Public officials' attitudes towards public participation in policymaking by people with dementia.

Introduction: Public participation by people with dementia in relevant policymaking has been advocated to improve the quality of health systems and democratic processes. Public officials' attitude is a key determinant of public participation. This study aimed to explore Japanese local-government officials' attitudes towards public participation by people with dementia in policymaking and associated factors.

Methods: This cross-sectional study, utilising an online survey conducted in December 2022, included public officials (n = 997) in charge of dementia policy in Japanese municipalities, with one respondent from each municipality. Participants' certifications were administrative, public-health nurse, or other professionals. Univariate and mediation analyses were performed with attitudes towards public participation by people with dementia as a dependent variable, attitudes towards people with dementia as a mediating variable, and demographic characteristics, contact opportunities with people with dementia, and sources of dementia-related information as exploratory variables.

Results: The mean attitude towards people with dementia and towards public participation was 45.1 (SD: 5.1) and 12.6 (SD: 1.8), respectively. Positive attitudes towards people with dementia were a significant determinant of supportive attitudes towards public participation. Participation in collaborative activities with people with dementia and a larger municipality population had positive and significant direct effects on attitudes towards public participation by people with dementia. Additionally, the public officials' sex and exposure to information about dementia directly from people with dementia showed a significant positive indirect effect mediated by attitude towards people with dementia.

Discussion: Attitudes towards people with dementia are the most significant factor influencing their public participation; therefore, reducing stigma among public officials is essential to foster public participation by people with dementia. Active involvement of public officials in collaborative activities with people with dementia at the micro level and valuing the perspectives of people with dementia as essential contributions can enhance public participation by in local policymaking.