NHS Better Health Healthy Choices Quiz

Evaluate whether the Healthy Choices Quiz provides a clear, trustworthy and usable public-health journey.

The evaluation examines whether the quiz communicates eligibility and expectations clearly, supports reliable task completion, gives users appropriate control over optional information, explains health-related scoring responsibly, and provides sufficient context for users to understand how their information and results are handled.

Evidence before judgement

The review followed a staged evaluation method: establish the product objective and public claims, inspect the live journey directly, deliberately test interaction rules and edge conditions, separate observed behaviour from inference, assign severity only where supported by evidence, preserve positive patterns as well as defects, and explicitly record limitations.

The walkthrough was conducted on the live NHS Better Health experience and included deliberate tests of validation, eligibility, optionality, selection limits, exclusive choices, disclosure controls, section transitions and back-navigation state persistence.

The service establishes an intended experience before the interactive journey begins.

Public NHS information positions the Healthy Choices Quiz as a short lifestyle assessment covering multiple areas of health and wellbeing and leading to an overall score, section-level feedback and recommended NHS resources.

Additional NHS material provides information about score calculation, privacy and interactive-tool data handling, while the Better Health accessibility statement documents the service's published accessibility position.

These statements were treated as product claims to be evaluated against the live interaction rather than as proof that the intended behaviour always occurs.

Sixty-nine-screen end-to-end walkthrough

The canonical observation ledger preserves the complete primary evaluation path from eligibility through the final result, score methodology and accessible chart description. Interaction states are retained separately where deliberate testing produced materially different evidence.

1. About you

2. S01 Age and eligibility. The first interactive question asks the user's age and states that the quiz is for adults aged 18 and over.
3. S02 Empty-age validation. Continuing without an age produces both a prominent error summary and inline guidance to enter an age.
4. S03 Under-18 handling. An ineligible age prevents continuation, explains why the quiz is unsuitable and provides a Health for Teens route.
5. S04 First-name optionality. The first-name question is explicitly optional and can be skipped without blocking progression.
6. S05 Gender optionality. Gender is optional, is stated not to affect the result and includes a Prefer not to say response.
7. S06 Gender disclosure. An expandable explanation refers to uses described in the privacy policy rather than naming a specific immediate purpose.
8. S07 Postcode optionality. Postcode is explicitly optional and is stated not to affect the result.
9. S08 Postcode disclosure. The expandable explanation points to the privacy policy rather than stating a concrete purpose at the question.
10. S09 About you transition. Completion of the About you section is explicitly acknowledged before Motivations begins.

11. Motivations

12. S10 Motivation selection. The interface says Select up to 3 and presents the choices as large checkbox cards.
13. S11 Fourth motivation selection. A fourth motivation can become selected despite the stated maximum of three.
14. S12 Motivation limit enforcement. Continuing with four selections produces a clear error instructing the user to select up to three.
15. S13 Exclusive motivation alternative. Selecting None of the above clears competing motivation selections.
16. S14 Support and guidance. A single-choice question asks how much support and guidance the user feels they have to make healthy changes.
17. S15 Areas to improve. Users select up to two lifestyle areas while I'm not sure is visually separated as an alternative.
18. S16 Back-navigation persistence. Returning to the preceding question preserves the existing answer rather than requiring re-entry.
19. S17 Motivations transition. The service confirms completion of Motivations and previews Eating as the next section.

20. Eating

21. S18 Fruit and vegetable portions. Eating begins with a daily fruit-and-vegetable question supported by contextual portion examples.
22. S19 Starchy foods. A multi-select question permits up to five choices, including wholegrain and refined options plus an exclusive I don't eat these foods alternative.
23. S20 Dairy and alternatives. A long multi-select question permits up to three dairy or plant-based alternatives and required multiple viewport captures to inspect fully.
24. S21 Pre-prepared meals. Eating includes a mutually exclusive frequency question about pre-prepared meals.
25. S22 Eating transition. The service confirms completion of Eating and previews Alcohol as the next section.

