ORIGINAL ARTICLE
Relationship between Low Evaluation by Recipients under
40 years old of Health Interviews by Occupational Health Nurses
and Deterioration in Health Checkup Results over One year
Hayato Shimizu,1 Naoki Shimada,2 Yumi Otahara,1 Hisako Minowa,3 Yoji Hattori4 and Minoru Sugita1

Department of Environmental and Occupational Health, Toho University
School of Medicine, Tokyo, Japan2
Department of Preventive Medicine and Public Health, School of Medicine,
Keio University, Tokyo, Japan
3
Professional Counseling Services Corporation, Tokyo, Japan
4
Health Care Center, NTT Data Corporation, Tokyo, Japan
1(Received for publication on August 25, 2007)(Revised for publication on November 13, 2007)(Accepted for publication on December 3, 2007)

Abstract: Improvement of an unhealthy lifestyle decreases the risk of incidence and mortality from lifestyle-related disease. One method for the improvement of an unhealthy lifestyle is interviewing for health and consultation regarding a healthy lifestyle to recipients ofhealth checkups by public health nurses. Original articles in occupational health for recipients’ evaluation in health checkups as longitudinal studies are rare. The purpose of thepresent study was to investigate in a longitudinal study the relationship between recipients’evaluation of interviews by public health nurses in a health checkup and variations in healthcheckup results for one year.
Data on 750 male white collar workers who underwent a company health checkup in1999 and 2000 were analyzed. The variation in health checkup results for one year from1999 to 2000 was studied by computing odds ratios in a conditional logistic analysis of therecipients who set a low value on the interview for health by occupational health nurses in
the health checkup in 1999 and those who did not.
It was found that among the subjects who set a low value on the usefulness of the interview by the occupational health nurses, the numbers of the subjects whose body mass index(BMI) and triglyceride value (TG) were healthy (normal) in 1999 and unhealthy (abnormal)
in 2000 were significantly greater than those of the subjects whose values were unhealthy
in 1999 and healthy in 2000, while such a finding was not detected in the subjects who set ahigh value on the interview. The differences for BMI and TG between (i) differences between deterioration and improvement of health checkup results in the subjects who evaluated the interview lowly and (ii) those in the subjects who did not were statistically significant as interactions. It can be supposed that some of the subjects who set a low value on
the usefulness of the interview by the occupational health nurses may be indifferent to theirhealth status, indicating that low recipient evaluation of the interview for health in healthcheckup may be regarded as a risk factor of metabolic syndrome from the viewpoint of prevention. (Keio J Med 57 (2) : 90－98, June 2008)
Key words: health checkup, recipient, evaluation, interview for health, longitudinal study

Corresponding Author: Minoru Sugita, MD, PhD, Department of Environmental and Occupational Health, Toho University School of Medicine, 5-21-16
Omori-nishi, Ota-ku, Tokyo 143-8540, Japan, E-mail: sugita@med.toho-u.ac.jp90Keio J Med 2008; 57 (2): 90－98

