How well does the eHealth tool recognize the health challenges in comparison to a nurse among the long-term unemployed?

Tuomas Koskela, Venla Raussi, Sari Kujala, Iiris Hörhammer

Keywords: eHealth; risk assessment; long-term unemployed

Background:

Lifestyle choices and socioeconomic status have a significant impact on the expected onset of diseases, age of death, and risk factors concerning long-term illnesses and morbidity. STAR® is an online health examination tool, which gives users a report that includes an evaluation of their life expectancy and lists the most important health challenges based on questions about health, characteristics, lifestyle and well-being.

Research questions:

How well does the eHealth tool recognize the health challenges in comparison to a nurse among the long-term unemployed?
What health problems does the tool not recognize?

Method:

49 unemployed participants attending a health check were recruited from two Finnish primary health care centers. At first, the participants used STAR® and attended a nurse’s health check after that. The health challenges provided by STAR® were compared with the three most important health challenges provided by a nurse. The health challenges were categorized and the percentages of agreement between STAR® and nurse and the confidence intervals of the percentages were calculated. The health challenges not recognized by STAR were recognized.

Results:

STAR® identified 365 health challenges in 49 individuals. For 47 cases the assessment by both a nurse and STAR was obtained. Health challenges were categorized in 17 different groups. In 63 % of cases, STAR identified all categorized health challenges identified by nurses, 95% CI [47.5, 76.8]. In 70 % of cases, STAR identified at least 2/3 of the categorized health challenges identified by the nurse, 95% CI [54.2, 82.3]. 32 health challenges identified by the nurse could’t be categorized into the 17 different categories in the STAR report.

Conclusions:

STAR® identified most of the health challenges identified by nurse, but missed some essential ones. The personal health counseling provided by the eHealth tool depends on the questions of the tool and data entered into the tool.

Points for discussion:

The reasons for the differences between the eHealth tool's assessment and the nurse's assessment

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