[Nippon koshu eisei zasshi] Japanese journal of public health

信克 石川

Nihon koshu eisei zasshi/Nihon kōshū eisei zasshi

わが国の結核対策の現状と課題(3) : 世界, 日本の結核の疫学と課題

我国结核对策的现状与课题(3) : 世界、日本的结核流行病学与课题

ObjectivesaThis study aims to develop a dietary consciousness scale and examine its reliability and validity, as well as investigate the changes in psychological aspects that influence diet among Japanese adults during the COVID-19 pandemic and clarify its related factors.MethodsaAn online survey was conducted from July 1, 2020 to July 3, 2020. Participants were adults aged between 20 and 69 years selected from 13 prefectures where the government declared the state of emergency from April to May 2020. All selected participants were shopping or cooking foods for more than 2 days a week at the time of the survey. A total of 2,299 participants were included in the analysis. Dietary consciousness was measured using 12 items, and the construct was examined using factor analysis. Cronbach's alpha was examined as an indicator of internal validity, and the criterion-referenced validity was confirmed using the Kruskal-Wallis test. To determine changes in dietary consciousness, we calculated total scores based on changes in each item of the Dietary Consciousness Scale as follows: no change (0 points), improved (+1 point), and (-1 point). The associations between the changes in dietary consciousness and characteristics or socioeconomic factors of the participants were examined using the chi-squared test and residual analysis.ResultsaExploratory and confirmatory factor analyses demonstrated that a model consisting of two factors fitted the data (GFI = 0.958, AGFI = 0.938, CFI = 0.931, RMSEA = 0.066). Cronbach's alpha of the first factor (importance of diet) was 0.838 and 0.734 for the second factor (precedence of diet), and the reliability was confirmed at 0.828 for the entire scale. In the examination of criterion-related validity, the higher the stage of change, the higher the total score of the scale, and a significant difference was observed (P<0.001). The percentage of participants whose precedence worsened was higher than the importance. Significant differences were observed regarding gender, age group, marital status, employment status, household annual income, and income change during the COVID-19 pandemic considering changes in both the importance and precedence of diet. Those who were in the worsening tendency group in both the importance and precedence were men, 20-29 years old, unmarried, full-time employees, with a household income of 4-6 million yen during the past year.ConclusionaDuring the COVID-19 pandemic, the precedence of diet worsened, compared to its importance, and men, young, or unmarried persons show a of dietary consciousness.

Fumi Hayashi

Yukari Takemi

Yuki Akaiwa

Hirono Ishikawa

Yoshiharu Fukuda

[Change in dietary consciousness and its related factors among Japanese adults under the COVID-19 pandemic: Analysis using Dietary Consciousness Scale].

[COVID-19疫情期间日本成年人饮食意识变化及其相关因素：基于饮食意识量表的分析]

ObjectivesaThe COVID-19 pandemic spread rapidly across the globe during the first half of 2020. In Japan, a state of emergency was declared on April 7, 2020, which had a significant impact on the life of citizens. This study focused on behaviors like avoiding going out or coming in contact with others and frequent hand-washing to prevent the infection and the spread of COVID-19 among people living in Tokyo. We also examined the factors associated with these behaviors during the declaration of emergency.MethodsaAn online survey was conducted from April 26 to 29, 2020, approximately 20 days after the declaration of the emergency, among men and women aged 20-69 years living in Tokyo. The study framework was based on the protection motivation theory, which explains the risk-reducing behaviors, and focus theory of normative conduct, which explains the effect of others' behavior on one's own behavior. The frequency of behaviors like avoiding going out or coming in contact with others and frequent hand-washing, as well as the perception of the risk of COVID-19 during the week preceding the survey, were assessed. Each preventive action was evaluated based on the following factors: perceived effectiveness (response efficacy), perceived practicability (self-efficacy), necessary cost (response cost), and perceptions of how much should be done (injunctive norm) and how well others are doing it (descriptive norm). Hierarchical multiple regression analysis with these behaviors as outcomes were performed.ResultsaThis study included 1,034 participants (50.3% male, mean age 44.82 years, standard deviation 14.00 years). The analyses of the frequency of avoiding going out or coming in contact with others showed that the injunctive norm was positively associated with the behavior (standardized partial regression coefficient (s)=0.343, P<0.001), while the descriptive norm was negatively associated with the behavior (s=-0.074, P=0.010). Furthermore, the two-way interaction between risk perception, response efficacy, and self-efficacy was significant (s=0.129, P<0.001), indicating that risk perception was positively associated with the behavior only when either response efficacy or self-efficacy was low. A similar analysis conducted for hand-washing behavior revealed that injunctive norm (s=0.256, P<0.001) and response efficacy (s=0.132, P<0.001) were positively associated with the behavior, while the response cost (s=-0.193, P<0.001) was negatively associated with the behavior.ConclusionaSome variables in the protection motivation theory and the focus theory of normative conduct were related to the behavior for the prevention of COVID-19. The results suggest that the application of these theories is useful in future studies.

