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Attitude change to secondary health examination using social nudging through a spouse

Wataru Katagiri1, Masaaki Shimono2, Shunsuke Eguchi1

  • 1Medical Affairs Division, Novartis Pharma K.K., Tokyo, Japan.

Environmental and Occupational Health Practice
|June 26, 2025
PubMed

Insights

A novel social nudge, involving postcards sent to spouses, significantly increased employees' willingness for secondary health examinations for hypertension and dyslipidemia. However, actual examination uptake did not significantly increase, suggesting combined strategies may be needed.

Area of Science:

  • Public Health
  • Behavioral Science
  • Cardiovascular Disease Prevention

Background:

  • Hypertension and dyslipidemia are critical risk factors for cardiovascular diseases.
  • Many individuals underestimate the importance of these conditions, leading to delayed or neglected treatment.
  • Annual health checkups often identify these risk factors, but proactive follow-up for secondary examinations is frequently lacking.

Purpose of the Study:

  • To investigate the effectiveness of a novel social nudge intervention in increasing the willingness to undergo secondary health examinations.
  • To assess changes in willingness to undergo secondary health examinations among employees with identified hypertension or dyslipidemia.

Main Methods:

  • Employees with elevated blood pressure or lipid levels were assigned to a social nudge group (spouses received postcards) or a control group (individuals received postcards).
  • Participants' agreement to receive postcards was confirmed prior to the intervention.
  • A web-based survey measured willingness for secondary health examinations before and after the postcard intervention.

Main Results:

  • The social nudge group showed a significant increase in willingness for secondary health examinations, rising from 12.1% to 46.6% (p<0.0001).
  • The control group did not exhibit a significant change in willingness (p=1.0000).
  • Despite increased willingness, the proportion of employees undergoing actual secondary health examinations did not significantly improve in either group.

Conclusions:

  • A low-cost social nudge targeting spouses can effectively enhance the willingness to undergo secondary health examinations.
  • To improve actual uptake of secondary health examinations, combining social nudges with other interventions may be necessary.
Abstract

Keywords:
family supportnudgeoccupational healthsecondary health examination

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