[Investigate factors influencing secondary health examination behavior among workers]

Opportunities for health examinations are available for the early detection of illness. However, although the majority of people examined have findings discovered, particularly in occupational areas, many do not undergo re-examination (secondary examination). In this study, we used the Health Belief Model to investigate the factors that affect the decision to undergo secondary examination in occupational areas. Consequently, we would be able to determine an effective method to encourage individuals to undergo secondary examination.

For a pilot study, we created a questionnaire based on 5 factors (25 items) derived from the components of the Health Belief Model: "Overconfidence in health," "Support for behavior," "Feeling burdened by re-examination," "Significance of getting sick," and "Poor awareness of re-examination." A web-based survey was then conducted on 1,400 workers who have been recommended taking re-examination. The valid 167 answers (valid response rate 11.9%) were divided based on the presence or absence of a secondary examination, and the ratio of basic attributes and the factor scores were compared and examined. The attributes with a statistically significant difference depending on the presence or absence of the secondary examination underwent logistic regression analysis, with the constituent factors of the questionnaire as the independent variables and the presence or absence of the secondary examination as the dependent variable.

The "presence or absence of a spouse" and "presence or absence of a family doctor" were significantly different between the groups with and without taking re-examination. Those with a spouse (p = .005) and those with a family doctor (p = .003) were more likely to take the secondary examination. In comparing factor scores in both groups, "Support for behavior" and "Poor awareness of re-examination" were significantly different. The scores for "Support for behavior" were significantly higher in the group that had undergone secondary examination (p = .024), and the scores for "Poor awareness of re-examination" were significantly higher in the group that had not undergone secondary examination (p < .001). In the logistic regression analysis, the "presence or absence of a spouse," "presence or absence of a family doctor," and "Poor awareness of re-examination" were found to be independent factors.

The "presence or absence of a spouse," "presence or absence of a family doctor," and "Poor awareness of re-examination" directly influence the workers' decision to undergo secondary examination. Therefore, awareness of one's familial relations and health literacy is necessary for encouraging an individual to undergo secondary examination.