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

{"title":"[Definition, concept, and practical example of information bias].","authors":"Sadao Suzuki","doi":"10.11236/jph.25-088","DOIUrl":"10.11236/jph.25-088","url":null,"abstract":"<p><p>Objectives　This paper aims to elucidate the fundamental concept of \"information bias\" in analytical epidemiological studies. Specifically, it focuses on bias arising from covariates, an area for which educational case examples are scarce, and explains how and why such bias distorts research results. Using a real-world example, the paper examines the underlying mechanism and emphasizes the importance of precise covariate definition in study design.Methods　Information bias is defined as \"a flaw in measuring exposure, covariate, or outcome variables that results in different quality (accuracy) of information between comparison groups.\" Based on this definition, we explain how distorted results arise and analyze information bias associated with the covariate \"Study Period (SP)\" in an epidemiological study using human papillomavirus vaccination data from Nagoya City. The starting point of SP differed between comparison groups, with the vaccinated group having a shorter period defined from age 12 years to the first vaccination date. Using the Nagoya data, we evaluated the impact of adjusting for SP, a covariate that meets the definition of information bias, on the study results.Results　Simulation analyses showed that bias emerged when SP was used as a covariate instead of age, which should have been adjusted for. Adjustment for SP introduced differential misclassification because the average observation period was shorter in the vaccinated group than in the non-vaccinated group, leading to distortion in the study results. Consequently, the reported odds ratios were distorted due to information bias originating from the covariate SP.Conclusion　This study demonstrates through simulation that information bias arises when covariate definitions differ between comparison groups in analytical epidemiological studies, leading to distorted results. Compared with bias related to exposure or outcome variables, information bias originating from covariates is rarely addressed in educational materials, and its mechanisms are more complex, making it less likely to be recognized. Ensuring uniform covariate definitions is crucial for valid analytical epidemiological research and warrants greater emphasis in future research and education.</p>","PeriodicalId":72032,"journal":{"name":"[Nihon koshu eisei zasshi] Japanese journal of public health","volume":" ","pages":"567-573"},"PeriodicalIF":0.0,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147357735","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":"[Influence of the COVID-19 pandemic on cancer incidence in Japan].","authors":"Rina Tanaka, Masashi Matsuzaka","doi":"10.11236/jph.25-114","DOIUrl":"10.11236/jph.25-114","url":null,"abstract":"<p><p>Objectives　The first case of the novel coronavirus disease 2019 (COVID-19) was confirmed in China in December 2019, rapidly escalating into a global pandemic. The first case in Japan was detected in January 2020 and a state of emergency was declared in April. Citizens were urged to stay at home, and healthcare facilities limited their services. Patients with cancer were compelled to postpone or alter their medical visits, either voluntarily or at the request of the institutions. This study aimed to evaluate the impact of the COVID-19 pandemic on the incidence of cancer diagnosis in Japan.Methods　A summary of the population-based cancer registry data in Japan from 2016 to 2021 from e-Stat was evaluated. The average annual number of cancer cases diagnosed from 2017 to 2019 was then calculated and analyzed compared to the 2020 and 2021 statistics according to age group, cancer site, method of cancer detection, and stage at diagnosis.Results　Between 2019 and 2020, the number of cases decreased by 67,305. Case counts decreased across nearly all cancer sites, except for pancreatic cancer and malignant lymphoma. The most substantial decrease was observed in patients with stomach cancer. Notably, cancers detected through screenings, health checkups, and comprehensive medical exams showed significant decreases, including a 24.0% decrease (5,806 fewer cases) in cases of stomach cancer diagnosis. Declines were observed in the carcinoma in situ, localized, and lymph node metastasis stages for most cancer types. Specifically, for stomach cancer, the number of localized cases decreased by 15.8% (11,596 cases), whereas the number of cases involving lymph node metastasis decreased by 12.7% (1,570 cases). In contrast, from 2020 to 2021, the number of cancer cases increased by approximately 50,000, with growth observed across most sites. Detection through screening and of all stages of cancer, except for those with unknown status, also increased.Conclusion　The number of cancer diagnoses decreased in 2020, particularly cases of early stage cancers. This finding suggests that restrictions related to the pandemic may have limited access to screening and medical visits. The 2021 rebound may reflect the resumption of routine medical services. These findings underscore the importance of assessing the effect of delayed diagnosis during a pandemic on subsequent cancer progression and outcomes.