia.
192:
in 1970 – a guide for practising physicians, which outlined the health risk assessment questionnaire, risk computations and patient feedback strategies. During the 1960s, some researchers in
California formed the
337:
program. Applied in this way, the HRA is used primarily as a tool to identify health risks within a population and then target health interventions and behavior change programs to address these areas.
249:
basic supporting activities such as annual conferences and, over time, the State-based liaison network and associated intellectual capital atrophied as programs lost funding and liaisons moved on.
597:
949:"The development of a new corporate specific health risk measurement instrument, and its use in investigating the relationship between health and well-being and employee productivity"
232:
also took an interest and asked to fund an update of the program, the CDC, which could not accept private project funding at the time, transferred ownership to the Carter Center at
1128:
Burton WN, Chen CY, Conti DJ, Schultz AB, Edington DW (August 2003). "Measuring the relationship between employees' health risk factors and corporate pharmaceutical expenditures".
1007:
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to conduct a study to determine the probable 10-year lifespan of individuals based on lifestyles and predisposed conditions. The project, led by Lewis C. Robbins, MD, of the
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and created a mainframe version of the book. The
Centers for Disease Control became aware of this product and adapted it to the newly available personal computer. When
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Tailoring – online HRAs can adapt content based on an individual's answers to the HRA questionnaire to provide a personalised, relevant and interactive user experience.
710:
522:
383:
Yen L, McDonald T, Hirschland D, Edington DW (October 2003). "Association between wellness score from a health risk appraisal and prospective medical claims costs".
1343:
Ozminkowski RJ, Dunn RL, Goetzel RZ, Cantor RI, Murnane J, Harrison M (1999). "A return on investment evaluation of the
Citibank, N.A., health management program".
1386:
Ozminkowski RJ, Goetzel RZ, Wang F, et al. (November 2006). "The savings gained from participation in health promotion programs for
Medicare beneficiaries".
62:
185:
236:
where it was updated from 1986 to 1987. The transfer and subsequent program were managed by Dr. Ed
Hutchins, who had worked on the HRA in positions at the
1035:
Yen L, Schultz A, Schnueringer E, Edington DW (September 2006). "Financial costs due to excess health risks among active employees of a utility company".
217:
523:"Worksite: Assessment of Health Risks with Feedback (AHRF) to Change Employees' Health – AHRF Plus Health Education With or Without Other Interventions"
177:
The study was based on in-depth longitudinal studies of 5,000 families in
Framingham, Massachusetts, that continues to this day under funding from the
95:
69:, provides individualised feedback, and links the person with at least one intervention to promote health, sustain function and/or prevent disease".
594:
358:
675:
1429:
Anderson DR, Staufacker MJ (1996). "The impact of worksite-based health risk appraisal on health-related outcomes: a review of the literature".
188:
in
Indianapolis where, working with Jack Hall, M.D., he developed the first set of health hazard tables. This culminated in the publication of
357:
There are reportedly over 50 different HRA providers in the market, offering a variety of versions and formats. Major vendors generally have
84:
assessments ask questions about health-care access, availability of food, and living conditions. Most HRAs capture information relating to:
345:
The limitations of a HRA are largely related to its usage and it is important to recognise that a HRA highlights health risks but does not
166:
1300:
Burton WN, Chen CY, Conti DJ, Schultz AB, Edington DW (March 2006). "The association between health risk change and presenteeism change".
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Mills PR, Kessler RC, Cooper J, Sullivan S (2007). "Impact of a health promotion program on employee health risks and work productivity".
170:
605:
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42:) is a questionnaire about a person's medical history, demographic characteristics and lifestyle. It is one of the most widely used
667:
72:
There is a range of different HRAs available for adults and children. Some target specific populations. For example, in the US,
804:
668:"A Systematic Review of Selected Interventions for Worksite Health Promotion: The Assessment of Health Risks with Feedback"
430:"Comparing the predictive accuracy of health risk appraisal: the Centers for Disease Control versus Carter Center program"
178:
550:
Baker K, DeJoy D, and Wilson M. Using online health risk assessments, The Journal of Employee Assistance. April 2007.
197:(HPL) to investigate factors contributing to quality of life. Inspired by a research article reporting on the HPL's
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237:
98:, questions regarding family medical history are not permitted if there is any incentive attached to taking a HRA)
1522:
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241:
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Belloc, Nedra; Breslow, Lester (August 1972). "Relationship of physical health status and health practices".
361:(NCQA) Wellness and Health Promotion (WHP) Certification or Health Information Products (HIP) Certification.
1214:
Loeppke R, Taitel M, Richling D, et al. (July 2007). "Health and productivity as a business strategy".
696:
220:
released a publicly available version, that the HRA became widely used, particularly in workplace settings.
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Boles M, Pelletier B, Lynch W (July 2004). "The relationship between health risks and work productivity".
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define a HRA as: "a systematic approach to collecting information from individuals that identifies
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Inform and provide feedback to participants to motivate behaviour change to reduce health risks
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organizations can target and monitor appropriate health interventions within their workforce.
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and Charlotte-Mecklenburg Hospital. At Charlotte Mecklenburg, he secured a contract with the
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635:"Core Set of Children's Health Care Quality Measures for Medicaid and CHIP (Child Core Set)"
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329:
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47:
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205:, developed a Health Age Assessment algorithm on a calculator while a masters student at
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Personal and family medical history (in the US, due to the current interpretation of the
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Center for Medicaid and CHIP Services and Centers for Medicare & Medicaid Services.
