BMC Medical Research Methodology (Jan 2007)

Development, feasibility and performance of a health risk appraisal questionnaire for older persons

  • Egger Matthias,
  • Ivanova Katja,
  • Swift Cameron G,
  • Harari Danielle,
  • Meier-Baumgartner Hans,
  • von Renteln-Kruse Wolfgang,
  • Anders Jennifer,
  • Dapp Ulrike,
  • Kharicha Kalpa,
  • Stuck Andreas E,
  • Gillmann Gerhard,
  • Higa Jerilyn,
  • Beck John C,
  • Iliffe Steve

DOI
https://doi.org/10.1186/1471-2288-7-1
Journal volume & issue
Vol. 7, no. 1
p. 1

Abstract

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Abstract Background Health risk appraisal is a promising method for health promotion and prevention in older persons. The Health Risk Appraisal for the Elderly (HRA-E) developed in the U.S. has unique features but has not been tested outside the United States. Methods Based on the original HRA-E, we developed a scientifically updated and regionally adapted multilingual Health Risk Appraisal for Older Persons (HRA-O) instrument consisting of a self-administered questionnaire and software-generated feed-back reports. We evaluated the practicability and performance of the questionnaire in non-disabled community-dwelling older persons in London (U.K.) (N = 1090), Hamburg (Germany) (N = 804), and Solothurn (Switzerland) (N = 748) in a sub-sample of an international randomised controlled study. Results Over eighty percent of invited older persons returned the self-administered HRA-O questionnaire. Fair or poor self-perceived health status and older age were correlated with higher rates of non-return of the questionnaire. Older participants and those with lower educational levels reported more difficulty in completing the HRA-O questionnaire as compared to younger and higher educated persons. However, even among older participants and those with low educational level, more than 80% rated the questionnaire as easy to complete. Prevalence rates of risks for functional decline or problems were between 2% and 91% for the 19 HRA-O domains. Participants' intention to change health behaviour suggested that for some risk factors participants were in a pre-contemplation phase, having no short- or medium-term plans for change. Many participants perceived their health behaviour or preventative care uptake as optimal, despite indications of deficits according to the HRA-O based evaluation. Conclusion The HRA-O questionnaire was highly accepted by a broad range of community-dwelling non-disabled persons. It identified a high number of risks and problems, and provided information on participants' intention to change health behaviour.