</p>","PeriodicalId":72032,"journal":{"name":"[Nihon koshu eisei zasshi] Japanese journal of public health","volume":" ","pages":"557-566"},"PeriodicalIF":0.0,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147357723","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":"[Psychological changes and contributing factors, weighted by resilience, among mothers from pregnancy to early childrearing during the COVID-19 pandemic: A life-line method approach].","authors":"Yuko Hirano, Shinobu Ishii","doi":"10.11236/jph.25-065","DOIUrl":"10.11236/jph.25-065","url":null,"abstract":"<p><p>Objective　The COVID-19 pandemic has significantly affected the families of infants and young children. This study explored psychological changes in mothers from pregnancy through early childrearing, related factors, and resilience-based support strategies.Methods　Surveys and semi-structured interviews were conducted with 51 mothers who had experienced pregnancy, childbirth, and childrearing during the COVID-19 pandemic. Participants were asked about the changes in their psychological state and related factors from pregnancy to the time of the survey using the life-line method. Resilience was measured before pregnancy, during their worst psychological state, and upon survey. Qualitative analysis identified factors triggering or explaining for the changes in their psychological states. Resilience scores corresponding to the relevant time points were assigned to these factors and weighted by calculating the average scores of participants who cited them.Results　Changes in psychological state were categorized as experiencing recovery and stability after learning of one's pregnancy or a worsening or low psychological state, with both patterns observed amid various fluctuations until the present. Twenty categories related to these changes were identified across different periods of pregnancy through childrearing, including the \"COVID-19 pandemic\" and associated domains, such as \"pregnancy,\" \"childbirth,\" \"physical condition,\" \"childcare,\" \"interpersonal relationships,\" \"support,\" and \"social resources.\" The most frequently cited factors for psychological decline were \"fear and anxiety related to the COVID-19 pandemic\" during pregnancy and \"the burden from the lack of child-rearing support and environment\" during the first postpartum year. Contrastingly, the most frequently cited factors for recovery were \"joy and gratitude regarding pregnancy.\" The lowest average resilience scores were associated with \"limited societal and public understanding and support for families with young children\" from pregnancy until two years postpartum, whereas the highest scores were linked to \"involvement in child-rearing support\" and \"reassurance by improvement disinfection\" after two years postpartum.Conclusion　Mothers' psychological responses varied, influenced by personal, social, and environmental factors unique to the COVID-19 pandemic. Supporting pregnancy, childbirth, and childrearing during crises and reducing isolation and anxiety, requires mitigating factors undermining psychological well-being and resilience and enhancing those that aid recovery. Public health efforts should offer individual support, cross-sector collaboration among medical, health, and welfare services, and inclusive environments in which mothers and families feel secure and connected.</p>","PeriodicalId":72032,"journal":{"name":"[Nihon koshu eisei zasshi] Japanese journal of public health","volume":" ","pages":"532-543"},"PeriodicalIF":0.0,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147313088","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 evaluation indicators for service housing for older people: Focusing on social participation and communication].","authors":"Hequn Wang, Kenjiro Kawaguchi, Lingling, Kazushige Ide, Atsushi Nakagomi, Katsunori Kondo","doi":"10.11236/jph.25-092","DOIUrl":"10.11236/jph.25-092","url":null,"abstract":"<p><p>Objectives　Valid indicators for evaluating housing environments and services must be developed to enhance the quality of services provided in service housing for older people (SHOP) and provide a better living environment for residents. This study aimed to develop evaluation indicators for SHOP by examining their associations with residents' health and well-being at the facility and individual levels.Methods　Survey data collected between February and March 2023 from 39 SHOP facilities (Sekisui House Realty Tokyo, Ltd) were analyzed. Individual-level analysis included 1,085 residents aged ≥65 years (average age: 83.9 ± 6.5years). Facility-level analysis involved 883 residents (average age: 83.7 ± 6.5years) from 25 facilities, with ≥20 respondents each. Outcome indicators included three health (depression, dementia risk, and frailty) and nine well-being indicators across four domains (happiness and life satisfaction, mental and physical health, meaning and purpose, and close social