Department of Human Health Sciences, Graduate School of Medicine, Kyoto University, Kyoto, Japan.
Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States of America.
PLoS One. 2023 May 25;18(5):e0286317. doi: 10.1371/journal.pone.0286317. eCollection 2023.
Japan has conducted a nationwide annual health check-up program since 2008, focusing on metabolic syndrome and subsequent health guidance in individuals at high risk for cardiovascular disease. However, the adherence rate to health guidance invitations was assumed to be low in previous reports. Therefore, this study aimed to characterize adherence patterns in the program and identify major predictors of adherence to health guidance invitations.
We studied 186,316 adults (aged 40-74 years) who were included in a nationwide employer-sponsored insurer's database in Japan at the beginning of the fiscal year 2017. We first described adherence to health check-ups, the proportion of individuals with high cardiovascular risk, and adherence to health guidance invitations. Predictors of adherence to the invitation were then identified among eligible high-risk individuals.
In 2017, 71.7% of the study population (n = 133,573) underwent health check-ups, among whom 23.2% (n = 30,979) were invited for health guidance because of their high cardiovascular risk. Among those individuals, 35.2% (n = 10,614) received health guidance. Predictors of improved adherence to health guidance invitation were older age, more concerning blood pressure or laboratory data results, and self-reported motivation for a lifestyle change.
Though 70% of eligible adults attended Japan's annual cardiovascular risk check-ups, only 35% of individuals with high cardiovascular risk adhered to health guidance invitations. Future policy reforms to improve adherence to this program should target younger individuals and those with mild stages of hypertension, diabetes, or dyslipidemia.
自 2008 年以来，日本开展了一项全国性的年度健康检查计划，重点关注代谢综合征和随后对心血管疾病高危人群的健康指导。然而，既往报告显示，健康指导邀请的依从率较低。因此，本研究旨在描述该计划的依从模式，并确定对健康指导邀请的依从的主要预测因素。
我们研究了 186316 名成年人（年龄 40-74 岁），他们在 2017 财年初被纳入日本一家全国性雇主赞助的保险公司的数据库。我们首先描述了健康检查的依从性、心血管高风险个体的比例以及健康指导邀请的依从性。然后，在符合条件的高风险个体中确定了对邀请的依从性的预测因素。
2017 年，研究人群中有 71.7%（n=133573）接受了健康检查，其中 23.2%（n=30979）因心血管风险高而被邀请接受健康指导。在这些人中，有 35.2%（n=10614）接受了健康指导。对健康指导邀请依从性提高的预测因素是年龄较大、更令人关注的血压或实验室数据结果，以及自我报告的生活方式改变的动机。
尽管 70%的合格成年人参加了日本的年度心血管风险检查，但只有 35%的心血管高风险个体依从了健康指导邀请。未来改善对该计划的依从性的政策改革应针对年轻个体和高血压、糖尿病或血脂异常的轻度阶段的个体。
