{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,19]],"date-time":"2026-03-19T02:32:24Z","timestamp":1773887544360,"version":"3.50.1"},"reference-count":30,"publisher":"BMJ","issue":"5","license":[{"start":{"date-parts":[[2023,5,16]],"date-time":"2023-05-16T00:00:00Z","timestamp":1684195200000},"content-version":"unspecified","delay-in-days":15,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001691","name":"Japan Society for the Promotion of Science","doi-asserted-by":"publisher","award":["JP17K09152"],"award-info":[{"award-number":["JP17K09152"]}],"id":[{"id":"10.13039\/501100001691","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2023,5,4]]},"published-print":{"date-parts":[[2023,5]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To determine whether a minimal intervention based on the data envelopment analysis (DEA)-identified efficiency score effectively prevents hypertension.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>Randomised controlled trial.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>Takahata town (Yamagata, Japan).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants<\/jats:title>\n                    <jats:p>Residents aged 40\u201374 years belonged to the information provision group for specific health guidance. Participants with a blood pressure \u2265140\/90\u2009mm Hg, those taking antihypertensive medication, or those with a history of cardiac diseases were excluded. Participants were consecutively assigned based on their health check-up visit at a single centre from September 2019 to November 2020 and were followed up at the check-up in the following year, until 3 December 2021.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Intervention<\/jats:title>\n                    <jats:p>A targeted approach using minimal intervention. Target was identified using DEA and 50% of participants with higher risk were targeted. The intervention was notifying the results of their risk of hypertension according to the efficiency score obtained by the DEA.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Primary outcome measures<\/jats:title>\n                    <jats:p>A reduction in the proportion of participants who developed hypertension (\u2265140\/90\u2009mm Hg or taking antihypertensive medication).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A total of 495 eligible participants were randomised, and follow-up data were available for 218 and 227 participants in the intervention and control groups, respectively. The risk difference for the primary outcome was 0.2% (95% CI \u22127.3 to 6.9) with 38\/218 (17.4%) and 40\/227 (17.6%) events in the intervention and control group, respectively (Pearson\u2019s \u03c7\n                      <jats:sup>2<\/jats:sup>\n                      test, p=0.880). The adjusted OR of the effect of the intervention was 0.95 (95% CI 0.56 to 1.61, p=0.843), and that of the efficiency score (10-rank increase) was 0.81 (95% CI 0.74 to 0.89, p&lt;0.0001).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Minimal intervention to a high-risk population stratified by DEA was not effective in reducing the onset of hypertension in 1\u2009year. The efficiency score could predict the risk of hypertension.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Trial registration number<\/jats:title>\n                    <jats:p>UMIN000037883<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2022-070187","type":"journal-article","created":{"date-parts":[[2023,5,16]],"date-time":"2023-05-16T10:07:29Z","timestamp":1684231649000},"page":"e070187","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":5,"title":["Effectiveness of a targeted primary preventive intervention in a high-risk group identified using an efficiency score from data envelopment analysis: a randomised controlled trial of local residents in Japan"],"prefix":"10.1136","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5378-9477","authenticated-orcid":false,"given":"Sho","family":"Nakamura","sequence":"first","affiliation":[{"name":"Graduate School of Health Innovation, Kanagawa University of Human Services, Kawasaki, Kanagawa, Japan"},{"name":"Cancer Prevention and Control Division, Kanagawa Cancer Center Research Institute, Yokohama, Kanagawa, Japan"},{"name":"CIKOP, Specified Nonprofit Corporation, Yamagata, Yamagata, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Satoru","family":"Kanda","sequence":"additional","affiliation":[{"name":"Cancer Prevention and Control Division, Kanagawa Cancer Center Research Institute, Yokohama, Kanagawa, Japan"},{"name":"CIKOP, Specified Nonprofit Corporation, Yamagata, Yamagata, Japan"},{"name":"Office of Health Policy, Department of Health and Welfare, Iwate Prefectural Government Office, Morioka, Iwate, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hiroko","family":"Endo","sequence":"additional","affiliation":[{"name":"Section of Welfare and Child Service, Takahata Town Office, Takahata, Higashiokitama-gun, Yamagata, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Emiko","family":"Yamada","sequence":"additional","affiliation":[{"name":"Section of Health and Longevity Service, Takahata Town Office, Takahata, Higashiokitama-gun, Yamagata, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Miki","family":"Kido","sequence":"additional","affiliation":[{"name":"Section of Health and Longevity Service, Takahata Town Office, Takahata, Higashiokitama-gun, Yamagata, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shoko","family":"Sato","sequence":"additional","affiliation":[{"name":"Section of Health and Longevity Service, Takahata Town Office, Takahata, Higashiokitama-gun, Yamagata, 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