Health hazard appraisal in a family practice center: an exploratory study

Health Hazard Appraisal (HHA), a tool of primary prevention, has been advocated for use in family practice. Yet little evidence exists regarding its effectiveness in clinical settings or its acceptability to practitioners or patients. In this study, 69 family practice patients completed a HHA questionnaire. Their responses were computer-analyzed and returned in two to three weeks. The patients were telephoned three to five months later to assess the effectiveness of HHA in terms of desired behavioral changes. Of the patients who were recommended to undertake specified behavioral changes, 41.3% reported that they had begun an exercise program, 27.8% had stopped smoking cigarettes, 20.0% had limited their alcohol intake, 23.5% had reduced their driving mileage to under 10,000 miles, and 75.0% of the women started breast self examinations. Although the patients' self-reports may have been exaggerated, they nonetheless represent encouraging results. Evaluations by patients revealed little objection to the personal questions, length of time to complete, or cost of the HHA form. Physician evaluations expressed the consensus that HHA was beneficial to the doctor-patient relationship, but a few indicated they did not feel comfortable discussing the HHA results with the patient.