Novel Computerized Health Risk Appraisal May Improve Longitudinal Health and Wellness in Primary Care: a Pilot Study

Overview

Journal Appl Clin Inform

Publisher Thieme

Specialties Health Services
Medical Informatics

Date 2013 May 8

PMID 23650489

Citations 16

Authors

Z J Nagykaldi

V Voncken-Brewster

C B Aspy

J W Mold

Affiliations

Soon will be listed here.

Abstract

Objectives: Health Risk Appraisals (HRAs) have been implemented in a variety of settings, however few studies have examined the impact of computerized HRAs systematically in primary care. The study aimed at the development and pilot testing of a novel, comprehensive HRA tool in primary care practices.

Methods: We designed, implemented and pilot tested a novel, web-based HRA tool in four pair-matched intervention and control primary care practices (N = 200). Outcomes were measured before and 12 months after the intervention using the HRA, patient surveys, and qualitative feedback. Intervention patients received detailed feedback from the HRA and they were encouraged to discuss the HRA report at their next wellness visit in order to develop a personalized wellness plan.

Results: Estimated life expectancy and its derivatives, including Real Age and Wellness Score were significantly impacted by the HRA implementation (P<0.001). The overall rate of 10 preventive maneuvers improved by 4.2% in the intervention group vs. control (P = 0.001). The HRA improved the patient-centeredness of care, measured by the CAHPS PCC-10 survey (P = 0.05). HRA use was strongly associated with better self-rated overall health (OR = 4.94; 95% CI, 3.85-6.36) and improved up-to-dateness for preventive services (OR = 1.22; 95% CI, 1.12-1.32). A generalized linear model suggested that increase in Wellness Score was associated with improvements in patient-centeredness of care, up-to-dateness for preventive services and being in the intervention group (all P<0.03). Patients were satisfied with their HRA-experience, found the HRA report relevant and motivating and thought that it increased their health awareness. Clinicians emphasized that the HRA tool helped them and their patients converge on high-impact, evidence-based preventive measures.

Conclusions: Despite study limitations, results suggest that a comprehensive, web-based, and goal-directed HRA tool can improve the receipt of preventive services, patient-centeredness of care, behavioral health outcomes, and various wellness indicators in primary care settings.

Citing Articles

Feasibility and Acceptability of a Mobile-Assisted Screening and Brief Intervention for Multiple Health Behaviors in Medical Settings.

Forcier C, Constant A, Grisard F, Clair E, Val-Laillet D, Thibault R J Prim Care Community Health. 2024; 15:21501319241303604.

PMID: 39707878 PMC: 11663265. DOI: 10.1177/21501319241303604.

A Novel and Comprehensive Wellness Assessment for Lifestyle-Based Interventions.

Ellison K, Smith K, Fernandez J, Plaisance E, Chui T, Hill J Obes Sci Pract. 2024; 10(6):e70022.

PMID: 39529897 PMC: 11553003. DOI: 10.1002/osp4.70022.

Operationalizing the Chronic Care Model with Goal-Oriented Care.

Grudniewicz A, Gray C, Boeckxstaens P, De Maeseneer J, Mold J Patient. 2023; 16(6):569-578.

PMID: 37642918 PMC: 10570240. DOI: 10.1007/s40271-023-00645-8.

Personalized Disease Prevention (PDP): study protocol for a cluster-randomized clinical trial.

Taksler G, Le P, Hu B, Alberts J, Flynn A, Rothberg M Trials. 2022; 23(1):892.

PMID: 36273151 PMC: 9587586. DOI: 10.1186/s13063-022-06750-7.

Failure of the Problem-Oriented Medical Paradigm and a Person-Centered Alternative.

Mold J Ann Fam Med. 2022; 20(2):145-148.

PMID: 35346930 PMC: 8959733. DOI: 10.1370/afm.2782.

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