91

Introduction
Mortality, incidence and prevalence rates of lifestylerelated diseases (e.g. cancer and cardiovascular diseases)
are recently higher in developed countries compared to
fifty years ago,1 and this is one of the major social problems that should be settled. An unhealthy lifestyle fromchildhood involves a major risk of incidence, prevalence,and mortality from lifestyle-related diseases,2-4 while
improvement of an unhealthy lifestyle can decrease therisk.5-10 Reduction of the risk is related to the decreasein mortality, incidence and prevalence rates,6-11 accompanied by improved well-being and a decrease in medical expenses.10, 11
To improve an unhealthy lifestyle, it is important not
only to spread widely information about the reduction of
the risk of lifestyle-related diseases but also to provide
educational intervention to subjects in health care systems. Methods to improve an unhealthy lifestyle include
interviews for health and consultations regarding ahealthy lifestyle to recipients of health checkups in occupational and community health fields by public healthnurses 5, 9, 1 2 and to patients in hospitals or clinics by
medical staffs.1 3 A number of reports1 2, 1 4-1 7 in which
recipients’ satisfaction and evaluation of interviews forhealth and intervention in consulting regarding a healthy
lifestyle were studied have been published. These reports1 2, 1 4-1 7 noted that the satisfaction of the recipientswas influenced by the employee’s age, job type, waitingtime during health checkup, burden involved in fillingout a checklist, courtesy of health care staff, technicallevel of staff, and contents of the interview. Lifestyles ofrecipients after the consultation were improved 1 7 inthose cases where the recipients indicated satisfaction regarding the interviews. However, the degree of recipients’ satisfaction and evaluation of the interview and theintervention varied.1 7 Original articles in occupational
health for recipients’ evaluation and satisfaction in healthcheckups as longitudinal studies are rare.
The authors reported that those subjects who complained of many problems in a questionnaire were apt to
set a high value on the interview and intervention as across-sectional study. 1 8 The objective of the present
study is to investigate the variations in health checkup
results for one year in the subjects who gave a low evaluation for the interview by occupational health nurses ina health checkup and those who did not. The present
study is a longitudinal study on the difference in improvement and deterioration of health checkup results
after the health checkup between the subjects who gavea low evaluation regarding the interview and those who
did not. This makes it possible to discuss the significance of the recipients’ evaluation of the interview by
occupational health nurses in health checkups from theviewpoint of occupational health.

Subjects and Methods
Subjects
In October 1999 and 2000, 1,490 and 1,684 white collar workers, respectively, under the age of 40 years old
employed at the headquarters of a large computer system
corporation in the Tokyo area were examined for healthstatus. In both health checkups, 798 white collar workers were examined and 796 workers responded to thequestionnaire for recipient evaluation of the health interview by occupational health nurses. In the present study,
data on 750 male subjects were analyzed. Female subjects were not included because their number was not
sufficiently large. The number of subjects of 21-25,
26-30, 31-35, and 36-39 years old was 32, 312, 276, and130, respectively. The mean, standard deviation, maximum and minimum of age of the male subjects in 1999
were 30.5, 3.9, 38, and 21 years old, respectively. The
data in 1999 were analyzed and the results were reported
as a cross-sectional study.18
The number of subjects who were examined for healthstatus at the headquarters in 1999 but were not examinedin 2000 was 692 (= 1,490-798). Most of those 692 subjects were transferred from the headquarters to other offices of the corporation.
Health checkup
Health checkup for employees must be performed every year by law in Japan. Occupational health nurses are
the main providers of health services to employees including interviews for recipients of health checkups.
In the headquarters of the corporation investigated, ahealth checkup for employees under 40 years old is conducted every autumn,1 8 while a health checkup for employees over 40 including more examination items is
conducted almost all year round in some health care institutions. Therefore, elder employees were not included
as subjects in the present study. The health checkup includes (i) a self-administered questionnaire, (ii) blood,urine, and physical examinations, and (iii) an interview
by public health nurses. Recipients reply to the questionnaire before health checkup. The questionnaire comprises 127 items divided into four categories (i.e., physical symptoms, mental symptoms, occupational environment, and daily life habits) and the number of items in
the four categories is 30, 31, 32, and 34, respectively.
In the interview for health conducted by the occupational health nurses, each recipient is questioned regarding his/her health taking account of the above information obtained. The interview was conducted by ten occupational health nurses in 1999, and matching of an occupational health nurse and a recipient is not designed
previously. The purposes of the interview by the occu-

