title: Development, feasibility and performance of a health risk appraisal questionnaire for older persons.
abstract: BACKGROUND
  Health risk appraisal is a promising method for health promotion and prevention in older persons. The Health Risk Appraisal for the Elderly (HRA-E) developed in the U.S. has unique features but has not been tested outside the United States.
  
  
  METHODS
  Based on the original HRA-E, we developed a scientifically updated and regionally adapted multilingual Health Risk Appraisal for Older Persons (HRA-O) instrument consisting of a self-administered questionnaire and software-generated feed-back reports. We evaluated the practicability and performance of the questionnaire in non-disabled community-dwelling older persons in London (U.K.) (N = 1090), Hamburg (Germany) (N = 804), and Solothurn (Switzerland) (N = 748) in a sub-sample of an international randomised controlled study.
  
  
  RESULTS
  Over eighty percent of invited older persons returned the self-administered HRA-O questionnaire. Fair or poor self-perceived health status and older age were correlated with higher rates of non-return of the questionnaire. Older participants and those with lower educational levels reported more difficulty in completing the HRA-O questionnaire as compared to younger and higher educated persons. However, even among older participants and those with low educational level, more than 80% rated the questionnaire as easy to complete. Prevalence rates of risks for functional decline or problems were between 2% and 91% for the 19 HRA-O domains. Participants' intention to change health behaviour suggested that for some risk factors participants were in a pre-contemplation phase, having no short- or medium-term plans for change. Many participants perceived their health behaviour or preventative care uptake as optimal, despite indications of deficits according to the HRA-O based evaluation.
  
  
  CONCLUSIONS
  The HRA-O questionnaire was highly accepted by a broad range of community-dwelling non-disabled persons. It identified a high number of risks and problems, and provided information on participants' intention to change health behaviour.
authors.affiliation: Department of Geriatrics, University of Bern, Spital Bern-Ziegler, Morillonstrasse 75-91, CH-3001 Bern, Switzerland. andreas.stuck@bluewin.ch
authors.forename: Andreas E
authors.initials: AE
authors.lastname: Stuck
authors.forename: Kalpa
authors.initials: K
authors.lastname: Kharicha
authors.forename: Ulrike
authors.initials: U
authors.lastname: Dapp
authors.forename: Jennifer
authors.initials: J
authors.lastname: Anders
authors.forename: Wolfgang
authors.initials: W
authors.lastname: von Renteln-Kruse
authors.forename: Hans Peter
authors.initials: HP
authors.lastname: Meier-Baumgartner
authors.forename: Danielle
authors.initials: D
authors.lastname: Harari
authors.forename: Cameron G
authors.initials: CG
authors.lastname: Swift
authors.forename: Katja
authors.initials: K
authors.lastname: Ivanova
authors.forename: Matthias
authors.initials: M
authors.lastname: Egger
authors.forename: Gerhard
authors.initials: G
authors.lastname: Gillmann
authors.forename: Jerilyn
authors.initials: J
authors.lastname: Higa
authors.forename: John C
authors.initials: JC
authors.lastname: Beck
authors.forename: Steve
authors.initials: S
authors.lastname: Iliffe
mesh_terms: D000368:Aged; D015577:Geriatric Assessment; D015438:Health Behavior; D006293:Health Promotion; D006304:Health Status; D006801:Humans; D012307:Risk Factors; D011795:Surveys and Questionnaires