Preconception care is defined by the government of Japan as initiatives that encourage individuals, regardless of all genders to acquire accurate knowledge about sexuality and health at appropriate life stages and to engage in health management that considers future well-being, including life planning related to pregnancy and childbirth. Based on the Five-Year Action Plan for Promoting Preconception Care, formulated in May 2025, the government is promoting the development of an environment that enables each individual to proactively engage in health management according to their life stage. Based on this plan, specific initiatives have been implemented nationwide. In September 2025, it launched the website "Let's Start Preconception Care," which provides accessible information through articles, comics, Q&A sections, and short dramatized videos, to continuously disseminate accurate information on sexuality and health. In parallel, the Agency has been developing human resources known as "Precon Supporters," who engage in awareness-raising activities and consultation support across local governments, companies, and educational institutions, thereby broadening the reach of community‑based implementation. Additionally, by utilizing programs such as the Sexual and Health Consultation Center Program, efforts are being made to strengthen and publicize accessible local consultation services for general inquiries related to sexuality and health. For individuals requiring specialized support, including those with underlying medical conditions, a nationwide consultation framework is being developed through enhanced collaboration with medical institutions. Local governments play a central role in the effective promotion of preconception care. Specifically, they are expected to promote preconception care as a continuous effort for community residents by coordinating with public health centers, medical institutions, educational organizations, and local businesses, while ensuring continuity with existing maternal and child health services, school health programs, and occupational health initiatives, in line with regional characteristics. This paper outlines the current status and future directions of preconception care promotion in Japan, from the perspective of initiatives led by local governments.

Background: Preconception care (PCC) refers to interventions taken before conception to optimize individuals' health and improve pregnancy outcomes and the health of the next generation. Policy interest in PCC has been growing rapidly both internationally and in Japan. This review aims to summarize the conceptual development of and international trends in PCC, review scientific evidence across key health domains, and examine the current state and challenges for policy implementation in Japan. Methods: A narrative literature review was conducted using domestic and international peer-reviewed articles, WHO reports, government documents, and clinical guidelines. Results: PCC has evolved from narrow clinical measures focused on "preparing for pregnancy" into a broader public health approach targeting all people of reproductive age regardless of intention to achieve pregnancy. This shift is based on the DOHaD theory and life-course framework. Scientific evidence supporting preconceptional interventions was accumulated in relation to nutrition and diet, folic acid supplementation, smoking and alcohol use, weight management, infectious disease prevention and vaccination, mental health, and social determinants of health. Japan formulated the "Five-Year Plan for the Promotion of Preconception Care" in 2025, providing a policy foundation. However, remaining challenges include low public awareness, insufficient gender-inclusive approaches, overemphasis on individual responsibility, and limited integration of PCC into healthcare, education and workplace settings. Internationally, the iCIPHE (International Core Indicators for Preconception Health and Equity) Alliance, involving researchers from 24 countries including Japan, is conducting an international consensus study to identify core surveillance indicators for preconception health. Conclusion: To promote PCC in Japan, a comprehensive strategy combining population- and individual-level interventions, a gender-inclusive approach, multisectoral collaboration, and an evidence-based monitoring system aligned with international indicators is essential.

Adolescence and young adulthood are critical periods during which lifestyle behaviors are established and consolidated. Health status and health behaviors during these stages may influence not only future health outcomes of individuals but also pregnancy, childbirth, and the health of the next generation. In recent years, interest in preconception care has increased in Japan, and the Children and Families Agency formulated the Five-Year Action Plan for Promoting Preconception Care. This review summarizes the status and challenges of lifestyle behaviors among young people in Japan, based mainly on national statistics and public reports, and discusses these issues from the perspective of preconception care. Among young people in Japan, multiple nutritional challenges were identified, including underweight among young women, obesity among young men, low vegetable intake, and insufficient intake of nutrients such as iron, calcium, and folate. In the area of physical activity, the prevalence of regular exercise habits was low, and prolonged sedentary behavior was recognized as a major issue. Regarding sleep, a certain proportion of young people reported insufficient restorative sleep, and shortened sleep duration was also observed. Health behaviors among young people are influenced not only by individual awareness and choices but also by social determinants such as income, education, employment, and information environments. Therefore, in addition to individual-based approaches, initiatives based on the life-course approach and improvement of the quality of social environments for health are important. It is also essential to promote continuous and coordinated efforts involving multiple sectors, including local governments, communities, schools, universities, and workplaces. Furthermore, it is necessary to continuously monitor the living conditions and health challenges of young people and to promote policy development and evaluation based on the perspective of Evidence-Based Policymaking (EBPM). Supporting the establishment of healthy lifestyle behaviors from a young age may contribute not only to the future health of individuals but also to pregnancy, childbirth, and the health of the next generation, and is therefore important for promoting preconception care.

