Determinants of Participation in a Web-Based Health Risk Assessment and Consequences for Health Promotion Programs

Maurice Aj Niessen,Coen K Van Kalken,Roderik A Kraaijenhagen,Alex Burdorf,Niels Peek,Suzan Jw Robroek,Marie-Louise Essink-Bot,Eva L Laan

doi:10.2196/jmir.2387

Abstract

BackgroundThe health risk assessment (HRA) is a type of health promotion program frequently offered at the workplace. Insight into the underlying determinants of participation is needed to evaluate and implement these interventions.ObjectiveTo analyze whether individual characteristics including demographics, health behavior, self-rated health, and work-related factors are associated with participation and nonparticipation in a Web-based HRA.MethodsDeterminants of participation and nonparticipation were investigated in a cross-sectional study among individuals employed at five Dutch organizations. Multivariate logistic regression was performed to identify determinants of participation and nonparticipation in the HRA after controlling for organization and all other variables.ResultsOf the 8431 employees who were invited, 31.9% (2686/8431) enrolled in the HRA. The online questionnaire was completed by 27.2% (1564/5745) of the nonparticipants. Determinants of participation were some periods of stress at home or work in the preceding year (OR 1.62, 95% CI 1.08-2.42), a decreasing number of weekdays on which at least 30 minutes were spent on moderate to vigorous physical activity (ORdayPA0.84, 95% CI 0.79-0.90), and increasing alcohol consumption. Determinants of nonparticipation were less-than-positive self-rated health (poor/very poor vs very good, OR 0.25, 95% CI 0.08-0.81) and tobacco use (at least weekly vs none, OR 0.65, 95% CI 0.46-0.90).ConclusionsThis study showed that with regard to isolated health behaviors (insufficient physical activity, excess alcohol consumption, and stress), those who could benefit most from the HRA were more likely to participate. However, tobacco users and those who rated their overall health as less than positive were less likely to participate. A strong communication strategy, with recruitment messages that take reasons for nonparticipation into account, could prove to be an essential tool for organizations trying to reach employees who are less likely to participate.

Highlights

Seven modifiable risk factors account for more than half of the chronic disease burden: high blood pressure, tobacco use, excess alcohol consumption, high serum cholesterol, overweight, low fruit/vegetable intake, and physical inactivity [1]
In 2009, the authors of a review concluded that few studies have evaluated the influence of health, lifestyle, and work-related factors on participation, which hampers insight into the underlying determinants of participation in worksite health promotion programs (WHPPs), and the influence of selective participation on the effectiveness of these WHPPs [3]
We evaluated the determinants of participation in a Web-based health risk assessment (HRA) by comparing participants and nonparticipants with regard to demographics, health behavior, self-rated health, and work-related factors

Summary

Introduction

Seven modifiable risk factors account for more than half of the chronic disease burden: high blood pressure, tobacco use, excess alcohol consumption, high serum cholesterol, overweight, low fruit/vegetable intake, and physical inactivity [1]. Recent reviews of effectiveness studies concluded there is sufficient evidence that worksite health promotion programs (WHPPs) have meaningful effects on a number of risk factors [7,8]. The latter is directly beneficial for the employer: implementing a WHPP can lead to reductions in both absenteeism and productivity loss at work [9,10]. In 2009, the authors of a review concluded that few studies have evaluated the influence of health, lifestyle, and work-related factors on participation, which hampers insight into the underlying determinants of participation in WHPPs, and the influence of selective participation on the effectiveness of these WHPPs [3]. Insight into the underlying determinants of participation is needed to evaluate and implement these interventions

Methods

Results

Discussion

Conclusion