National Center for Health Marketing, CDC, Atlanta, Georgia 30333, USA.
Am J Prev Med. 2010 Feb;38(2 Suppl):S237-62. doi: 10.1016/j.amepre.2009.10.030.
Many health behaviors and physiologic indicators can be used to estimate one's likelihood of illness or premature death. Methods have been developed to assess this risk, most notably the use of a health-risk assessment or biometric screening tool. This report provides recommendations on the effectiveness of interventions that use an Assessment of Health Risks with Feedback (AHRF) when used alone or as part of a broader worksite health promotion program to improve the health of employees.
The Guide to Community Preventive Services' methods for systematic reviews were used to evaluate the effectiveness of AHRF when used alone and when used in combination with other intervention components. Effectiveness was assessed on the basis of changes in health behaviors and physiologic estimates, but was also informed by changes in risk estimates, healthcare service use, and worker productivity.
The review team identified strong evidence of effectiveness of AHRF when used with health education with or without other intervention components for five outcomes. There is sufficient evidence of effectiveness for four additional outcomes assessed. There is insufficient evidence to determine effectiveness for others such as changes in body composition and fruit and vegetable intake. The team also found insufficient evidence to determine the effectiveness of AHRF when implemented alone.
The results of these reviews indicate that AHRF is useful as a gateway intervention to a broader worksite health promotion program that includes health education lasting > or =1 hour or repeating multiple times during 1 year, and that may include an array of health promotion activities. These reviews form the basis of the recommendations by the Task Force on Community Preventive Services presented elsewhere in this supplement.
许多健康行为和生理指标可用于评估一个人患病或早逝的可能性。已经开发出一些方法来评估这种风险，最著名的是使用健康风险评估或生物计量筛查工具。本报告就使用评估健康风险与反馈（AHRF）的干预措施的有效性提供了建议，这些措施单独使用或作为更广泛的工作场所健康促进计划的一部分，用于改善员工的健康。
使用社区预防服务指南的系统评价方法，评估单独使用 AHRF 以及与其他干预措施组合使用时的有效性。根据健康行为和生理估计的变化来评估有效性，但也考虑了风险估计、医疗保健服务使用和工人生产力的变化。
审查小组确定了 AHRF 在与健康教育结合使用时的有效性的有力证据，无论是否有其他干预措施，对于五个结果都是如此。对于另外四个评估结果，也有足够的有效性证据。对于其他结果，如身体成分和水果和蔬菜摄入量的变化，证据不足，无法确定有效性。小组还发现，没有足够的证据来确定单独实施 AHRF 的有效性。
这些审查的结果表明，AHRF 作为一种进入更广泛的工作场所健康促进计划的途径是有用的，该计划包括持续时间大于等于 1 小时的健康教育，或在 1 年内重复多次，并且可能包括一系列健康促进活动。这些审查构成了社区预防服务工作队在本增刊其他地方提出的建议的基础。
