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

{"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}

{"title":"[Using Geographic Information Systems to Identify the Locations of Patients with Intractable Diseases and Support Disaster Response: Development of NHAMs (Nyamuzu)].","authors":"Tasuku Hoshi, Yosuke Tobita, Tomoko Igeta","doi":"10.11236/jph.25-032","DOIUrl":"https://doi.org/10.11236/jph.25-032","url":null,"abstract":"","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":"144602388","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":"[Multiple medicines and incidence of functional disability among older adults according to age groups: A JAGES 2013-2019 longitudinal study].","authors":"Masayuki Kasahara, Kazushige Ide, Natsuyo Yanagi, Katsunori Kondo","doi":"10.11236/jph.24-127","DOIUrl":"https://doi.org/10.11236/jph.24-127","url":null,"abstract":"<p><p>Objectives　The use of multiple medicines that increase frailty and functional disability among older adults is a significant public health concern. However, no study has analyzed whether the intake of multiple medicines increases functional disability according to age. The number and severity of diseases and frailty that are positively correlated with medicines have not been considered. In this longitudinal study, we aimed to investigate whether multiple medicines increased functional disability incidence according to age groups (65-74 and ≥75 years) after adjusting for disease status and frailty.Methods　Data from the 2013 Japan Gerontological Evaluation Study (JAGES)-collected during a follow-up period of approximately six years-were used. Individuals aged ≥65 years who were activities of daily living (ADL) dependent, using an unknown number of medicines, and experiencing functional disabilities at the time of response were excluded. A total of 12,752 functionally independent older adults from 14 municipalities were included in this study. The outcome variable was whether the participants had functional disabilities. The explanatory variable was the intake of multiple medicines (reference group, no medicines; exposure group, 1-2, 3-4, or ≥5 medicines). As covariates, 12 variables were considered potential confounding factors between the intake of multiple medicines and functional disabilities. A survival analysis (Cox's proportional hazards model) was used to calculate the hazard ratio (HR), 95% confidence interval (CI), and p-value (5% significance level). After confirming the association between multiple medicines and age groups (65-74 and ≥75 years), participants were analyzed according to age groups. Multiple imputation methods were used for the missing variables.Results　Among the 65-74 and ≥75 years age groups, the incidence of functional disabilities was 10.3% and 37.6%, respectively. The interaction between multiple medicines and age was significant (P < 0.05). During the follow-up period, the HR (95% CI, P-value) for functional disability incidence with the intake of multiple medicines was higher compared to that of the reference group, as follows: for 3-4 and ≥5 medicines among individuals aged 65-74 years, 1.31 (1.01-1.69, 0.042) and 1.89 (1.44-2.49, <0.001), respectively; and for ≥5 medicines among individuals aged ≥75 years, 1.43 (1.19-1.72, <0.001).Conclusion　The study findings indicate that multiple medicines administered to community-dwelling older adults increase their susceptibility to functional disabilities. However, individuals aged 65-74 years with a lower disease status and frailty percentages may be attentive when using multiple medicines. Guidelines for appropriate medicine use among older adults emphasize the importance of healthcare workers in medical institutions and community pharmacies. These workers should also address the issue of multiple medicines among individuals aged 65-74 years.</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":"144602387","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":"[Indoor radon mitigation: Recommendations from a building sanitation and disease prevention perspective].","authors":"Ichiro Yamaguchi, Kenichi Azuma, Kyoichi Goto, Sumitaka Kobayashi, Takehiro Michikawa, Yuko Sato, Masayuki Shima","doi":"10.11236/jph.24-117","DOIUrl":"10.11236/jph.24-117","url":null,"abstract":"","PeriodicalId":72032,"journal":{"name":"[Nihon koshu eisei zasshi] Japanese journal of public health","volume":" ","pages":"428-434"},"PeriodicalIF":0.0,"publicationDate":"2025-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144050671","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":"[Development of the shortened scale for health interest].","authors":"Takuya Yamada, Kumi Sugimoto, Yoko Nishizawa, Hirono Ishikawa, Yoshiharu Fukuda","doi":"10.11236/jph.24-070","DOIUrl":"10.11236/jph.24-070","url":null,"abstract":"<p><p>Objective　Addressing the needs of a population that is indifferent to health is becoming increasingly important. Previous research has developed the \"Interest in Health Scale,\" which assesses the level of interest in health. It comprises three subscales; health consciousness, motivation, and value. This study aimed to enhance the usability of the 12-item Interest in Health Scale by creating a shortened version.Methods　Using data from a web survey of 800 participants, factor analysis was conducted on the 12-item Interest in Health Scale to select items for the shortened version. From the factor analysis, two items were selected from each subscale based on their factor loadings to create a 6-item scale, and a 4-item scale was created, excluding two items from the health value subscale. We evaluated the reliability of the newly created shortened version, its correlation with the 12-item version, and its validity through correlations with health literacy (CCHL scale) and lifestyle habits (diet, exercise, alcohol consumption, and smoking).Results　Cronbach's alpha was 0.72 and 0.80 for the 6- and 4-item scale, respectively. The correlation coefficients between the 12-item and 6- and 4-item versions were 0.94 and 0.88, respectively. The correlation with health literacy were 0.28, 0.27, and 0.22 for the 12-, 6-, and 4-item versions, respectively. The correlation coefficients for the four lifestyle habits were similar across all the three scales.Conclusion　This study created 6- and 4-item versions of the scale with reliability and validity comparable to that of the 12-item version. While the 6-item version, containing all three subscales, is preferable for measuring health interest more easily, the 4-item version, which excludes health value for convenience, can be used.