This project will design and implement a comprehensive health risk appraisal and tailored booklet for patients of the University of Michigan M-CARE health maintenance organization.

alcohol, asthma, bicycle helmet, breast cancer, cancer prevention, cervical cancer, cholesterol, colorectal cancer, depression, diet, exercise, family planning, heart disease, injury, medication compliance, prostate cancer, safety, screening, seal belt use, skin cancer, tobacco, expert tailored

1. Design a series of health risk appraisal instruments to measure risk factors, life style behaviors, barriers to change, and readiness to change.
2. Develop a 12-page tailored health report identifying an individual’s health risks and strategies for behavior change to improve risk.
3. Develop a tailored report for clinicians outlining member-specific risk data, including positive health behaviors, high risk behaviors, member perceptions of risk as well as interest, motivation, and readiness to make behavior changes.

Members of M-CARE HMO.

In collaboration with M-CARE, the HMRL will complete an M-CARE HRA process, consisting of a survey, data processing, a tailoring engine for creating individualized messages based on member characteristics, several electronic data files, a customizable health magazine layout, and a summary letter to providers.

Members will complete a print survey that is mailed to them, return mail it to HMRL in a pre-paid envelope for processing, and will receive a 12 page tailored print magazine with their results within two weeks of mailing in their survey. The member's physician will receive a summary report on their members who complete the HRA.

The survey will provide raw data on which steering decisions may be made. In other words, the data may identify people who:

• have a personal history of asthma, congestive heart failure, angina/heart attack, other heart disease, and diabetes
• have a family history of congestive heart failure, angina/heart attack, other heart disease, and diabetes
• have potential problems with alcohol
• have symptoms of depression (and are not currently being treated)

By providing tailored feedback, our program will directly serve people for whom at least one of the following apply:

• do not eat enough fruits and vegetables and/or eat too much fat
• do not engage in adequate physical activity (150 minutes per week)
• use tobacco
• do not adequately protect their skin from the sun
• do not wear bicycle helmets (every time they ride a bike)
• do not use seat belts (all of the time)
• drive drunk
• ride with drunk drivers
• have potential problems with alcohol
• have symptoms of depression
  

If at least one of the previous applies to the individual, they will also get feedback if any of the following apply:

• are planning a pregnancy within 3 years
• do not use effective birth control methods
• are trying to lose weight
• are candidates for hormone replacement therapy
• need cholesterol tests
• need a mammogram
• need a Pap smear
• need a fecal occult blood test (FOBT) or sigmoidoscopy

Messages will aim to increase the actual utilization of, increase readiness to utilize, or reduce barriers to utilizing the following preventive services, as appropriate:

• breast cancer screening
• cervical cancer screening
• cholesterol screening
• hypertension screening
• colorectal cancer screening
• pre-conception planning
• effective birth control methods
• hormone replacement therapy

The appraisal will also aim to create an actual change in, increase readiness to change, or reduce barriers to changing the following:

• tobacco use
• problem alcohol use
• drinking and driving
• riding with a drunk driver
• unhealthy weight loss
• symptoms of depression
• skin protection habits
• physical inactivity
• inadequate nutrition
• seat belt use
• bicycle helmet use

Not applicable - HRA was not part of a study, but a service provided to MCARE.

Not applicable - HRA was not part of a study, but a service provided to MCARE.

Not applicable - HRA was not part of a study, but a service provided to MCARE.