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Introduction: With health promotion initiatives in small companies lagging behind those in larger corporations, strengthening health and productivity management in small companies through innovative strategies is an urgent priority. We hypothesized that an outreach strategy involving a public-private partnership would be beneficial for this purpose. The present study examines the implementation of a public-private partnership strategy in Yokohama City, Japan, assessing its impact on health and productivity management in small enterprises, focusing on implementation outcomes., Methods: As part of the Yokohama Linkworker Project (Y-Link Project), this study describes and examines a public-private partnership program in Yokohama City, Japan, involving the city's government and a private life insurance company. Trained insurance sales representatives served as "Linkworkers" for the program, reaching out to small enterprises in the city. These Linkworkers provided tailored support to these companies, assisting them with obtaining the "Yokohama Health and Productivity Management Certification" issued by the City of Yokohama authorities and collaborating with external entities to offer health promotion programs for employees. Program interventions took place from August to September 2020. The RE-AIM framework was utilized to evaluate the Project. Data were extracted from Linkworkers' activity records, certification records, the Linkworker survey, and follow-up surveys with participating companies at 6- and 18- months post-interventions., Results: Within 2 months, 71 Linkworkers visited 500 companies (50% were small firms, <50 employees). Among them, 224 (45%) enterprises received certifications, contributing to an increased regional certification rate. Linkworker-assisted companies tended to be significantly smaller in size. The odds ratios of implementing workplace health promotion programs in certified firms, compared to non-certified firms, were 4.09 (95% CI: 1.79-9.35) at 6 months and 2.31 (95% CI: 1.04-5.11) at 18 months. For small firms, the odds ratios were 6.87 (95% CI: 1.74-27.06) at 6 months and 3.42 (95% CI: 1.17-10.03) at 18 months. The certification retention rate at 24 months was 60%, irrespective of company size. Linkworkers perceived the outreach strategy as having a positive impact on their primary operations., Conclusion: The Y-Link Project's outreach strategy enhanced health and productivity management in small enterprises in Yokohama City, enabling long-term health promotion programs addressing program availability disparities related to company size., Competing Interests: The Meiji Yasuda Life Foundation of Health and Welfare, where YK, YF, KY, YM-N, TN, and TA work, receives donations from Company M. However, this organization is a public interest incorporated foundation under the jurisdiction of the Cabinet Office of the Japanese government and is obligated to conduct research activities for the public interest. The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2024 Kai, Fujii, Takashi, Yoshiba, Muramatsu-Noguchi, Noda, Jindo, Kidokoro, Yajima, Kasuga and Arao.)

Background: The novel coronavirus disease 2019 (COVID-19) pandemic may have reduced opportunities for engaging in physical activity (PA) and increased sedentary behavior (SB) among workers. However, most previous studies used self-reported assessments. This study aimed to examine the changes in accelerometer-measured PA and SB from before to after COVID-19 outbreak among Japanese workers., Methods: This 1-year longitudinal study used data from the annual health check-ups of workers who lived in the Tokyo metropolitan area. Baseline and follow-up data were collected from June to November of 2019 and June to November of 2020, respectively. Participants were asked to wear the accelerometer on their hip during awake hours for at least 10 days in both the surveys. Before the analysis, considering the difference in wearing time, time spent in PA and SB were converted to the percentage of wearing time. To investigate the changes in PA or SB from before to during COVID-19 outbreak, paired t-tests were performed., Results: Of the 757 eligible participants, 536 were included in the analysis (70.8%). Participants' mean age was 53.3 years, 69.6% were female, and most were full-time employees. Time spent in PA decreased, regardless of weekdays or weekends, although changes on the weekends were not significant. Conversely, time spent in SB increased on both weekdays and weekends in 2020. These changes corresponded to approximately 10 minutes per day decrease in PA and increase in SB., Conclusion: Objectively measured PA decreased and SB increased by approximately 10 minutes per day after the COVID-19 outbreak among Japanese workers.