One-Year Changes in Metabolic Syndrome Indicators Among Workers Participating in an Online Specific Health Guidance Program Incorporating Nudges and Health Education: A Pre–Post Field Study

OBJECTIVES: To address metabolic syndrome among middle-aged workers in Japan, the Specific Health Guidance (SHG) program was implemented, comprising motivational and intensive support. Conventional informational SHG approaches have been reported to have limited impact, and integrating psychological approaches, such as nudges, may offer a promising option. This study aimed to assess the one-year outcomes of an online SHG program incorporating nudges and health education among workers. METHODS: A 100-day online SHG program was implemented for workers at a Japanese securities firm in 2022. The motivational support program comprised an initial seminar, individual counseling, and twice-weekly 90-second exercise videos, integrating multiple nudges with health education. The intensive support program additionally included individualized email support and follow-up seminars. RESULTS: Data from 659 participants (329 in the motivational support group and 330 in the intensive support group) were analyzed. After one year, significant favorable changes (P < 0.05) were observed in seven of the nine indicators among men in the intensive support group, including waist circumference (-0.8 cm, P < 0.001). Similarly, the number of participants with abnormal findings decreased significantly in six indicators, including waist circumference (27 participants; 9.2 percentage points, P < 0.001). CONCLUSION: Favorable changes in several metabolic indicators were observed among men in the intensive support group. However, these findings cannot establish causality because of the lack of a control group. Alternative explanations, including regression to the mean, cannot be excluded, underscoring the need for further studies.