Proactive multipurpose health risk screening in health care settings: Methods, design, and reach

Abstract

Objectives Real world implementation of proactive screening and brief intervention in health care is threatened by high cost. Using e‐health interventions and screening for multiple health risk factors may provide more efficiency. We describe methodological details of a proactive multipurpose health risk screening in health care settings and report on participation rates, participants' characteristics, and participation factors. Methods Patients between 18 and 64 years from ambulatory practices and hospitals were proactively approached by study assistants at three sites for a computerized screening on harmful alcohol and tobacco consumption, depressive symptoms, insufficient fruit/vegetable consumption, physical inactivity and overweight. On the basis of their health risk pattern, a computerized algorithm allocated patients to one of five studies each of them addressing a psychiatric research question. Results Among all eligible patients, 13,763 (86.5%) were screened. Younger age and being female predicted screening participation. Of those with complete data (n = 12,828), 82.9% reported at least two health risks and 34.0% were eligible for a study. Study participation ranged between 35.2% and 50.8%, and was associated with socio‐demographics and problem severity. Conclusions This study supports the use of systematic proactive screening for multiple health risks in health care settings as it is more resource‐saving than single focused screening.

Behavioral health risk factor profiles in general hospital patients: identifying the need for screening and brief intervention

“…Energy-balance related HRF profiles were particularly common in the total sample. With a proportion of 22%, overweight plus inactivity was the most common HRF profile as also found in a general population and in a general hospital study in Germany [11,44]. Similar to a previous general hospital study that investigated the HRFs smoking and alcohol only [57], our findings showed that about half of the hospital patients reported at least one of the two substance-use related HRFs.…”

“…The second limitation concerns the generalizability of our findings to patients from other departments, or to other general hospitals in Germany or beyond. A multisite study in Germany, however, revealed similar proportions of the single HRFs [44]. The third limitation concerns that some significant differences in proportions between subgroups may have been missed.…”

“…As depicted in Table 5, the multivariate analysis revealed that the number of HRFs was significantly increased in males (incident rate ratio, IRR = 1.18), [35][36][37][38][39][40][41][42][43][44][45][46][47][48][49] year olds (IRR = 1.13), 50-64 year olds (IRR = 1.07), persons with the lowest (IRR = 1.39) or medium (IRR = 1.23) level of school education, and unemployed persons (IRR = 1.12).…”

“…However, systematically drawn data is scarce. A systematic screening study that assessed five behavioral HRFs (the four plus low vegetable and fruit intake) and depressive symptoms at three sites in Germany revealed that 83% of the patients screened positive for two or more of the six screening targets [44]. HRF profiles and their variation across gender, age and SES have not been investigated in the general hospital.…”

Latent alcohol use patterns and their link to depressive symptomatology in medical care patients

“…For this purpose, a consecutive sample of medical care patients is used. Medical care provides a valuable setting for studying and managing alcohol use and depressive symptoms, given the frequent presentation of both conditions due to accompanying physical health problems [3,12,13].…”