Efficacy of Additional Intervention to the Specific Health Guidance in Japan: The Takahata GENKI Project

Abstract

Purpose A tailored approach to individual risk factors for developing lifestyle-related diseases would help induce behavioral changes toward intervention acceptability. The addition of preventive healthcare programs to nationwide specific health guidance in Japan is adapted in a given region. Patients and Methods We conducted a prospective parallel-group comparison study on 195 eligible residents from Takahata, Japan, with a high risk of lifestyle-related diseases from 2014 to 2017 to examine whether such an intervention could improve the body mass index (BMI) and estimated glomerular filtration rate (eGFR). Results Of the 195 enrolled residents, 117 were assigned to the control group and 78 to the intervention group. They were ≤65 years old and had a BMI ≥25 kg/m 2 and an eGFR ≤90 mL/kg/1.73 m 2 . We conducted certain interventions for each group, including additional blood testing, regular health guidance, and specific health guidance. After one year, neither BMI (intervention: 26.7 ± 2.17 kg/m 2 vs control: 27.3 ± 2.12 kg/m 2 , p = 0.076) nor eGFR (intervention: 72.2 ± 11.1 mL/kg/1.73 m 2 vs control: 73.1 ± 10.5 mL/kg/1.73 m 2 , p = 0.608) differed significantly between groups. However, after three years, the BMI in the intervention group (26.4 ± 2.05 kg/m 2 ) was significantly reduced compared to that in the control group (27.4 ± 2.26 kg/m 2 ; p = 0.005). Conclusion The additional interventions might have contributed to a reduction in metabolic syndrome. Trial Registration This study was registered in the UMIN-Clinical Trials Registry (ID:000013581). More information: https://upload.umin.ac.jp/cgi-open-bin/ctr_e/ctr_view.cgi?recptno=R000015868 . The registration date was 31/03/2014.

Effectiveness of a targeted primary preventive intervention in a high-risk group identified using an efficiency score from data envelopment analysis: a randomised controlled trial of local residents in Japan

“…‘Action’ refers to evidence-based non-pharmacologic interventions, such as salt reduction, healthy diet, weight reduction, smoking cessation and adequate physical activity 2 3. Our group has previously reported the long-term preventive effect of an intensive intervention that was performed by healthcare professionals 20. Given these points, future research that focuses on optimising the combination of the following aspects according to the available resource is needed; the intensity of an intervention, including its possible effect on the behavioural change and a strategy to identify the target population.…”

“… 2 3 Our group has previously reported the long-term preventive effect of an intensive intervention that was performed by healthcare professionals. 20 Given these points, future research that focuses on optimising the combination of the following aspects according to the available resource is needed; the intensity of an intervention, including its possible effect on the behavioural change and a strategy to identify the target population. In addition, the design of the intervention must be strengthened using an intervention based on appropriate theories of behaviour change.…”

“…2 3 Our group has previously reported the long-term preventive effect of an intensive intervention that was performed by healthcare professionals. 20 Given these points, future research that Figure 2 Scatterplots of salt intake and efficiency score. The rank of the efficiency score is based on the efficiency score calculated using the data envelopment analysis, converted into a ranking from 1 to 101, with a higher rank (first) indicating an increased risk of hypertension.…”

“…Takahata town is responsible for disseminating appropriate healthcare services to the residents. The need to identify high-risk residents among the normotensive population and the need for effective mild intervention were derived through communication and experience of health guidance provided to the public 20. Participants and/or the public were not involved in planning the design, performance, reporting or dissemination of this research.…”