[5] Commonly a HRA incorporates three key elements – an extended questionnaire, a risk calculation or score, and some form of feedback, i.e. face-to-face with a health advisor or an automatic online report.
[8][9] The Community Preventive Services Task Force (CPSTF) recommends the use of HRAs in workplace settings when used in combination with health education,[4] having found there is strong or satisfactory evidence that they help improve the following behaviors among employees:[10] The original concept of the HRA can be traced back to the decision by the assistant Surgeon General of the United States to conduct a study to determine the probable 10-year lifespan of individuals based on lifestyles and predisposed conditions.
[7][11] During the 1960s, some researchers in California formed the Human Population Laboratory (HPL) to investigate factors contributing to quality of life.
[citation needed] It was not until 1980, when the Centers for Disease Control and Prevention released a publicly available version, that the HRA became widely used, particularly in workplace settings.
The transfer and subsequent program were managed by Dr. Ed Hutchins, who had worked on the HRA in positions at the University of Pennsylvania and Charlotte-Mecklenburg Hospital.
At Charlotte Mecklenburg, he secured a contract with the World Health Organization to create a mainframe product that could be used on an international basis.
Copies were distributed to every state health department, and liaisons were assigned to each to work with their staffs to evaluate related data.
[citation needed] The Carter Center's interest shifted to Africa and Dr. Hutchins founded the Healthier People Network (HPN) in 1991 to continue the work.
[citation needed] The use of HRAs and corporate wellness programs has been most prevalent in the United States, with comparatively slower growth elsewhere.
Initially distributed as paper-based, self-scoring questionnaires through on-site workplace health promotion sessions, HRAs are now most commonly implemented online.