In Yamanashi Prefecture, declining birth rates and limited public knowledge regarding pregnancy and childbirth—identified by recent surveys—underscore the need to position preconception care (PCC) as a cornerstone of health support starting from adolescence. Accordingly, the prefecture has implemented a multilayered approach comprising public awareness initiatives, preconception health checkups, and social media–based consultations. This report summarizes the achievements and challenges of these efforts and provides informative insights for future policy development. Public awareness activities included seminars for university students, young professionals, and corporate executives, all of which provided high participant satisfaction. In particular, approximately 60% of executive participants expressed their intention to engage in PCC-related initiatives, and some companies subsequently introduced their own seminars. With the launch of preconception health checkups, an open-access e-learning program was introduced to enhance access to PCC knowledge. Individuals are now required to complete this program before undergoing the checkup. The social media–based consultation service, which had been initiated before preconception health checkups were available, provides a platform where individuals can easily seek expert advice on menstrual issues, infertility concerns, and other related questions or anxieties. Since preconception health checkups started in FY2024, a total of 4,310 individuals have participated as of early March 2026, far exceeding the initial expectations. The checkup results revealed several health concerns—including vitamin D and zinc deficiencies, underweight BMI, and indications for rubella vaccination—suggesting the usefulness of the checkups to identify health issues in young women and to serve as a starting point for consultations and medical care. Post-checkup survey data further indicated that approximately 70% of participants intended to make lifestyle improvements, and many expressed willingness to seek obstetric and gynecological care. At the same time, challenges that emerged include the financial burden borne by the prefecture, regional disparities in the availability of checkup facilities, the need to reach more young people, and limited involvement of men. Future priorities include the enhancement of learning opportunities by collaborating with schools, community health services, and workplaces; the adoption of public awareness approaches involving youth participation; the establishment of a sustainable checkup system; strengthening of support for men; and the development of a program evaluation framework.

Kyoto Prefecture is intensively promoting a preconception care initiative called "Kyoto Precon" since FY2024 to support desired pregnancies, prevent unintended pregnancies, and enable young people to achieve their preferred way of life (wellbeing). This initiative is based on the fact that about 70% of recipients of the prefecture's financial assistance program for advanced infertility treatment are 35 years or older, suggesting that their pregnancy potential may already be declining by the time they start trying to conceive. There are also approximately 150 cases of induced abortions among teenagers each year. These circumstances highlighted the need to provide opportunities for young people to consider their life design based on scientific knowledge about pregnancy. Prior to the full-scale efforts that started in FY2024, Kyoto Prefecture has been implementing outreach lectures at schools since FY2016 in collaboration with the Midwives Association and the Medical Association to disseminate knowledge related to pregnancy and childbirth and provide opportunities for young people to think about their life design at an early stage. These continuous efforts established a foundation of trust with educational institutions, which is essential to promote preconception care in the school setting. The December 2023 revision of the "Strategy to Create Japan's Best Child-Rearing Environment" sets the promotion of preconception care as a key project. In response, Kyoto Prefecture established a review committee including various experts like physicians, midwives, and university faculty to discuss comprehensive topics such as gender equality, sexual diversity, interpersonal skills, health management, and life design. Based on the committee's recommendations, the prefecture, in collaboration with the Board of Education, developed the nation's first systematic educational program for high school students. The program follows the national curriculum guidelines while responding to school needs, offering practical content such as videos and interactive activities. Model classes were conducted at several high schools and special-needs schools in the prefecture, where teachers evaluated the program highly—citing reduced preparation burden and ease of instruction—and students also gave positive feedback regarding their understanding and the program's usefulness in daily life. As part of the consultation support system for individuals with concerns about sexual health or unintended pregnancy, Kyoto Prefecture also integrated existing consultation services and launched a comprehensive SNS-based consultation service in July 2025. A significantly high number of inquiries have been received from young people. To support these services, the prefecture is also promoting awareness efforts in collaboration with the Board of Education, such as distributing consultation cards at all high schools in the prefecture. These initiatives have been made possible by years of collaborative experience with schools, a shared understanding among the relevant departments, the governor-led strategy revision, and the establishment of a review structure involving experts. Moving forward, Kyoto Prefecture will continue efforts to promote seamless preconception care from early childhood through adulthood.

