Do Health Risk Assessments Have Value?
Is a self reporting assessment tool too subjective? There have been a number of articles written lately about the validity of information obtained by having employees complete a health risk assessment (HRA). HRA’s are a “self-reporting” tool that employer groups use to analyze trends; they can be used to look at the health of a population. They can be seen as one tool that an employer uses to implement a comprehensive wellness program. HRA’s should not be the only piece of the program. Just offering an incentive to complete the HRA and stopping there doesn’t provide the employees with the necessary information to make lifestyle changes.
HRA’s are structured to ask lifestyle questions and family medical history. They also ask questions that assess readiness to change. One of the major criticisms regarding HRA’s is the “under reporting” of our habits. The best way to validate this information is to combine the HRA with a biometric screening. Biometrics eliminates the “human” factor. The Case Against HRA’s, Lisa Holland, RN, MBA of Simplicity Health Plans states “When HRA’s are self-reported, the reliability and validity of the outcome data is questionable. Generally, the best way to validate HRA data is to include biometric screenings in conjunction with an HRA campaign, then crosswalk the outcome data against the employer medical trend reports. This method improves validity.”
Most biometric screening include panels for cholesterol , blood sugar, check blood pressure and measure body mass index (BMI). Some add additional screening for nicotine use.
To further effect lifestyle change, incorporating a wellness coaching program is the final component that will help communicate information and educate the population. HRA’s and biometric screenings are only as good as the understanding of the data. Participants receive a report with values and terminology that they don’t understand. They see red bars on graphs showing “at risk” for disease, but they don’t really understand what they are reading. Not only do they not understand the terminology, but then they don’t know what to do with the information. A comprehensive corporate wellness program will have certified wellness coaches, that are also registered nurses, contact each participant, review the results of the screening, assess family history obtained from the HRA reporting, look at risk factors for pre-disease and work out a plan of action. They can incorporate motivational interviewing techniques, assess readiness to change, and develop a personalized plan with goals. Ongoing advocacy, communication, and education will help sustain the lifestyle changes.
In summary, an effective corporate wellness programs should incorporate all of the three components of the HRA, Biometric Screening and the Wellness Coaching, to achieve the greatest success and measureable return on investment.