92

pational health nurses in the health checkup are (i) toraise the recipient’s own awareness of his/her health status and (ii) to screen for whether it is necessary to intervene with a consultation regarding healthy lifestyle. If
the recipient wants to understand his/her health status
sufficiently and the occupational health nurse determinesthat the recipient needs health consultation regarding
lifestyle, she intervenes regarding improvement of lifestyle. The items of intervention are abstinence fromsmoking, drinking in moderation, exercise, and improving eating habits. The purpose of the intervention is improvement of recipients’ lifestyle. However, improvement of recipients’ lifestyle as a result of the intervention
by occupational health nurses is not expected in the corporation. A manual on interviews for health and intervention for lifestyle by occupational health nurses does
not exist at present. The occupational health nurses usually take 7-10 minutes for the interview and intervention.
They take more time, at most 20 minutes, for the subjects who complain of many problems or whose examination values are unhealthy. In order to conduct thepresent study, an additional self-administered questionnaire18 survey regarding recipients’ evaluation of the interview for health and intervention for improving lifestyle by the occupational health nurses was conducted in
the health checkup of 1999. All recipients responded tothe questionnaire items for health interview. The subjects who thought that they were intervened regarding
lifestyle by the occupational health nurses responded tothe questionnaire items regarding recipients’ evaluationof the intervention. All subjects replied to the additionalquestionnaire right after the interview in 1999. The
items of the additional questionnaire are shown in Appendix. In the questionnaire, the recipients’ evaluation
items for the interview and intervention by the occupational nurses were composed of the items for usefulness
and understanding (Appendix).
The additional questionnaire contained the identification numbers of the subjects in the corporation, so the information from the additional questionnaire could belinked to the information from the previous self-administered questionnaire and examination data.
Statistical analyses
The data of the health checkup items (i.e., body massindex (BMI), systolic blood pressure (SBP), diastolicblood pressure (DBP), blood sugar (BP), total cholesterol(T-Cho), triglyceride (TG), high-density lipoprotein cholesterol (HDL-C), aspartate aminotransferase (AST), alanine aminotransferase (ALT), γ-glutamyltranspeptitase (γ-GTP)) were statistically analyzed. All variables in thepresent study were used as binary variables in the computation. The data of the health checkup items weredealt with as healthy (normal) or unhealthy (abnormal).

Shimizu H, et al: Health Interview Evaluation in a Follow-up Study

Table 1 Unhealthy range in the health checkup data
BMI
SBP
DBP
BS
T-Cho
TG
HDL-C
AST
ALT
γ-GTP

25 kg/m2 ≦140 mmHg ≦90 mmHg ≦110 mg/dl ≦220 mg/dl ≦150 mg/dl ≦40 mg/dl >41 U/l ≦46 U/l ≦74 U/l ≦BMI: body mass index,
SBP: systolic blood pressure,
DBP: diastolic blood pressure,
BS: blood sugar,
T-Cho: total cholesterol,
TG: triglyceride,
HDL-C: high-density lipoprotein cholesterol,
AST: aspartate aminotransferase, ALT: alanine aminotransferase,
γ-GTP: γ-glutamyltranspeptitase

Table 1 shows the ranges of the unhealthy values for thehealth checkup items. The data from the questionnaire
items with four choices in the present study were also
dealt with as binary data (i.e., the upper two and the lower two choices) with due consideration for qualitative
difference between affirmation and negation.
Conditional logistic analysis was conducted regarding
variations in the health checkup results for one year from1999 to 2000 obtaining odds ratio with its 95% confidence interval (95% CI) and statistical test in the subjects
who gave a low evaluation for the interview for healthby the occupational health nurses in the health checkup
and those who did not. The odds ratio in conditional logistic analysis indicates the ratio between the number ofsubjects whose health checkup results deteriorated for
one year from 1999 to 2000 and that of improved. This
odds ratio is equivalent to McNemar’s odds ratio mathematically. In order to compare the odds ratio of the conditional logistic analysis of the subjects who gave a low
evaluation for the interview with that of those who did
not, ordinary logistic analysis calculating odds ratio withits 95% CI and statistical test was conducted using dataof the subjects whose health checkup results deteriorated
and improved. This odds ratio is equivalent to that of the
2X2 contingency table including the numbers of the subjects whose health checkup results deteriorated and improved according to the evaluation (low or high) mathematically. This statistical analysis is the main analysis in
the present study to investigate the relationship between
recipients’ evaluation of the interview for health andvariations in health checkup results. This odds ratiomeans the ratio between the two odds ratios in the conditional logistic analysis of the subjects who evaluated theinterview lowly and highly, indicating an interaction.
Greater odds ratio for the interaction than 1.0 indicatesthat the odds ratio between the number of subjects whose
health checkup results deteriorated and that improved inKeio J Med 2008; 57 (2): 90－98

