[Relationships between participation of national-health-insurance members in a health education program and exercise habits, medical expenses and other related parameters].

Purpose: This study was conducted with the aim of multi-faceted evaluation of a health education program, "Genki-jaya", run at Fukushima City Health and Welfare Center.

Methods: "Genki-jaya" is a health education program including individual health instructions combined with group education on exercises as well as diet. A total of 55 participants completed the program through December 1999 to March 2001. Twenty-six were under the medical care covered by national-health-insurance when the program started, and 19 of these, whose medical expenses for one month prior to the program were zero, were studied. The program was evaluated using the following: 1. Results of questionnaire surveys to examine self-care ability and perceived health conducted at the end of the program and three months after it finished. 2. Physical measurement items (blood pressure, weight, body fat rate, and BMI) and physical fitness items (maximum-oxygen-uptake, muscle-strength of legs, etc.) at the start of, and three months after the program. 3. Change in the total medical expenses between one year prior to and after the program, and its relationship with physical measurements and satisfaction with the program. Comparison of the mean three-month medical expenses before, during, and after the program. Comparison of medical expenses three months before, at the beginning and end of, and three months after the program. 4. Follow-up of continuous activities among graduates of the program.

Results: 1. Regarding self-care ability, dietary habits, and exercise habits, these continued to improve after the program and all participants were satisfied. Regarding perceived health, subjective symptoms improved. 2. Physical measurements improved through the program. Both mean diastolic pressure and body fat rate at the end of the program were significantly lower than at the beginning. Moreover, mean systolic and diastolic pressures significantly decreased from the end of the program through three months thereafter. 3. The medical expenses before and after the program did not change significantly, and differences did not correlate with physical measurements and satisfaction with the program. 4. Three self-supporting associations among the graduates had been organized to continue instructed exercises were active at the end of March 2001.

Conclusion: Although Genki-jaya had no significant impact on medical expenses, improvement in self-care ability, perceived health, physical measurements and formation self-supporting associations was observed. Multi-faceted evaluation of the program will now be continued to examine larger numbers of newly enrolled trainees for a longer period of time.