[Nihon koshu eisei zasshi] Japanese journal of public health最新文献

{"title":"[Subjective swallowing function and oral-related quality of life among in community-dwelling older adults].","authors":"Marin Ishigami, Maho Omoda, Minami Kondo, Haruka Fukutani, Rumi Nishimura, Yoshimi Suzukamo, Mariko Naito","doi":"10.11236/jph.24-082","DOIUrl":"10.11236/jph.24-082","url":null,"abstract":"<p><p>Objectives　Swallowing function and oral-related quality of life (QOL) are important factors for maintaining general health. However, few studies have investigated the association between both factors among community-dwelling older adults. This cross-sectional study examined subjective swallowing function and oral-related QOL among community-dwelling older adults.Methods　A questionnaire survey was conducted by mail in January 2022 among men and women in 47 Japanese prefectures. This study included 552 men and women aged ≥ 65 years with no missing data (93.7% response rate). Information regarding sex, age, oral-related QOL, swallowing function, number of teeth, and history of diabetes were collected using a self-administered questionnaire. Oral-related QOL and swallowing function was assessed using the Japanese version of the General Oral Health Assessment Index (GOHAI) and Dysphagia Risk Assessment for Community-dwelling Elderly (DRACE), respectively.Results　Logistic regression analysis was used to examine the association between subjective swallowing function and oral-related QOL. The dependent variable was whether the GOHAI was ＜ or ＞ 52.5, the GOHAI national reference value, independent variable was whether the DRACE score was ＞ or ＜ 4, and covariates were sex, age, and current number of teeth.Logistic regression analysis revealed that older adults with impaired subjective swallowing function were more likely to have a GOHAI score ＜ 52.5 (odds ratio ＝ 4.9, 95% confidence interval ＝ 3.1-7.5). After adjusting for covariates, the group with impaired subjective swallowing function was significantly more likely to have GOHAI scores ＜ 52.5.Conclusion　The study results indicate a significant positive association between oral-related QOL and subjective swallowing function. This association was stronger among women, adults aged ≥ 75 years, those with ≥ 20 teeth, and those with a history of diabetes mellitus.</p>","PeriodicalId":72032,"journal":{"name":"[Nihon koshu eisei zasshi] Japanese journal of public health","volume":" ","pages":"449-455"},"PeriodicalIF":0.0,"publicationDate":"2025-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143568997","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Examining the application forms of housing adaptations in the Japanese long-term care insurance system by care need level and professional type: A descriptive study].","authors":"Rumiko Tsuchiya-Ito, Satomi Kitamura, Tomoyuki Ota, Shinji Hattori","doi":"10.11236/jph.24-081","DOIUrl":"10.11236/jph.24-081","url":null,"abstract":"<p><p>Objectives　Statistical data on housing adaptation services provided by Japanese long-term care insurance are limited. We described the application status by analyzing the application forms of housing adaptation services based on differences in care need levels and health and social welfare professional types.Methods　We obtained data from the application forms of housing adaptation services in Hachioji City, Tokyo in fiscal year 2015. The variables were individual factors (age, care needs level, family status, primary disease, and information about housing) and detailed content of the applied housing adaptations (daily activities expected to improve, expected effects, and types of housing adaptations). We described the number and percentage of individuals according to care need level and type of professional; care managers (long-term care agencies), care manager (community comprehensive support centers), social workers, public health/registered nurses, housing environment coordinators, and certified housing renovation specialists.Results　We analyzed 1,652 participants. The participants were mostly in care needs level 1 (30.2%), and individuals in care needs level 3 (33.3%) applied for housing adaptation during hospitalization. Regarding the daily activities expected to improve, individuals requiring severe care needs likely aimed for toileting (care support level 1; 47.2%, care need levels 4/5; 57.8%) but less likely to expect to improve going outside and up and down the stairs. Individuals with care needs level 1 expected the greatest improvement in their bathing activities (58.1%). Regarding the expected effects, \"fall preventions,\" \"improved ease of activities,\" and \"reducing the applicant's mental burden and anxiety\" were crucial regardless of their care need levels, and \"enabling what cannot be done\" and \"reducing the burden on caregivers\" were more likely to be expected in individuals with more severe care needs. Regarding professional differences, the highest percentages of \"enabling what cannot be done\" were for care managers (long-term care agency) in toileting, bathing, and going outside, and social workers in getting up and down the stairs, and moving indoors. The certified housing renovation specialists emphasize on \"reducing the burden on caregivers.