Evaluation of Nudge-Based Notification for Follow-Up Examinations in Health Check-Ups Targeting Occupational Health Staff and Undiagnosed Workers: A Randomized Controlled Trial

Purpose Follow-up examinations after health check-ups are important for early detection of noncommunicable diseases among workers. Nudging can serve as an effective intervention for individuals who avoid follow-up examinations due to cognitive biases. This study aims to evaluate the interest in nudge-based notification for follow-up examinations, targeting occupational health staff and undiagnosed workers in a randomized controlled trial. Methods Participants were randomly assigned to either a control group (receiving a text-based notification without nudges) or a nudge group (receiving a notification that modified the control group based on Easy-type nudges). An anonymous web survey was administered. Results Occupational health staff (n = 425) rated all items significantly higher, including "willingness to use the notification" which scored 2.22 for the control group vs. 3.62 for the nudge group on a 1- to 5-point scale (P < 0.001). Among undiagnosed workers (n = 871), there was no significant difference in "willingness to apply for the follow-up examinations" (3.01 vs. 3.09; P = 0.272), but all other items were rated significantly higher in the nudge group (P < 0.05). Conclusion Based on these findings, we suggest that occupational health staff should use nudge-based notifications. However, increasing the willingness of undiagnosed workers to undergo follow-up examinations remains challenging. To achieve this goal, it is necessary to incorporate multiple nudge elements into notifications.