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BackgroundMobile health (mHealth) apps are considered to be potentially powerful tools for improving lifestyles and preventing cardiovascular disease (CVD), although only few have undergone large, well-designed epidemiological research. “kencom” is a novel mHealth app with integrated functions for healthy lifestyles such as monitoring daily health/step data, providing tailored health information, or facilitating physical activity through group-based game events. The app is linked to large-scale Japanese insurance claims databases and annual health check-up databases, thus comprising a large longitudinal cohort. ObjectiveWe aimed to assess the effects of kencom on physical activity levels and CVD risk factors such as obesity, hypertension, dyslipidemia, and diabetes mellitus in a large population in Japan. MethodsDaily step count, annual health check-up data, and insurance claim data of the kencom users were integrated within the kencom system. Step analysis was conducted by comparing the 1-year average daily step count before and after kencom registration. In the CVD risk analysis, changes in CVD biomarkers following kencom registration were evaluated among the users grouped into the quintile according to their change in step count. ResultsA total of 12,602 kencom users were included for the step analysis and 5473 for the CVD risk analysis. The participants were generally healthy and their mean age was 44.1 (SD 10.2) years. The daily step count significantly increased following kencom registration by a mean of 510 steps/day (P

Objective: Prior research has implied that promoting sustaining physical activity through nudges is challenging and boosting health literacy is important for the long-term establishment of behaviors. This study aimed to investigate the effects of commitment-based health application on step count and health literacy. Methods: A control experiment was conducted involving employees from companies located in Shizuoka Prefecture, Japan. Participants were divided into three groups: the commitment app group (utilizing a commitment-based application "Minchalle," where teams of around five members were randomly assigned to declare a target step count and report daily step count with pictures), the self-commitment group (individuals declaring a target step count and endeavoring on their own), and the control group (no intervention). Changes in step count and health literacy were examined over one month. Results: A total of 109 employees from 7 companies participated. The changes in step count were an increase of 893 steps for the commitment app group, 243 steps for the self-commitment group, and 178 steps for the control group, with a significant increase in the commitment app group compared to the control group. Regarding health literacy measures, there was significant progress in four items out of five for the commitment app group compared to the control group, and significant progress in one item for the self-commitment group compared to the control group. Conclusion: Communication within the app teams, such as commitment, sharing photos of their goal achievements and provide encouraging comments to others, functioned as social nudges, suggesting the potential for an immediate increase in step count and long-term behavioral reinforcement through improved health literacy. [ABSTRACT FROM AUTHOR]

Purpose Follow-up examinations after health check-ups are important for early detection of noncommunicable diseases among workers. Nudging can serve as an effective intervention for individuals who avoid follow-up examinations due to cognitive biases. This study aims to evaluate the interest in nudge-based notification for follow-up examinations, targeting occupational health staff and undiagnosed workers in a randomized controlled trial. Methods Participants were randomly assigned to either a control group (receiving a text-based notification without nudges) or a nudge group (receiving a notification that modified the control group based on Easy-type nudges). An anonymous web survey was administered. Results Occupational health staff (n = 425) rated all items significantly higher, including "willingness to use the notification" which scored 2.22 for the control group vs. 3.62 for the nudge group on a 1- to 5-point scale (P < 0.001). Among undiagnosed workers (n = 871), there was no significant difference in "willingness to apply for the follow-up examinations" (3.01 vs. 3.09; P = 0.272), but all other items were rated significantly higher in the nudge group (P < 0.05). Conclusion Based on these findings, we suggest that occupational health staff should use nudge-based notifications. However, increasing the willingness of undiagnosed workers to undergo follow-up examinations remains challenging. To achieve this goal, it is necessary to incorporate multiple nudge elements into notifications., Competing Interests: Human subjects: Consent was obtained or waived by all participants in this study. The Research Ethics Committee of the Aomori University issued approval 06-2023. This study was approved by the Research Ethics Committee of the Aomori University (Approval No. 06-2023). Animal subjects: All authors have confirmed that this study did not involve animal subjects or tissue. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: Masaki Takebayashi and Yuri Mizota declare(s) a grant from Nippon Boehringer Ingelheim Co., Ltd. and Eli Lilly Japan, K.K. This research was funded by Nippon Boehringer Ingelheim Co., Ltd. and Eli Lilly Japan, K.K., which was received by Masaki Takebayashi and Yuri Mizota on behalf of the research team. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work., (Copyright © 2024, Takebayashi et al.)

Purpose This study aimed to investigate the willingness to use and the application interest toward a smoking cessation program flyer among occupational health staff and smokers, utilizing a nudge approach. Methods A control group (typical flyer) and a nudge group (flyer improved according to the Easy, Attractive, Social, Timely (EAST) framework from the control flyer) were established. Occupational health staff and workers with a desire to quit smoking were randomly divided into two groups, and a web survey was conducted. Results Among occupational health staff, the nudge group flyers received significantly higher evaluations with desires "to apply" (control group: 1.7±0.7 vs. nudge group: 3.7±1.2: 5-point scale) and "to recommend to colleagues in the same profession" (control group: 1.7±2.4 vs. nudge group: 6.6±2.4: 11-point scale), and the reading completion rates were 7.0% for the control group vs. 70.7% for the nudge group (p<0.001). Although there was no significant difference in smokers' willingness "to apply" (control group: 2.9±1.2 vs. nudge group: 3.1±1.2: 5-point scale; p=0.388), the nudge group flyer was significantly more likely to be "want to recommend to other smokers" (control group: 4.9±2.4 vs. nudge group: 5.5±2.4: 11-point scale; p=0.032), with reading completion rates of 73.1% for the control group and 87.4% for the nudge group (p=0.001). Conclusion Typical flyers were not preferred by occupational health staff and may not have been effectively promoted to workers wishing to quit smoking. This study suggests that the combination of the EAST nudges could potentially increase the appeal to occupational health staff. To enhance the application interest among workers wishing to quit smoking, introducing other methods such as incentives might be necessary., Competing Interests: Human subjects: Consent was obtained or waived by all participants in this study. Ethics Committee of Aomori University issued approval 07-2023. Animal subjects: All authors have confirmed that this study did not involve animal subjects or tissue. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: Masaki Takebayashi declare(s) personal fees from Sangyoui Inc. Mayumi Ouchi and Kazushi Yasaka declare(s) employment from Sangyoui Inc. Takao Sensui declare(s) employment from Linkage Inc. Other relationships: This study was funded by the existing budget of the participating company (Sangyoui Inc.) with contributions from the researchers’ personal research funds (Aomori University)., (Copyright © 2024, Takebayashi et al.)

On January 20, 2023, the Japanese government announced easing the legal handling of the novel coronavirus disease 2019 (COVID-19) under its Infectious Diseases Control Act, effective May 8, 2023. While free vaccines will continue in fiscal year 2023, the future of mass vaccinations remains uncertain. The opt-out system, wherein local governments schedule vaccinations on behalf of the residents, may potentially alleviate issues associated with the currently adopted opt-in approach, such as procedural intricacies and scheduling difficulties, thereby facilitating the recovery of vaccination rates and simultaneously addressing vaccine wastage concerns. Given that COVID-19 still presents a substantial risk to specific groups, such as the elderly, recognizing the benefits of the opt-out system and the ethical and geographical challenges it poses is essential. With the collaboration of local governments and healthcare institutions, ongoing surveillance and scientific assessment are indispensable., Competing Interests: None, (Copyright © Japan Medical Association.)