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Sandra Vosbergen,1 Niels Peek,1 Johanna MR Mulder-Wiggers,1 Hareld MC Kemps,1,2 Roderik A Kraaijenhagen,3 Monique WM Jaspers,1,4 Joyca PW Lacroix51Department of Medical Informatics, Academic Medical Center, Amsterdam, the Netherlands, 2Department of Cardiology, Máxima Medical Centre, Veldhoven, the Netherlands, 3NIPED Research Foundation, Amsterdam, the Netherlands, 4Center for Human Factors Engineering of Health Information Technology (HIT Lab), Academic Medical Center, Amsterdam, the Netherlands, 5Department of Brain, Body and Behavior, Philips Research, Eindhoven, the NetherlandsObjective: To evaluate patients’ preferences for message features and assess their relationships with health literacy, monitor–blunter coping style, and other patient-dependent characteristics.Methods: Patients with coronary heart disease completed an internet-based survey, which assessed health literacy and monitor–blunter coping style, as well as various other patient characteristics such as sociodemographics, disease history, and explicit information preferences. To assess preferences for message features, nine text sets differing in one of nine message features were composed, and participants were asked to state their preferences.Results: The survey was completed by 213 patients. For three of the nine text sets, a ­relationship was found between patient preference and health literacy or monitor–blunter coping style. Patients with low health literacy preferred the text based on patient experience. Patients with a monitoring coping style preferred information on short-term effects of their treatment and mentioning of explicit risks. Various other patient characteristics such as marital status, social support, disease history, and age also showed a strong association.Conclusion: Individual differences exist in patients’ preferences for message features, and these preferences relate to patient characteristics such as health literacy and monitor–blunter coping style.Keywords: patient preferences, patient education, monitor–blunter coping style, information tailoring, message features

Abstract Background Primary prevention programs at the worksite can improve employee health and reduce the burden of cardiovascular disease. Programs that include a web-based health risk assessment (HRA) with tailored feedback hold the advantage of simultaneously increasing awareness of risk and enhancing initiation of health-behaviour change. In this study we evaluated initial health-behaviour change among employees who voluntarily participated in such a HRA program. Methods We conducted a questionnaire survey among 2289 employees who voluntarily participated in a HRA program at seven Dutch worksites between 2007 and 2009. The HRA included a web-based questionnaire, biometric measurements, laboratory evaluation, and tailored feedback. The survey questionnaire assessed initial self-reported health-behaviour change and satisfaction with the web-based HRA, and was e-mailed four weeks after employees completed the HRA. Results Response was received from 638 (28%) employees. Of all, 86% rated the program as positive, 74% recommended it to others, and 58% reported to have initiated overall health-behaviour change. Compared with employees at low CVD risk, those at high risk more often reported to have increased physical activity (OR 3.36, 95% CI 1.52-7.45). Obese employees more frequently reported to have increased physical activity (OR 3.35, 95% CI 1.72-6.54) and improved diet (OR 3.38, 95% CI 1.50-7.60). Being satisfied with the HRA program in general was associated with more frequent self-reported initiation of overall health-behaviour change (OR 2.77, 95% CI 1.73-4.44), increased physical activity (OR 1.89, 95% CI 1.06-3.39), and improved diet (OR 2.89, 95% CI 1.61-5.17). Conclusions More than half of the employees who voluntarily participated in a web-based HRA with tailored feedback, reported to have initiated health-behaviour change. Self-reported initiation of health-behaviour change was more frequent among those at high CVD risk and BMI levels. In general employees reported to be satisfied with the HRA, which was also positively associated with initiation of health-behaviour change. These findings indicate that among voluntary participating employees a web-based HRA with tailored feedback may motivate those in greatest need of health-behaviour change and may be a valuable component of workplace health promotion programs.