relationships). Twenty-eight SHOP evaluation indicators related to social participation, communication and information, outdoor spaces and buildings, transportation, and housing were developed using an age-friendly cities and communities' framework. Facility-level analysis used Spearman's rank correlation based on the proportion of binary indicators. Individual-level analyses used multiple regression for continuous outcomes and modified Poisson regression for binary outcomes, adjusted for age, sex, and other covariates. Indicators were classified into \"key,\" \"moderately relevant,\" or \"limited\" based on their consistent association with outcomes at both analysis levels.Results　At the facility level, 16 indicators (57.1%) showed significant associations with at least one health and well-being outcome. At the individual level, 23 indicators (82.1%) exhibited significant associations. Fourteen indicators (50.0%) consistently showed significant associations at both levels. Among these, eight were classified as \"key,\" four as \"moderately relevant,\" and two as \"limited.\"Conclusion　Eight \"key\" indicators can be used for evaluating SHOP: social participation (sports, hobbies, learning groups, sharing skills and experiences), communication and information (laughter, friends for interaction, and conversations with non-family members), and housing (satisfaction with one's own room). These indicators may serve as a guide for quality improvements and enhance resident well-being in SHOP settings.</p>","PeriodicalId":72032,"journal":{"name":"[Nihon koshu eisei zasshi] Japanese journal of public health","volume":" ","pages":"518-531"},"PeriodicalIF":0.0,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147313107","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 of information collection with indoor smoking regulations and legal understanding, and public health center approaches with legal compliance in eating and drinking establishments].","authors":"Isao Muraki, Aoi Kataoka, Yuri Ito, Masakazu Nakamura, Kota Katanoda","doi":"10.11236/jph.25-097","DOIUrl":"10.11236/jph.25-097","url":null,"abstract":"&lt;p&gt;&lt;p&gt;Objectives　We aimed to determine how owners of eating and drinking establishments gather information on indoor smoking regulations and to assess owners' understanding of the revised Health Promotion Act. Additionally, we sought to identify factors that promote compliance with these regulations.Methods　We conducted Internet-based surveys targeting owners of eating and drinking establishments in five prefectures, in 2022, and targeting owners of new establishments across Japan, in 2023, were conducted. Valid responses were obtained from the owners of 257 existing establishments in the 2022 survey and from the owners of 202 new establishments in the 2023 survey. Participants provided information on location, opening date, seating capacity, indoor smoking policies, sources of information on indoor smoking regulations, legal understanding, and public health center (PHC) approaches (2023 survey only). The proportions of different information sources and legal understanding, comprising five core items and four items on the smoking-room criteria, among regulated, transitional-measure, and new establishments, were compared. Logistic regression analysis was used to calculate the odds ratios (ORs) for suspected legal non-compliance and pooled ORs for pre-existing and new establishments were calculated using random-effects meta-analysis.Results　The owners of regulated, transitional-measure, and new establishments gathered information on indoor smoking regulations from similar sources. However, establishments under transitional measures were less likely to correctly understand indoor smoke-free principle than those under regulations. Suspected non-compliance was identified in 22.8% of pre-existing establishments and in 17.8% of new establishments. A good understanding of the smoking-room criteria, but not the core items, was associated with a higher likelihood of suspected legal non-compliance compared with a good understanding of the core items but not the smoking-room criteria (pooled OR=3.36, 95% confidence interval [CI]: 1.36-8.29). However, in establishments that confirmed their indoor smoking policies or provided information about the regulations when applying for a business license at a PHC, there was lower potential to be suspected of non-compliance (OR=0.25, 95% CI: 0.07-0.87).Conclusions　Suspected legal non-compliance was identified in approximately 20% of establishments. A good understanding of smoking room criteria, but not the core items of the law, was associated with a higher suspicion of legal non-compliance. This stems from a lack of awareness of owners of the compliance requirements and the complexity and ambiguity of these regulations. To improve compliance, terminating transitional measures and clarifying smoking-room criteria would be effective. Confirming indoor smoking policies or providing information on these regulations during PHC administrative procedures may play key roles in advancing second-hand smoke prevention measures.