[Objective] As issues involving adolescents become increasingly complex and diverse, this city recognized the importance of fostering an understanding of the sanctity of life and mutual respect, and of promoting appropriate help-seeking behavior as the foundation to prevent future social isolation. This report describes the development and implementation of "Adolescence Seminars," which have been designed to ensure systematic educational opportunities for all students through inter-departmental collaboration between educational and welfare services. [Methods] In FY2021, an overseeing committee comprising members from various departments (child support, health promotion, gender equality, education, etc.), experts, and school personnel was established. By repeating the process of making adjustments for schools, pilot implementation, and improvement based on student surveys, a standard program aligned with the national "Safety Education for Life" policy was developed. This program has been implemented in all public elementary and junior high schools in the city since FY2022, and student feedback was collected via tablets. [Results/Discussion] The seminar integrates preventive education with counseling and support services, structured as part of school educational activities. Close information sharing by education, welfare, and health departments in alignment with the National Curriculum Standards has facilitated a sustainable framework that is practical for school settings. Sharing of survey results and instructor insights among the relevant organizations ensures a seamless transition to individual support when needed. We aim to strengthen this collaboration to promote continuous preconception care throughout all life stages.

This report presents two cases of occupational health support incorporating preconception care (PCC) forming part of human capital management aimed at sustained corporate value enhancement. In Case 1, a "meal committee " involving multidisciplinary collaboration was established to improve the food environment, including Smart Meal certification and the introduction of a "chewing power-enhancing lunch" that was co-developed with the oral health research department. In Case 2, health education addressing biological sex differences (sex differences awareness training) was integrated into new employee orientation. Outcomes were assessed using dietary intake data and pre- and post-intervention questionnaires. The food environment intervention achieved Smart Meal three-star certification and attained an acceptance rate of approximately 80% despite featuring a health-focused menu, ultimately accounting for 20% of all meals provided. The chewing power-enhancing menu increased interest in oral health among 69% of employees. Following sex differences awareness training, knowledge comprehension improved to 95%, and active engagement in workplace environment improvement and a sense of psychological safety were observed both among male and female employees. This combined approach—integrating food environment intervention (hardware) with educational programming (software)—enhanced self-care among young workers and strengthened organizational health awareness. These initiatives extend beyond employee benefits and serve as an implementation model for "strategic health management" that simultaneously addresses future labor loss prevention and investment in the next generation. Future activities will aim to quantitatively verify the medium- to long-term health outcomes and economic impact of these interventions and to standardize sustainable occupational PCC support.

Objectives: Work engagement is negatively and positively associated with burnout and work performance, respectively. Therefore, building an environments that supports work engagement is important. Recently, the number of workers with neurodevelopmental disorders, particularly autism spectrum disorder, has increased. Autism spectrum (AS) tendencies vary in degree across individuals. Previous studies identified a negative relationship between AS tendencies and work engagement. Establishing a workplace environments that accommodates neurodevelopmental characteristics may promote engagement among workers with high AS tendencies. Therefore, this study aimed to examine the buffering effect of workplace inclusivity on the relationship between work engagement and AS tendencies, and to investigate workplace environments that may enhance work engagement even among individuals with high AS tendencies. Methods: A web-based survey was conducted with 404 sergeants, privates, and equivalent civilians from 30 sections of the Japan Self-Defense Force. The survey assessed work engagement, AS tendencies, and included a nine-item scale on workplace inclusivity for neurodevelopmental characteristics. Demographic characteristics (e.g., sex and age) and coping traits were also assessed. Exploratory and confirmatory factor analyses and hierarchical linear modeling were performed. Results: Confirmatory factor analysis revealed a one-factor structure of workplace inclusivity for neurodevelopmental disorders with a good model fit. A stepwise hierarchical linear model yielded four findings: 1) AS tendencies were negatively associated with work engagement; 2) inclusive workplace environments were positively associated with engagement, especially at the group level; 3) no significant interaction effect emerged between AS tendencies and workplace inclusivity; and 4) random slope effects were excluded through stepwise modeling. Conclusion: Workplace environments, as a workplace job resource, is positively associated with work engagement, regardless of AS tendencies. This inclusive environments is characterized by 1) communication performed with simplification in mind, 2) utilization of visual aids, and 3) efforts to maintain sustained concentration. Stronger group-level relationships highlight the importance of organizational over individual interventions. Finally, the exclusion of random slope effects suggests consistent findings across organizational sections, supporting the generalizability of the results. These results emphasize the value of inclusive workplace practices that account for neurodevelopmental characteristics in organizational settings.