26. Alcohol

27. S23 Alcohol frequency. Alcohol begins with a frequency question and provides a collapsed Pregnancy and alcohol disclosure.
28. S24 Pregnancy and alcohol disclosure. Pregnancy guidance expands inline without requiring the user to leave the questionnaire.
29. S25 Alcohol type. The service asks which alcohol types are usually consumed and explicitly permits all relevant options to be selected.
30. S26 Alcohol-type required validation. Submitting without an alcohol type produces both summary and inline guidance to select what type of alcohol is consumed.
31. S27 Conditional drink quantities. Selecting beer or cider, wine and spirits or alcopops generates corresponding quantity fields with standard measures, ABV values, examples and illustrations.
32. S28 Empty alcohol-quantity validation. Leaving all quantity fields empty produces one grouped instruction to enter an amount for at least one drink.
33. S29 Negative quantity validation. A value of -1 is rejected with a measure-specific rule requiring a bottle amount between 1 and 50 using whole numbers.
34. S30 Decimal bottle validation. A value of 1.5 is also rejected, confirming that the displayed whole-number rule is enforced.
35. S31 Higher-consumption threshold. The service asks whether a single day in the last year included 6 or more units for females or 8 or more for males, with contextual unit explanations.
36. S32 Six-unit explanation. The six-unit disclosure translates the threshold into examples using higher-strength beer, large wine and single spirits.
37. S33 Eight-unit explanation. Both threshold disclosures can remain open together and the eight-unit guidance includes practical beer, spirit and wine equivalents.
38. S34 Threshold required validation. Continuing without Yes or No produces a detailed error while preserving both expanded disclosure states.
39. S35 Frequency of higher-consumption days. A Yes response triggers a follow-up asking how often the 6/8-unit threshold was exceeded.
40. S36 Six-versus-eight guidance. The service explains explicitly which threshold should be used and repeats practical drink equivalents.
41. S37 Alcohol transition. The service confirms completion of Alcohol and previews Movement.
42. S38 Occupational physical activity. Movement begins with five ordered activity categories supported by concrete employment examples.

43. Movement

44. S39 Brisk walking. Weekly brisk walking is measured using four time bands and a practical definition based on pace, talking and breathlessness.
45. S40 Cycling. Weekly cycling is measured separately and explicitly includes commuting and leisure cycling.
46. S41 Breathless physical activity. A separate question captures activities such as swimming, jogging, sport and workouts and explicitly excludes walking.
47. S42 Movement transition and progress milestone. Completion of Movement produces the message that the user is more than halfway through and previews Smoking and vaping.
48. S43 Smoking status. Smoking distinguishes daily use, non-daily use, former smoking and never smoking and provides pregnancy guidance.

49. Smoking and vaping

50. S44 Vaping status. Vaping is assessed separately and explicitly includes nicotine-free vapes and electronic cigarettes.
51. S45 Pregnancy and vaping. The expanded guidance advises stopping vaping during pregnancy while recognising its harm-reduction role in staying smoke free.
52. S46 Vaping to quit smoking. For a user who both smokes and vapes, the questionnaire asks whether vaping is being used to quit smoking.
53. S47 Smoking and vaping transition. Completion confirms 4 out of 6 sections finished and previews Mental health.
54. S48 Mood. Mental health begins with a two-week mood question whose responses range from consistently positive mood to always feeling extremely low.

55. Mental health

56. S49 Anxiety. After the most severe mood response, the service proceeds to a two-week anxiety question without immediate support signposting.
57. S50 Stress. After the most severe anxiety response, the service continues to a two-week stress question without immediate support signposting.
58. S51 Mental-health transition. After maximum-severity mood, anxiety and stress responses, the service gives an ordinary section-completion message and moves to Sleep.
59. S52 Sleep. The final section asks how well the user has slept over the last two weeks, with responses ranging to extremely sleep deprived.

60. Sleep

61. S53 End of questions. The service states that the questions are complete and promises a score out of 10 plus advice for each lifestyle area.
62. S54 Result first viewport. The deliberately constructed profile receives 1 out of 10. Smoking and Sleep are Focus on changing, Eating and Alcohol are Try to improve, Movement is Great job, and Mental health is handled separately below.
63. S55 Mental-health result and urgent support. The dedicated mental-health result includes urgent 111 signposting, Every Mind Matters urgent support, NHS Talking Therapies, GP support and a CBT starting point.
64. S56 Mental-health follow-on and Smoking result. Mind Plan is offered as a further personalised mental-health route before the Smoking result recognises smoking, vaping and cessation intent.

