Effects on cardiovascular disease risk of a web-based health risk assessment with tailored health advice: a follow-up study

Abstract

Introduction:A large proportion of the cardiovascular disease (CVD) burden can potentially be prevented by primary prevention programs addressing major causal risk factors. A Web-based health risk assessment (HRA) with tailored feedback for individual health promotion is a promising strategy. We evaluated the effect on CVD risk of such a program among employees of a Dutch worksite.Methods:We conducted a prospective follow-up study among 368 employees who voluntarily participated in a Web-based HRA program at a single Dutch worksite in 2008. The program included a multicomponent HRA through a Web-based electronic questionnaire, biometrics, and laboratory evaluation. The results were combined with health behavior change theory to generate tailored motivational and educational health advice. On request, a health counseling session with the program physician was available. Follow-up data on CVD risk were collected 1 year after initial participation. The primary outcome was a change in Framingham CVD risk at 6 months relative to baseline. We checked for a possible background effect of an increased health consciousness as a consequence of program introduction at the worksite by comparing baseline measurements of early program participants with baseline measurements of participants who completed the program 6 months later.Results:A total of 176 employees completed follow-up measurements after a mean of 7 months. There was a graded relation between CVD risk changes and baseline risk, with a relative reduction of 17.9% (P = 0.001) in the high-risk category (baseline CVD risk ≥20%). Changes were not explained by additional health counseling, medication, or an increase in health consciousness within the company.Conclusions:Voluntary participation in a Web-based HRA with tailored feedback at the worksite reduced CVD risk by nearly 18% among participants at high CVD risk and by nearly 5% among all participants. Web-based HRA could improve CVD risk in similar populations. Future research should focus on the persistence of the effects underlying the CVD risk reduction.

Culturally Tailored Nutrition And Lifestyle Intervention Can Effectively Reduce The Cardio-metabolic Risk Factors In Korean Migrants Living In Australia

“…These results were consistent with the study by Colkesen et al [26] in that a 2 cm reduction in waist circumference was observed with no change in BMI over a 7-month period.…”

Personalized prevention approach with use of a web-based cardiovascular risk assessment with tailored lifestyle follow-up in primary care practice – a pilot study

“…Within this stepwise approach (one invitation by regular mail, with two reminders, and only a box with additional measurements for the increased risk population) the dropout percentage is relatively high. Although the dropout rate is comparable to studies in an occupational health setting, 3,4 we think optimization of follow-up response of the 'at risk' population is mandatory for improving overall effectiveness of the programme. In focus group research citizens of Leidsche Rijn stated that they prefer measurements immediately at the start of an HRA 32 and in the practice.…”

“…1 By addressing preventable risk factors, including high blood pressure, hypercholesterolaemia, hyperglycaemia, smoking, physical inactivity, stress and overweight, the CVD disease burden can be significantly decreased. [2][3][4] Many individuals are unaware of their risk of cardiovascular diseases and diabetes and, worldwide, health systems are struggling to determine the best ways for primary care and public health to collaborate in the implementation of effective prevention strategies. 5,6 Patients with coronary and vascular disease require a modern preventive cardiology programme to achieve healthier lifestyles, better risk factor control and, when needed, adherence to cardioprotective medications.…”

The Role of Worksite Health Screening

“…In 1 Dutch company, 368 employees volunteered to complete an internet-based health screening that included an evaluation of height, weight, waist circumference, blood pressure, a blood collection to determine lipids and glucose, and a urine sample for albumin and creatinine. 28 Employees were offered a health counseling session and tailored motivational and educational health advice. There was a significant improvement in the Framingham Risk Score (−4.9%, P=0.02) and even more substantial improvements among employees who were at the highest risk at baseline; among the 21 employees whose baseline Framingham Risk Score was ≥20%, CVD risk declined by 17.9% (P<0.001).…”