HEALTH RISK ASSESSMENT SOFTWARE FOR EVERYONE: TESTING THE ASSOCIATION OF NUMERACY WITH ENGAGEMENT, PERCEIVED USEFULNESS AND SATISFACTION

Purpose: We used an agile development process to design health risk assessment (HRA) software that meets the needs of diverse users. We hypothesized that empowerment, satisfaction and usefulness as rated by HRA users would be high and that participants with poor vs. adequate numeracy would have similar ratings.

Method: A convenience sample of 40 patients, visitors and employees completed a health risk assessment (available at http://healthylifeHRA.org). Computer malfunctions prevented 7 from completing the HRA and survey (final N=33). Participants had the option of using a laptop or tablet for completing the HRA. A brief survey measured engagement (4 items; 1-not at all to 5-very), perceived usefulness (9 items;1-disagree to 10-agree), and End User Computer Satisfaction (12 items; yes/no). A three item measure screened participants for poor/adequate numeracy.

Result: Participants were 64% Female, 41% white, 29% black 12% other, 18% did not respond; average age was 46 (SD=10). Participants were highly satisfied with the software; 97% responded “yes” on “easy to use,” and 100% "yes" on “quick enough,” "useful format" and "clear report." Participants rated the software as engaging them in caring for their health (Mean=4.5, SD=0.5 on the 1-5 scale). The majority of patients agreed that the software was useful (Mean=7.8, SD=0.9). Numeracy screening indicated that 63% had adequate and 37% poor numeracy. There was no difference in participant satisfaction between the two numeracy groups. Participants with poor numeracy rated the software as more useful (8.9 vs 7.1, p=.007) and more engaging (4.7 vs 4.3, p < .017) than participants with adequate numeracy.

Conclusion: Health risk assessment software can be successfully designed to meet the needs of users with poor numeracy. While satisfaction was similar, in contrast to prior studies, users with low numeracy rated the software as more useful and more engaging than those with adequate numeracy. Future work is necessary to examine whether this difference is explained by differences in health behavior risks and health states between low and adequate numeracy groups.