65. Quiz completion

66. S57 Smoking cessation resources. The Smoking result provides a Personal Quit Plan and the NHS Quit Smoking app alongside tailored cessation advice.
67. S58 Smoking service and Sleep result. A local Stop Smoking Service and pregnancy-specific advice complete Smoking before Sleep begins with targeted Every Mind Matters resources.

68. Results

69. S59 Eating result. The Try to improve tier identifies insufficient fruit and vegetable intake and provides practical 5 A Day guidance and NHS resources.
70. S60 Eating resources and Alcohol result. Eating adds recipe and BMI resources before Alcohol states that the observed drinking pattern raises long-term health risk.
71. S61 Alcohol support and Movement result. Alcohol provides Drink Free Days support and pregnancy guidance before Movement is correctly retained as Great job.
72. S62 Result persistence. The result closes with movement resources, an Email your result form, a warning that closing the tab loses the result, a Quiz score explained link and Restart quiz.
73. S63 Email-result consent validation. Submitting the result-email form empty proves that both an email address and agreement to one checkbox covering the result and supportive emails are required.

74. Scoring, labels and accessibility

75. S64 Score explainer entry. The Healthy Choices Quiz explained page states that it documents both the overall calculation and section scoring.
76. S65 Overall-score formula. Each of six lifestyle sections scores 0, 1 or 2; the total is divided by 12 and multiplied by 10, except tobacco smoking or an Alcohol score of 0 caps the overall result through a multiplier of 3.
77. S66 Section-scoring basis. The explainer documents the conceptual basis for Eating, Alcohol, Movement and Smoking and vaping, while leaving exact answer-to-0/1/2 thresholds undisclosed.
78. S67 Mental health, Sleep and section labels. Mental health and Sleep scoring bases are documented and the Focus on this, Try to improve and Great job labels are explained.
79. S68 Mental-health label exception and quiz limitations. The NHS explicitly explains that Mental health contributes to the overall score but intentionally receives no section label, and states that the quiz is not a medical diagnosis.
80. S69 Accessible score description. The result gauge provides a dedicated text description of the 1 out of 10 score and explains the numeric ranges and meaning of the red, amber and green bands.

Nine severity-rated findings survive evidence reconciliation

Earlier provisional findings were not automatically preserved. Later evidence was allowed to strengthen, narrow, downgrade or retire them. The register below is therefore the reconciled finding set supported by the completed primary walkthrough.

Important evidence deliberately not promoted to findings

The evaluation distinguishes a demonstrated defect from an open question, design exception or hypothesis that would require a controlled second run or additional evidence.

• Retired F03: Mental health is intentionally included in the overall score but excluded from the coloured section-label model. The exception is disclosed, explained and supported by a substantial dedicated result pathway, so it is retained as a design exception rather than a defect.
• F10 not promoted: the exploratory Alcohol profile mixed a low typical quantity with very frequent threshold exceedance, so the resulting Try to improve label cannot support a controlled claim that a coherent high-risk profile is systematically under-classified.
• Progress: there is no persistent overall progress indicator, but section-completion screens provide strong milestone and numerical progress feedback.
• Movement overlap: cycling is measured separately and the later breathless-activity question excludes walking but does not explicitly state whether previously reported cycling should also be excluded.
• Alcohol threshold framing: the 6-unit and 8-unit pathways use female/male categories and provide contextual guidance, but no further inclusion guidance was observed.
• Response-scale consistency: some Mental health and Sleep answer sets mix frequency and intensity descriptors. This was not shown to prevent completion or interpretation.
• Employment/activity framing: full-time caring appears within I am not in employment even though caring can involve substantial physical activity; later Movement questions may partly compensate for this.
• Smoking granularity: no cigarette-quantity or dependence measure was observed, but the result still produced highly actionable cessation guidance from the available smoking, vaping and quit-intent inputs.