特定健康診査・特定保健指導への提言

抄録

  Two years and six months have passed since the national health care system “Tokutei Kensin and Tokutei Hoken Sidoh”, which is a metabolic syndrome-specific health check up and counseling system, was enforced on April in 2008. It is high time for us to review it and make a proposal for a future improvement of the system. We would like to discuss the present problems and how we can increase the efficiency of the system in the workshop.
  Tokutei Hoken Sidoh, which is six month counseling and instruction for health-promoting lifestyle behavior, has significant effects not only on an improvement of lifestyle, i.e., physical activity and energy intake, but also on the reduction in body weight, waist circumference and blood pressure. Particularly, initial counseling and instruction after health check-up has a great importance for realization of future risks of cardiovascular diseases, and motivation for reducing abdominal obesity and other risk factors. However, the effects are lost in time after the accomplishment of the six-month program. Therefore, how to maintain the motivation and actual lifestyle change should be sought. At present, the cost effectiveness of Tokutei Hoken Sidoh appears to be low, because we tend to expend a lot of time in counseling. To increase efficiency, standardized group counseling would be needed. In addition, the stratification of individuals may be necessary for attending group counseling, because there are large differences in realization and motivation among subjects regarding metabolic syndrome.