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      Japanese health and safety information for overseas visitors: protocol for a randomized controlled trial

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          Abstract

          Background

          Before the COVID-19 pandemic occurred in January 2020, the number of overseas visitors to Japan had increased threefold over the last decade. To minimize the risk of health problems, visitors should be able to access information on the health care systems of the places they visit. Most short-term overseas visitors are young adults. Although they are not very likely to get sick from noncommunicable diseases, they are at high risk for injury and often experience stomach ailments, fever, or nausea when travelling. The objective of this study is to evaluate culturally and linguistically appropriate health information on preventive health behaviours and the health care system in Japan. We will examine the level of satisfaction of overseas visitors to Japan with health care-related educational materials using a five-minute digital game named Sa-Chan Japan.

          Methods

          Our study is a randomized controlled trial (RCT). We will assess both satisfaction and motivation before, during, and after the interventions and examine the changes over time. The intervention group will comprise overseas visitors who will view and answer questions in an animation named Sa-Chan Japan. The control group will comprise overseas visitors who will watch an English digital animation named Mari Info Japan. We will recruit 1002 participants through the Macromill Internet portal. We will contact overseas visitors who have either visited or wish to visit Japan from the United Kingdom, United States, and Australia. The participants will fill out a self-administered questionnaire online in the first quarter of 2021. We will determine the participants’ levels of satisfaction with the CSQ-8 (8-item Client Satisfaction Questionnaire). We will analyse the median score of the overseas visitors with both the Wilcoxon rank-sum and the Wilcoxon signed-rank tests. Our protocol of randomized controlled trials follows the SPIRIT guidelines.

          Discussion

          Our research will utilize unique digital education strategies in a game that promotes health and safety among overseas visitors to Japan. We believe the results of this study will be useful in overcoming the current challenges regarding pretravel health requirements for overseas visitors worldwide.

          Trial registration

          Version 1 of this trial was registered in the UMIN-CTR (University Hospital Medical Information Network Center Clinical Trials Registry), and the trial registration data are available on UMIN000042483, November 17, 2020.

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          Most cited references29

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          Travel-associated infection presenting in Europe (2008-12): an analysis of EuroTravNet longitudinal, surveillance data, and evaluation of the effect of the pre-travel consultation.

          Travel is important in the acquisition and dissemination of infection. We aimed to assess European surveillance data for travel-related illness to profile imported infections, track trends, identify risk groups, and assess the usefulness of pre-travel advice.
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            The effect of educational games on medical students' learning outcomes: a systematic review: BEME Guide No 14.

            An educational game is 'an instructional method requiring the learner to participate in a competitive activity with preset rules.' A number of studies have suggested beneficial effects of educational games in medical education. The objective of this study was to systematically review the effect of educational games on medical students' satisfaction, knowledge, skills, attitude, and behavior. We used the best evidence medical education (BEME) collaboration methods for conducting systematic reviews. We included randomized controlled trials (RCT), controlled clinical trials, and interrupted time series. Study participants were medical students. Interventions of interest were educational games. The title and abstract screening of the 1019 unique citations identified 26 as potentially eligible for this article. The full text screening identified five eligible papers, all reporting RCTs with low-to-moderate methodological quality. Findings in three of the five RCTs suggested but did not confirm a positive effect of the games on medical students' knowledge. The available evidence to date neither confirm nor refute the utility of educational games as an effective teaching strategy for medical students. There is a need for additional and better-designed studies to assess the effectiveness of these games and this article will inform this research.
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              Effect of a behaviour-change intervention on handwashing with soap in India (SuperAmma): a cluster-randomised trial.

              Diarrhoea and respiratory infections are the two biggest causes of child death globally. Handwashing with soap could substantially reduce diarrhoea and respiratory infections, but prevalence of adequate handwashing is low. We tested whether a scalable village-level intervention based on emotional drivers of behaviour, rather than knowledge, could improve handwashing behaviour in rural India. The study was done in Chittoor district in southern Andhra Pradesh, India, between May 24, 2011, and Sept 10, 2012. Eligible villages had a population of 700-2000 people, a state-run primary school for children aged 8-13 years, and a preschool for children younger than 5 years. 14 villages (clusters) were selected, stratified by population size ( 1200), and randomly assigned in a 1:1 ratio to intervention or control (no intervention). Clusters were enrolled by the study manager. Random allocation was done by the study statistician using a random number generator. The intervention included community and school-based events incorporating an animated film, skits, and public pledging ceremonies. Outcomes were measured by direct observation in 20-25 households per village at baseline and at three follow-up visits (6 weeks, 6 months, and 12 months after the intervention). Observers had no connection with the intervention and observers and participant households were told that the study was about domestic water use to reduce the risk of bias. No other masking was possible. The primary outcome was the proportion of handwashing with soap at key events (after defecation, after cleaning a child's bottom, before food preparation, and before eating) at all follow-up visits. The control villages received a shortened version of the intervention before the final follow-up round. Outcome data are presented as village-level means. Handwashing with soap at key events was rare at baseline in both the intervention and control groups (1% [SD 1] vs 2% [1]). At 6 weeks' follow-up, handwashing with soap at key events was more common in the intervention group than in the control group (19% [SD 21] vs 4% [2]; difference 15%, p=0·005). At the 6-month follow-up visit, the proportion handwashing with soap was 37% (SD 7) in the intervention group versus 6% (3) in the control group (difference 31%; p=0·02). At the 12-month follow-up visit, after the control villages had received the shortened intervention, the proportion handwashing with soap was 29% (SD 9) in the intervention group and 29% (13) in the control group. This study shows that substantial increases in handwashing with soap can be achieved using a scalable intervention based on emotional drivers. Wellcome Trust, SHARE. Copyright © 2014 Biran et al. Open Access article distributed under the terms of CC BY. Published by .. All rights reserved.
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                Author and article information

                Contributors
                mn378@nyu.edu
                yamanaka@jcga.ac.jp
                shibanuma@m.u-tokyo.ac.jp
                jkiriya@m.u-tokyo.ac.jp
                mjimba@m.u-tokyo.ac.jp
                Journal
                BMC Public Health
                BMC Public Health
                BMC Public Health
                BioMed Central (London )
                1471-2458
                21 March 2021
                21 March 2021
                2021
                : 21
                : 558
                Affiliations
                [1 ]GRID grid.443635.3, ISNI 0000 0004 0375 3497, Department of Global Health and Nursing, Graduate School of Nursing, , The University of Human Environments, Nagoya, ; 3-220, Ebata cho, Obu City, Aichi 474-0035 Japan
                [2 ]GRID grid.471643.3, ISNI 0000 0004 0618 818X, Department of Maritime Science and Technology, , Japan Coast Guard Academy, ; Kure, Japan
                [3 ]GRID grid.26999.3d, ISNI 0000 0001 2151 536X, Department of Community and Global Health, Graduate School of Medicine, , The University of Tokyo, ; Tokyo, Japan
                Author information
                http://orcid.org/0000-0001-9976-688X
                Article
                10627
                10.1186/s12889-021-10627-w
                7981386
                33743647
                fce650e3-9065-46bf-90ab-76d77986e6b3
                © The Author(s) 2021

                Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.

                History
                : 4 February 2021
                : 15 March 2021
                Funding
                Funded by: Japanese government (KAKEN)
                Award ID: Grants-in-Aid for Scientific Research (C) KAKEN HI(19K11157)
                Award Recipient :
                Categories
                Study Protocol
                Custom metadata
                © The Author(s) 2021

                Public health
                csq-8,health education,overseas visitors,sa-chan game
                Public health
                csq-8, health education, overseas visitors, sa-chan game

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