Papers

(Paper publication) Vegetable Intake Increased by 10.7%! Quiz-Based Incentives via Health App Show Promise for Behavior Change (Associate Professor Akira Kyan)

A study led by Associate Professor Akira Kyan of the University of the Ryukyus (formerly of Kyoto University), in collaboration with Assistant Professor Koryu Sato (Keio University, Faculty of Policy Management) and Professor Naoki Kondo (Kyoto University, Department of Social Epidemiology), found that a quiz-based incentive campaign delivered via a health app significantly increased vegetable intake among residents of a Japanese city.

As part of a long-running health communication campaign, 786 participants answered quizzes on vegetable nutrition and earned points that could be exchanged for product vouchers. Participants who completed all three quizzes consumed 10.7% more vegetables than non-participants.

Using multiple regression analysis and dietary data from the previous year (from 605 individuals), the study confirmed a statistically significant increase in vegetable consumption among frequent quiz participants.

These findings provide strong evidence that gamified, incentive-based interventions delivered through digital toolscan support improvements in dietary behavior and contribute to the prevention of noncommunicable diseases.

Article: Kyan A, Sato K, Kondo N. Increased vegetable consumption in Japan using an incentivized health communication campaign with a quiz. J Nutr Sci 2025 Apr 2; 2(14): e30.

Please click here for the full-text article.

(Paper publication) Tailor-Made Support for Children in Households Receiving Public Assistance: Establishing a Novel Method Toward Developing an Effective Support System (Visiting Researcher Keiko Ueno）

Poverty adversely affects children’s health and social lives. Children in households receiving public assistance often have diverse health and lifestyle needs that require individualized support tailored to their specific living backgrounds. Moreover, effective support methods vary depending on each child’s circumstances.

To address this issue, a research team led by Keiko Ueno, an assistant professor in the Department of Social Epidemiology at Kyoto University Graduate School of Medicine, utilized responses from a questionnaire survey of 1,275 children. Using a machine learning technique called soft clustering, they categorized the children into small groups (segments) based on differences in their living backgrounds. The researchers then conducted interviews with professionals (including NPO staff, child psychiatrists, public health nurses, and school counselors; hereafter referred to as “experts”) to understand each segment’s lifestyle characteristics and collect opinions on suitable health and life support strategies. As a result, five distinct and expert-validated segments were identified.From the expert interviews, diverse support strategies were suggested, addressing not only physical health but also social and mental well-being. Based on these findings, the team is now developing a tailor-made support system that presents support plans matched to each segment.

This research was published online in the International Journal for Equity in Health on April 16, 2025.

Article：Ueno K, Nishioka D, Shiho K, Naoki K. A data-driven approach to detect support strategies for children living in households receiving public assistance in Japan: a mixed methods study to establish tailor-made health and welfare care. Int J Equity Health. 2025;24:103.

Please click here for the full-text article. The press release is also available here.

Press Release: Older Adults Engaged in Social Participation Are More Likely to Maintain Independence Until the End of Life (Co-researcher: Takayuki Ueno)

A research group led by Takayuki Ueno, a researcher at the Tokyo Metropolitan Institute for Gerontology, and Professor Naoki Kondo of our lab had previously identified five patterns of physical function decline during the last three years of life: “maintained independence until death,” “rapid decline,” “gradual decline,” “moderate maintenance,” and “severe maintenance.” In this study, the group revealed that older adults who participated in social activities at least once a month in 2010 were more likely to follow the “maintained independence” trajectory compared to those who did not engage in social activities.
The findings of this study offer valuable insights into extending healthy life expectancy and improving the quality of life (QOL) for older adults. These results underscore the necessity of promoting social participation in future older adult care policies.

Article: Ueno T, Saito J, Murayama H, Saito M, Haseda M, Kondo K, Kondo N. Social participation and functional disability trajectories in the last three years of life: The Japan Gerontological Evaluation Study. Arch Gerontol Geriatr. 2024 Jun; 121: 105361.

DOI: 10.1016/j.archger.2024.105361

Paper publication: Discovering daily life needs of older public assistance recipient subgroups (Assistant Professor Ueno)

Health disparities have become a major social issue in Japan. To reduce health disparities, it is necessary to shift from individual-level to societal-level interventions. Since 2021, health management support programs for public assistance recipients have been mandated in welfare offices. Assistant Professor Keiko Ueno and her colleagues focused on older public assistance recipients, particularly those in need of health and daily life support, and identified the daily life needs of older public assistance recipient subgroups.

