This is a study to determine whether a computerized risk assessment and focused patient provider interaction can improve health outcomes in an employee population.

The overall goal of the proposed research is to test the effectiveness of a theoretically-based interactive behavioral and health risk assessment system to improve the mental and physical health outcomes of the primary care provided for the adult multicultural members of a university health center-employee-based practice. The new system will include:

1. administration of a computerized behavioral and health risk assessment,
2. calculation of an individualized risk profile for each patient participant,
3. individual patient computerized video training in interaction focused on the risk profile,
4. physician training in patient-provider interaction, motivational interviewing and counseling, and in referral and triage focused on the risk profile, and
5. development of a negotiated care plan between patient and clinician for follow-up care.

Expected outcomes include changes in: risk category scores, utilization patterns, costs for health care services, and health stage of change indicators. Expected impacts (mediating variables) are: compliance with recommendations, health locus of control, differences in patient-provider interaction patterns and patient and clinician satisfaction. If successful, this methodology would contribute significantly to the health promotion goals of Healthy People 2010 and provide much needed evidence of how a behavioral and health risk assessment system can help to reduce ethnic health disparities of multi-cultural populations. This proposal is responsive to CDC's RFA for Health Promotion in the Workplace; in particular it responds to requests for strategy #6: Identification and evaluation of public health informatics and communication strategies and tools to improve health decisions, health alerting, health literacy, or health assessment among employees and employer.

Inclusion Criteria:

• Employees who use University of New Mexico providers for medical care