Original Articles
Structure of the Strategies Used by Public Health Nurses in Japan for Developing Health Programs
A Causal Model of Activities and Their Outcomes
2018 Volume 21 Issue 2 Pages 4-13
Details
2018 Volume 21 Issue 2 Pages 4-13
Purpose: This study aimed to clarify the structure of the strategies used by public health nurses（PHNs）in developing public health programs.
Methods: Municipal PHNs were encouraged to respond by mail to a self-administered questionnaire directing them to select one of several cases and then answer questions regarding their experience in developing appropriate health programs. Based on the results, the structure of strategies took the form of a causal model related to PHNs’ activities and their outcomes, and was verified by a covariance structure analysis.
Results: The questionnaire was returned by 885 participants. The strategies for developing health programs consisted of two parts: an activity part and an outcome part, each of which contained five factors. The causal model consisted of a structure with three phases. The degrees of relevance of the main survey were as follows: GFI = 0.931, AGEI = 0.916, CFI = 0.942, and RMSEA = 0.042. Phase 1 consisted of “supporting subjects for voluntary participation,” “forming consensus for implementation,” “sharing all processes among planning members,” “attractive contents of programs” and “understanding subjects.” Phase 2 consisted of “advancing to more superior measures,” “strengthening collaborative systems,” and “autonomous changes by subjects.” Phase 3 consisted of “results corresponding to aims” and “improvement of expertise.”
Discussion: Our results revealed that PHNs require two particular strategy types to develop public health programs: a strategy to encourage residents’ autonomy and a strategy to enforce residents’ support systems in order to realize more superior measures.
