Yoshiki Ishikawa

Social Participation and the Prevention of Functional Disability in Older Japanese: The JAGES Cohort Study

Background We examined the relationship between incident functional disability and social participation from the perspective of number of types of organizations participated in and type of social participation in a prospective cohort study. Method The study was based on the Aichi Gerontological Evaluation Study (AGES) Cohort Study data. We followed 13,310 individuals aged 65 years or older for 4 years. Analysis was carried out on 12,951 subjects, excluding 359 people whose information on age or sex was missing. Social participation was categorized into 8 types. Results Compared to those that did not participate in any organizations, the hazard ratio (HR) was 0.83 (95% CI: 0.73–0.95) for participation in one, 0.72 (0.61–0.85) for participation in two, and 0.57 (0.46–0.70) for participation in three or more different types of organizations. In multivariable adjusted models, participation in the following types of organization was protective for incident disability: local community organizations (HR = 0.85, 95% CI: 0.76–0.96), hobby organizations (HR = 0.75, 95% CI: 0.64–0.87), and sports organizations (HR = 0.64, 95% CI: 0.54–0.81). Conclusion Social participation may decrease the risk of incident functional disability in older people in Japan. This effect may be strengthened by participation in a variety of different types of organizations. Participating in a local community, hobby, or sports group or organization may be especially effective for decreasing the risk of disability.

A community-wide campaign to promote physical activity in middle-aged and elderly people: a cluster randomized controlled trial

BackgroundWe aimed to evaluate the effectiveness of a community-wide campaign (CWC) for promoting physical activity in middle-aged and elderly people.MethodsA cluster randomized controlled trial (RCT) with a community as the unit of randomization was performed using a population-based random-sampled evaluation by self-administered questionnaires in the city of Unnan, Shimane Prefecture, Japan. The evaluation sample included 6000 residents aged 40 to 79 years. We randomly allocated nine communities to the intervention group and three to the control group. The intervention was a CWC from 2009 to 2010 to promote physical activity, and it comprised information, education, and support delivery. The primary outcome was a change in engaging in regular aerobic, flexibility, and/or muscle-strengthening activities evaluated at the individual level.ResultsIn total, 4414 residents aged 40–79 years responded to a self-administered questionnaire (73.6% response rate). Awareness of the CWC was 79% in the intervention group. Awareness and knowledge were significantly different between the intervention and control groups, although there were no significant differences in belief and intention. The 1-year CWC did not significantly promote the recommended level of physical activity (adjusted odds ratio: 0.97; 95% confidence interval: 0.84–1.14).ConclusionsThis cluster RCT showed that the CWC did not promote physical activity in 1 year. Significant differences were observed in awareness and knowledge between intervention and control groups as short-term impacts of the campaign.Trial registrationUMIN-CTR UMIN000002683

Socioeconomic Status and Health Communication Inequalities in Japan: A Nationwide Cross-Sectional Survey

Background Considerable evidence suggests that communication inequality is one potential mechanism linking social determinants, particularly socioeconomic status, and health inequalities. This study aimed to examine how dimensions of health communication outcomes (health information seeking, self-efficacy, exposure, and trust) are patterned by socioeconomic status in Japan. Methods Data of a nationally representative cross-sectional survey of 2,455 people aged 15–75 years in Japan were used for secondary analysis. Measures included socio-demographic characteristics, subjective health, recent health information seeking, self-efficacy in seeking health information, and exposure to and trust in health information from different media. Results A total of 1,311 participants completed the questionnaire, giving a response rate of 53.6%. Multivariate logistic regression revealed that education and household income, but not employment, were significantly associated with health information seeking and self-efficacy. Socioeconomic status was not associated with exposure to and trust in health information from mass media, but was significantly associated with health information from healthcare providers and the Internet. Conclusion Health communication outcomes were patterned by socioeconomic status in Japan thus demonstrating the prevalence of health communication inequalities. Providing customized exposure to and enhancing the quality of health information by considering social determinants may contribute to addressing social disparities in health in Japan.

