Med Decis Making - Effectiveness of personalized and interactive health risk calculators: a randomized trial.


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CKGROUND: Risk calculators are popular websites that provide individualized disease risk assessments to the public. Little is known about their effect on risk perceptions and health behavior.OBJECTIVE: This study sought to test whether risk calculator features-namely, personalized estimates of one's disease risk and feedback about the effects of risk-mitigating behaviors-improve risk perceptions and motivate healthy behavior.DESIGN: A web-based experimental study using simple randomization was conducted to compare the effects of 3 prediabetes risk communication websites. Setting The study was conducted in the context of ongoing health promotion activities sponsored by a university's human resources office. Patients Participants were adult university employees. Intervention The control website presented nonindividualized risk information. The personalized noninteractive website presented individualized risk calculations. The personalized interactive website presented individualized risk calculations and feedback about the effects of hypothetical risk-mitigating behaviors. Measurements Pre- and postintervention risk perceptions were measured in absolute and relative terms. Health behavior was measured by assessing participant interest in follow-up preventive health services.RESULTS: On average, risk perceptions decreased by 2%. There was no general effect of personalization or interactivity in aligning subjective risk perceptions with objective risk calculations or in increasing healthy behaviors. However, participants who previously overestimated their risk reduced their perceptions by 16%. This was a significantly larger change than the 2% increase by participants who underestimated their risk. Limitations Results may not generalize to different populations, different diseases, or longer-term outcomes.CONCLUSIONS: Compared to nonpersonalized information, individualized risk calculators had little positive effect on prediabetes risk perception accuracy or health behavior. Risk perception accuracy was improved in people who receive relatively "good news" about risk rather than "bad news."

Resumo Limpo

ckground risk calcul popular websit provid individu diseas risk assess public littl known effect risk percept health behaviorobject studi sought test whether risk calcul featuresnam person estim one diseas risk feedback effect riskmitig behaviorsimprov risk percept motiv healthi behaviordesign webbas experiment studi use simpl random conduct compar effect prediabet risk communic websit set studi conduct context ongo health promot activ sponsor univers human resourc offic patient particip adult univers employe intervent control websit present nonindividu risk inform person noninteract websit present individu risk calcul person interact websit present individu risk calcul feedback effect hypothet riskmitig behavior measur pre postintervent risk percept measur absolut relat term health behavior measur assess particip interest followup prevent health servicesresult averag risk percept decreas general effect person interact align subject risk percept object risk calcul increas healthi behavior howev particip previous overestim risk reduc percept signific larger chang increas particip underestim risk limit result may general differ popul differ diseas longerterm outcomesconclus compar nonperson inform individu risk calcul littl posit effect prediabet risk percept accuraci health behavior risk percept accuraci improv peopl receiv relat good news risk rather bad news

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