Enhancing Interest in Smoking Cessation Programs With Nudge-Incorporated Flyers: A Randomized Controlled Trial Among Occupational Health Staff and Workers in Japan.

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.

Impact on step count by commitment-based health application.

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.

Development of a Reverse-Yield Factor Database Disaggregating Japanese Composite Foods into Raw Primary Commodity Ingredients Based on the Standard Tables of Food Composition in Japan.

The reverse-yield factor (RF) database was developed for qualitatively and quantitatively disaggregating Japanese composite foods into raw primary commodity (RPC) ingredients. Representative equations for four types (dried, salted, fermented and mixed foods) were developed to calculate RFs using the food content and composition data for composite foods listed in the Standard Tables of Food Composition in Japan-2020-(STFCJ), published by the Ministry of Education, Culture, Sports, Science and Technology of Japan. Out of 1150 composite foods identified in the STFCJ, RFs for 54 dried, 41 salted, 40 fermented and 818 mixed foods were obtained. RFs for 197 mixed foods could not be calculated because these foods were produced from ingredients with no specified information and/or through complex processing. The content and composition of Japanese composite foods would be interpreted representatively by RFs in the developed database.

How can we promote vaccination of the mass population?-Lessons from the COVID-19 vaccination defaults.

While vaccines are pivotal in combating COVID-19, concerns about side effects and complex procedures have hindered complete vaccination. Prior studies suggest that individuals defaulted to opt-out exhibit higher COVID-19 vaccination rates compared to those in opt-in systems. However, these studies were conducted in countries with a tolerant attitude towards vaccination and default changes, targeting specific age groups, and did not address potential deterrents like the increase in cancellation rates on the day, discomfort towards changing defaults, or the possibility of the opt-out effect being a one-time occurrence. Under the hypothesis that the default nature of the COVID-19 vaccination system influences attitudes towards vaccination even in countries conservative about vaccination and default changes like in Japan, we aimed to examine the differences in the first and second dose vaccination rates, cancellation rates, and the number of complaints between the opt-in and opt-out systems for COVID-19 vaccination. An email survey was conducted in 10 cities in A Prefecture, Japan. The results showed not only higher COVID-19 vaccination rates across all comparable age groups in the opt-out group but also a notably smaller decrease in the second-dose vaccination rate compared to the opt-in group, all achieved without any complaints about the system's introduction. Consequently, it can be inferred that the potential inhibiting factors were largely overcome. Despite some limitations, such as regional specificity, the study suggests that opt-out systems might increase COVID-19 vaccination coverage without leading to significant cancellations or complaints, presenting a promising strategy to facilitate vaccination efforts.