the subjects who lowly evaluated the interview is greaterthan that in the subjects who did not. This indicator was
shown as an odds ratio ratio.19
The data were analyzed after establishing that each individual could not be identified. For the computation
SAS Release 6.12 was used.
Results
The number of subjects who highly evaluated the usefulness (Q.1, in Appendix) of the interview for health by
the occupational health nurses in the health checkup was
632 and that of subjects who did not was 118. The number of subject who highly evaluated the understanding(Q.2, in Appendix) of the interview was 671 and that ofsubjects who did not was 75. Table 2 shows the variations in health checkup results for one year from 1999 to2000 in all subjects (Table 2-a), the subjects who highly
evaluated the usefulness of the interview (Table 2-b),
and those who did not (Table 2-c) with the odds ratios in
conditional logistic analysis for the variations, their 95%
CIs, and statistical tests. Improvement of BS was shown(p<0.01) in all subjects and those who highly evaluatedthe interview. Statistical significant (p<0.05) deterioration of BMI and TG was detected in the subjects who
lowly evaluated the usefulness of the interview for healthby the occupational health nurses in the health checkup,
but not detected in the subjects who highly evaluated.
In order to detect the differences between the two odds
ratios in the conditional logistic analysis, the data on
variation of the health check-up results and evaluation of
the usefulness of the interview (Q.1 in Appendix) wereanalyzed using ordinary logistic analysis, and the results
calculated from the data are shown in Table 3. The relationship in Table 3 indicates an interaction which shows
the difference between (i) the difference between deterioration and improvement of health checkup results in thesubjects who gave a low evaluation of the interview and(ii) that in the subjects who did not. Greater odds ratio
than 1.0 in Table 3 indicates that the odds ratio between
the number of subjects whose health checkup results deteriorated and that improved in the subjects who lowly
evaluated the interview is greater than that in the subjects
who did not. The odds ratios of BMI and TG were statistically significant (p<0.05), while the statistical tests
other than the two were not significant. Odds ratio withits 95% CI of TG for the ordinary logistic analysis was
2.62 (1.12, 6.10). Table 3 shows that the number ofgreater odds ratios than 1.0 is nine and that of less than
1.0 is one.
Similar statistical analyses for recipients’ evaluation ofunderstanding the interview by the occupational healthnurses (Q.2 in Appendix) were conducted, but notablefindings were not detected. Therefore, the statistical results are not tabulated. Notable findings were not de-93

