# The impact of awareness of health checkup results on dropout from the specific health guidance programs on metabolic syndrome in the teacher population

## TL;DR

This study shows that teachers who are aware of their health checkup results and have a positive attitude toward healthy living are less likely to drop out of health guidance programs and more likely to improve their health.

## Contribution

The study identifies a novel association between awareness of health checkup results and attitude with dropout rates in health guidance programs for teachers.

## Key findings

- Dropout rates increased progressively from 19.88% in the highest awareness group to 27.77% in the lowest.
- The level 3 group had a 1.320 higher adjusted risk of dropout compared to the level 1 group.
- Improvement in health checkup results decreased progressively from level 1 to level 3.

## Abstract

In Japan, specific health guidance is a program based on health checkups to prevent metabolic syndrome. However, dropout from the program is an issue and reduces opportunities to improve cardiovascular risk. Lack of awareness of health checkup results is thought to be associated with dropout, but the association remains unclear. This study aimed to investigate the impact of awareness of health checkup results with related attitude on dropout from specific health guidance among teachers.

Data from medical insurance providers primarily serving teachers (n = 7,031; mean age = 51.19 years old) were analysed. Participants were categorized into 3 groups based on awareness of health checkup results and attitude toward adopting healthy lifestyles at the first time of the health guidance: awareness with the attitude (level 1 group), awareness without the attitude (level 2 group), and lack of awareness (level 3 group). Dropout rates from specific health guidance and improvement in health checkup results in the following year were compared across groups.

Dropout rates were 19.88% in the level 1 group, 22.03% in the level 2 group, and 27.77% in the level 3 group (P < 0.001 in a trend test). Compared with the level 1 group (reference), adjusted risk ratios for dropout were 1.139 (95% confidence interval: 1.001–1.295) for the level 2 group and 1.320 (95% confidence interval: 1.132–1.540) for the level 3 group. The degree of improvement in health checkup results decreased progressively from level 1 to level 3.

Among the participants who received the first health guidance, awareness of health checkup results combined with attitude to adopt healthy lifestyles was associated with lower dropout from specific health guidance and greater improvements in cardiovascular risk. Such individuals’ awareness and attitudes may help predict individuals at risk of dropout from health guidance in this population.