Health Risk Assessments (HRAs) are a wonderful resource to collect actionable information about employee lifestyle behaviors. This information can then be used to strategically guide a wellness program. Unfortunately, many health risk assessments are fraught with flaws that prevent them from performing their intended purpose. In order to obtain good, actionable information, there are factors to consider when evaluating an HRA.
Is the HRA Engaging?
Because employees are often completing an HRA solely to receive some sort of incentive (or avoid a disincentive), it’s important to structure it in a way to encourage completion–completely and honestly. If employees are approaching it with a “let’s just get this done” attitude, a long, tedious HRA will not encourage them to take their time and thoughtfully consider each question. Furthermore, if there is a laundry list of yes and no questions, it is simple to glide through mindlessly, without truly considering each question.
We have found that employees’ tolerance of the HRA’s length is related to how engaging and appealing it is.
Our HHRA (Holistic Health Risk Assessment) is generally completed on a computer or iPad, at each employee’s convenience. Each section is collapsible, so there is never a time that the employee can visualize a seemingly unmanageable volume of questions. Clicking on the next section makes the process more entertaining, and there is a sense of accomplishment as the employee completes each section. The types of questions (yes/no, multiple choice, etc.) are mixed up so the employee doesn’t get bored. At the end, when the process is complete, there are engaging dials, graphs, etc., that come to life, based on the employee’s information. We find that having a fun, interactive HRA increases employee motivation to thoughtfully complete this important assessment.
Is the HRA based on science?
When we began our HHRA development, we wanted to be mindful of the “whole” person. Our HHRA begins with assessing the employee’s sleep habits. Sleep impacts virtually every aspect of health and wellbeing. Employees who are sleep deprived are less productive and miss more work. Sleep deprivation can lead to chronic disease over time. While it may be difficult to quantify sleep, and its impact, in aggregate reports and it seems to be less directly/immediately tied to healthcare costs, long term poor sleep habits negatively impacts health and the bottom line in many ways. For these reasons, we chose to embed the Epworth Sleepiness Scale into our HRA.
Of course, a very common cause of sleepiness is Obstructive Sleep Apnea. Chronic sleep apnea can cause serious health problems. Screening for obstructive sleep apnea is simple–a few questions and measurements provide a solid screening for this underdiagnosed medical condition.
Depression and anxiety are common conditions on their own, as well as exacerbated by other disorders. Unfortunately, they go undiagnosed frequently. Mental illness can cause employees to struggle in the workplace and at home, and depression and anxiety can lead to physical illness. The HRA is a great opportunity to screen for these. So, just like we did for sleep, and all the other aspects that affect employee health and wellbeing, we looked to the experts to provide screening tools.
HRAs can range widely in their effectiveness, both because of the ease of use and science behind the questions. Engaging HRAs that take into account the whole person and use strong screening tools will yield the most useful information.
Armed with aggregate reports obtained from engaging, clinically sound HRA’s, employers are better equipped to strategically design their wellness programs to meet the unique needs of their employees. Of course, the HRA is just one piece of information. Claims data, biometric data, absenteeism, disability information, and employee feedback are also useful tools to help guide employers.