In 2021, we conducted interviews with four caseworkers from the welfare offices in two districts. The results of our previous quantitative study, which identified five subgroups of older public assistance recipients by sex, were presented to caseworkers. They were asked about their daily life needs in each subgroup. The interview results revealed the following five daily life needs among the subgroups of older public assistance recipients: (1) housing, (2) financial,(3) welfare service utilization, (4) medical, and (5) no specific daily life needs. These findings indicate that appropriate support interventions are necessary for each subgroup of older public assistance recipients. Future studies are warranted to conduct interviews with professionals from other fields (such as public health nurses and social workers) to further understand the daily life needs of the subgroups of older public assistance recipients.

Article: Ueno K , Nishioka D, Saito J, Kino S, Kondo N. Understanding the daily life needs of older public assistance recipient subgroups in Japan: A qualitative study.Glob Health Med. 2024. doi: 10.35772/ghm.2024.01029

* Please click here for the Press Release (in English) and here to access the full text article.

Press Release: Living Arrangement Status and Treatment Effectiveness of Cardiovascular Prevention – (Medical Student Kanta Kiyohara)

Medical student Kanta Kiyohara, Associate Professor Kosuke Inoue, Professor Taku Iwami, and Professor Naoki Kondo published a study using data from a large-scale randomized controlled trial to reveal that the effectiveness of intensive glycemic and blood pressure control among patients with diabetes varies by living arrangement status (living alone or not).

This research, published in the Journal of the American Heart Association (JAHA) on June 27, 2024, highlights the need to consider living arrangements, particularly living alone, as a critical social determinant of cardiovascular health that can modify the effectiveness of cardiovascular prevention among individuals with diabetes.

Article: Kiyohara K., Kondo N., Iwami T., Yano Y., Nishiyama A., Node K., et al. Heterogeneous Effects of Intensive Glycemic and Blood Pressure Control on Cardiovascular Events Among Diabetes Patients by Living Arrangements. J Am Heart Assoc. 2024 Jul 2; 13(13): e033860

DOI: 10.1161/JAHA.123.033860

[Click here for detailed information in Japanese.]

Press Release: Income and impaired kidney function –the disparities of rapid kidney function decline and hemodialysis were 1.7 times– (Doctoral Student Ishimura)

Ph.D. student Ishimura and her team published a study examining the association between income and the development of impaired kidney function in JAMA Health Forum.
The study showed the lowest income group had 1.7 times higher risks of rapid kidney function decline and initiation of kidney replacement therapy (dialysis or kidney transplantation) than the highest income group, based on the analysis of 5.6 million insured individuals from the Japan Health Insurance Association.

Article: Ishimura N, Inoue K, Maruyama S, Nakamura S, Kondo N. Income Level and Impaired Kidney Function Among Working Adults in Japan. JAMA Health Forum. 2024;5(3):e235445.
DOI link：10.1001/jamahealthforum.2023.5445

Press release: 3.8 times the risk of depression when moving to temporary housing; however, those who changed their participation in group activities upon moving had a 40% reduction in the risk (Visiting Researcher Matsuoka)

A research group led by Yoko Matsuoka (Chiba University, Center for Preventive Medical Sciences) and Professor Naoki Kondo analyzed the effect of post-disaster relocation on mental health and the factors explaining this effect among the affected older adults of the 2016 Kumamoto earthquake.

Post-disaster relocation is a risk factor for worsening mental health, but the mechanism has not been elucidated. Therefore, we analyzed the effect of relocation on mental health by housing type and what factors explain this effect. We included 828 older adults aged 65 years or older who participated in the 2013 survey before the earthquake and seven months later in the 2016 survey in Mifune Town, Kumamoto Prefecture, which was affected by the April 2016 Kumamoto earthquake. Focusing on participation in group activities, the risk of depression due to relocation to temporary housing was 3.8 times higher for those who had no change before and after the earthquake, but this risk was reduced by 40% for those who had a change in group participation. After the 2016 Kumamoto earthquake, temporary housing facilities were relocated based on lessons learned from past earthquakes and tsunami disasters, including group relocation policies, the establishment of meeting places in proximity, and visitation activities by support centers. There, residents were able to change their involvement in group activities and optimize their connections, which may have led to a reduction in relocation stress.

The paper was published in BMC Public Health in the online edition on October 11, 2023.

The press release is available here.

