Relationship between communicative and critical health literacy, health information sources, and participation in health checkups among middle-aged Japanese community residents.

We assessed the relationship between health literacy and participation in health checkups among middle-aged Japanese community residents. Additionally, we explored the health information sources related to participation in health checkups among those with low, medium, and high health literacy. This mail survey using a self-administered questionnaire was conducted in 2020 and included 33,902 community residents with National Health Insurance (NHI), aged 40-64 years from five cities in Osaka Prefecture, Japan. Of these, 12,446 (36.7%) agreed to participate in the survey. After exclusion of those with regular visits to medical institutions and those with missing data, the analysis included 3582 participants. Health literacy was measured by the Communicative and Critical Health Literacy (CCHL) scale, and participants were classified into three groups (low, medium, and high health literacy groups) by the tertiles of CCHL scale score. After adjusting for confounding factors, the multivariable-adjusted odds ratios for non-participation in health checkups were 1.20 (95% CI 1.01-1.43, p = 0.039) in the medium health literacy group and 1.47 (95% CI 1.20-1.80, p < 0.001) in the low health literacy group compared with the high health literacy group. Additionally, some health information sources were associated with participation in health checkups in the medium and high health literacy groups, whereas none of the health information sources were associated with participation in health checkups in the low health literacy group. We believe that it is important to develop materials and interventions aimed at low health literacy populations to promote participation in health checkups.

Association between Recommendations from Public Health Nurses, Medical Professionals, and Family Members and Participation in Health Checkups among Middle-aged Community Residents with National Health Insurance.

Introduction: Participation in specific health checkups is low in Japan, especially among middle-aged community residents with municipal National Health Insurance (NHI). This study explored associations between recommendations from public health nurses, medical professionals, and family members and participation in specific health checkups among middle-aged Japanese community residents with NHI. Methods: This mail survey was conducted in 2020, and it included 33,902 community residents with NHI aged 40-64 years from five cities in Osaka Prefecture, Japan. Of these, 12,446 (36.7%) community residents agreed to participate in the survey. After excluding those with missing data, 11,180 participants were included in the analyses. Participants were classified into a participation group and a nonparticipation group. Those who selected "I underwent a specific health checkup in the past year" were classified as the participation group. Results: Of the 11,180 community residents with NHI, 4,384 (39.2%) were classified in the participation group. After adjusting for confounding factors, the presence (vs. absence) of recommendations from public health nurses (multivariable-adjusted odds ratio [OR], 1.81; 95% confidence interval [CI], 1.47-2.24), primary care physicians (multivariable-adjusted OR, 2.79; 95% CI, 2.49-3.13), nurses (multivariable-adjusted OR, 2.06; 95% CI, 1.57-2.69), and family members (multivariable-adjusted OR, 1.22; 95% CI, 1.12-1.32) was positively associated with participation in specific health checkups. Conclusions: Our findings suggest that recommendations from public health nurses, medical professionals (primary care physicians and nurses), and family members may be important to promote participation in specific health checkups among middle-aged Japanese community residents with NHI.

[Activities of public health nurses during routine health check-ups for 18-month-old children in Japan].

OBJECTIVE: This study was conducted to investigate the actual activities of public health nurses (PHNs) during routine health check-ups at health centers of municipalities, for the 18-month-old children in Japan. METHODS: The targets were municipalities with 200 births and more per year. A questionnaire about the contents of implementation of health check-ups, and follow-up activities, were mailed to 105 municipalities between April 2000 and March 2001. The response rate was 62.9%. RESULTS: 1) All municipalities adopted some form of group checku-ups. They mainly conducted medical interviews by physicians and dentists (100%), somatometry (100%), health interviews by PHNs (95.5%), group lectures (47.0%), individual health consultations, 93.9% (for all participants, 83.3%), and conferences after check-ups by main staff, (92.4%). 2) The allocation of various professionals included physicians and dentists (100%), PHNs (100%), dental hygienists (98%), dieticians (88%), and psychological staff. (75%). 3) Municipal populations had a negative correlation with check-up rates. Municipal populations and birth numbers per year had positive correlations with the frequency of group check-ups per year. 4) PHNs were involved in many scenarios, and were concerned with decisions regarding the effects of health check-ups. However, among these municipalities, only 36.4% had definite criteria, or a manual, for assessment of check-ups by PHNs. The follow-up rates ranged from 1.9 to 56.3%, with considerable differences. 5) Follow-up and absentees of check-ups were mainly dealt with by PHNs. CONCLUSIONS: We clarified the implementation of health check-ups and associated activities of PHNs among municipalities. The check-ups and follow-up activities were mostly conducted PHNs. However, the existence of standards for check-ups by PHNs, and the methods for follow-up differed considerably. Therefore, it is necessary to further consider the quality of check-ups.

[Effects of home visitation by nurses around one month after delivery focus on mother's anxiety and awareness of child rearing problems].

PURPOSE: We evaluated the effects of home visitation by nurses around one month after delivery, focusing on mother's anxiety and awareness of child rearing problems. METHOD: We selected mothers who had a normal first child, and assigned them to the intervention (n = 131) or control (n = 100) groups. For the former, home visits were made by nurses, and for the controls, the usual care was provided. Outcome measurements were conducted before the intervention (Time I) and two months after (Time II). Usual care (neonatal home visiting service) was commonly provided by city health department, but not all subjects received a visit. We excepted the subjects who were provided with this usual care, analyzing the remaining subjects in the two groups. RESULTS: The eligible subjects of the intervention group were 64 mothers (48.9%) and in the control group were 66 mothers (66%). There were no significant difference in terms of Time I demographic characteristics and outcome measures between two groups. However, there were significant differences in outcomes (mother's anxiety and awareness) between the two groups by ANCOVA, the intervention group showed decline of anxiety (P = 0.04) and improved enjoyment of child rearing (P = 0.02). Almost all mothers of the intervention group expressed the opinion that home visits by nurses were useful for themselves. CONCLUSION: We suggest that nurse home visitation around one month after delivery is useful to provide formal support for mother childcare.