How accurate are self-reports? Analysis of self-reported health care utilization and absence when compared with administrative data.

OBJECTIVE: To determine the accuracy of self-reported health care utilization and absence reported on health risk assessments against administrative claims and human resource records. METHODS: Self-reported values of health care utilization and absenteeism were analyzed for concordance to administrative claims values. Percent agreement, Pearson's correlations, and multivariate logistic regression models examined the level of agreement and characteristics of participants with concordance. RESULTS: Self-report and administrative data showed greater concordance for monthly compared with yearly health care utilization metrics. Percent agreement ranged from 30% to 99% with annual doctor visits having the lowest percent agreement. Younger people, males, those with higher education, and healthier individuals more accurately reported their health care utilization and absenteeism. CONCLUSIONS: Self-reported health care utilization and absenteeism may be used as a proxy when medical claims and administrative data are unavailable, particularly for shorter recall periods.

Using formative research to develop environmental and ecological interventions to address overweight and obesity.

OBJECTIVE: This paper presents the formative research phase of a large multi-site intervention study conducted to inform the feasibility of introducing environmental and ecological interventions. RESEARCH METHODS AND PROCEDURES: Using mixed methods that included an environmental assessment, climate survey, leadership focus groups and interviews, and archival data, information was collected on employee health and job factors, the physical environment, social-organizational environment, and current health programs. RESULTS: Results show that 83% of employees at the study sites were overweight or obese. Leadership was very supportive of health initiatives and felt integrating the strategies into organizational operations would increase their likelihood of success. Environmental assessment scores ranged from 47 to 19 on a 100-point scale. Health services personnel tended to view the organizational climate for health more positively than site leadership (mean of 3.6 vs. 3.0, respectively). DISCUSSION: Intervention strategies chosen included increasing healthy food choices in vending, cafeterias, and company meetings, providing a walking path, targeting messages, developing site goals, training leaders, and establishing leaders at the work group level.