Masataka Higuchi

Hirokazu Arai

Taku Ito

Nanako Nakamura

Yuko Kai

[Factors associated with behaviors to prevent COVID-19 infection during the declaration of emergency: A study among Tokyo residents].

[紧急事态宣言期间与预防COVID-19感染行为相关的因素：一项针对东京居民的研究]。

Objectives　We investigated the 5-year disease-related mortality risk, including that associated with neoplasms, mental/behavioral/neurodevelopmental disorders, and diseases of the circulatory system and respiratory system,in ambulatory frail Japanese older adults.Methods　We retrospectively analyzed long-term care and health insurance claims data in this cohort study performed between April 2012 and March 2017. The primary outcome was mortality, and the secondary outcome was care-need level decline. Risk factors were determined based on the International Statistical Classification of Disease and Related Health Problems, 10th Revision codes, hospitalization, and institutionalization. The study included 1,239 ambulatory frail older adults newly certified as needing Support-Level care at baseline (April 2012-March 2013) across three Japanese municipalities.Results　Of the 1,239 participants, 454 (36.6%) died. Neoplasms (hazard ratio [HR] 2.69, 95% confidence interval [CI] 1.97-3.68) or respiratory system diseases (HR 1.62, 95%CI 1.26-2.08) were independently associated with mortality. Mental/behavioral/neurodevelopmental disorders (HR 1.39, 95%CI 1.17-1.66) or diseases of the respiratory system(HR 86, 95%CI 75-99) were independently associated with care-need level decline.Conclusions　This study suggests that neoplasms or respiratory system diseases were associated with a high mortality risk and that mental/behavioral/neurodevelopmental disorders were associated with care-need level decline among ambulatory frail older adults. Optimal disease management and effective long-term care are important to delay the onset of these events in older adults certified as needing Support-Level care.

Ayumi Kono

Naomi Fukushima

Takuma Ishihara

Noriko Yoshiyuki

Kouji Yamamoto

Five-year disease-related risk of mortality in ambulatory frail older Japanese.

日本门诊虚弱老年人五年疾病相关死亡风险。

Objectives To develop and assess the reliability and validity of a scale measuring subjective quality of life (QOL), which encompasses the strength and ability to live positively through the three dimensions of biological life, everyday life, and overall course of life, in order to support QOL in older adults.Methods We reviewed related literature and conducted interviews with patients with chronic diseases. Participants rated their QOL on a seven-point scale using the visual analog scale. Interviewer-administered questionnaires were used to collect data from 100 older adults living in their own homes. The participants were between the ages of 70 and 84, and were recruited from comprehensive community support centers or from among hospital outpatients. We assessed scale reliability using Cronbach's α, item-total (I-T) correlation analysis, and calculation of α coefficient-if-item-deleted. We examined content validity by analyzing the content of the free response items. To evaluate construct validity, we carried out a hierarchical multiple regression analysis, examined the semantic content of the factors related to subjective QOL, and confirmed consistency with previous studies.Results Regarding the reliability analysis of the scale, the α coefficient was 0.898, and both the I-T correlation and α coefficient-if-item-deleted exceeded the minimum value considered reliable. In examining content validity, the categories extracted for each of the three dimensions were found to demonstrate the characteristics of the general ideas of each dimension of QOL. Thus, the scale was confirmed to have overall content validity. As for the assessment of validity of its constitutive concepts, subjective QOL scores were significantly high among participants who had jobs, had role-related or financial capacity, used two or more nursing services, or scored high in perceived health competence, social networking, and sense of coherence (SOC). In addition, meaningfulness of SOC, and financial capacity had significant correlations with subjective QOL. These results are consistent with past research and therefore confirm construct validity.Conclusion This study sufficiently confirmed the reliability and validity of the scale, and consequently its usability.

