Principal findings
anxiety
DISEASE
In this study, both the intervention group and the control group showed improvements in health knowledge levels. The group that played the Both groups increased their knowledge of Japanese health care after the interventions. The high scores indicated that the participants learned more through a simple technique. We believe that the participants wanted to gain a deeper understanding of each topic. In the intervention group, the participants’ demographic backgrounds regarding gathering information before this study and the number of times they visited Japan were associated with understanding information topics. In the control group, the participants’ backgrounds regarding gathering information before this study were correlated with understanding information topics.Both the intervention and control groups increased their CSQ-8 scores significantly after the interventions. Gathering Japanese health information is not easy for foreign visitors, whether they have already visited or are potential visitors. On the other hand, during our study, the participants’ health concerns were partly alleviated because they gained relevant knowledge through a visually pleasant method. They could access information that they did not know.The intervention group had higher CSQ-8 scores than the control group. The game method was more satisfying than only watching a cartoon because it required thinking and providing answers to the situations and questions. The use of a game involves participation. In other words, the participants needed to think quickly and answer. This finding is similar to the results of a study in New York that used an interactive computer game for adults to increase their skills and self-efficacy for safer sex and HIV prevention (26). The researchers used a program structured as a time travel adventure game [Both the intervention and control groups showed an association of sex, age, number of visits to Japan, and previous Japanese health information received with CSQ-8 scores. Women 60–69 years old had a higher score than the other age groups. The reason for women’s higher satisfaction was that women were more concerned about health-related issues than men. A study in Germany showed that more women collected necessary health information on the internet than men [Before this study, we thought that young people would have higher CSQ-8 scores than older age groups; however, the results showed the opposite, even though young adults use the internet in greater numbers. Medlock et al. found that regular internet users in the Netherlands were more likely to receive health information [The participants wanted to follow the information to stay healthy in Japan. After the intervention, the participants acquired information about health and safety in Japan more readily. We used disease prevention information and willingness from the IMB model [It is possible that the responses were influenced by the fact that this study was conducted during the COVID-19 pandemic. During the three years of the pandemic, the number of overseas visitors to Japan was greatly reduced, and participants stayed in their home countries. Because they had no plans to travel abroad in the near future, they had fewer concerns or anxiety about overseas travel when they participated in this study.