Grit and Work Engagement: A Cross-Sectional Study

Grit, defined as perseverance of effort and consistency of interest, has attracted attention as a predictor of success in various fields beyond IQ and the Big Five personality dimension of Conscientiousness. The purpose of the current study was to examine previously uninvestigated questions regarding grit using a cross-sectional design among a large number of working adults in Japan. First, we tested geographical generalizability of associations between grit and orientations towards happiness by comparing previous studies in the U.S. and the current study in Japan. It was confirmed that orientation towards meaning rather than orientation towards engagement had a stronger positive correlation with grit in our sample of Japanese people. This result is inconsistent with previous studies in the U.S. Furthermore, the Big Five dimension of Openness to Experience was newly confirmed as having a positive association with grit. Second, we examined the association between grit and work engagement, which is considered as an outcome indicator for work performance. In this analysis, grit was a strong predictor for work performance as well as academic performance.

Cost-effectiveness of a tailored intervention designed to increase breast cancer screening among a non-adherent population: a randomized controlled trial

BackgroundAlthough the percentage of women who initiate breast cancer screening is rising, the rate of continued adherence is poor. The purpose of this study was to examine the effectiveness and cost-effectiveness of a tailored print intervention compared with a non-tailored print intervention for increasing the breast cancer screening rate among a non-adherent population.MethodsIn total, 1859 participants aged 51–59 years (except those aged 55 years) were recruited from a Japanese urban community setting. Participants were randomly assigned to receive either a tailored print reminder (tailored intervention group) or non-tailored print reminder (non-tailored intervention group). The primary outcome was improvement in the breast cancer screening rate. The screening rates and cost-effectiveness were examined for each treatment group (tailored vs. non-tailored) and each intervention subgroup during a follow-up period of five months. All analyses followed the intention-to-treat principle.ResultsThe number of women who underwent a screening mammogram following the reminder was 277 (19.9%) in the tailored reminder group and 27 (5.8%) in the non-tailored reminder group. A logistic regression model revealed that the odds of a woman who received a tailored print reminder undergoing mammography was 4.02 times those of a women who had received a non-tailored print reminder (95% confidence interval, 2.67–6.06). The cost of one mammography screening increase was 2,544 JPY or 30 USD in the tailored intervention group and 4,366 JPY or 52 USD in the non-tailored intervention group.ConclusionsProviding a tailored print reminder was an effective and cost-effective strategy for improving breast cancer screening rates among non-adherent women.

Structural equation modeling for implementation intentions, cancer worry, and stages of mammography adoption

This study aimed to develop a structural model for mammography adoption in Japanese middle‐aged women by using constructs from the transtheoretical model (TTM), the theory of planned behavior (TPB), implementation intentions, and cancer worry.

Worry and Intention Among Japanese Women: Implications for an Audience Segmentation Strategy to Promote Mammography Adoption

We examined the predictive validity of a segmentation strategy based on intention and cancer worry for mammography adoption and explored key factors for promoting mammography adoption in each segment. A questionnaire survey was completed by 641 women aged 40–59 years. Among them, 559 answered a follow-up survey after 15 months. They were categorized into five segments: maintenance group (S5), higher implementation intention group (S4), higher goal intention group (S3), higher worry group (S2), or lower worry group (S1). The odds of participants in each segment adopting mammography during the follow-up period were calculated. Logistic regression analysis was conducted to identify psychological predictors (five attitudes to mammography and perceived health competence) of transition to upper segments (S1 vs. S2, S2 vs. S3, S3 vs. S4, S4 vs. S5). Compared to S5, other segments did not undertake mammography at significant rates during the follow-up. The following were significant predictors for inclusion in upper segments: Lack of importance and perceived health competence were associated with inclusion in S2; lack of importance and barriers to screening were associated with inclusion in S3; perceived health competence was associated with inclusion in S4; and lack of importance was associated with inclusion in S5. These results confirm the predictive validity of a segmentation strategy, and indicate that there might be specific key factors for each segment in promoting mammography adoption.

Are socioeconomic disparities in health behavior mediated by differential media use? Test of the communication inequality theory.