\" The most common type of housing adaptation was the installation of handrails or grab bars.Conclusion　Housing adaptations differ depending on applicants' care needs and professional types. A system that considers the different needs should be designed depending on their care need levels and professional types and has a place in which each profession can understand the differences.</p>","PeriodicalId":72032,"journal":{"name":"[Nihon koshu eisei zasshi] Japanese journal of public health","volume":" ","pages":"495-505"},"PeriodicalIF":0.0,"publicationDate":"2025-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143797244","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Health education on controlling digital device use and lifestyle habits for adolescents' physical and mental health: School health promotion activities at a junior high school in Matsue City].","authors":"Yuki Kuwabara, Aya Kinjo, Hongja Kim, Yoneatsu Osaki","doi":"10.11236/jph.24-102","DOIUrl":"10.11236/jph.24-102","url":null,"abstract":"<p><p>Objectives　Healthy Parents and Children 21 (Tier 2) promotes health education collaboration across multifaceted sectors in order to realize a society that supports the physical and mental health of the next generation. The purpose of this report is to provide an overview of the school's health activities and present the findings obtained through surveys and health education activities at a junior high school.Methods　The activities were focused on activities targeting the junior high school in Town A, Matsue City, Shimane. The town launched a pediatric lifestyle-related disease control project in 1991. Even after the municipal merger, local school health committee activities were maintained. The Division of Environmental and Preventive Medicine at Tottori University has been participating in school health activities in Town A since the beginning of the project. Elementary and junior high schools in Town A allowed medical students from Tottori University to participate in health activities for social medicine training. Herein, we discuss (1) the results of the survey conducted at A junior high school in 2022; topics included lifestyle, digital device use, and mental health (Patient Health Questionnaire-9) and (2) feedback from junior high school students, school health workers, and medical students regarding activities for social medicine training.Results　Medical students provided a 50-minute health education program at A junior high school. Based on interviews and questionnaires administered to junior high students and school health workers, important health issues were identified. Accordingly, the medical students planned a program aimed at acquiring favorable lifestyle habits, with a particular focus on sleep and excessive digital device use. The program was conducted in each second-grade class. Additionally, activities at the junior high school and town A allowed us to collaborate with the Matsue City Board of Education and Youth Development Organization. They shared our concerns about adolescent lifestyles and digital device use.Conclusion　Our activity provided health education on controlling digital device use and promoting favorable lifestyles using a peer education strategy. In the future, connecting related sectors and making the best use of local resources are desirable for developing activities for a broader area. Evaluating the effectiveness of these activities and establishing a system that enables primary healthcare workers, schools, and local boards of education to develop their own school health activities in collaboration with the local government are warranted.</p>","PeriodicalId":72032,"journal":{"name":"[Nihon koshu eisei zasshi] Japanese journal of public health","volume":" ","pages":"456-467"},"PeriodicalIF":0.0,"publicationDate":"2025-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143775063","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[A cross-sectional study of maternal social isolation and child maltreatment risk: The impact of social support and loneliness among mothers].","authors":"Shiqi Zhang, Takafumi Soejima","doi":"10.11236/jph.24-089","DOIUrl":"10.11236/jph.24-089","url":null,"abstract":"<p><p>Objective　This study examined the association between maternal social isolation and child maltreatment risk by measuring social support and loneliness among mothers.Methods　Anonymous questionnaires were distributed to 365 mothers who underwent health checkups for their infants. The examined parameters were the Japanese version of the Duke Social Support Index, revised University of California, Los Angeles Loneliness Scale (third edition), and Childcare Stress-Short Form. Child maltreatment risk was assessed using an 11-item scale developed by the author, based on previous research. Additionally, the basic attributes of the mothers and