Aim 1. Design a series of health risk appraisal instruments to measure risk factors, life style behaviors, barriers to change, and readiness to change.

Aim 2. Develop a 12-page tailored health report identifying an individual's health risks and strategies for behavior change to improve risk.

Aim 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.

The M-CARE HRA consists 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 complete a print survey that is mailed to them, return mail it to CHCR, and then receive a 12 page tailored print magazine with their results within two weeks of mailing in their survey. The member's physician receives a summary report on their members who complete the HRA.

The survey provides raw data on which steering decisions may be made. In other words, the data 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 directly serves 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 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 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 also aims 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. All About You was not part of a study, but a service provided to MCARE.