Objectives　This study elucidated the relationship between work and family conflicts of employees working in small and medium-sized businesses in Japan and its association with their lifestyle and working conditions.

Methods　A self-report questionnaire survey was conducted with 294 employees of four small and medium-sized businesses that agreed to participate in the study. The survey included items on demographics, working conditions, lifestyle, the Japanese version of the multidimensional Work-Family Conflict Scale (WFCS), and subjective health and stress. Based on the scores of both the subscales of the WFCS, Work Interference with Family (WIF), and Family Interference with Work (FIW), participants were divided into two groups (high and low score groups). Using these scores as dependent variables, a logistic regression analysis was performed to examine factors related to the WIF and FIW.

Results　Of the 227 collected responses, 185 responses with no missing values were determined as valid for the analysis. Participants were 146 men (78.9%) and 39 women (21.1%) with an average age of 43.6±11.2 years. The proportion of spouses and children was about 60%. The median values of WIF and FIW were 3.0 and 2.3, respectively. There were statistically significant differences in “average working hours per day,” “ease of taking vacations,” “skipping or not skipping meals,” and others, between the two groups of WIF, and in “ease of taking vacations” and “subjective health” between the two groups of FIW. A significant difference was found in “subjective stress.” Logistic regression analysis showed that the WIF was related to “skipping or not skipping meals,” “subjective stress,” “average working hours per day,” “age,” “subjective health,” and “ease of taking vacations.” FIW was related to “subjective health” only and different factors were extracted.

Conclusions　The results of this study suggest that an acceptable lifestyle and better workplace environment is essential to reduce the WIF. Thus, employees should work fewer hours and feel comfortable to take vacations. Additionally, it is necessary to deal with stress skillfully and improve mental and subjective health to reduce FIW.

Objective　The increasing aging population has increased the number of older people who need lifestyle support because of their declining mental and physical health. In recent years, it has become necessary to increase the number of residents who can provide lifestyle support. It is highly expected that older people, as local residents, will be keen to offer lifestyle support. This study identified the characteristics of older people willing to offer lifestyle support to other members of the community living in rural areas with heavy snowfall.

Methods　We surveyed 801 people, aged 65 years and above, who lived in Yoshijima, Kawanishi town, Yamagata Prefecture, and were not certified in nursing care levels 1-5. A questionnaire was distributed and collected by the president of the neighborhood association and the head of the neighboring group. Data were collected from June to July 2018. The survey included items on basic attributes, health status, social relations with neighbors, and willingness to offer lifestyle support (eight types). A logistic regression analysis was conducted for each support type, with basic attributes, health status, and social relations with neighbors as independent variables and willingness to offer lifestyle support as the dependent variable.

Results　We analyzed the data of 586 participants (73.2% valid responses) and found that women were interested in “being a talking partner/consultant in cases of trouble,” “helping with meal preparation/cleaning and laundry,” and “inviting their neighbors to gatherings and events.” However, they were uninterested in “performing outside work such as gardening or fieldwork” and “snow shoveling and removal.” People who felt they were affluent were eager to perform “pick-ups and hospital visits,” and the higher educated were more interested in “being a talking partner/consultant in cases of trouble” and “helping with meal preparation/cleaning and laundry.” Those involved in highly instrumental activities were interested in “monitoring/safety confirmation,” “inviting their neighbors to gatherings and events,” “accompanying their neighbors for shopping or serving as a substitute,” and “pick-up and hospital visits.” Further, except “helping with meal preparation/cleaning and laundry” and “performing outside work such as gardening or fieldwork,” people with close relationships with their neighbors were significantly more willing to offer support.

Conclusion　The characteristics of older people willing to support others depended on the type of lifestyle support required. This finding could help in the recruitment and facilitation of older people willing to offer lifestyle support.

Objectives　This study aimed to identify how communicative and critical health literacy (CCHL) was associated with hypertension, diabetes, and dyslipidemia in a regional Japanese community.

Methods　A cross-sectional survey was conducted through stratified random sampling to achieve the study objectives. The sample comprised adults aged 20-75 years, residing in Ebetsu in Hokkaido, Japan. Stratification was accomplished by classifying the population into 3 districts of Ebetsu city, with 1,000 people being randomly selected from each district. A self-reporting questionnaire was then administered over July and August 2018 to these 3,000 participants. Ebetsu city officials distributed and collected the questionnaires, delivering anonymized data to the researchers. Of the 1,630 respondents, 8 did not complete the CCHL questionnaire and 43 did not fill the disease status questionnaire, so these were excluded. The final analysis was performed on the responses received from 692 men and 887 women. The CCHL scores were grouped into quartiles to identify trends related to the diseases and lifestyles. A multiple logistic regression analysis was performed to estimate the associations between CCHL and instances of hypertension, diabetes, and dyslipidemia in both sexes. The analysis was adjusted for age, living arrangement, marital status, educational attainment, current employment status, body mass index, frequency of regular exercise, habit of skipping breakfast, and smoking status.