infants were collected. Hierarchical multiple regression analyses were conducted with child maltreatment risk as the dependent variable and demographics, social support, loneliness, and parenting stress as independent variables. Structural equation modeling was conducted to examine the hypothetical model, and indirect effects were examined using mediation analysis.Results　This study included 91 questionnaires (response rate; 24.9%) returned to the authors' institutions. Hierarchical multiple regression analyses revealed that \"stress-related child characteristics\" was a risk factor for child maltreatment by mothers. Mothers who reported lower levels of social support had higher levels of loneliness and parenting stress; consequently, higher levels of child maltreatment risk, indicating that social support was related to child maltreatment risk through loneliness and parenting stress.Conclusion　This study revealed that maternal social isolation can lead to high parenting stress and increased risk of child maltreatment. It is important to increase the level of social support for mothers, alleviate their loneliness, and implement highly specialized intervention programs to prevent child maltreatment.</p>","PeriodicalId":72032,"journal":{"name":"[Nihon koshu eisei zasshi] Japanese journal of public health","volume":" ","pages":"468-476"},"PeriodicalIF":0.0,"publicationDate":"2025-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143568953","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Difficulties faced and support sought by individuals responsible for planning and managing cancer information specialist training sessions in each prefecture: Consideration of the content and direction of support provided by the National Cancer Center].","authors":"Tomoko Takahashi, Chikako Yamaki","doi":"10.11236/jph.24-046","DOIUrl":"10.11236/jph.24-046","url":null,"abstract":"<p><p>Objectives　Training sessions for cancer information specialists at cancer information and support centers were conducted according to the designated cancer hospital's guidelines. The National Cancer Center (NCC) assists in the planning and management of training sessions for cancer information specialists in each prefecture. However, whether the support currently provided meets these needs remains unclear. Therefore, this study clarified the difficulties faced and support sought by specialists in each prefecture to help the NCC tailor the content and direction of support for holding training sessions, which should be prioritized eventually.Methods　We used data from training sessions held from 2020-2022 registered with the NCC. We aggregated information, such as the number of hours, target participants, and style of training sessions held. Data on participants' reactions, points that were directed careful attention during planning and managing training sessions, and required support were qualitatively and descriptively analyzed.Results　From 2020-2022, 195 training sessions were held in each prefecture, with four (2%) held in multiple prefectures. Moreover, 172 (88%) were online training sessions, 147 (75%) were exclusive to participants within one prefecture, and 82 (49%) were training sessions with ＜ 30 participants. The most common training topic was patient support, which occurred in 77 (40%) sessions. Based on the practical reports (free description) of the training sessions, the study identified the support from administrative staff, securing facilitators and participants, work burden associated with holding online training sessions, and securing a venue for consultation and information exchange.Conclusion　Training sessions for cancer information specialists in each prefecture are vital for acquiring and updating information about the trends in prefectural policies and local characteristics. Furthermore, they strengthened connections among individuals responsible for planning and managing these training sessions. To support each prefecture, the NCC should eventually hold training sessions in multiple prefectures, establish a network, and share specific information on the training sessions held in each prefecture.</p>","PeriodicalId":72032,"journal":{"name":"[Nihon koshu eisei zasshi] Japanese journal of public health","volume":" ","pages":"477-485"},"PeriodicalIF":0.0,"publicationDate":"2025-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143568993","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Effects and driving factors of digital transformation in measures against infectious disease operations at a public health center].","authors":"Kana Yamamoto, Yuuki Zentoku, Takahisa Sugisawa","doi":"10.11236/jph.24-116","DOIUrl":"https://doi.org/10.11236/jph.24-116","url":null,"abstract":"<p><p>Objective　The study aim was to clarify the effects and driving factors of digital transformation (DX) on COVID-19 countermeasures.Methods　The Obihiro Public Health Center promoted the use of DX to cope with the increased workload caused by the COVID-19 pandemic. Before August 3, 2022 (early phase), the center devised