Design, development and validation of the RedBrick Health Assessment: a questionnaire-based study

OBJECTIVES Health risk assessment (HRA) questionnaires have become a popular tool to help quantify health issues within populations. Over the last decade HRAs have increasingly been delivered in the online environment. The objective of this study was to create and validate an HRA that is optimized for delivery via the Internet. DESIGN After an iterative process of user testing and interface design the RedBrick Health Assessment (RBHA) was validated against known domain specific questionnaires with 464 working Americans, and with medical claims data from over 25,000 employees. SETTING All consumer testing, data capture and analysis occurred at the offices of RedBrick Health Corporation, Minneapolis, USA and via a secure online portal. PARTICIPANTS Individuals in full-time employment in the USA, who were between 18 and 65 years of age at the time inquiry. MAIN OUTCOME MEASURES Correlation of the included RBHA domains with the output from known gold standard health question sets for each assessed health domain. RESULTS The iterative development process employed in creating the RBHA produced a tool that had a high degree of user acceptability. The domains demonstrated good correlations with relevant gold standard questionnaire measures, good internal consistency, and acceptable sensitivity and specificity when compared to gold standard risk stratification and high-risk classification (specificity of domains ranged from 76-94%). A test-retest correlation co-efficient of 0.7, or greater, was achieved 8 weeks after initial completion. CONCLUSIONS The RBHA is a new breed of HRA that has been specifically developed for capturing health status information in an online environment. At its heart is user centricity and this focus has enabled the creation of a tool that is not only highly engaging but also captures accurate and robust health status information.