Objective: The purpose of this study was to describe the provision and initiation of self-help for children with medical care and their families needs in　Nagano　Prefecture under disaster conditions, as well as study local government disaster countermeasures. Methods: We used secondary data from a questionnaire survey conducted among the parents of recipients of medical care for chronic childhood diseases at Pediatric Chronic Specified Disease in Nagano prefecture (Recipients Survey) and Nagano's municipal health office and welfare department (Municipal Survey) were used. With Recipients Survey Data, we examined the relationship between the conditions of medical care and the check hazard map, item preparedness, registration of the list of persons requiring assistance during evacuation, individual evacuation plan, and possible evacuation relying on family members only and analyzed using logistic regression analysis. With Municipal survey data, we conducted a descriptive analysis of the disaster preparedness of children with medical care needs. Results: For Recipients Survey (n=732), among families with children receiving medical care for chronic childhood diseases (n=256, 35.0%), 76.2% of the respondents with medically cared children in the families of recipients of medical care had checked hazard maps,68.8% had prepared disaster preparedness items, 5.9 had prepared individual evacuation plans, and 37.1% thought that or were uncertain whether they could not evacuate by relying on family members only. In the settings of adjusted attributes and independence in life of children, according to the presence or absence of medical care, significant differences were found in the category of evacuation relying on family members only (OR=0.66, 95%CI 0.44-0.90). However, significant differences were found not according to the presence or absence of medical care but to the presence or absence of supporters during evacuation (OR=2.54, 95%CI 1.70-3.79). No significant differences were observed in the other categories. However, children's age and independence suggest a relationship between their registration on the list of persons requiring disaster support and the preparation of individual evacuation plans. In relation to the measures taken by local authorities, children who received medical care were provided with disaster support, and individual evacuation plans were prepared for two same local authorities (22.2%). The major reason that those children aren't registered on the list is that children who require medical care have disability certifications. The reason for lack of preparation is a shortage of skilled workers and a lack of know-how. Conclusion: As a result of the study findings, it is suggested that few families of children with medical care in Nagano are prepared to be registered in a list of persons requiring assistance in evacuations or to make individual evacuation plan regardless of presence of medical care for children. Such families may have difficulty evacuating if they only relied on family members. Considering their children's age, circumstances, and independence, support for the preparation of such plans and securing the supporters by local authorities during evacuation remain issues for the future.

This paper proposes a model for health-management support for recipients of public assistance that centers on promoting social independence. Drawing on a review and synthesis of existing empirical and qualitative studies, the paper highlights how social isolation—exacerbated by economic hardship, administrative barriers, and stigma—contributes to poorer health-related behaviors and outcomes among recipients. While national initiatives such as the "Health Management Support Project for Recipients of Public Assistance" have emphasized medical measures (e.g., screening encouragement and lifestyle-disease prevention), they often lack systematic measures to rebuild social connections. Based on the literature, the paper organizes factors that contribute to social isolation into individual and institutional domains and argues that strengthening social-life independence is essential to improving health behaviors and quality of life. It then outlines a four-pillar support approach: (1) combined emotional and instrumental supports to reduce isolation, (2) strengthened social-context assessment during initial interviews and intake, (3) introduction of social prescribing that links recipients to community resources and accompaniment support, and (4) standardization and accumulation of data to inform evidence-based policy. The paper presents these measures as a programmatic proposal—grounded in prior studies and practice examples—to integrate social-participation support with health management for recipients of public assistance.

