[Determining the status of health application implementation in Japanese prefectures for health promotion]

Objectives　This study aimed to determine the current implementation status and content of health applications (apps) targeting all Japanese prefectures as part of their health promotion measures using Information and Communication Technology (ICT).Methods　Information on health apps and health promotion projects was collected from the official websites of all Japanese prefectures and special sites focusing on these topics operated by the prefectures between August 6 and September 3, 2024. The status of health promotion app implementation, implementation period, development leaders, targets, number of users, and functions in the financial year (FY) 2024 was evaluated. We categorized app functions into six types: action records, health management, health information acquisition, competitiveness, gamification, and incentives.Results　Thirty-four (72.3%) prefectures implemented health apps between FY2014 and FY2024, excluding limited-time projects. App development leaders were divided into local governments and private companies. When local government was the development leader, the apps tended to be multifunctional, including functions such as the number of steps, health management, health checkups, and event participation. With private companies, local governments tend to adopt applications with only one or a few functions, with many involving a system that allowed users to select their region of residence. Among the categorized functions in the apps, the most common action records functions were step count (33 prefectures), event participation (21 prefectures), and health checkups (18 prefectures). The most common health management functions in the apps were data concerning body weight (28 prefectures), caloric intake (22 prefectures), and blood pressure levels (19 prefectures). The most common health information acquisition function was the type of exercise (11 prefectures). Some prefectures incorporated competitiveness into their apps, such as the number of steps and point rankings (28 prefectures); gamification, such as collecting and nurturing characters (13 prefectures); incentives through privileges and lotteries; and other conditions (limited to higher-ranking individuals) (30 prefectures) to motivate behavioral change and continued app usage.Conclusion　We clarified the current state of health-app implementation in all the prefectures, including their functions and content. This information may serve as a useful reference when considering local government initiatives that use ICT to promote health.