&lt;/","PeriodicalId":72032,"journal":{"name":"[Nihon koshu eisei zasshi] Japanese journal of public health","volume":" ","pages":"497-507"},"PeriodicalIF":0.0,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147312995","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":"[Correlates of domain-specific walking time in a national sample of Japanese adults: A cross-sectional study focused on exercise preferences].","authors":"Misaki Takahashi, Shiho Amagasa, Noritoshi Fukushima, Hiroyuki Kikuchi, Masaki Machida, Yoshiharu Fukuda, Shigeru Inoue","doi":"10.11236/jph.25-112","DOIUrl":"10.11236/jph.25-112","url":null,"abstract":"<p><p>Objective　Although many studies have investigated the factors associated with physical activity, few have examined these associations in relation to walking using large-scale nationwide data from Japanese adults. Furthermore, the association between exercise preference (liking or disliking exercise) and physical activity remains unclear. This study aimed to examine the factors associated with total and domain-specific walking times (utilitarian and leisure) among Japanese adults.Methods　This nationwide cross-sectional study included 40,286 Japanese adults (50.5% men, mean age; 49.4±15.6 years) who responded to a web-based survey in December 2021. Multivariable logistic regression analysis was performed to examine the association between walking time (total, utilitarian, and leisure, dichotomized at the median) and sex, age, the Japan Postcode-level Walkability Index (JPWI), years of education, employment status, household income, living arrangements, driving frequency, body mass index, self-rated health, smoking status, and exercise preference (based on the question, \"Do you like exercise?\" participants who answered \"yes\" were classified as \"liking exercise,\" whereas those who answered \"no\" as \"disliking exercise\").Results　Longer total walking time was significantly associated with men (adjusted odds ratio [95% confidence interval]; 1.16 [1.11-1.21]), older age (≥60 years; 1.57[1.48-1.66]), higher JPWI (0.5-＜1.0:1.17[1.11-1.24], ≥1:1.56[1.47-1.65]), higher level of education (≥13 years; 1.12[1.07-1.17]), higher household income (middle; 1.06[1.01-1.12], high; 1.26[1.18-1.34]), living alone (1.07[1.01-1.14]), lower driving frequency (＜3 days/week; 2.20[2.10-2.30]), better self-rated health (1.21[1.15-1.28]), not smoking (1.27[1.20-1.34]), and liking exercise (2.10[2.01-2.20]). Among these, driving frequency and exercise preference showed the strongest associations based on odds ratios. For utilitarian and leisure walking, lower driving frequency (2.29[2.19-2.39]) and liking exercise (2.59[2.48-2.71]) had the strongest association (2.29[2.19-2.39]), respectively.Conclusions　Exercise preference and driving frequency were strongly associated with walking time. These findings highlight the importance of developing effective interventions and improving environments to promote behavioral changes among individuals with low physical activity levels who dislike exercising.</p>","PeriodicalId":72032,"journal":{"name":"[Nihon koshu eisei zasshi] Japanese journal of public health","volume":" ","pages":"508-517"},"PeriodicalIF":0.0,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147313005","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":"[Home care duration and service use among elderly patients with terminal cancer in Japan: A nationwide study using the Japanese Long-Term Care Insurance Claims].","authors":"Yuki Maura, Sayaka Tabuchi, Takumi Shirakata, Katsuyuki Miura, Akiko Harada, Mikiko Ito","doi":"10.11236/jph.25-051","DOIUrl":"10.11236/jph.25-051","url":null,"abstract":"<p><p>Objectives　In Japan, the number of home-based cancer deaths has been increasing due to population aging. However, home-based end-of-life care among patients with terminal cancer are short-term, and the actual use of long-term care (LTC) insurance services remains unclear. This study aimed to elucidate the duration of home-based care and use of LTC insurance services before death among older adults with terminal cancer in Japan.Methods　Using data extracted from the Japanese Long-term Care Database provided by the Ministry of Health, Labour and Welfare, we analyzed 16,865 insured individuals aged ≥65 years who were billed for the Terminal Care Management (TCM) add-on between April 2018 and March 2021. The observation period was set at 12 months preceding the month of death (the month in which the add-on was billed). Monthly data on the use of home care support and services were examined to determine the duration of home-based care and trends in service use antemortem.Results　Of the participants, 57.5% were men, 40% were aged 75-84 years, and approximately 60% were cognitively independent. The national TCM billing rate among home-based cancer deaths in individuals aged ≥65 years was 12.4%, with substantial prefectural variation; Nagasaki and Yamanashi were >20%, whereas Akita, Niigata, and Tottori were <5%.　