measures using questionnaires; however, we had to print and file an epidemiological investigation form and questionnaire for each patient. From August 4 to November 16, 2022 (middle phase), we created a database that consolidated all the information on a sheet of paper and printed it automatically. After November 17, 2022 (later phase), the workflow was reviewed to completely digitize the operations, and personal records were handed over within an electronic folder. Quantitative indicators included the percentage of groups adopting DX, and paper usage was compared for the three phases. The number of days required from notification acceptance to recuperation began, and the questionnaire response time was analyzed using the Mann-Whitney U-test. Questionnaire response rates were compared using the chi-square (χ²) test. Qualitative data were coded based on the reflections of the staff involved in the DX promotion. Subcategories were created from commonalities among the codes, and categories were generated through increasing levels of abstraction.Results　As the phases progressed, the percentage of groups adopting DX increased and paper usage decreased. The number of days required was shorter in the later phase (0.4 days) than in the middle phase (0.6 days, P < 0.05). The questionnaire response time was shorter in the later phase (72.3 minutes) than in the middle phase (97.5 minutes, P < 0.01). The questionnaire response rate increased from 4.9% in the middle phase to 11.4% in the later phase (P < 0.01). Seven [categories] of DX driving factors were extracted from the qualitative data. The middle phase included [a need to review the support system because of the rapid spread of infection] and [concrete proposals to introduce DX and decisions by management]. During the later phase, the workflow became paperless as it was completed electronically. Furthermore, we promoted our efforts while providing [technical support to enhance the understanding and adaptation to the DX promotion]. We also sought to [understand individual values and encourage improved awareness].Conclusion　DX efforts reduced paper usage and the time spent on administrative tasks. The driving factors for DX were motivation from social situations, actions, decision-making to solve issues, and support for organizations and individuals. The promotion of DX across departments has led to labor-saving improvements and greater efficiency in operations.</p>","PeriodicalId":72032,"journal":{"name":"[Nihon koshu eisei zasshi] Japanese journal of public health","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144683711","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Evaluation of the effectiveness of exercise classes for middle-aged and older people using the Kokuho database].","authors":"Yumi Tanno, Hiroaki Nobuhara, Miyuki Seki, Yoko Tsuno, Aki Shibata","doi":"10.11236/jph.24-136","DOIUrl":"https://doi.org/10.11236/jph.24-136","url":null,"abstract":"<p><p>Objectives　This study evaluated the long-term effects of exercise classes for middle-aged and older people with reduced medical care expenditures. Participants who had previously been compared with regards to medical costs through a retrospective cohort study were further followed up for eight years using the Kokuho database, comparing medical care expenditures, long-term care (LTC) costs, survival rates, and independence rates.Methods　A total of 416 matched pairs (832 individuals) of exercise-class participants and non-participants were followed between April 1, 2015 and March 31, 2023. For the survival and independence analyses, 410 pairs (820 individuals) were included, excluding those certified as requiring Level 2 nursing care or higher by March 31, 2015. To compare medical and LTC costs, 345 pairs (690 individuals) insured under the National Health Insurance or Late-Stage Senior Citizen's Health Insurance until March 31, 2023, were analyzed. Descriptive statistics were calculated for medical and LTC costs and paired t-tests were performed to compare expenditures between the participating and the non-participating groups. McNemar's test was used to compare the recipients of medical treatment. Kaplan-Meier curves were generated to calculate the eight-year survival and independence rates for both groups. In addition, stratified log-rank tests were performed for survival time analysis. Statistical significance set at P＜0.05.Results　When comparing hospitalization expenditures, the participating group incurred significantly lower hospitalization costs (P＝0.009) and higher outpatient and pharmacy expenses than the non-participating group (P＝0.019). For LTC costs, the facility and total service scores were higher in the non-participating group; however, these differences were not significant. The non-participating group was significantly more likely to receive inpatient treatment (P＝0.032), whereas the participating group was significantly more likely to receive outpatient care (P＝0.004). Survival analysis revealed significantly lower survival and independence rates in the non-participating group (P＝0.031 and P＝0.003, respectively).Conclusion　The participating group had significantly lower mortality, loss of independence, hospital admissions, and hospitalization expenditures. These findings indicate that regular participation in exercise classes assists in maintaining quality of life and extending healthy life expectancy in middle-aged and older people.