Objective: To confirm the basis for mutual recommendations between medical and dental consultation as a periodontal disease prevention measure for diabetic patients, we verified the association between periodontal disease and diabetes. Study Design and Methods: The study design was a cross-sectional study.This study included 298 people aged 20 years or older selected from the 2016 Iwate Prefecture Lifestyle Survey.Items used in the analysis were subjects' age, gender, periodontal pocket status in dental disease survey and presence or absence of diabetes, smoking status in lifestyle survey. Statistical analysis was performed using chi-square tests and logistic regression analysis adjusting for gender, age, and smoking to determine the association between periodontal disease and diabetes. Results: No association was found between moderate or greater periodontitis and diabetes, but an association was found with diabetes when limited to severe periodontitis (P < 0.05). Severe periodontitis was associated with age (P < 0.01), gender (P < 0.05), and smoking (P < 0.05), while diabetes was associated only with gender (P < 0.05). Next, adjusted logistic regression analysis revealed a significant association (P < 0.05 for both). Conclusion: Even after adjusting for the related factors, a significant association between both diabetes and severe periodontitis was suggested. This would be useful in diabetes prevention measures that take into account the regional characteristics of Iwate Prefecture.

[Introduction] Home-based medical care is increasingly important in an aging society, yet its provision varies across regions. This study aimed to describe regional differences in home medical care provision in Kagawa Prefecture using standardized claim-data ratios (SCRs) at the secondary medical area level. [Methods] We conducted an ecological study of Kagawa Prefecture and its three secondary medical areas (Eastern, Western, and Shozu). SCRs for home visit medical care and home visits on demand were obtained from NDB Open Data Japan and Cabinet Office datasets and compared across regions. Regional differences and annual trends from 2019 to 2022 were examined descriptively. [Results] Clear regional variation was observed in SCRs for both home visit medical care and home visits on demand. Overall provision of home visit medical care in Kagawa Prefecture was lower than the national average, particularly in the Shozu area. In contrast, home visit medical care for residents of the same building showed relatively higher SCRs in the Eastern area. Over time, SCRs for home visits on demand declined slightly in the Eastern and Western areas, whereas a modest increasing trend was observed in the Shozu area despite low overall levels. [Conclusion] The volume and structure of home-based medical care differed across secondary medical areas, suggesting that provision reflects regional characteristics such as population structure, medical resources, and geographic conditions. While SCR-based analysis at the secondary medical area level is useful for capturing the overall structure of home medical care provision, further analyses using smaller geographic units, such as municipalities, are warranted.

Objective: This study examined the impact of weight loss on the incidence of long-term care certification among older adults in Nagoya City, Japan. Study Design and Methods: A retrospective cohort study was conducted by linking responses from a mailed survey on frailty prevention with KDB (Kokuho Database) records from 2021 to 2023. Participants were 3,714 community-dwelling adults aged ≥65 years who had undergone consecutive health checkups in 2020 and 2021 and had not been certified for long-term care at baseline. Weight loss was defined as ≥3 kg reduction within one year. Logistic regression analyses estimated odds ratios (ORs) for new long-term care certification, adjusting for demographic, health, and psychosocial factors. Results: During follow-up, 233 new cases of long-term care certification occurred. Weight loss was significantly associated with higher risk. The sex- and age-adjusted odds ratio was 1.84 (95% confidence interval = 1.39–2.43), and even after adjusting for all covariates, it remained at 1.79 (1.35–2.37). Stratified analyses revealed stronger associations among younger-old adults and among those already classified as frail. Conclusions: Weight loss of ≥3 kg within one year is an independent risk factor for subsequent long-term care certification. Monitoring weight changes and providing early interventions may be effective strategies for frailty prevention.

