Background Lifestyle choices and socioeconomic status have a significant impact on the expected onset of diseases, age of death, and risk factors concerning long-term illnesses and morbidity. STAR is an online health examination tool, which gives users a report that includes an evaluation of their life expectancy and an estimated risk for developing common long-term illnesses based on questions about health, characteristics, lifestyle, and quality of life. Objective The goals of this study are to (1) review the capacity of STAR to recognize morbidity risks in comparison to a traditional nurse-led health examination and patient-reported health challenges; (2) evaluate the user experience and usability of STAR; and (3) assess the potential impact of STAR on the health confidence and motivation of patients to make healthier lifestyle choices. Methods This mixed methods validation study will consist of a quantitative part (questionnaires) and a qualitative part (phone interviews and open-ended questions from the questionnaires). The participants will include 100 long-term unemployed individuals attending a health check for the unemployed. The participants will be recruited from three Finnish public health centers in Espoo, Hämeenlinna, and Tampere. At the health centers, the participants will use STAR and attend a nurse’s health check. Surveys with multiple-choice and open-ended questions will be collected from the participants, the nurse, and a study assistant. The questionnaires include questions about the participant’s background and health challenges from the patient and nurse points of view, as well as questions about how well the health challenges matched the STAR report. The questionnaires also gather data about user experience, health confidence, and usability of STAR. A study assistant will fill out an observer’s form containing questions about use time and possible problems encountered while using STAR. A sample of the unemployed participants will be interviewed by telephone subsequently. For the quantitative data, descriptive statistics and a reliability analysis will be performed, and mean sum scores will be computed for the study variables. Thematic analysis of the qualitative data will be performed. Results This study was approved by the Ethics Committee of the Expert Responsibility Area of Tampere University Hospital in June 2020 (ETL Code R20067). Data collection will begin in June 2021 and will take approximately 3-6 months. Conclusions Online health examinations can improve the effectiveness of primary prevention in health care by supporting efficient evidence-based morbidity risk estimation and motivating patients to change unhealthy behaviors. A multimethod approach is used to allow for assessment of the tool’s usefulness from the points of view of both professionals and patients. This study will further provide a rich understanding of how the tool can be used as part of routine health checks, and how and why the tool may or may not motivate users for making healthier lifestyle choices. International Registered Report Identifier (IRRID) PRR1-10.2196/27668

BACKGROUND Long-term illnesses and multimorbidity have become more common, thus reducing quality of life and increasing the demand for healthcare services. Lifestyle choices and socioeconomic status have a significant impact on the expected onset of diseases, age of death, and risk factors concerning long-term illnesses and morbidity. STAR is an online health examination tool which, based on questions about health, characteristics, lifestyle, and quality of life, gives users a report that includes an evaluation of their life expectancy and an estimated risk for developing common long-term illnesses. OBJECTIVE The goals of this study: 1. To review the capacity of STAR to recognize morbidity risks in comparison to a traditional nurse-led health examination and patient-reported health challenges; 2. To evaluate the user experience and usability of STAR; 3. To assess the potential impact of STAR on the health confidence and motivation of patients to make healthier lifestyle choices. METHODS This validation study will be conducted among 100 long-term unemployed persons attending a health check for the unemployed. The participants will be recruited from three Finnish public health centers in Espoo, Helsinki, and Tampere. At the health centers, the participants will use STAR and attend a nurse’s health check. Surveys with multiple-choice and open-ended questions will be collected from the participants, the nurse, and a study assistant. The questionnaires include questions about the participant’s background and health challenges from the individual’s and the nurse’s point of view, as well as questions about how well the health challenges matched the STAR report. The questionnaires also gather data about the user’s experience, usability, and the participants’ confidence in managing their health. A study assistant will fill an observer’s form containing questions about use time and possible problems encountered while using STAR. A sample of the unemployed participants will be interviewed by phone afterwards to collect more qualitative data. For the quantitative data, descriptive statistics and a reliability analysis will be performed, and mean sum scores will be computed for the study variables. Thematic analysis of the qualitative data will be performed. This study was approved by the Ethics Committee of the Expert Responsibility Area of Tampere University Hospital in June 2020. ETL Code R20067. RESULTS The data collection will begin at the start of 2021. CONCLUSIONS Multi-method assessment of online health examinations can provide an understanding of how and for whom the tools may be effective and efficient. This study provides an understanding of the novel information provided by STAR, an online health examination, to the healthcare professional and the patient, the usability of the tool, and the potential of the tool to activate patients in the management of their own health.