Development, feasibility and performance of a health risk appraisal questionnaire for older persons.
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.
Stuck
Andreas E
AE
Department of Geriatrics, University of Bern, Spital Bern-Ziegler, Morillonstrasse 75-91, CH-3001 Bern, Switzerland. andreas.stuck@bluewin.ch
Kharicha
Kalpa
K
Dapp
Ulrike
U
Anders
Jennifer
J
von Renteln-Kruse
Wolfgang
W
Meier-Baumgartner
Hans Peter
HP
Harari
Danielle
D
Swift
Cameron G
CG
Ivanova
Katja
K
Egger
Matthias
M
Gillmann
Gerhard
G
Higa
Jerilyn
J
Beck
John C
JC
Iliffe
Steve
S
D000368:Aged; D015577:Geriatric Assessment; D015438:Health Behavior; D006293:Health Promotion; D006304:Health Status; D006801:Humans; D012307:Risk Factors; D011795:Surveys and Questionnaires