tected from the similar statistical analyses for intervention of lifestyle (i.e., with or without the intervention(Q.a-d in Appendix) and high and low evaluation of theinterventions (Q.3-10 in Appendix)). Therefore, the statistical results are not tabulated.
The relationship between the recipients’ evaluation of
the interview for usefulness and understanding (Q.1 and
2 in Appendix) was analyzed statistically, and a strong
positive relationship was detected as odds ratio 23.21.
Relationships between (i) variations (i.e., deterioration or
improvement) of lifestyle (e.g. smoking, drinking, exercise, and eating) obtained from the self-administeredquestionnaire for one year and (ii) information on the additional questionnaire (Appendix) were also analyzed
statistically, but meaningful results were not found.
Therefore, the statistical results are not tabulated.
The notable differences of the health checkup results in1999 between the subjects who were transferred fromthe headquarters in 1999-2000 and those who were notwere not detected. Age did not significantly influence
the results in the present study.
Discussion
Odds ratios of BMI and TG in conditional logistic
analysis were greater than 1.0 with statistical significance (p<0.05) in the group indicating low recipient
evaluation for the usefulness of the interview for health(Table 2-c), while this was not detected in the group indicating high evaluation (Table 2-b). This means that the
numbers of the subjects whose BMI and TG values deteriorated for one year were significantly greater than thenumbers of the subjects whose values improved in thegroup with low recipient evaluation, while such differences were not detected in the group with high evaluation. Odds ratios for BMI and TG in conditional logistic
analysis of the subjects who lowly evaluated the usefulness of the interview for health by the occupational
health nurses (Table 2-c) were greater with statisticalsignificance (p<0.05) (Table 3) than those of the subjects
who evaluated the interview highly (Table 2-b).
It is difficult for employees of a corporation to set low
values on the interview in health checkups conducted intheir corporation using questionnaire with their identification numbers. More than 80% (632/750 = 0.843 and671/746 = 0.899) of the subjects set a high value on thehealth interview by the occupational health nurses regarding usefulness and understanding, indicating that thehealth checkup was favorably regarded in the corporation.
It was reported that about 60% of the subjects were satisfied with the health checkup of their company,1 4 andmore than 75% with the interview for health.17 Subjects
who set a low value on the interview conducted in theircorporation are not part of the majority group, indicatinga special character. It can be considered that the subjects

Shimizu H, et al: Health Interview Evaluation in a Follow-up Study

94

Table 2 Variations in health checkup results for one year from 1999 to 2000 in subjects who highly evaluated usefulness of theinterview for health in the health checkup and those who did not and odds ratios in conditional logistic analysis for the variations with
their 95% confidence intervals(Table 2-a)
All subjects
Year
1999
2000
BMI
SBP
DBP
BS
T-Cho
TG
HDL-C
AST
ALT
γ-GTP

Healthy
Healthy
586
690
691
606
575
407
653
691
590
650

Number of subjects
Healthy
Unhealthy
Unhealthy
Healthy
24
18
25
13
25
14
47
83
34
31
93
95
22
30
17
18
42
43
21
17

Unhealthy
Unhealthy
122
22
20
13
109
154
44
23
74
61

Conditional logistic analysis
Odds ratio
95% CI
p-value
1.33
2.46
0.72
1.92
3.76
0.98
1.79
3.44
0.93
0.57
0.81
0.40
<0.01
1.10
1.78
0.67
0.98
1.30
0.74
0.73
1.27
0.42
0.94
1.83
0.49
0.98
1.49
0.64
1.24
2.34 0.65

CI: confidence interval, BMI: body mass index, SBP: systolic blood pressure, DBP: diastolic blood pressure, BS: blood sugar, T-Cho:total cholesterol, TG: triglyceride, HDL-C: high-density lipoprotein cholesterol, AST: aspartate aminotransferase, ALT: alanine
aminotransferase, γ-GTP: γ-glutamyltranspeptitase(Table 2-b)
Subjects who highly evaluated usefulness of the interview for health
Year
Number of subjects
1999
Healthy
Healthy
Unhealthy
Unhealthy
Conditional logistic analysis
2000
Healthy
Unhealthy
Healthy
Unhealthy
Odds ratio
95% CI
p-value
BMI
491
18
18
105
1.00
1.92
0.52
SBP
582
18
11
21
1.64
3.46
0.77
DBP
581
20
13
18
1.54
3.09
0.77
BS
511
39
69
12
0.57
0.84
0.38
<0.01
T-Cho
483
28
26
94
1.08
1.84
0.63
TG
337
73
86
135
0.85
1.16
0.62
HDL-C
553
16
23
39
0.70
1.32
0.37
AST
581
15
16
19
0.94
1.90
0.46
ALT
496
38
35
62
1.09
1.72
0.69
γ-GTP
545
19
16
51
1.19
2.31 0.61(Table 2-c)
Subjects who lowly evaluated usefulness of the interview for health
Year
Number of subjects
1999
Healthy
Healthy
Unhealthy
Unhealthy
Conditional logistic analysis
2000
Healthy
Unhealthy
Healthy
Unhealthy
Odds ratio
95% CI
p-value
BMI
95
6
0
17
∞
―― ――
<0.05
SBP
108
7
2
1
3.50
16.85 0.73
DBP
110
5
1
2
5.00
42.80 0.58
BS
95
8
14
1
0.57
1.36
0.24
T-Cho
92
6
5
15
1.20
3.93
0.37
TG
70
20
9
19
2.22
4.88
1.01
<0.05
HDL-C
100
6
7
5
0.86
2.55
0.29
AST
110
2
2
4
1.00
7.10
0.14
ALT
94
4
8
12
0.50
1.66
0.15
γ-GTP
105
2
1
10
2.00
22.06 0.18

