Interactive health risk appraisal
Funded by the National Heart, Lung and Blood Institute
Scientist(s):
Blair Irvine, PhD
,
Natasha Beauchamp, MSc
Every year, 800,000 Americans die before their time as a consequence of unhealthy habits such as smoking, lack of exercise, or eating high-fat diets. The cost to society is not small. Medical services for cancer and heart disease alone total more than $200 billion, and this figure does not count the worksite costs of absenteeism and lost productivity for these patients and their caregivers. Many of these conditions are lifestyle related and are potentially preventable through changes in daily habits.
The Interactive Health Risk Appraisal is a multimedia program designed to help users identify their greatest health risks and make actual changes in their lifestyle. (Many health risk appraisals offer education, but rarely do they lead to actual behavior change.) Users of the program answer questions about their personal habits and family medical history. The program processes their answers, and an onscreen doctor interprets the results in the form of a prescription for a longer, healthier life. Risks for heart disease, cancer, and motor vehicle accidents are given top priority. Viewers hear practical recommendations for behavior change from ordinary people who have successfully handled the same issues (e.g., losing weight, controlling blood pressure, getting more exercise, quitting smoking, remembering to use their seatbelt). To promote the transition from intentions to action, the Interactive Health Risk Appraisal encourages viewers to commit to trying some of the personalized recommendations presented. This becomes their Change Plan, which is highlighted in the printout they receive at the end of the video report. To encourage the continuation of good habits, positive viewer behaviors are acknowledged with support to "keep up the good work."
In addition to lifestyle habits, viewers are given feedback regarding the frequency of their cancer screenings—Pap smears, breast exams, prostate exams, and colorectal screenings—relative to their individual risks based on personal and family medical history. This too is included in the summary printout.
The Interactive Health Risk Appraisal has undergone two evaluations: one with 517 patients at two medical settings and the other with 561 employees in a corporate work site. In both studies, even 30 days after watching the program, those who watched the Interactive Health Risk Appraisal showed immediate improvements over those who had not yet seen it. For instance, those who watched the program adopted significantly more healthy habits (actual behavior change), particularly in the areas of weight loss, blood pressure control, smoking habits, and seatbelt use. More of the program viewers actually quit smoking and began using their seatbelts regularly. In addition, those who saw the Interactive Health Risk Appraisal made advances in important precursors to change: self confidence and intention to change.
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