Examination of risk status transitions among active employees in a comprehensive worksite health promotion program.

Most worksite health promotion programs are designed to effect risk reduction. Net changes in the prevalence of health behaviors are a combination of individuals who reduce to low-risk and those who become high-risk. It is the purpose of this study to examine overall risk status transitions, between low-risk (0-2 risks); medium-risk (3-4 risks); and high-risk (5 or more risks), within a comprehensive worksite health promotion program over the first year of the program (short-term) and after 5 years (long-term). Significant increases were demonstrated in the numbers of individuals who transitioned to lower risk status. Nearly half (0 percentage points) of the net reduction to low-risk status (+10.4 percentage points) occurred during the first year of the program. The design of health promotion programs may need to be adjusted from risk reduction in the short-term to programs that maximize retention of individuals within low-risk categories over the long-term. This program design would maximize the opportunity to obtain initial risk reduction during the first years of the program and then maximize the opportunity to maintain low-risk status in the long-term.