Keio J Med 2008; 57 (2): 90－98

who lowly evaluated the usefulness of the interview
might have been reluctant to be interviewed. It can besupposed that some of them may not be interested intheir health and not have any intention of improving
their lifestyle. This is not inconsistent with the deterioration of BMI and TG values they showed for one year in
the present study. It is possible that the deterioration of
BMI and TG indicates that some subjects who lowly
evaluated the usefulness of the interview may eat highenergy foods including rich fat resulting in increased
body weight. The deterioration of BMI and TG can beconsidered to be derived from the same background. It
is not likely that the deterioration was detected bychance. BMI and TG values objectively observed are reliable, while information on lifestyle usually obtained bysubjective questionnaire is not always reliable. In thepresent study, the deterioration in lifestyle obtained by
the self-administered questionnaire among the subjects
who lowly evaluated the interview for health could not
be detected. Table 3 shows that the number of greater
odds ratios than 1.0 is much greater than that of less than
1.0. Low recipient evaluation of the usefulness of theinterview in the health checkup may be regarded as arisk factor of metabolic syndrome. This finding is usefulpractically for occupational health systems in corporations, because health care staff can pay attention to thedeterioration of health status in the subjects who lowly
evaluate health checkup from the viewpoint of preventing lifestyle-related diseases.
However, this finding is not proved biologically in thepresent study because of the limitations on an observational study. Therefore, strict studies should be conducted in order to prove deterioration of medical examination
values in subjects who lowly evaluate interviews in
health checkups from the viewpoint of biological mechanism.
The authors analyzed the data in 1999 on the same
male subjects as the present study and reported1 8 thatthose subjects who complained of many problems regarding physical symptoms, mental symptoms, occupational environment, and daily lifestyle in the questionnaire were apt to set a high value on the interview andthe intervention as a cross-sectional study. Relationships
between complaints in the questionnaire and recipient
evaluation of understanding the interview by the publichealth nurses were especially notable. Common findings
regarding the way of the health checkup is conductedamong the occupational health nurses in the corporation
as follows. The occupational health nurses usually take7-10 minutes for the interview and the intervention in thehealth checkup. They take more time, at most 20 minutes, for the subjects who complain of many problems orwhose examination values are abnormal. Spending moretime to the interview and intervention in the healthcheckup may be a cause of high evaluation by the sub-95

