Longitudinal survey of depressive symptoms among university students during the COVID-19 pandemic in Japan.

While changes in response to the different stages of the pandemic remain unknown, this study investigated the longitudinal impact of the COVID-19 pandemic on depressive symptoms in Japanese university students and identified factors associated with new onset of depression and suicidal ideation. Two surveys were conducted at one university in Akita, Japan, during the first COVID-19 outbreak period (T1: May-June 2020) and 1 year later (T2: March-May 2021). Moderate depressive symptoms were defined as a Patient Health Questionnaire-9 score ≥ 10 and suicide-related ideation score ≥ 1 on question 9 of the questionnaire. Among 985 students who completed surveys in T1 and T2, participants with moderate depressive symptoms and suicide-related ideation increased from 11 to 17% and from 5.8 to 11.8%, respectively. Among 872 students at risk after excluding those with moderate depressive symptoms at T1, 103 students (11.8%) developed moderate depressive symptoms at T2. Among the 928 students at risk, after excluding those who had suicidal ideation at T1, 79 (8.5%) developed suicidal ideation. Multivariate logistic modeling revealed financial insecurity and academic performance as risk factors (ps < 0.01), while having someone to consult about worries was a coping factor for depressive symptoms and suicidal ideation (ps < 0.001). Our findings demonstrated that socioenvironmental factors may determine depressive symptoms of university students.

Subgroup characteristics of the association between volunteering and the risk of functional disability among older Japanese people: The Tsurugaya project.

BACKGROUND AND OBJECTIVE: Although it has been well known that volunteering is associated with a significantly decreased risk of incident disability among older people, it remains unanswered which subgroups of older people the above association is most remarkable. We aimed to identify such subgroups by conducting subgroup analyses for age, sex, chronic medical condition, and socio-demographic factors. METHODS: Participants were 826 Japanese community-dwelling people aged ≥70 years who lived in Tsurugaya, Sendai. Volunteering status was assessed with a baseline survey conducted in 2003. Incident functional disability was defined as the first certification of Long-term Care Insurance until 2017. The Cox proportional hazard model was used to estimate the multivariate-adjusted hazard ratios (HR) with 95% confidence intervals (CI) for incident functional disability. Subgroup analyses were conducted according to sex, age, medical history, marital status, and educational level. RESULTS: The association between current volunteering and the risk of incident functional disability was not significant (HR 0.77, 95% CI 0.56-1.06) compared to non-volunteers. In the subgroup analysis, the association between current volunteering and the risk of incident functional disability was significant among participants who were women (HR 0.52, 95% CI 0.30-0.91), those who were aged 75 years or over (HR 0.57, 95% CI 0.36-0.91), and those living without a spouse (HR 0.47, 95% CI 0.24-0.91). CONCLUSION: The association between volunteering and a decreased risk of incident functional disability was remarkable among vulnerable groups such as women, those aged 75 years or over, those living without a spouse.

Effect of a financial incentive (shopping point) on increasing the number of daily walking steps among community-dwelling adults in Japan: a randomised controlled trial.

OBJECTIVE: The aim of this study was to investigate the effect of a financial incentive on the number of daily walking steps among community-dwelling adults in Japan. STUDY DESIGN: Two-arm, parallel-group randomised controlled trial. SETTING/PARTICIPANTS: We recruited physically inactive community-dwelling adults from Sendai city, Japan. Eligible participants were randomly allocated to an intervention or a wait list control group. Pedometers were used to assess the mean number of daily steps in three periods: baseline (weeks 1-3), intervention (weeks 4-6) and follow-up (weeks 7-9). INTERVENTION: The intervention group was offered a financial incentive (shopping points) to meet the target number of increased daily steps in the intervention period. MAIN OUTCOME MEASURES: The primary outcome was an increase in the mean number of daily steps in the intervention and follow-up periods compared with baseline. RESULTS: Seventy-two participants (69.4% women; mean age, 61.2±16.2 years; mean number of daily steps at baseline, 6364±2804) were randomised to the intervention (n=36) and control groups (n=36). During the intervention period, the increase in mean daily steps was significantly higher in the intervention group (1650, 95% CI=1182 to 2119) than in the control group (514, 95% CI=136 to 891; p<0.001). However, the difference between groups was not significant at follow-up after the incentives were removed (p=0.311). In addition, compared with controls, a significantly higher proportion of participants in the intervention group showed an increase in mean daily steps of ≥1000 (69.4% vs 30.6%, respectively; OR=5.17, 95% CI=1.89 to 14.08). There were no adverse effects from the intervention. CONCLUSIONS: The present results suggest that financial incentives are effective in promoting short-term increases in physical activity. TRIAL REGISTRATION NUMBER: UMIN000033276.

Randomised controlled trial of a financial incentive for increasing the number of daily walking steps: study protocol.

INTRODUCTION: Physical activity is one of the major modifiable factors for promotion of public health. Although it has been reported that financial incentives would be effective for promoting health behaviours such as smoking cessation or attendance for cancer screening, few randomised controlled trials (RCTs) have examined the effect of financial incentives for increasing the number of daily steps among individuals in a community setting. The aim of this study is to investigate the effects of financial incentives for increasing the number of daily steps among community-dwelling adults in Japan. METHODS AND ANALYSIS: This study will be a two-arm, parallel-group RCT. We will recruit community-dwelling adults who are physically inactive in a suburban area (Nakayama) of Sendai city, Japan, using leaflets and posters. Participants that meet the inclusion criteria will be randomly allocated to an intervention group or a waitlist control group. The intervention group will be offered a financial incentive (a chance to get shopping points) if participants increase their daily steps from their baseline. The primary outcome will be the average increase in the number of daily steps (at 4-6 weeks and 7-9 weeks) relative to the average number of daily steps at the baseline (1-3 weeks). For the sample size calculation, we assumed that the difference of primary outcome would be 1302 steps. ETHICS AND DISSEMINATION: This study has been ethically approved by the research ethics committee of Tohoku University Graduate School of Medicine, Japan (No. 2018-1-171). The results will be submitted and published in a peer-reviewed scientific journal. TRIAL REGISTRATION NUMBER: UMIN000033276; Pre-results.