Shinji Yoshida

Yoshihiko Yamazaki

[Development and testing of reliability and validity of a subjective QOL scale for older adults perceiving a dynamic healthy life through the three dimensions of biological life, everyday life, and overall course of life].

[老年人主观生活质量量表的信效度开发与测试：基于生物生命、日常生活和生命历程三个维度的动态健康感知]

Objectives Approximately 40% of new fitness club (FC) members drop out within the first six months; however, the factors associated with FC membership resignation are largely unknown. This study aimed to identify the association between psychological attitudes toward exercise and FC membership resignation.Methods We conducted a cohort study enrolling participants from 17 FCs. All individuals who became members at FCs between April 1st, 2015 and March 31st, 2016 (n=5,421) were invited to participate in the study, and those who agreed to participate completed a self-administered baseline questionnaire (n=2,934). We excluded participants aged <20 years (n=167) and those with missing values (n=702). Psychological factors were evaluated using the short version of the perceived benefit and barriers to exercise scale. Participants were followed until September 30th, 2016, at which time we assessed the FC membership drop-out rate. Cox proportional-hazards models were used to evaluate the association between perceived benefits/barriers of exercise and FC membership resignation. Sub-analyses were then conducted, stratifying by gender and age group.Results A total of 2,065 participants were included in the analyses. The mean (standard deviation) age was 39.0 (15.0) years and 28.8% were male. Over 10.1 (4.4) months of newly-joined member follow-up, the FC membership drop-out rate was 24.6 instances per 1000 person-months. Multivariable analyses revealed no significant factors associated with FC membership drop-out. However, men aged 40-59 years who had a high physical benefit score and who perceived improving physical fitness as a benefit, were less likely to resign their memberships (hazard ratio [HR], 95% confidence interval [CI], 0.72 [0.52-1.00]). However, women aged <40 years with a high discomfort score and who saw discomfort as a barrier were more likely to resign membership (HR, 1.10 [1.01-1.19]). Women aged 40-59 years with high social benefit scores and who perceived social interaction as a benefit were less likely to resign their memberships, as were women with higher lack of motivation to exercise scores and who perceived lack of motivation as a barrier to exercise (HR for social benefit, 0.84 [0.74-0.97]; HR for lack of motivation, 0.85 [0.73-0.99]). Among both male and female participants aged ≥60 years, higher self-improvement scores, indicating that peer recognition was perceived as a benefit of exercise, was associated with higher HR for drop-out (men, 2.52 [1.10-5.81]; women, 1.31 [1.00-1.72]).Conclusions The results revealed gender and age differences in the association between the perceived benefits/barriers of exercise and FC membership dropout. Implementing programs based on enrollees' characteristics and psychological factors may contribute to preventing FC dropout in the future.

Nobumasa Kikuga

Noritoshi Fukushima

Susumu Sawada

Munehiro Matsushita

Yuko Gando

Natsumi Watanabe

Yuko Hashimoto

Yoshio Nakata

Shigeru Inoue

[Associations between psychological attitudes toward exercise and fitness club membership resignation among new members: A cohort study].

新会员心理态度与健身俱乐部会员退会之间的关联：一项队列研究

出版信息	出版商: Nihon Eisei Gammai/Japanese Society of Public Health，出版周期: ，期刊类型: journal，开源期刊: 否
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[Nippon koshu eisei zasshi] Japanese journal of public health

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わが国の結核対策の現状と課題(3) : 世界, 日本の結核の疫学と課題

わが国の結核対策の現状と課題(3) : 世界, 日本の結核の疫学と課題

わが国の結核対策の現状と課題(3) : 世界, 日本の結核の疫学と課題

わが国の結核対策の現状と課題(3) : 世界, 日本の結核の疫学と課題

わが国の結核対策の現状と課題(3) : 世界, 日本の結核の疫学と課題

[Change in dietary consciousness and its related factors among Japanese adults under the COVID-19 pandemic: Analysis using Dietary Consciousness Scale].

[Factors associated with behaviors to prevent COVID-19 infection during the declaration of emergency: A study among Tokyo residents].

Five-year disease-related risk of mortality in ambulatory frail older Japanese.

[Development and testing of reliability and validity of a subjective QOL scale for older adults perceiving a dynamic healthy life through the three dimensions of biological life, everyday life, and overall course of life].

[Associations between psychological attitudes toward exercise and fitness club membership resignation among new members: A cohort study].