jects who complain of many problems. The present
study indicated the deterioration of BMI and TG over
one year among the subjects who set a low value on theusefulness of the interview for health as a longitudinal
study. The above two studies using the same group show
different aspects of study results between cross-sectional
and longitudinal studies. A significant relationship between high recipient evaluation of understanding the interview and complaints in the cross-sectional study18 andbetween low recipients’ evaluation of the usefulness of
the interview and deterioration of results in checkup examinations in the present longitudinal study was detected. Significance of evaluation for the usefulness of theinterview must be different from that for understanding.
The relationship between recipient evaluation of theinterview conducted by the occupational health nurses
for usefulness and understanding (Q.1 and 2 in Appendix) was analyzed statistically, showing a strong positive
relationship. The statistical analyses for the relationshipbetween recipient evaluation of understanding the interview (Q.2 in Appendix) and variations in health checkup
results for one year from 1999 to 2000 revealed no notable findings. This means that the recipients’ evaluationof the interview for usefulness is similar to that for understanding, but the two are different from each other.
The recipients’ evaluation for usefulness may be that forthe contents of the interview and the evaluation for understanding may be that for the ability of giving information on health in the interview by the occupational healthnurses. This difference between the two evaluation
items of the interview may be expressed by the difference between findings for (i) the remarkable relationshipbetween recipients’ evaluation of understanding the interview and complaints in the previous cross-sectional
study1 8 and (ii) the relationship between the recipients’evaluation of the usefulness of the interview and variations of the data in health checkup examinations in thepresent longitudinal study.
Table 2 shows statistically significant (p<0.01) improvement of BS for all subjects and the subjects who
highly evaluated the interview (Tables 2-ab), but not forthe subjects who lowly evaluated the interview (Table2-c). The three odds ratios in conditional logistic analysis according to the groups, however, were nearly equal
to each other, showing that the ratio between (i) the odds
ratio between deterioration and improvement of BS in
the subjects who lowly evaluated the usefulness of theinterview and (ii) that in the subjects who did not was
1.01 (N.S.) (i.e., no interaction in Table 3). In the present study, the difference between the subjects who lowly
evaluated the interview and the subjects who did not is
the most important indicator. This indicates that similarbiases must affect the BS values in the two groups withand without high recipient evaluation. The reason for
the improvement of BS can be elucidated. The methods,

96

season, time, staff, and the institution conducting theblood tests of the health checkup in 1999 were the sameas those in 2000. As biases of BS, differences between
measurement lots in 1999 and 2000 and amounts of foodintake before drawing blood can be enumerated. Fastingis desirable before drawing blood for determination of
BS in health checkups. However, fasting is not always
observed by the recipients of the health checkup. Fasting may have been conducted more firmly by the recipients in 2000 than in 1999. The bias of BS is not important in the present study because it is independent of thedifference between groups with high and low recipient
evaluation of the usefulness of the interview for health.
Notable findings for BS from statistical analyses were
not detected in any other except those in Tables 2-ab.
Notable findings were not detected from the statisticalanalyses for the relationship between the intervention inlifestyle (Q.a-d, 3-10 in Appendix) and variations inhealth checkup results including improvement of lifestyle for one year from 1999 to 2000. This indicates thatthe deterioration of the health checkup results in the subjects who evaluated the usefulness of the interview lowly
is independent of the intervention for a healthy lifestyle.
The number of subjects who received intervention to encourage them to lead a more healthy lifestyle was notlarge,18 and the occupational health nurses in the corporation are not required to conduct effective intervention.
The previous cross-sectional study18 did not find significant differences in results among the public health nurses
who conducted the interview and the intervention in thehealth checkup in 1999.
The variation in recipients’ lifestyle (e.g. smoking,drinking, exercise, and eating) obtained from the self-administered questionnaire for one year from 1999 to 2000
was not influenced by their evaluation of the interview
and the intervention by the occupational health nurses
and recipients’ consciousness of receiving intervention
for healthy lifestyle (Appendix). Occupational healthnurses are not required to conduct an intervention thatmust result in measurable improvement of a recipient’s
lifestyle in the corporation. It is difficult to determine
whether intervention by consultation for a healthy lifestyle in the corporation is effective. This means thatchanging lifestyle is difficult, indicating coincidencewith previous reports.20-22 In the present study, it could
not be determined whether deterioration of BMI and TG
in the subjects who lowly evaluated the usefulness of theinterview derived from deterioration of their lifestyle
and/or lack of intervention to encourage a healthy lifestyle by the occupational health nurses. Information on
evaluation, intervention, and lifestyle was obtained by
self-administered questionnaires, thus it is not objective.
It is not appropriate that we discuss thoroughly the relationship among the intervention for healthy lifestyle, theimprovement of lifestyle, the improvement of the exami-

