Assessment of Health Risks with Feedback to Change Employees’ Health

Task Force Finding & Rationale Statement

"Assessment of health risks with feedback" (AHRF) refers to a process that includes three elements: (1) the collection of information about at least two personal health behaviors or indicators; (2) translation of the information collected into one or more individual risk scores or categorical descriptions of risk status; and (3) provision to the participants of feedback regarding their risk status, either overall or with respect to specific risk behaviors.

The Task Force finds insufficient evidence to determine the effectiveness of AHRF when implemented as a primary intervention.

The Task Force finding of insufficient evidence to determine effectiveness is based on concerns with recurring combinations of flaws in individual studies across the body of evidence. The most important concern was the paucity of comparative studies in which the intervention was offered to one defined population and outcomes compared to another defined population which received a lesser (or no) intervention. Many of the studies identified in this review provided the intervention of interest (assessment of health risks with feedback alone) to the "control" arm of the trial and focused on the question of effectiveness of the combined intervention (these results were considered in the multicomponent intervention review described below). In the absence of measurements from a concurrent comparison population, the Task Force noted the potential for bias in the reliance on self-report for most measured changes in behavior. Most studies analyzed only a small subset of participants whose follow-up data was complete. (Baseline data from participants who did not return for follow-up were not included in the reported baseline measurements.) Because follow-up rates across this body of evidence were generally low, the analytic focus potentially favored the inclusion of results from individuals who had changed their health behaviors in the interval.

Review completed: June 2006