Effects on cardiovascular disease risk of a web-based health risk assessment with tailored health advice: a follow-up study

Vasc Health Risk Manag. 2011:7:67-74. doi: 10.2147/VHRM.S16340. Epub 2011 Feb 9.


Introduction: A large proportion of the cardiovascular disease (CVD) burden can potentially be prevented by primary prevention programs addressing major causal risk factors. A Web-based health risk assessment (HRA) with tailored feedback for individual health promotion is a promising strategy. We evaluated the effect on CVD risk of such a program among employees of a Dutch worksite.

Methods: We conducted a prospective follow-up study among 368 employees who voluntarily participated in a Web-based HRA program at a single Dutch worksite in 2008. The program included a multicomponent HRA through a Web-based electronic questionnaire, biometrics, and laboratory evaluation. The results were combined with health behavior change theory to generate tailored motivational and educational health advice. On request, a health counseling session with the program physician was available. Follow-up data on CVD risk were collected 1 year after initial participation. The primary outcome was a change in Framingham CVD risk at 6 months relative to baseline. We checked for a possible background effect of an increased health consciousness as a consequence of program introduction at the worksite by comparing baseline measurements of early program participants with baseline measurements of participants who completed the program 6 months later.

Results: A total of 176 employees completed follow-up measurements after a mean of 7 months. There was a graded relation between CVD risk changes and baseline risk, with a relative reduction of 17.9% (P = 0.001) in the high-risk category (baseline CVD risk ≥ 20%). Changes were not explained by additional health counseling, medication, or an increase in health consciousness within the company.

Conclusions: Voluntary participation in a Web-based HRA with tailored feedback at the worksite reduced CVD risk by nearly 18% among participants at high CVD risk and by nearly 5% among all participants. Web-based HRA could improve CVD risk in similar populations. Future research should focus on the persistence of the effects underlying the CVD risk reduction.

Keywords: cardiovascular disease risk; health risk assessment; primary prevention.

MeSH terms

  • Adult
  • Cardiovascular Diseases / diagnosis
  • Cardiovascular Diseases / etiology*
  • Cardiovascular Diseases / prevention & control*
  • Chi-Square Distribution
  • Feedback, Psychological
  • Female
  • Follow-Up Studies
  • Health Behavior
  • Health Knowledge, Attitudes, Practice*
  • Humans
  • Internet*
  • Logistic Models
  • Male
  • Middle Aged
  • Motivation
  • Netherlands
  • Occupational Health Services*
  • Patient Education as Topic*
  • Preventive Health Services*
  • Prospective Studies
  • Risk Assessment
  • Risk Factors
  • Risk Reduction Behavior
  • Time Factors
  • Volition