OBJECTIVE Communication inequality has been offered as one potential mechanism through which social determinants influence multiple health behaviors. The purpose of this study was to examine the underlying mechanisms between communication inequality and health behaviors. METHODS Data from a nationally representative cross-sectional survey of 18,426 people aged 18 years and above in the United States were used for secondary analysis. Measures included socio-demographic characteristics, social participation (structural social capital), health media use (TV, print, and the Internet), and five health behaviors (physical activity, cigarette smoking, alcohol use, and intake of fruit and vegetable). Path analysis was performed to examine the linkages between social determinants, health media use, social participation, and social gradients in health behaviors. RESULTS Path analysis revealed that socioeconomic gradients in health behaviors is mediated by: 1) inequalities in health media use; 2) disparities in social participation, which leads to differential media use; and 3) disparities in social participation that are not mediated by media use. CONCLUSIONS Consistent with the theory of communication inequality, socioeconomic disparities in media use partially mediate disparities in multiple health behaviors. PRACTICE IMPLICATIONS To address health inequalities, it is important to utilize health media to target populations with low socioeconomic statuses.

Using a Marginal Structural Model to Design a Theory-Based Mass Media Campaign.

Background The essential first step in the development of mass media health campaigns is to identify specific beliefs of the target audience. The challenge is to prioritize suitable beliefs derived from behavioral theory. The purpose of this study was to identify suitable beliefs to target in a mass media campaign to change behavior using a new method to estimate the possible effect size of a small set of beliefs. Methods Data were drawn from the 2010 Japanese Young Female Smoker Survey (n = 500), conducted by the Japanese Ministry of Health, Labor and Welfare. Survey measures included intention to quit smoking, psychological beliefs (attitude, norms, and perceived control) based on the theory of planned behavior and socioeconomic status (age, education, household income, and marital status). To identify suitable candidate beliefs for a mass media health campaign, we estimated the possible effect size required to change the intention to quit smoking among the population of young Japanese women using the population attributable fraction from a marginal structural model. Results Thirteen percent of study participants intended to quit smoking. The marginal structural model estimated a population attributable fraction of 47 psychological beliefs (21 attitudes, 6 norms, and 19 perceived controls) after controlling for socioeconomic status. The belief, “I could quit smoking if my husband or significant other recommended it” suggested a promising target for a mass media campaign (population attributable fraction = 0.12, 95% CI = 0.02–0.23). Messages targeting this belief could possibly improve intention rates by up to 12% among this population. The analysis also suggested the potential for regulatory action. Conclusions This study proposed a method by which campaign planners can develop theory-based mass communication strategies to change health behaviors at the population level. This method might contribute to improving the quality of future mass health communication strategies and further research is needed.

The Association between Meditation Practice and Job Performance: A Cross-Sectional Study

Many previous studies have shown that meditation practice has a positive impact on cognitive and non-cognitive functioning, which are related to job performance. Thus, the aims of this study were to (1) estimate the prevalence of meditation practice, (2) identify the characteristics of individuals who practice meditation, and (3) examine the association between meditation practice and job performance. Two population-based, cross-sectional surveys were conducted. In study 1, we examined the prevalence of meditation practice and the characteristics of the persons practicing meditation; in Study 2, we examined the association between meditation practice and job performance. The outcome variables included work engagement, subjective job performance, and job satisfaction. The Utrecht Work Engagement Scale was used to assess work engagement, the World Health Organization Health and Work Performance Questionnaire (HPQ) was used to measure subjective job performance, and a scale developed by the Japanese government was used to assess job satisfaction. Hierarchical multiple regression analyses were used in Study 2. Demographic characteristics and behavioral risk factors were included as covariates in the analyses. The results of Study 1 indicated that 3.9% of persons surveyed (n = 30,665) practiced meditation; these individuals were younger and had a higher education, higher household income, higher stress level, and lower body mass index than those who did not practice meditation. The results of Study 2 (n = 1,470) indicated that meditation practice was significantly predictive of work engagement (β = 0.112, p < .001), subjective job performance (β = 0.116, p < .001), and job satisfaction (β = 0.079, p = .002), even after adjusting for covariates (β = 0.083, p < .001; β = 0.104, p < .001; β = 0.060, p = .015, respectively). The results indicate that meditation practice may positively influence job performance, including job satisfaction, subjective job performance, and work engagement.