Strategy for Hepatitis B and C Virus Testing Campaigns Through Web Services and Digital Advertising in Japan:...

Public awareness campaigns and testing promotion must be strengthened to eliminate infections with hepatitis B and C viruses (HBV and HCV, respectively) by 2030. Although public health campaigns using various forms of advertising are widely implemented, the most appropriate channels for viral hepatitis testing remain unclear.

This study aims to identify web services and digital advertising channels appropriate for promoting HBV and HCV testing, segmented by prior testing history and the desire for hepatitis virus testing.

A nationwide cross-sectional online survey of Japanese adults aged 20 to 69 years was conducted. The respondents answered questions regarding viral hepatitis testing status, routinely used web services (180 options), and exposure to digital advertising (25 options). Correspondence analysis was used to visualize relationships among testing segments, web services, and digital advertising. For individuals classified as "never having been tested and wishing to be tested," channel-specific alignment was quantified using cosine θ. Sensitivity analyses were conducted by repeating the correspondence analysis after excluding respondents uncertain about their testing history and by fitting modified Poisson regression models with robust variance to estimate prevalence ratios and 95% CIs.

Of the 2000 respondents (1011 male and 989 female), 18% (n=359) reported prior HBV and HCV testing, and 22.1% (n=441) were unsure whether they had ever been tested. Web services characteristically associated with "never having been tested and wishing to be tested" included Lawson (convenience store: cosine θ=0.989) and Cosme (shopping: cosine θ=0.987). The corresponding digital advertising channels included in-store and storefront screens at Welcia (pharmacy chain: θ=0.994) and Lawson (cosine θ=0.937). Segment-specific patterns varied according to age group and sex. Sensitivity analyses excluding the unsure group showed similar patterns. Modified Poisson regression results were also consistent; for example, Lawson web service use was associated with a desire for hepatitis virus testing (prevalence ratio 1.75, 95% CI 1.22-2.52).

In Japan, the convenience store chain Lawson was a frequently used touchpoint, both online and offline, among individuals seeking viral hepatitis testing. Future studies are needed to determine whether implementing awareness-raising activities through Lawson can increase the uptake of testing and subsequent treatment.