Objectives　This report aims to present the community assessment model developed by the Committee on Public Health Nursing (6th term) of the Japanese Association of Public Health. This new model was designed such that it could be applied to a broad range of public health activities. It aims at theorizing public health nurses’ practice-based knowledge and sharing it among other public health professionals.

Methods　The model was developed during seven committee meetings held from October 2014 to September 2017. In the first step, we brainstormed the definition and methods of community assessment and constructed a framework for a literature review. In the second step, information on theories, research, and practice relevant to community assessment was reviewed based on this framework. In the third step, the community assessment model was developed based on the results of the literature review and the practice experience of the committee members. In the last step, we examined the applicability of this model to the practice of occupational health and public health administration.

Project activities　We defined community assessment as the “skills and methods based on applied science that drive Plan-Do-Check-Action (PDCA) cycles in every activity that aims at achieving a better quality of life (QOL).” We further classified community assessment into two types; comprehensive assessment and targeted assessment. The model underlined that community assessment was a continuous and developmental process that occurs throughout every stage of the PDCA cycle, and that it was oriented toward improving the QOL of community residents. This model also purported that the empirical and scientific intuition, and ethical sensitivity of assessors were among the key determinants of assessment quality.

Conclusion　The model on community assessment developed in the present study based on the empirical knowledge of public health nurses could be applied to all types of public health activities in communities.

Objectives　The aim of this research is to classify elderly adults who live alone by their marital status type and to clarify how those types affect their higher-level functional capacity and mental health with a 2-year follow-up survey.

Methods　This research is based on the results from a survey in 2013. The base-line scores were from 757 participants who completed a survey by mail, carried out in B area of A ward, Tokyo, within the jurisdiction of community general support centers, with people who were not at nursing care levels 4 or 5 and who were not residents of welfare facilities. This study analyzed data for 517 of 527 participants, who answered all questions in the 2015 survey and indicated their marital status. This research categorized the respondents into 4 types of marital status: separation, divorce, bereavement, and unmarried groups. This study adopted the Tokyo Metropolitan Institute of Gerontology Index of Competence (TMIG-IC) as the index of higher-level functional capacity, and the WHO-Five Well-Being Index (WHO-5-J) as the mental health index. In the analysis of the causes of 2-year variations in TMIG-IC total scores and WHO-5-J scores, the dependent variable was each variation. This study used an analysis of covariance in which the fixed factors were types of living alone, sex, annual income, and having children who lived separately in the 2013 survey, and the covariance comprised the base-line scores for the dependent variables, age, and chronic diseases in the 2013 survey.

Results　With regards to the variation in TMIG-IC total scores, main effects of the types of living alone were observed. The adjusted variation of covariance decreased most in the separation group (−0.95). For the variation in WHO-5-J scores, main effects of the types of living alone were indicated. In the divorce group, the adjusted variation of covariance was significantly higher than for the unmarried group (2.33 vs. −0.55).

Conclusion　The results revealed that the types of marital status: separated, divorced, bereaved, and unmarried, affect changes in the higher-level functional capacity and mental health status of elderly adults living alone, 2 years later. Thus, although previously regarded as a single category, types of marital status should be considered in the analysis of elderly adults who live alone.

Objectives　To elucidate the actual status of children with food allergies and the measures of allergy-appropriate food provisions at residential nurseries and children's care homes. We also compared institutions that used guidelines, manuals, etc. with those that did not.

Methods　Self-administered questionnaires were administered to residential nurseries and children's care homes in Japan. Responses were received from 394 institutions, yielding a response rate of 53.6%. The prevalence of food allergies was assessed in 392 institutions. To investigate the relationship between using guidelines and the status of the children, the analysis included 230 institutions where there were children with food allergies. The relationships between the presence or absence of guidelines and (i) occurrence or non-occurrence of anaphylactic shock or other allergy-related events and (ii) each step of food service were evaluated.

Results　The prevalence of food allergies at the 392 institutions was found to be 3.31%. It was difficult to obtain information concerning food allergies at admission to the institutions because a high proportion of children were reported as “children with no physician's diagnostic record,” “children admitted without confirmation of allergy information,” or “children with discrepancies between the information at admission and actual state.”

　Of the 230 institutions studied, guidelines were followed at 25.0% of the institutions. Even when institutions with other written rules were included, this proportion only increased to 32.1%. The statistical analysis involved adjustments for different types of institutions. A multivariate logistic regression analysis showed that the odds ratio for institutions where treatment was based on guidelines were significant for the following items: children with no physician's diagnostic record (0.35), existence of a consistent documentation method for collection of information (5.04), regular revisions of information being made (2.85), and reports being submitted when mistakes in food provided to children with allergies were made or narrowly avoided (2.49). In addition, strong correlations were found for the following: children who experienced anaphylactic shock during the previous 3 years (9.72) and children admitted without confirmation of a food allergy (3.12).

Conclusions　When rule-based approaches were established, the preparation of information collection forms, revision of information, and reporting of food provision mistakes proceeded more efficiently than when rule-based approaches were not used. Although the prevalence of children experiencing anaphylactic shock and the cases in which information was not confirmed at admission were higher in the institutions using guidelines, this survey revealed that when guidelines were followed, appropriate measures were taken after the admission of children to the institution and that physicians’ medical diagnoses were obtained.

Objectives　The purpose of this study was to examine the psychometric properties of the diet-related quality of life (DRQOL) scale among older adults. Specifically, the study was conducted to confirm the scale's factor structure and construct a short version of the scale. Further, the scale's internal consistency and gender- and age-based differences as well as the validity of the DRQOL scale and its short version were examined.

Methods　We surveyed a random sample of community-dwelling older Japanese adults (aged 60-84 years; N=1,200; response rate: 70.8%) and used the data of 780 participants (367 men and 413 women). We used the DRQOL scale, comprising 18 items that were measured using a five-point Likert-type scale. Additionally, we assessed subjective well-being, diet satisfaction, appetite, meal restriction, mastication, number of meals with others, frequency of using ready-made and instant food, information gathering regarding food, and dietary variety scores as external criterion variables; socioeconomic status and health habits were used to describe basic participant characteristics.

Results　Confirmatory factor analysis revealed a replication of the four-factor structure of the measure (“pleasure from a meal,” “eating satisfaction,” “circumstances of meal,” and “diet diversity”). A short version of the measure comprising 8 items was developed. The DRQOL scale, its subscales, and its short version had high Cronbach's alpha coefficients as indicators of reliability (0.94; 0.86, 0.89, 0.77, and 0.72; and 0.90, respectively). There were significant sex differences in the scores of all constructs, and no significant age-based differences. The DRQOL scale scores had weak-to-moderate correlations with the external criterion variables mentioned above.

Conclusion　Overall, this study confirmed the psychometric properties of the DRQOL scale, including factor structure, reliability, gender and age differences, and its validity among older adults using data from the general population in Japan. In addition, a short version of the DRQOL scale was developed. Future studies should examine the factors associated with the DRQOL. The predictive validity of the scale, with health outcomes as external criteria, should be examined to test its usefulness for epidemiological surveys among older adults in community settings.