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The original concept of the HRA can be traced back to the decision by the assistant
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Working well: A global survey of health promotion and workplace wellness strategies
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disease and should not replace consultation with a medical or health practitioner.
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Soler, Robin; et al; the Task Force on Community Preventive Services (2010).
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Gazmararian JA, Foxman B, Yen LT, Morgenstern H, Edington DW (October 1991).
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In addition to individual feedback, HRAs are also used to provide aggregated
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and is often the first step in multi-component health promotion programs.
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Attitudes and willingness to change behaviour in order to improve health
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Extensive research has shown that HRAs can be used effectively to:
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Lifestyle – exercise, smoking, alcohol intake, diet
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face-to-face with a health advisor or an automatic online report.
779:"Maha Safety: Expert Engineering Consultancies & IT Training"
820:"The Alameda County Study: a Systematic, Chronological Review"
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in 1972. In 1977, Hall coded his longevity calculations on a
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Encyclopaedia of Occupational Health and Safety 4th ed. 1998
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System of information collection and screening in healthcare
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Community Preventive Services Task Force (February 2007).
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The International Electronic Journal of Health Education
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Dr. Robbins left the Public Health Service and joined
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Demographic characteristics – age, sex
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Physiological data – weight, height,
1388:Journal of Occupational and Environmental Medicine
1302:Journal of Occupational and Environmental Medicine
1216:Journal of Occupational and Environmental Medicine
1173:Journal of Occupational and Environmental Medicine
1130:Journal of Occupational and Environmental Medicine
1037:Journal of Occupational and Environmental Medicine
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386:Journal of Occupational and Environmental Medicine
328:Evaluate the efficacy and return on investment of
201:on the best lifestyle practices for good health,
80:about their ability to perform daily activities.
1006:. Buck Consultants. October 2008. Archived from
620:"Preventive visit & yearly wellness exams"
618:Centers for Medicare & Medicaid Services.
63:The Centers for Disease Control and Prevention
1474:"Wellness & Health Promotion Report Card"
8:
709:: CS1 maint: multiple names: authors list (
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1472:National Committee for Quality Assurance.
218:Centers for Disease Control and Prevention
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96:Genetic Information Nondiscrimination Act
827:The American Journal of Health Education
359:National Committee for Quality Assurance
676:American Journal of Preventive Medicine
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286:The advantages of online HRAs include:
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702:
818:Housman, Jeff; Dorman, Steve (2005).
112:The main objectives of a HRA are to:
7:
1431:American Journal of Health Promotion
1345:American Journal of Health Promotion
1259:American Journal of Health Promotion
1084:American Journal of Health Promotion
516:
514:
226:How to Practice Prospective Medicine
190:How to Practice Prospective Medicine
167:Surgeon General of the United States
606:International Labour Organization's
1400:10.1097/01.jom.0000240709.01860.8a
1314:10.1097/01.jom.0000201563.18108.af
1185:10.1097/01.jom.0000131830.45744.97
1142:10.1097/01.jom.0000079090.95532.db
1049:10.1097/01.jom.0000235987.75368.d0
731:"Appraising health risk appraisal"
399:10.1097/01.jom.0000088875.85321.b9
40:health & well-being assessment
25:
735:American Journal of Public Health
595:Chapter 15: Health risk appraisal
435:American Journal of Public Health
119:Estimate the level of health risk
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216:It was not until 1980, when the
679:. 38(2S) (2 Suppl): S237–S262.
839:10.1080/19325037.2005.10608200
1:
179:National Institutes of Health
156:Summary health risk estimates
1228:10.1097/JOM.0b013e318133a4be
874:10.1016/0091-7435(72)90014-X
729:Schoenbach VJ (April 1987).
685:10.1016/j.amepre.2009.10.030
315:Predict health-related costs
312:Identify health risk factors
296:Reduced administrative costs
195:Human Population Laboratory
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1443:10.4278/0890-1171-10.6.499
803:: CS1 maint: url-status (
266:changing their lifestyle.
238:University of Pennsylvania
136:Consuming too much alcohol
1357:10.4278/0890-1171-14.1.31
1271:10.4278/0890-1171-22.1.45
1096:10.4278/0890-1171-15.1.45
242:World Health Organization
230:Prudential Life Insurance
222:Health and Welfare Canada
293:Improved data management
697:Elsevier Science Direct
494:"Health risk appraisal"
448:10.2105/ajph.81.10.1296
283:mail and face-to-face.
153:Healthcare services use
34:(also referred to as a
896:"Commencement program"
783:Maha Safety Consultant
46:tools in the field of
32:health risk assessment
966:10.1186/1476-069X-4-1
747:10.2105/AJPH.77.4.409
207:Loma Linda University
171:Public Health Service
36:health risk appraisal
1499:at Wikimedia Commons
953:Environmental Health
600:7 April 2011 at the
492:Alexander G (2000).
252:The use of HRAs and
199:Alameda County Study
116:Assess health status
862:Preventive Medicine
507:(Special): 133–137.
785:. 13 February 2024
647:on 8 February 2015
254:corporate wellness
186:Methodist Hospital
1495:Media related to
1013:on 16 August 2009
947:Mills PR (2005).
849:– via ERIC.
203:Don R. Hall, DrPH
175:Framingham study.
16:(Redirected from
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