Shimizu H, et al: Health Interview Evaluation in a Follow-up Study

Table 3 Odds ratios with their 95% confidence intervals andstatistical tests for relationship between (i) variations in healthcheckup results for one year from 1999 to 2000 and (ii) evaluation
regarding usefulness of the interview for health
BMI
SBP
DBP
BS
T-Cho
TG
HDL-C
AST
ALT
γ-GTP

Odds ratio
∞
2.14
3.25
1.01
1.11
2.62
1.23
1.07
0.46
1.68

95% CI
――
――
12.20
0.37
31.08
0.34
2.62
0.39
4.09
0.30
6.10
1.12
4.36
0.35
8.56
0.13
1.66
0.13
20.33
0.14

p-value
<0.05

<0.05

CI: confidence interval, BMI: body mass index, SBP: systolicblood pressure, DBP: diastolic blood pressure, BS: blood sugar,
T-Cho: total cholesterol, TG: triglyceride, HDL-C: high-density
lipoprotein cholesterol, AST: aspartate aminotransferase, ALT:
alanine aminotransferase, γ-GTP: γ-glutamyltranspeptitasenation results in health checkup, and the recipient evaluation of the intervention in the present study.
Further analyses on the differences in variations ofcomplaint symptoms in a self-administered questionnaire
after health checkup between the subjects who lowly
evaluated the interview for health and those who did notshould be conducted as a longitudinal study.
Acknowledgements
The present study was conducted in collaboration with
Ms. Tomoko Fujishige, Ms. Kirika Sato, Ms. Akiko
Tada, Ms. Mayumi Yamamoto, Ms. Yuko Takeoka, and
Ms. Masako Suzuki of NTT Data Corporation, and theauthors are grateful to them. This research was supported in part by a grant from the Smoking Research Foundation in 2001. Data on the same male subjects investigated in the present study have been analyzed for otherpurposes and reported elsewhere.18, 23
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Appendix Questionnaire for evaluation of interview and intervention by occupational health nurses
Q.1 Do you think that the interview by an occupational health nurse in health check-up is useful?
1. Very useful 2. Somewhat useful 3. Slightly useful 4. Not useful
Q.2 Did you understand the interview by an occupational health nurse in health check-up?
1. Very much 2. Somewhat
3. Slightly
4. NotQ.a Did you accept the intervention of abstinence from smoking by an occupational health nurse?
1. No 2. Yes↓↓
Q.3 Do you think that the intervention for abstinence from smoking is useful?
1. Very useful 2. Somewhat useful 3. Slightly useful
4. Not useful
Q.4 Do you understand to the intervention regarding abstinence from smoking?
1. Very much 2. Somewhat
3. Slightly
4. NotQ.b Did you accept the intervention to stop or reduce drinking by an occupational health nurse?
1. No 2. Yes↓↓
Q.5 Do you think that the intervention regarding drinking is useful?
1. Very useful 2. Somewhat useful 3. Slightly useful
4. Not useful
Q.6 Do you understand to the intervention regarding drinking?
1. Very much 2. Somewhat
3. Slightly
4. NotQ.c Did you accept the intervention to do exercise by an occupational health nurse?
1. No 2. Yes↓↓
Q.7 Do you think that the intervention for exercise is useful?
1. Very useful 2. Somewhat useful 3. Slightly useful
4. Not useful
Q.8 Do you understand to the intervention for exercise?
1. Very much 2. Somewhat
3. Slightly

4. NotQ.d Did you accept the intervention regarding eating by an occupational hearth nurse?
1. No 2. Yes↓↓
Q.9 Do you think that the intervention regarding eating is useful?
1. Very useful 2. Somewhat useful 3. Slightly useful
4. Not useful
Q.10 Do you understand to the intervention regarding eating?
1. Very much 2. Somewhat
3. Slightly
4. Not