A systematic review of selected interventions for worksite health promotion. The assessment of health risks with feedback.
BACKGROUND
Many health behaviors and physiologic indicators can be used to estimate one's likelihood of illness or premature death. Methods have been developed to assess this risk, most notably the use of a health-risk assessment or biometric screening tool. This report provides recommendations on the effectiveness of interventions that use an Assessment of Health Risks with Feedback (AHRF) when used alone or as part of a broader worksite health promotion program to improve the health of employees.


METHODS
The Guide to Community Preventive Services' methods for systematic reviews were used to evaluate the effectiveness of AHRF when used alone and when used in combination with other intervention components. Effectiveness was assessed on the basis of changes in health behaviors and physiologic estimates, but was also informed by changes in risk estimates, healthcare service use, and worker productivity.


RESULTS
The review team identified strong evidence of effectiveness of AHRF when used with health education with or without other intervention components for five outcomes. There is sufficient evidence of effectiveness for four additional outcomes assessed. There is insufficient evidence to determine effectiveness for others such as changes in body composition and fruit and vegetable intake. The team also found insufficient evidence to determine the effectiveness of AHRF when implemented alone.


CONCLUSIONS
The results of these reviews indicate that AHRF is useful as a gateway intervention to a broader worksite health promotion program that includes health education lasting > or =1 hour or repeating multiple times during 1 year, and that may include an array of health promotion activities. These reviews form the basis of the recommendations by the Task Force on Community Preventive Services presented elsewhere in this supplement.
Soler
Robin E
RE
National Center for Health Marketing, CDC, Atlanta, Georgia 30333, USA. RSoler@cdc.gov
Leeks
Kimberly D
KD
Razi
Sima
S
Hopkins
David P
DP
Griffith
Matt
M
Aten
Adam
A
Chattopadhyay
Sajal K
SK
Smith
Susan C
SC
Habarta
Nancy
N
Goetzel
Ron Z
RZ
Pronk
Nicolaas P
NP
Richling
Dennis E
DE
Bauer
Deborah R
DR
Buchanan
Leigh Ramsey
LR
Florence
Curtis S
CS
Koonin
Lisa
L
MacLean
Debbie
D
Rosenthal
Abby
A
Matson Koffman
Dyann
D
Grizzell
James V
JV
Walker
Andrew M
AM
D004526:Efficiency; D005246:Feedback; D015438:Health Behavior; D006266:Health Education / Q000379:methods; D006293:Health Promotion / Q000379:methods*; D006801:Humans; D016272:Occupational Health; D009786:Occupational Health Services / Q000458:organization & administration*; D018570:Risk Assessment / Q000379:methods; D017132:Workplace