Beyond the Questionnaire: Using the Health Assessment as a tool for behavior change

Beyond the Questionnaire: Using the Health Assessment as a tool for behavior changeBarton H. Sheeler

Typically, the first interaction individuals have with a health or wellness program is when they take the initial health assessment. Whether they are completing the health assessment in response to an incentive offer or other promotion, the act of completing the assessment is personal and self-directed. It is the first step on the path to self-awareness and behavior change. As individuals answer questions, each one becomes a decision point for them to reflect on the impact that their current lifestyle choices have on their health. This awareness must be present before there can be real change, which makes the health assessment a critical tool in the overall success of a health and wellness program.
A health assessment is:

  • a tool for moving an individual to consider, or even take action, to change health behaviors aimed at improving their quality of life and health
  • a way to identify and suggest areas for improvement
  • a means for providing a baseline to track outcomes and improvement

As part of a comprehensive health and wellness program, a good health assessment is designed to prompt follow-through at both the individual and organizational levels. For example, if a health risk or condition is identified, the health assessment should include clear steps for referral to the appropriate health management or wellness program.

Health assessments identify an individual’s health risks, and their healthy and unhealthy behaviors through a set of specific and focused questions. They can be designed to ascertain disease-specific risk profiles, or to provide a comprehensive overview of the whole person.

High-quality health assessments are individualized and dynamic yet structured and controlled. Generally, they cover a combination of topic areas such as:

  • demographics
  • biometric and physical health information
  • exercise and nutrition patterns
  • conditions of personal risk (i.e., motor vehicle safety, alcohol and tobacco use, etc.)
  • components of daily life
  • stress status
  • productivity
  • readiness-to-change

While they can be delivered on paper, most progressive companies see the value in using online assessments for the ease-of-use and flexibility in applying the results – especially when coordinating other components of the health and wellness program. Regardless of the delivery method, the design and structure of the health assessment is an important point for leveraging this teachable moment for education and engagement.

Selecting a Health Assessment

When selecting a health assessment, you first need to consider the goals you are trying to achieve. Why do you need a health assessment? What need are you trying to meet or fill? The answers to these questions will give you your first criteria against which you will judge the health assessments in the market place. It doesn’t matter if a health assessment is top-notch or developed by a leader in the field, if it cannot meet your outlined objectives it will not be of good use to you.

Once you have decided on a health assessment that can meet your needs, consider its origin. Where and why was it developed and what credibility does it have? An assessment that is evidence-based and includes readiness-to-change indicators is best in returning accurate and pertinent information to individuals. There are several areas to consider in evaluating a health assessment:

  • Is it evidence-based?
  • Was it designed by experts in medical and biostatistical/epidemiological fields using current nationally-recognized reference standards to measure risk?
  • Are questions based on validated data collection tools developed by reviewers in the field of data collection and analysis as well as subject specialists?
  • Does it incorporate the concept of readiness to change states* along with individual risk factors as part of the initial collection of key data from each participant?
  • Does it include a simple registration process for each member with simple navigation and links to find the health assessment?
  • Is the health assessment question format segmented into clearly titled sections for quick reference and ease of updating?
  • Can the participant come back and “finish later” – saving the data entered without having to start all over again?

The health assessment should go beyond just being a questionnaire to serve as a tool for “problem identification.” It should focus on the modifiable risk factors that the individual currently has, and hone in on the items the participant is ready to change.

A comprehensive health and wellness program will then use the data collected by the health assessment to encourage enrollment in suitable lifestyle and disease management resources. By maximizing the opportunity of the teachable moment, completing the health assessment serves as a catalyst to identify modifiable health risks and spur behavior change.

Making the Experience Fun and Valuable

The user experience is also of key importance. Having a good question set, but not taking into consideration the time and acceptance of the participant will impact the utilization rate of the health assessment.

While the health assessment is the critical first step on the path to behavior change, what follows the assessment is just as important in moving an individual down a path to better health. Questions to consider include:

  • Does the health assessment generate a personalized health report that reviews where a person is currently and identifies items that can be modified for a healthier lifestyle?
  • Does it offer follow on content that is based on the specific responses and health issues identified in the health assessment awareness stage?
  • Are other resources immediately available to the participant to keep them engaged in the process?

These all are important points to consider when incorporating a health assessment into an organized health and wellness program.

Other areas of consideration include how to incorporate the health assessment with other programs like reporting, developing personalized action plans, participant education, and coordination with incentive programs? Also does it incorporate an administrator portal to support easy member activity look-up and report processing? Tools and features like these can take much of the hard work out of managing an integrated health and wellness initiative.


In the end, the focus is not as much about evaluating the health assessment as much as it is a thorough consideration of your program goals. There is no shortage of health assessment tools in the marketplace. The key is finding one that meets the needs of your health and wellness program from both a cost and comprehensive health management standpoint.

A health assessment that supports a complete wellness program will result in a more effective engagement and better outcomes. If it enables members to create a personalized action plan based on areas that are both meaningful and appropriate at the current stage in an individual’s life, it is more likely to be the first step in making lasting change. Creating awareness is the foundation to building a roadmap toward a healthier lifestyle and ultimately provides greater opportunities to improve health status over time.

Barton H. Sheeler

About the Author Barton H. Sheeler, President, ActivHealth
Through a careful mix of entrepreneurial drive and tenacious leadership, Bart Sheeler is President of ActivHealth, whose products and services were acquired by Nurtur in January 2010. He is the visionary force behind the company’s partnership with the Duke University Center for Living and The PHD Network (Personal Health Development Network), an online health and wellness platform. The PHD Network is a state-of-the-art online platform that integrates health assessment results with individual risk factors to deliver personalized health and wellness information. It includes content including educational lesson plans, goal setting tools, program tracking and incentive point management all within one health management platform.

About Nurtur
Nurtur is the work-life, health and wellness company dedicated to helping people transform their lives with support, encouragement and motivation. The company offers life and health coaching to help people at all life stages address the life issues that get in the way of health as well as the health issues that complicate living. Nurtur life and health management programs include wellness, disease management (including Back Pain, Depression, Diabetes, Heart Disease and Respiratory Disease), episodic/catastrophic care management, work-life resource and referral, employee assistance and professional training. The company provides services to multi-market segments including employers, plan sponsors, Third-Party Administrators, commercial health plans and government agencies. For more information, visit contact Bart Sheeler at or by phone 800-293-0056.

Material from (4 May 2011):

About BVG Janaka dasa das

The counsellor, trainer and lecturer of Balanced and Healthy lifestyle, body, art, music, trance etc philosophy, psychology and psychotherapy. The leader of personal development and team building groups and private practice of psychotherapy.
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4 Responses to Beyond the Questionnaire: Using the Health Assessment as a tool for behavior change

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