HRA Supplemented With Counseling In Improving Employees' Health Behavior As Part Of Worksite Wellness Program.

Abstract

The use of health risk appraisal (HRA) has become a major part of worksite health promotion programming in order to assess behavior, health risks, knowledge, attitudes, and readiness to change of employees at risk for chronic diseases. These programs are effective if they are incorporated into methods for prioritization and decision making for health improvement strategies of defined population. One approach is to supplement the HRA with individualized tailored counseling. PURPOSE: To determine if individualized consultation, based on the constructs of the Trans Theoretical Model (TTM), is more effective in behavior change than HRA alone. METHODS: Pre-post-test control group design with sixty employees of a public sector agency, consisting of 14 male (47.0±10.4yr) and 46 female (43.9 ±10.2 yr). HRAs were completed by employees voluntarily in six months interval. Comparison of two self-selected groups, one that received 15-minutes consultation about their HRA results and the other that only received their HRA results, was used to assess the differences in progression through the stage of change (SOC) for physical activity, healthy eating habits and weight management consistent with constructs of the TTM as well as other health related behaviors. RESULTS: Both groups showed significant improvements in nutrition, fitness and overall health scores (p<0.05) according to HRA results. Significant between group differences in SOC for exercise (p=.041), the amount of snack food and number of fruits and vegetables consumed, as well as the number of days engaged in physical activity (p<0.05) were found. There were also significant relationships between SOC in exercise, (p= .043,) change in nutrition stage (p=.002,), and change in weight management stage (p=.000) and receiving a consultation. CONCLUSION: The use of HRA at the worksite is an effective way to promote behavior change, based on significant improvements in TTM stage of change and calculated health scores. Also, the use of consultations tailored to the TTM may be an effective means for prioritization and decision making in improving health and influencing behavior change. Supported by grant from Center for Disease Control Cardiovascular Health Program (CDC).