[Article Information]

Yoko Matsuoka, Maho Haseda, Mariko Kanamori, Koryu Sato, Airi Amemiya, Toshiyuki Ojima, Daisuke Takagi, Masamichi Hanazato & Naoki Kondo. Does disaster-related relocation impact mental health via changes in group participation among older adults? Causal mediation analysis of a pre-post disaster study of the 2016 Kumamoto earthquake. BMC Public Health 23, 1982 (2023).

DOI: https://doi.org/10.1186/s12889-023-16877-0

Paper Publication: Development and validation of Healthy Ageing indicator proposed by the United Nations (PhD student, Marisa Nishio)

Marisa Nishio, PhD student, announces the publication of a research paper concerning the validity of the concept of Healthy Ageing proposed by the United Nations.

The United Nations has designated the period from 2021 to 2030 as the “Decade of Healthy Ageing,” encouraging countries worldwide to monitor the progress of Healthy Ageing using Functional Ability as an indicator (Functional Ability refers to the combination of an individual’s physical and mental abilities and the supportive environment enabling them to utilize these abilities). However, the measurement for Functional Ability and its conceptual validity have not been extensively studied, making the implementation of monitoring efforts challenging.

This research utilized data from approximately 35,000 older individuals residing in Japan to develop a measurement for Functional Ability and assess its validities. 

Her study confirmed the empirical validity of Functional Ability. To promote the global dissemination and monitoring of Healthy Ageing, further research validating the concept of Functional Ability using data from other countries is essential.

This study was published in “Age and Ageing,” a journal by Oxford University Press. 

Press release is here

【Article information】

Nishio M, Haseda M, Inoue K, Saito M, Kondo N. Measuring functional ability in Healthy Ageing: testing its validity using Japanese nationwide longitudinal data. Age Ageing. 2024 Jan 2;53(1):afad224. doi: 10.1093/ageing/afad224. PMID: 38275093; PMCID: PMC10811647.

URL: Measuring functional ability in Healthy Ageing: testing its validity using Japanese nationwide longitudinal data | Age and Ageing | Oxford Academic (oup.com)

Paper publication: Paramedics require more than 30 minutes of activity at the scene in older patients, female patients, fire accidents, natural disasters, motor vehicle accidents, assaults, self-injuries, number of hospital inquiries ≥ 4, and the COVID-19 pandemic among ambulance users with minor diseases or injuries (Assistant Professor Ueno)

Prolonged activity time of paramedics at the scene is a major global problem in the emergency medical system (EMS). Assistant Professor Keiko Ueno conducted collaborative research with Hiroshima University, utilizing data from the ambulance transportation and request call records databases of the Higashihiroshima Fire Department over a period of seven years. They revealed that paramedics required more than 30 minutes of activity at the scene in older patients, female patients, fire accidents, natural disasters, motor vehicle accidents, assaults, self-injuries, number of hospital inquiries ≥ 4, and the COVID-19 pandemic among ambulance users with minor diseases or injuries. We need to reconsider how to intervene with potentially modifiable factors, such as EMS personnel performance, the impact of the presence of allied services, hospital patient acceptance systems, and cooperation between general emergency and psychiatric hospitals to improve community EMS.
Article: Ueno, K., Teramoto, C., Nishioka, D. et al. Factors associated with prolonged on-scene time in ambulance transportation among patients with minor diseases or injuries in Japan: a population-based observational study. BMC Emerg Med 24, 10 (2024). https://doi.org/10.1186/s12873-023-00927-2

Press Release: Review of Screening and Assessment Tools for Social Determinants of Health in the Field of Cardiovascular Disease

We have published a comprehensive review article on screening and assessment tools for Social Determinants of Health (SDOH) in the field of cardiovascular disease (CVD).
This is a collaborative effort with researchers from the Department of Cardiology at St. Luke’s International Hospital and the Department of Academic Informatics at St. Luke’s International University.

The article elucidates the deployment of previously reported SDOH assessment tools in relation to CVD and the correlation between individual SDOH factors and CVD outcomes.
Our research findings were released on December 11, 2023, in the Circulation Journal, an international journal issued by the Japanese Circulation Society.
Press release is here (in Japanese)

【Article information】
Journal: Circulation Journal
Article title: Scoping Review of Screening and Assessment Tools for Social Determinants of Health in the
Field of Cardiovascular Disease
DOI: 10.1253/circj.CJ-23-0443
URL: https://doi.org/10.1253/circj.CJ-23-0443