The distribution of continuous home-based care antemortem was skewed toward shorter durations, with 26.2% of patients receiving care for ≤1 month and 52.8% receiving care for up to two months. In the month of death, the most frequently used LTC services were welfare-equipment-rental (97.1%), home-medical-care-management-guidance (59.3%), home-visit-care (38.2%), and home-visit-bathing (26.5%). Physicians and pharmacists predominantly provided guidance. The use of home-visit bathing increased sharply from two months antemortem.Conclusion　The duration of home-based care among older adults with terminal cancer was short, with a median of <2 months (mode; 0.5 months), corresponding to the month of death. Key home care services, such as welfare-equipment-rental, home-medical-management-guidance, home-visit-care, and home-visit-bathing, were intensively used near the end of life. However, the use of the TCM add-on remained limited. These findings highlight the regional disparities and challenges in home care systems, underscoring the need for early support and care management to promote interdisciplinary collaboration.</p>","PeriodicalId":72032,"journal":{"name":"[Nihon koshu eisei zasshi] Japanese journal of public health","volume":" ","pages":"544-556"},"PeriodicalIF":0.0,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147313170","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":"[Relationship between assignment of supervisory public health nurses and recruitment of municipal public health nurses].","authors":"Yuki Okada, Haruko Ono, Ryoko Kawasaki, Emiko Kishi, Yuka Dai, Kazuko Saeki, Noriko Kato, Sachiyo Murashima","doi":"10.11236/jph.25-144","DOIUrl":"https://doi.org/10.11236/jph.25-144","url":null,"abstract":"<p><p>Objective　Municipal public health nurses (PHNs) provide diverse community health services, including the planning, implementation, and evaluation of local health policies. A well-planned and continuous recruitment system is essential for performing these duties effectively and efficiently; however, many municipalities face difficulties in securing adequate full-time PHNs amid increasing workloads, and establishing sustainable recruitment measures remains a challenge. In this context, supervisory PHNs are expected to possess the ability to establish systems for recruiting and training local government PHNs and are considered to play a crucial role in these processes. However, a quantitative evaluation of the relationship between assignment of supervisory PHNs and number of PHN recruits has not been conducted. This study aimed to clarify this association.Methods　This cross-sectional study was conducted by analyzing the data of 1,733 municipalities in the fiscal year 2020. Data on the presence of supervisory PHNs, number of full-time PHNs, annual PHN recruits, and the total population of each municipality were obtained from the Ministry of Health, Labour and Welfare's Survey on Public Health Nurse Activities by Area of Work and the Ministry of Internal Affairs and Communications' Population Census, and other official statistics. The outcome was the annual number of PHN recruits, and the main explanatory variable was the presence of a supervisory PHN. Multivariable negative binomial regression analysis was used to calculate incidence rate ratios and 95% confidence intervals (CIs), with adjustments for variables related to regional characteristics.Results　Of the 1,733 municipalities analyzed, 865 (49.9%) had a supervisory PHN. After adjusting for municipality size, retirements, and other covariates, municipalities with a supervisory PHN had 1.167 times more PHN recruits than those without a supervisory PHN (95% CI: 1.040-1.310).Conclusions　Municipalities with supervisory PHNs tended to have more PHN recruits than those without supervisory PHNs. This suggests that supervisory PHNs play a crucial role in securing PHN personnel through their involvement in recruitment planning, enhancing workplace attractiveness, and promoting strategic recruitment activities. This result may have important implications for the development of stable and continuous recruitment strategies for municipal PHNs.</p>","PeriodicalId":72032,"journal":{"name":"[Nihon koshu eisei zasshi] Japanese journal of public health","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-06-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148347501","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":"[Participation in community gathering places and frailty among older adults: A longitudinal study using three-wave panel data from JAGES 2016, 2019, and 2022].","authors":"Aki Shibata, Kazushige Ide, Ryota Watanabe, Kiyomi Matsumura, Taishi Tsuji, Katsunori Kondo","doi":"10.11236/jph.26-001","DOIUrl":"https://doi.org/10.11236/jph.26-001","url":null,"abstract":"<p><p>Objectives　Community gathering places have emerged as a key population-level approach for frailty prevention in Japan. Although these activities are expected to support health maintenance and long-term care prevention among older adults, evidence regarding their association with frailty remains limited because few studies have adequately addressed potential confounding and reverse causation. This study aimed to examine the association between participation in community gathering places and frailty using large-scale three-wave panel data.Methods　Data