Miyazaki Prefecture faces an exceptionally high abortion rate, with artificial stillbirths. This study aimed to identify factors associated with artificial stillbirth and evaluate the impact of the COVID-19 pandemic using vital statistics from birth and stillbirth certificates. A multi-year cross-sectional observational study analyzed approximately 16,000 birth certificates and 500 artificial stillbirth certificates. Comparative analyses were performed between the "birth group" and "artificial stillbirth group" regarding age, marital status, residential area, and household occupation. Selecting artificial stillbirth was strongly associated with non-marital status and economic hardship. A high proportion occurred among young women during their first pregnancy, with a second peak observed in the 35–39 age group. While birth and artificial stillbirth rates declined during the COVID-19 pandemic, no significant changes in specific risk factors were identified within the survey data. This study statistically demonstrated that being unmarried, young, or economically disadvantaged contributes significantly to Miyazaki's high abortion rate. These findings provide a critical evidence base for implementing targeted measures to realize the prefecture's vision.

Objective To ensure sustainable medical access in remote areas facing population decline and aging, online consultations where a nurse is present with the patient (D to P with N) are highly anticipated. This study aimed to clarify the current status, challenges, and future needs regarding medical procedures performed by nurses within the D to P with N model. Methods This study utilized secondary data from an anonymous, self-administered online survey conducted in 2025, involving 81 physicians and nurses with experience in D to P with N. Descriptive statistics were calculated for the status and challenges of medical procedures, and correlations with factors such as years of service were analyzed. Results In addition to assessment, nurses performed a wide range of medical procedures, such as specimen collection and wound treatment under remote instructions. In particular, those who completed specific procedure training performed significantly more invasive medical procedures than those who did not, and a positive correlation was also observed between years of service and experience with medical procedures. There was also a high intention to perform these procedures in the future, indicating a potential need. Conclusion D to P with N can be an effective model for improving medical quality in remote areas. For its widespread adoption, it is essential to establish educational systems to ensure safety and resolve institutional issues, such as clarifying legal responsibility and ensuring appropriate medical fee reimbursement.

Objective: The aim of this study was to clarify trends in foreign-born tuberculosis (TB) patients in Kagawa Prefecture and to examine issues and future measures for regional public health administration. Methods: A descriptive epidemiological study of newly registered TB patients was conducted using the Japan Tuberculosis Surveillance data from 2016 to 2022. The analysis included demographic characteristics, countries of birth, occupations, methods of detection and treatment outcomes of foreign-born and Japan-born patients. We then compared the characteristics of patients nationwide, in Osaka Prefecture, and in Kagawa Prefecture. Results: In Kagawa Prefecture, the proportion of foreign-born TB patients increased annually, exceeding that in Osaka Prefecture and nationwide. Foreign-born TB patients were predominantly young adults in their 20s and 30s, with a higher proportion of females. Most of them were from Vietnam, Indonesia, Myanmar, and the Philippines. More than half were regular workers or students, and many cases were detected through routine health check-ups. The proportion of successful treatment in Kagawa Prefecture was higher than that in Osaka Prefecture and nationwide. There were few cases of multidrug-resistant TB or TB/HIV co-infection. Conclusion: It is important to address the issues of TB among young foreign-born workers in Kagawa Prefecture. Strengthening collaboration with workplaces and enhancing support systems that enable patients' continuity of treatment and employment are essential.

Okinawa Prefecture is a region without an organized primary emergency medical system, and the hospitals with emergency room handle primary emergency care. This unique emergency medical system has not been evaluated quantitatively. This study focused on the central and southern secondary medical areas of Okinawa Prefecture and aimed to evaluate them quantitatively by comparison with secondary medical areas exhibiting similar demographic characteristics, including population size, population density, and aging rates. We utilized indicators such as the number of ambulance acceptances obtained from open data, and non-parametric tests were performed for secondary and tertiary emergency medical hospitals within the target areas. We divided into two groups based on with or without primary emergency medical system, and a Mann-Whitney U test was performed. The number of after-hour visits per general bed (median, 32.8 vs. 26.7; p=0.015) and walk-in acceptances per general bed (median, 37.5 vs. 16.3; p=0.048) were significantly higher in the group without a primary emergency care system than those in the group with a primary emergency care system. This suggests that in areas without a primary emergency medical system, there is a marked concentration of patients at secondary and tertiary emergency medical hospitals. These findings may provide insights for establishing emergency medical systems in other areas facing similar challenges.