Many critics of certain wellness programs, including us, have been very vocal about the lack of efficacy of health risk assessments (HRAs) and biometric screenings. In the interest of being fair and covering both sides, we felt compelled to share research that shows positive outcomes from biometric screenings. Before you rejoice, it is important to note a couple of important aspects of the study.
In the study led by Andreas E. Stuck of University Hospital Bern in Switzerland, 874 healthy adults over the age 65 filled out questionnaires and received individualized computer-generated feedback reports, which were also sent to their doctors. Since this age group is likely to be a small portion of an employer’s workforce, the impact HRAs can have, according to this study, needs to be tempered. Since only 14.5% of people in the U.S. are over the age of 65 and many of them leave the workforce or choose Medicare, the gains employers can expect must be reasonable.
Post-HRA Follow Up
In summarizing his research, Stuck told Reuters Health, “prevention in old age is likely effective, but only if risk assessment is combined with individualized counseling over an extended period of time.” Like HRAs for all other age groups, the tool assesses risk but does not coach or motivate behavior change beyond someone making a life change based on “knowing their numbers.” For two years after the HRA was taken, nurse counselors visited patients at home and called them every three to six months to reinforce what health behaviors they should be pursuing or preventive care they should be obtaining based on their individualized reports. This is a common element of most HRA programs; many employers provide follow up coaching for individuals. This is very costly and seems to only be effective for adults over the age of 65.
Although the study may be considered generally positive news for advocates of HRAs, employers should adjust for the age focus and cost of follow up coaching, and after accounting for these factors, we believe the conclusion is largely the same – skip the HRA.