title: Evaluation of end-user satisfaction among employees participating in a web-based health risk assessment with tailored feedback.
abstract: BACKGROUND
  Web technology is increasingly being used to provide individuals with health risk assessments (HRAs) with tailored feedback. End-user satisfaction is an important determinant of the potential impact of HRAs, as this influences program attrition and adherence to  behavioral advice.
  
  
  OBJECTIVE
  The aim of this study was to evaluate end-user satisfaction with a web-based HRA with tailored feedback applied in worksite settings, using mixed (quantitative and qualitative) methods.
  
  
  METHODS
  Employees of seven companies in the Netherlands participated in a commercial, web-based, HRA with tailored feedback. The HRA consisted of four components: 1) a health and lifestyle assessment questionnaire, 2) a biometric evaluation, 3) a laboratory evaluation, and 4) tailored feedback consisting of a personal health risk profile and lifestyle behavior advice communicated through a web portal. HRA respondents received an evaluation questionnaire after six weeks. Satisfaction with different parts of the HRA was measured on 5-point Likert scales. A free-text field provided the opportunity to make additional comments.
  
  
  RESULTS
  In total, 2289 employees participated in the HRA program, of which 637 (27.8%) completed the evaluation questionnaire. Quantitative analysis showed that 85.6% of the respondents evaluated the overall HRA positively. The free-text field was filled in by 29.7 % of the respondents (189 out of 637), who made 315 separate remarks. Qualitative evaluation of these data showed that these respondents made critical remarks. Respondents felt restricted by the answer categories of the health and lifestyle assessment questionnaire, which resulted in the feeling that the corresponding feedback could be inadequate. Some respondents perceived the personal risk profile as unnecessarily alarming or suggested providing more explanations, reference values, and a justification of the behavioral advice given. Respondents also requested the opportunity to discuss the feedback with a health professional.
  
  
  CONCLUSIONS
  Most people were satisfied with the web-based HRA with tailored feedback. Sources of dissatisfaction were limited opportunities for providing additional health information outside of the predefined health and lifestyle assessment questionnaire and insufficient transparency on the generation of the feedback. Information regarding the aim and content of the HRA should be clear and accurate to prevent unrealistic expectations among end-users. Involving trusted health professionals in the implementation of web-based HRAs may enhance the use of and confidence in the HRA.
authors.affiliation: Academic Medical Center, Department of Medical Informatics, University of Amsterdam, Amsterdam, Netherlands. s.vosbergen@amc.uva.nl
authors.forename: Sandra
authors.initials: S
authors.lastname: Vosbergen
authors.forename: Eva K
authors.initials: EK
authors.lastname: Laan
authors.forename: Ersen B
authors.initials: EB
authors.lastname: Colkesen
authors.forename: Maurice A J
authors.initials: MA
authors.lastname: Niessen
authors.forename: Roderik A
authors.initials: RA
authors.lastname: Kraaijenhagen
authors.forename: Marie-Louise
authors.initials: ML
authors.lastname: Essink-Bot
authors.forename: Niels
authors.initials: N
authors.lastname: Peek
mesh_terms: D015438:Health Behavior; D006304:Health Status; D006801:Humans; D020407:Internet; D008019:Life Style; D017060:Patient Satisfaction; D036301:Qualitative Research; D018570:Risk Assessment