</p>","PeriodicalId":72032,"journal":{"name":"[Nihon koshu eisei zasshi] Japanese journal of public health","volume":" ","pages":"419-427"},"PeriodicalIF":0.0,"publicationDate":"2025-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143257423","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 perspective of community general support centers and promoting the use of early stage dementia-intensive support teams: Comparing institutions with and without support teams].","authors":"Yumi Kozaki","doi":"10.11236/jph.24-014","DOIUrl":"10.11236/jph.24-014","url":null,"abstract":"<p><p>Objectives　Although numerous studies have explored early stage dementia-intensive support teams, focusing on their effectiveness and associated challenges, there is insufficient research on community comprehensive support centers that use support teams. Thus, we focused on community comprehensive support centers from the perspectives of their operators and users, examined the actualities and challenges of support team use, and considered ways to encourage such use.Methods　A questionnaire survey was mailed to 2,000 community general support centers selected through evenly-spaced sampling from 5,625 centers in Japan. The survey was conducted from November to December 2022. The survey included basic attributes (institution and presence of a support team), number of times a support team was used, actual number of users, and issues with support team use. For the analysis, we defined centers with and without support teams as \"operators\" and \"users,\" respectively, and analyzed each group. The participants' demographic details and data related to the frequency of use of support teams were tabulated. Text mining was used to analyze free-field responses.Results　A total of 773 responses were received (response rate; 38.8%). Among the respondents, 313 (41.5%) had support teams and 441 (58.4%) did not. The support team use rate was 86.6% for the former and 79.4% for the latter. In 2021, most respondents noted that approximately \"1-5 individuals\" used support teams, regardless of whether the support center had one.Challenges with support team use identified by centers without support teams were as follows; requirements of support recipients and rules for use under \"mechanisms of use,\" involvement of team doctors and expertise of team members under \"support functions,\" and collaborative support relationship and dissemination of project information under \"system for use.\" Support centers with support teams identified the following challenges; requirements of support recipients and management rules under \"management mechanisms,\" involvement of team doctors and healthcare collaboration under \"support functions,\" and team members role awareness and staff shortage under \"management system.\"Conclusion　Many comprehensive centers infrequently used support teams. To promote support team use, the system must be reviewed from the operator and user perspectives to simplify the support team system's rules and ease the requirements for support recipients. Moreover, all dementia supporters must engage in regular and ongoing discussions about the dementia support system, focusing on the municipal responsibility for system operation.</p>","PeriodicalId":72032,"journal":{"name":"[Nihon koshu eisei zasshi] Japanese journal of public health","volume":" ","pages":"397-407"},"PeriodicalIF":0.0,"publicationDate":"2025-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143257429","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":"[Factors associated with program implementation competencies used to improve health service development capacity of public health nurses: A nationwide survey of prefectures and cities with public health centers].","authors":"Mirei Shimodawa, Reiko Okamoto, Keiko Miyamoto, Keiko Koide, Masako Kageyama","doi":"10.11236/jph.24-054","DOIUrl":"10.11236/jph.24-054","url":null,"abstract":"<p><p>Objectives　Public health nurses (PHNs) are necessary in introducing evidence-based health programs to address various health challenges. This study aimed to identify the factors related to PHNs' ability to implement programs across different career-level groups.Methods　A self-administered questionnaire was administered to PHNs working in prefectures or cities with public health centers. PHNs were categorized into three career-level groups based on their seniority and position; novice with ≥ 5 years of experience, no-position with ≥ 6 years of experience without a position, and with-position with ≥ 6 years of experience holding a position. Simple regression analysis was conducted using the Implementation Degree Assessment Sheet (Okamoto et al., 2022; IDAS) score as the dependent variable and experience in developing new projects, learning experiences, horizontal development exposure, and PHNs' competency scale scores as independent variables. Stepwise multiple regression analysis was conducted with the IDAS score as the dependent variable and statistically significant variables in the simple regression analysis as the independent variables. The competency measurement scales used were the Professional Development Scale (PDS), Reflective Practice Skill Scale (RPS), and Research Utilization Competency Scale (RUC).Results　We obtained 702 out of 966 valid responses (72.7%). The overall mean IDAS scores was 115.7; 107.6 for novice PHNs, 111.3 for no-position PHNs, and 119.6 for with-position PHNs. Multiple regression analysis revealed that RPS and PDS scores contributed to novice and with-position PHNs' abilities. Additionally, \"recognition of the importance of horizontal development: agree\" significantly influenced novice PHNs' ability, whereas RUC score contributed to with-position PHNs' ability. RUC scores and recognition of the current implementation of horizontal development significantly contributed to the ability of No-position PHNs.Conclusion　For improving PHNs' program implementation abilities, novice PHNs should focus on reflective practices, improve professional knowledge and skills, acquire knowledge and competence in program implementation, and improve understanding of its importance. Moreover, no-position PHNs must collect, examine, and use information, such as recent research findings. With-position PHNs must continuously improve their skills and apply them comprehensively in management and program implementation. These findings underscore the importance of tailored program implementation training for each career level, providing opportunities to reflect on practice and one's own activities, and assessing the level of mastery.</p>","PeriodicalId":72032,"journal":{"name":"[Nihon koshu eisei zasshi] Japanese journal of public health","volume":" ","pages":"408-418"},"PeriodicalIF":0.0,"publicationDate":"2025-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143257443","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}