</p>","PeriodicalId":72032,"journal":{"name":"[Nihon koshu eisei zasshi] Japanese journal of public health","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144683712","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Association between driver's license possession and outings for personal errands among older adults in Higashi-Surugawan metropolitan area].","authors":"Daigo Inamasu, Akio Kubota","doi":"10.11236/jph.25-012","DOIUrl":"https://doi.org/10.11236/jph.25-012","url":null,"abstract":"<p><p>Objective　Public transport is less developed in regional cities than in metropolitan areas. Consequently, older adults in these cities often face difficulties in securing alternative means of transportation after surrendering their driver's licenses, which can lead to reduced outings. Understanding the relationship between possessing a driver's license by an older adult and the purpose of outings in regional cities can provide fundamental information for designing appropriate support measures. This study aimed to examine the association between driver's license possession and outings for personal errands among older adults living in regional cities, while focusing on sex-specific patterns and differences between early- and late-stage older adults.Methods　A cross-sectional study was conducted using data from 9,463 individuals aged 65-84 years who responded to the third Higashi-Surugawan metropolitan area person trip survey, which was carried out in Shizuoka Prefecture in December 2015 and February 2016. Outing purposes were classified into categories such as \"routine household chores and shopping,\" \"non-routine shopping,\" \"social activities, meetings, recreation, dining,\" \"pick-up and drop-off,\" \"medical visits,\" \"tourism and leisure,\" and \"other personal purposes.\" Logistic regression analyses were performed separately by sex and by early- and late-stage older adults, with the presence or absence of outings for each purpose as the dependent variable and driver's license possession as the independent variable.Results　The findings indicated a significant positive association between driver's license possession and outings for certain purposes. Among early-stage older men, possessing a license was associated with outings for \"non-routine shopping,\" \"pick-up and drop-off,\" and \"tourism and leisure,\" whereas among late-stage older men, it was associated with outings for \"routine household chores and shopping\" and \"pick-up and drop-off.\" Among early stage older women, possessing a license was associated with outings for \"social activities, meetings, recreation, dining,\" \"pick-up and drop-off,\" \"medical visits,\" \"tourism and leisure,\" and \"other personal purposes,\" whereas among late-stage older women, it was associated with outings for \"social activities, meetings, recreation, dining,\" \"pick-up and drop-off,\" \"tourism and leisure,\" and \"other personal purposes.\"Conclusion　Drivers' license possession among older adults living in regional cities is associated with outings for several personal purposes, such as household chores, shopping, social activities, and medical visits.</p>","PeriodicalId":72032,"journal":{"name":"[Nihon koshu eisei zasshi] Japanese journal of public health","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144683700","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Community development for health and well-being through multi-stakeholder collaboration in Yotsukaido City: Achievements and challenges related to the collective impact framework over the first year].","authors":"Kazushige Ide, Kenjiro Kawaguchi, Katsunori Kondo, Daisuke Katagiri, Atsushi Nakagomi","doi":"10.11236/jph.24-120","DOIUrl":"https://doi.org/10.11236/jph.24-120","url":null,"abstract":"<p><p>Objectives　The Health Japan 21 initiative (third term) requires establishing an environment that allows people of all ages to lead healthy lives without excessive exertion. Such environments should be created by local governments, in collaboration with multiple stakeholders. Such initiatives carry the potential for collective impact, wherein multiple stakeholders with varying perspectives work together to solve societal challenges. However, research institutions rarely join backbone organizations to direct such collective impacts in Japan. Herein, we describe the first year (2023) of the health community development initiatives conducted by the Department of Community Building for Well-being, jointly established by the Center for Preventive Medical Sciences of Chiba University and Iwabuchi Pharmaceutical Co. in Yotsukaido City (Chiba Prefecture), and aim to demonstrate