Social capital in Japan: What characteristics do public health nurses see in their communities?

Message framing effects on attitude and intention toward social participation in old age

BACKGROUND

Message framing is frequently used to advocate health perceptions and behaviors. The effects of message framing on various health behaviors have been examined; however, its effects on social participation, a key determinant of healthy aging, are unclear. This study investigated the effects of message framing on older adults' attitudes and intentions toward social participation.

METHODS

A questionnaire survey conducted in 2020 targeted community-dwelling people aged ≥ 65 years in two rural areas in Japan. Participants were randomly allocated to four groups according to the types of framed messages to promote social participation activities: "private gain-framed message," "private loss-framed message," "public gain-framed message," or "no message." Outcomes included attitudes and intentions toward social participation (impression, interest, and readiness for social participation activities).

RESULTS

A total of 1,524 participants were analyzed (men: 46.3%; average age: 75.7 ± 7.9 years). Ordinal logistic regression analyses of individuals who engaged in any social participation activity showed no significant intergroup difference in the outcomes after adjusting for potential covariates. Among people who did not engage in any activity, the private loss-framed message was associated with a more favorable impression and higher interest and readiness than no message. The private gain-framed message was related to a higher interest in social participation.

CONCLUSIONS

Private loss-framed messages are possibly most effective in reinforcing attitudes and intentions toward social participation, particularly among individuals without social participation experience. These findings highlight the possibility of using a message-framing approach to promote social participation in older adults.

Developing a Theory of Community Caring for Public Health Nursing

Nursing theories focus on individual and community care and human relationships in unique contexts. One of these contexts is the community in which a theory-based systematic nursing practice process is warranted. This article describes a theory of Community Caring for Public Health Nursing (CCPHN), which is grounded in four nursing metaparadigms by Fawcett: persons, environment, health, and nursing. This theory has three assumptions: (1) community caring fosters care demonstrations in nursing, (2) caring communities comprise members with community attachments united by their common values rather than rigid customs, and (3) community caring is expressed competently in mutual-care practices. From these assumptions, a nursing perspective supporting the community caring process is exhibited as the expression of caring by public health nurses toward supportive and promotive nursing processes that enhance a caring community. Nurses play critical roles in leading the establishment of caring communities. In future research, it is critical to verify whether building a caring community by public health nursing practices based on this theory of CCPHN contributes to the health and well-being of the people in the community.

Social capital and use of assisted reproductive technology in young couples: Ecological study using application information for government subsidies in Japan

BACKGROUND

Assisted reproductive technology (ART) is a globally established treatment; however, large disparities exist in ART use among young couples. We investigated regional-level factors associated with ART use in Japan.

METHODS

We calculated the use rate of ART using the number of women aged <35 years who applied for government subsidies in 2017; we divided that figure by the number of women aged 20-35 years in each prefecture. Prefectural-level average household income; social capital indicators including voting rate, volunteer rate, and move-in rate; and Gini coefficients as indicators of income inequality were linked to ART use, adjusting for prefectural size, the mean age of women at first marriage, number of ART facilities, and additional prefectural subsidies.

RESULTS

The rate of ART use (per 10,000 women) varied significantly from 22.0 to 58.8 across Japan's 47 prefectures. Multivariate analysis demonstrated that the use rate increased by 0.048 (95% confidence interval [CI], 0.007 to 0.088) for each 10,000-yen increase in average household income and 1.5 (95% CI, 0.65 to 2.3) for each 1% increase in volunteer rate. Conversely, the use rate decreased by 18.4 (95% CI, -28.6 to -8.1) for each 1% increase in the move-in rate. There was no significant association between ART use and income inequality.

CONCLUSION

Although we cannot infer causal relationships, the findings suggest that improving financial access and enhancing social capital may increase access to ART. Further research, particularly multilevel analysis using individual data, is required to confirm these findings.