背景:日本自2008年以来一直在全国范围内进行年度健康检查计划,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,在以往的报告中,健康指导邀请的依从率被认为较低.因此,本研究旨在表征项目的依从性模式,并确定健康指导邀请依从性的主要预测因子.
方法:我们研究了186,316名成年人(40-74岁),他们在2017财年初被纳入日本全国雇主赞助的保险公司数据库。我们首先描述了坚持健康检查,高心血管风险个体的比例,坚持健康指导邀请。然后在符合条件的高风险个体中确定遵守邀请的预测因素。
结果:在2017年,71.7%的研究人群(n=133,573)接受了健康检查,其中23.2%(n=30,979)因心血管风险高被邀请接受健康指导。在这些人中,35.2%(n=10,614)接受健康指导。改善对健康指导邀请的依从性的预测因素是年龄较大,更多关于血压或实验室数据结果,以及自我报告的改变生活方式的动机。
结论:尽管70%的合格成年人参加了日本的年度心血管风险检查,只有35%的心血管疾病高危人群接受了健康指导邀请.未来的政策改革,以提高对这一计划的坚持应针对年轻的个人和那些患有轻度高血压的人,糖尿病,或血脂异常。
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.