their results, achievements, challenges, and future prospects, in line with the concept of collective impact.Methods　The results, achievements, and challenges related to the initiatives were organized in alignment with the five conditions of collective success: backbone support organizations, continuous communication, mutually-reinforcing activities, common agendas, and shared measurement systems.Results　We established a joint research department in April 2023, and hosted a commemorative symposium to establish it. We then organized 15 lectures focused on health community development. We collaborated with several companies, Yotsukaido City, local residents, and community organizations. We ultimately launched the \"Yotsuba Project\" through the various initiatives undertaken in 2023. This project emphasizes collaboration between multiple stakeholders.Conclusion　Through our activities in 2023, we established an operational structure with the main team from Chiba University and Iwabuchi Pharmaceutical Co. as the backbone support organizations. Through continuous communication, a network was established between multiple stakeholders, including Yotsukaido City. Various examples of collaboration between stakeholders took place that exemplified the principles of mutually-reinforcing activities. The major challenges related to the project include the way it is run, the large number of people involved, the common agenda of promoting the concept of the \"Yotsuba Project,\" and the need to share measurement systems. Through our efforts, we hope to promote the creation of health and well-being communities for people of all ages, contribute to realizing the \"Healthy Japan 21 (third term)\" vision, and create a robust model that can be applied by other local governments as well.</p>","PeriodicalId":72032,"journal":{"name":"[Nihon koshu eisei zasshi] Japanese journal of public health","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144602385","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Acceptance of telemedicine use among residents in rural and remote areas].","authors":"Takao Kojo, Ryusuke Ae, Kenyu Nishimura, Masanori Harada","doi":"10.11236/jph.24-125","DOIUrl":"https://doi.org/10.11236/jph.24-125","url":null,"abstract":"<p><p>Objective　We broadly assessed how open residents in rural and remote areas are to using telemedicine, and whether an association exists between openness to telemedicine use and resident demographics including clinical visit status and advance care planning. Methods　A self-administered survey was disseminated via mail between October 2022 and January 2023. Participants included 3,767 residents of nine districts with remote and rural medical care services in Shunan City, Yamaguchi Prefecture aged ≥20 years. We selected participants using stratified random sampling by district, sex, and age. The survey comprised questions regarding willingness to use telemedicine services including online medical care and medication counseling, resident characteristics, clinical visit status, and willingness to accept long-term and terminal care. Multivariate logistic regression analysis was used to assess potential factors associated with willingness or unwillingness to use telemedicine. We also analyzed the specific reasons given in the responses of those who did not want to use telemedicine.Results　A total of 1,540 respondents were included in the final analyses (valid response rate: 40.9%). Regarding telemedicine use, 43.0% and 48.1% of respondents were willing to use online medical care in their family clinics and in their own houses, respectively. Additionally, 53.5% expressed a desire to use medication counseling clinics. Willingness to use telemedicine associated significantly with smartphone users and responders aged ≤50 years of age. Notably, hospital visitors and remote island residents were unwilling to use online medical care services. Time required to visit a hospital/clinic, residents living alone, and resident's desire to receive terminal care at home did not correlate significantly. The most common reasons given by those who did not want to use telemedicine were \"easier to talk to someone in person (45.2-56.0%),\" \"never experienced it before (36.6-41.2%),\" and \"difficult to hear explanations (12.5-14.3%).\" Other reasons (free responses) included \"Don't know/don't need it (27.8-42.4%), \"No problem with current hospital visit/pharmacy care (13.6-21.5%),\" and \"Concerns regarding equipment operation (10.4-18.2%).Conclusions　We identified factors associated with positive and negative attitudes toward telemedicine among residents of rural and remote areas. Our findings underscore the importance of promoting residents' understanding of the convenience and necessity of telemedicine by increasing their opportunities to experience it.</p>","PeriodicalId":72032,"journal":{"name":"[Nihon koshu eisei zasshi] Japanese journal of public health","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144602384","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}