were obtained from the 2016, 2019, and 2022 waves of the Japan Gerontological Evaluation Study (JAGES). The analytic sample comprised 41,245 community-dwelling older adults aged ≥65 years from 25 municipalities. Frailty status in 2022 was the outcome, and participation in community gathering places in 2019 was the primary exposure. Thirteen covariates measured in 2016 were included: sex, age, baseline frailty status, urbanicity, equivalent household income, educational attainment, marital status, household composition, employment status, social participation, social support, depressive symptoms, and current medical treatment. Modified Poisson regression models were used to estimate risk ratios. Subgroup analyses stratified by demographic and socioeconomic characteristics were also performed.Results　Older adults who participated in community gathering places at least once monthly had a lower risk of frailty in 2022 than nonparticipants (risk ratio: 0.93, 95% confidence interval: 0.88-0.97). Subgroup analyses showed that the association was generally consistent across sex and age categories. Similar findings were observed among individuals with lower socioeconomic status, indicating that the potential benefits of participation may extend across diverse population groups.Conclusion　Participation in community gathering places was associated with a reduced risk of frailty, suggesting that these community-based activities may contribute to frailty prevention. These findings highlight the importance of strengthening and expanding such programs as part of broader population strategies to promote healthy longevity among older adults.</p>","PeriodicalId":72032,"journal":{"name":"[Nihon koshu eisei zasshi] Japanese journal of public health","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-06-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148347498","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":"[Barriers to psychological safety in long-term care insurance facilities: A qualitative study of directors' perspectives].","authors":"Maki Tominaga, Masae Tanaka, Tomoyuki Yabuki, Miharu Nakanishi, Yasumasa Adachi","doi":"10.11236/jph.25-171","DOIUrl":"https://doi.org/10.11236/jph.25-171","url":null,"abstract":"<p><p>Objective　To identify barriers to psychological safety in long-term care insurance facilities through a qualitative descriptive analysis of verbatim transcripts obtained from facility directors.Methods　Directors of long-term care insurance facilities in the Kinki region of Japan were recruited using snowball sampling. Semi-structured interviews were conducted between August and September 2023. Verbatim transcripts were analyzed qualitatively and inductively to generate codes representing statements that impede psychological safety. Codes were iteratively grouped to increase abstraction, forming subcategories and higher-order categories. Findings were further organized according to three antecedent domains: individual, structural/system, and interpersonal factors, to examine how these barriers manifest within facilities.Results　A total of 11 directors participated (9 male; age distribution: 40s, n=5; 50s, n=5). Mean age was 50.0 years (SD=6.44), and mean tenure in the current role was 10.4 years (SD=5.12). Three categories of individual factors were identified: \"Position of new employees and junior employees,\" \"Trait of being overly conscious of others and defensive of oneself,\" and \"Difficult work performance among employees suspected of having psychological issues.\" Three structural/system categories were identified: \"Limited understanding and capability regarding managerial duties,\" \"Difficulties in managing, supporting, and training staff,\" and \"Burden due to staff shortages and challenges in appropriate staffing.\" Five interpersonal categories were identified: \"Self-centered and dismissive behavior toward others,\" \"Self-righteous and pressure-generating behavior from superiors,\" \"Intolerance and low flexibility associated with excessive righteousness,\" \"Misunderstandings and concerns arising from insufficient ethical knowledge and rumors,\" and \"Emotionally complex relationships that are difficult to reconcile.\" Interpersonal factors were prominent and interacted with individual factors. The findings suggested that the lack of effective organizational and workplace structures and systems to address these issues hinders psychological safety in long-term care facilities.Conclusion　Individual, interpersonal, and structural/system factors directly and indirectly inhibit open work-related communication among employees in long-term care insurance facilities. Persistent staffing shortages in Japan further exacerbate these barriers. Enhancing psychological safety requires targeted interventions addressing structural/system factors, particularly leadership practices within management.</p>","PeriodicalId":72032,"journal":{"name":"[Nihon koshu eisei zasshi] Japanese journal of public health","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-06-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148347430","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}