Initiatives for the 4th Phase of Specific Health Guidance at Occupational Health Institutions

Abstract

 In the 4^th phase of the Specific Health Guidance, which commenced in 2024, outcome evaluation was newly introduced. Performance evaluation now requires health guidance providers to demonstrate results by confirming reductions in abdominal circumference and body weight, as well as behavioral changes that prevent lifestyle-related diseases (improvements in dietary, exercise, smoking, rest, and other lifestyle habits). In response to the 4^th phase revisions, the Junpukai Foundation focused on three key considerations: (1) Review of the active support program, (2) Setting achievable goals during the initial interview, (3) Standardization of outcome evaluation methods. Consequently, for fiscal year 2024 (Phase 4) implementation, the percentage achieving a 2 cm reduction in abdominal circumference and a 2 kg reduction in body weight was 40.2% among those completing the active support program and 15.3% among those completing the motivational support program. Thus, both groups achieved a significant improvement rate compared with fiscal year 2023. However, only 147 participants—a mere 4.3% of those completing active support—earned additional points through outcome evaluation of behavioral change, posing a new challenge.

 Following the commencement of Phase 4, the extremely low number of outcome evaluations for behavioral change led to a significant number of additional support cases arising after the performance evaluation, resulting in the support period being extended by approximately two weeks. A survey of instructors revealed that approximately 60% were inexperienced, and it became clear that the high number of inexperienced instructors and their limited skills were affecting the outcome evaluation of behavioral change. Consequently, an "Action Plan Checklist" was created to supplement the skills of these instructors.

 This significant revision presents an opportunity for occupational health organizations to reassess their specific health guidance programs, and it is hoped that various measures will be implemented to achieve the objectives of Specific Health Guidance.