Results　The overall CCHL score was computed as 3.58±0.67 (mean±SD). Among men, the prevalence of hypertension in the highest CCHL score group was significantly lower than that in the lowest CCHL group (OR 0.49; 95%CI: 0.28-0.84). The analysis indicated that the prevalence of hypertension among men was low for the highest CCHL score group (AOR 0.62; 95%CI: 0.32-1.22). Associations between CCHL scores and other diseases were found to be non-significant in both men and women.

Conclusion　Male participants with the highest CCHL scores had a significantly lower prevalence of hypertension than those with the lowest CCHL scores. However, these associations were found to be non-significant after adjusting for confounding factors. Future studies on the association of CCHL with lifestyle disorders should apply a longitudinal design.

Objectives　The Japan Health Insurance Association (JHIA) conducts training in each branch facility to improve the ability of public health nurses (PHNs). The headquarters of the PHNs of JHIA and the researchers conducted a training program for leaders of PHNs at each JHIA branch. The goal of the program was to create a training plan using role-play to acquire facilitation skills. This study aimed to examine the effects of training.

Methods　The study was designed in accordance with the Instructional Designs. The training goals were as follows: (1) understanding the role of facilitation and the facilitator in the debriefing session after the role-play, (2) understanding facilitation techniques, (3) being confident in performing as facilitators in the debriefing session; and (4) conducting the debriefing sessions using facilitation skills. The evaluation of the training was based on the Kirkpatrick model from the viewpoint of confidence in using facilitation, knowledge of facilitation, and conduct of training and utilization of facilitation technology. Questionnaire evaluations were conducted three times before the training, immediately after the training, and three months after the training. In August 2016, 4.5 hours of training were conducted in one day.

Results　There were 79 participants in the training group. The mean points of knowledge and confidence were 2.6-3.6 before training, 6.3-7.9 after training, and 6.0-6.9 at 3 months after training. The participants rated their interest in three questions of the training as high as 8.1-8.6. In addition, 64.6% of participants held a role-play session at each branch within three months of the initial training. In the role-play session planned by the participants, the practitioners implemented the explanation of the purpose and the rules at each branch 96.1% and 98.0%, respectively. Participants who had attended facilitation training prior to our program scored higher points of knowledge and confidence before and after three months. Three months after the training, 79 participants responded to the question of the role of the facilitator in role-playing. The descriptions were categorized into “opinions on the basics and planning of role-play training” and “opinions on the roles in retrospectives.”

Conclusion　The participants evaluated the training contents and the materials used as appropriate, and their knowledge and confidence in facilitation improved after the training. To maintain and improve facilitation skills, the educational system needs to implement training using role-playing at each branch consistently.

Objectives　This study aimed to examine employment status differences in the marriage and fertility rates of Japanese women via an age-period-cohort (APC) analysis.

Methods　We used data collected from 1995 to 2015 in Japan based on the government's “Report of Vital Statistics: Occupational and Industrial Aspects,” which recorded the marriage rates of unmarried adults and fertility rates of married adults-according to their employment status. A Bayesian APC analysis was performed to identify changes in marriage and fertility rates based on three effects: age, period, and cohort. Finally, we calculated the marriage and fertility rate ratios between non-employed and employed women for each age group, period, and cohort.

Results　The APC analyses showed that the period effect on marriage rates for non-employed women decreased during the periods analyzed, while that for employed women increased from 2005. Meanwhile, the period effect on fertility rates increased regardless of employment status, albeit to a larger degree for employed women. The cohort effect on marriage rates began to decrease from cohorts born in the 1960s for non-employed women, and from cohorts born in the 1970s for employed women. And the degree of the decrease was larger among non-employed women than those employed. Meanwhile, the marriage rate ratio increased from 0.46 (95% CI: 0.21, 0.90) in the cohort born between 1946 and 1950 to 1.00 (95% CI: 0.45, 1.92) in the cohort born between 1991 and 1995. Finally, the fertility rate ratio increased from 0.31 (95% CI: 0.12, 0.69) in the cohort born between 1946 and 1950 to 0.38 (95% CI: 0.14, 1.81) in the cohort born between 1991 and 1995.

Conclusion　Employment status differences in the marriage rates of unmarried adults and fertility rates of married adults decreased among younger Japanese cohorts and in recent years. By contrast, there were statistically significant differences in fertility rates of married adults based on employment status, even in cohorts born more recently.