A case study of 10-year health risk appraisal participation patterns in a comprehensive health promotion program.

Between 1990 and 1999, cumulative participation in a health risk appraisal (HRA) reached 79%, and participation in any health promotion program reached 94% of employees employed continuously by the Progressive Corporation during that time period. Participation rates in the HRA per year ranged from 14% to 36%. First time participants reached no higher than 2.6% after the sixth year. Non-participants tended to have higher mean but lower median costs.