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Effect of Health Risk Appraisal Frequency on Change in Health Status

Pai, Chih-Wen PhD; Hagen, Susan E. MS; Bender, Joel MD, PhD; Shoemaker, David; Edington, Dee W. PhD

Journal of Occupational and Environmental Medicine: April 2009 - Volume 51 - Issue 4 - p 429-434
doi: 10.1097/JOM.0b013e3181a039a4
Original Articles

Objective: To examine the association between repeat participation in health risk appraisal (HRA) and change in health status. If low-risk individuals get worse in their health status, the amount of cost increase tends to be greater than the amount of cost reduction when high-risk individuals improve their health status. Thus, “no change” in health status was considered a desired change along with “getting better” in this study.

Methods: Longitudinal data (1997 to 2004) were used to measure change in health status and participation in HRAs and wellness programs.

Results: Taking an HRA more than once between 2002 and 2004 was associated with a desired change in health status (staying no change or getting better) (P < 0.0001). Additionally, participation in wellness programs during the same time period was also positively associated with a desired change (P < 0.05).

Conclusions: These results highlight the effect of continued engagement in health promotion activities on health status change. Combined with other education and intervention programs, HRAs can be useful tools in promoting and maintaining healthy lifestyles.

From the Health Management Research Center (Dr Pai, Dr Hagen, Dr Edington), University of Michigan, Ann Arbor, Mich; General Motor Corporation (Dr Bender), Pontiac, Mich; and International Union (Mr Shoemaker), United Automobile, Aerospace and Agricultural Implement Workers of America, Detroit, Mich.

CME Available for this Article at

Chih-Wen Pai and coauthors have no financial interest related to this research.

Address correspondence to: Chih-Wen Pai, PhD, Health Management Research Center, University of Michigan, 1015 E. Huron Street, Box 1689, Ann Arbor, MI 48104; E-mail:

©2009The American College of Occupational and Environmental Medicine