Investigation of basic versus additional EAST nudge-based reminders for follow-up examination attendance among workers: a quasi-experimental study
8 affiliations
- 1Aomori University of Health and Welfare
- 2Aomori University
- 3Shizuoka Graduate University of Public Health
- 4Graduate School of Public Health, Shizuoka Graduate University of Public Health
- 5Jyoban Hospital
- 6Iwaki City Medical Center
- 7Yokohama City University
- 8Saitama Medical University
Abstract
Background: Follow-up examinations after abnormal health checkup findings are important for addressing chronic diseases. While Easy–Attractive–Social–Timely (EAST) nudge-based reminders have been used to promote follow-up examination attendance, the appropriate extent of nudge content to include remains unclear. This study investigated the association between basic and additional EAST nudge-based reminders and follow-up examination attendance among workers.
Methods: A quasi-experimental study was conducted among workers at a Japanese transportation company who had abnormal findings and did not respond to an initial notification from October 2024 to March 2025. Participants were geographically assigned to either the basic EAST group ( n = 210) or the additional EAST group ( n = 122). The basic EAST group received mailed reminders incorporating one principal design element corresponding to each EAST component: Easy (e.g., specifying the appropriate medical departments), Attractive (e.g., a four-panel comic), Social (e.g., encouraging commitment), and Timely (e.g., “Final” labeling). The additional EAST group received reminders containing the same elements as those provided to the basic EAST group, together with a photograph of an expert, her professional affiliations, and an explanation of the commitment concept (Attractive and Social).
Results: Attendance at follow-up examinations was higher in the basic EAST group than in the additional EAST group (29.0% versus 18.0%; p = 0.022; adjusted odds ratio = 1.80; 95% confidence interval, 1.11–3.25).
Conclusion: Although positive outcomes were observed for the basic EAST reminder, the nonrandomized allocation and unequal group sizes warrant cautious interpretation of the findings, and further well-designed studies are needed.
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BibTeX
@article{takebayashi2026investigation,
title = {{Investigation of basic versus additional EAST nudge-based reminders for follow-up examination attendance among workers: a quasi-experimental study}},
author = {Masaki Takebayashi and Tatsuya Koyama and Yuri Mizota and Yudai Kaneda and Mira Namba and Hirohide Shibutani and Kouichi Tamura and Yasuo Terauchi and Hirokazu Okada},
journal = {Frontiers in Public Health},
year = {2026},
month = oct,
doi = {10.3389/fpubh.2026.1948841},
url = {https://www.frontiersin.org/articles/10.3389/fpubh.2026.1948841/full},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Investigation of basic versus additional EAST nudge-based reminders for follow-up examination attendance among workers: a quasi-experimental study
AU - Masaki Takebayashi
AU - Tatsuya Koyama
AU - Yuri Mizota
AU - Yudai Kaneda
AU - Mira Namba
AU - Hirohide Shibutani
AU - Kouichi Tamura
AU - Yasuo Terauchi
AU - Hirokazu Okada
PY - 2026
DA - 2026/10/14
JO - Frontiers in Public Health
DO - 10.3389/fpubh.2026.1948841
UR - https://www.frontiersin.org/articles/10.3389/fpubh.2026.1948841/full
AB - Background: Follow-up examinations after abnormal health checkup findings are important for addressing chronic diseases. While Easy–Attractive–Social–Timely (EAST) nudge-based reminders have been used to promote follow-up examination attendance, the appropriate extent of nudge content to include remains unclear. This study investigated the association between basic and additional EAST nudge-based reminders and follow-up examination attendance among workers. Methods: A quasi-experimental study was conducted among workers at a Japanese transportation company who had abnormal findings and did not respond to an initial notification from October 2024 to March 2025. Participants were geographically assigned to either the basic EAST group ( n = 210) or the additional EAST group ( n = 122). The basic EAST group received mailed reminders incorporating one principal design element corresponding to each EAST component: Easy (e.g., specifying the appropriate medical departments), Attractive (e.g., a four-panel comic), Social (e.g., encouraging commitment), and Timely (e.g., “Final” labeling). The additional EAST group received reminders containing the same elements as those provided to the basic EAST group, together with a photograph of an expert, her professional affiliations, and an explanation of the commitment concept (Attractive and Social). Results: Attendance at follow-up examinations was higher in the basic EAST group than in the additional EAST group (29.0% versus 18.0%; p = 0.022; adjusted odds ratio = 1.80; 95% confidence interval, 1.11–3.25). Conclusion: Although positive outcomes were observed for the basic EAST reminder, the nonrandomized allocation and unequal group sizes warrant cautious interpretation of the findings, and further well-designed studies are needed.
SN - 2296-2565
ER -