Objectives　Community-based activities led by older residents are important in preventing long-term care and enhancing social participation among older persons in Japan. Local governments and community nurses are required to support these activities. However, there is no knowledge about the issues of residents who participate in community-based activities, which is essential for the effective support of community-based activities. We aimed to examine the association between the length of participation and recognized issues among community-based activities.

Methods　Through the local governments in Tokyo, we recruited participants from community-based activity groups; 2,367 people from 155 activity groups from 40 municipalities responded. The presence or absence of 10 items of recognized issues, such as lack of management members and lack of teachers, were examined. The number of years of participation in the activity was divided into four groups: “less than 1 year,” “more than 1 year and less than 2 years,” “more than 2 years and less than 4 years,” and “more than 4 years.” Logistic regression analysis was conducted to examine the association between the length of participation and recognized issues.

Results　The number of analyzed respondents was 2,194 (14.5% were male and the average age was 76.9 years). Compared to “less than 1 year” group, the “more than 2 years and less than 4 year” group recognized “aging of group” (OR=1.92), “lack of management members” (OR=1.61), and “health condition of participants” (OR=1.47) as issues. In the “more than 4 years” group, “aging of group” (OR=3.24), “lack of management members” (OR=2.63), “lack of participants” (OR=2.12), “health condition of participants” (OR=1.95), “mannerism of activities” (OR=1.62), and “lack of place” (OR=1.48) were recognized as issues.

Conclusion　Issues recognized by participants in community-based activities differed depending on the number of years they had been participating in the activity. This suggests that it is necessary to provide appropriate support taking the length of participation into account. For example, the issue of the “health condition of participants” was recognized by participants who had been participating in the activity for approximately two years. Consequently, “lack of participants” may have occurred in participants who have been participating in the activity for four years. Therefore, promoting the health management of participants from the early phase of community-based activity would be effective in preventing dropout.

Objectives　The shortage of professional caregivers is a critical issue in care facilities, which are a key social resource in the community-based integrated care system for Japan's super-aging society. However, professional caregivers report a high intention to continue working. This study aims to reveal the factors surrounding working intentions among professional caregivers, from a positive perspective, using a qualitative design.

Methods　A qualitative design, based on a content analysis approach, was used in this study. From August to November 2018, semi-structured joint interviews, using the interview guide, were conducted with 14 experienced professional caregivers working in 11 care facilities for the elderly in Japan. The participants were paired, or grouped, into three groups and were interviewed. The interviews, recorded with participant approval and transcribed in their entirety, were analyzed. The researchers identified and categorized common themes emerging from the participants’ responses to each question as codes. We raised the abstraction level of the codes into subcategories, and subcategories to categories. Approval was obtained from the Institutional Ethics Committee of Setsunan University (No. 2018-018).

Results　The average age of the participants was 35.0±6.45 years. Three categories, consisting of nine sub-categories across 27 codes, emerged as the main themes. The first was ‘attachment to care work for older adults,’ which consisted of three sub-categories, which included “love of and enjoyment in dealing with older adults.” The second was ‘cohesion in the workplace and linkage inside and outside the workplace,’ which consisted of sub-categories, such as “cohesion of rational workplace members.” The final category was ‘supportive workplace management and human resource development from an on-site perspective,’ which consisted of sub-categories, including “psychological rewards and support from superiors.” These findings revealed that attachment to care work for older adults and the work environment influencing attachment are important factors concerning their work intentions.

Conclusion　We found that ‘attachment to care work for older adults,’ ‘cohesion in the workplace and linkage inside and outside the workplace,’ and ‘supportive workplace management and human resource development from an on-site perspective’ were factors that affect the work intentions of professional caregivers. The findings suggest that encouraging professional caregivers to continue working, using measures that foster attachment to work, and which develop their work environment, such as cohesion and linkage based on human relationships, are required.

Objectives　This study examined the effects of checking the “Tabepo Check Sheet,” which has 10 food groups, on changes in dietary variety among older adults living in Japanese metropolitan areas.

Methods　We used baseline and two-year follow-up data from a community-wide intervention to prevent frailty in Ota City, Tokyo. A total of 8,635 non-disabled residents (4,145 men and 4,490 women) aged 65-84 years who responded to the self-administered questionnaire surveys in 2016 and 2018, were included in the two analyses. In 2018, we asked about their experience with the “Tabepo Check Sheet,” which had been distributed among participating communities from three districts in Ota City since July 2017. The “checked group” consists of those who answered “habitually check” or “have checked.” Dietary variety was assessed using the Dietary Variety Score (DVS). We performed propensity score matching with a 1:1 ratio (checked group vs. non-checked group) for the following variables: demographic, socioeconomic, physical, medical, and lifestyle variables, and DVS. After propensity score matching, 876 participants from the checked and non-checked groups were selected. We used a two-way ANOVA to examine the changes in DVS over two years. We also compared the rates of DVS ≤3 and ≥7 points in 2018 using multivariate adjusted logistic regression analysis.

Results　In 2018, 11.9% of the respondents had checked the “Tabepo Check Sheet.” The DVS mean±standard deviation in the checked and non-checked groups were 3.9±2.2 points and 3.9±2.3 points in 2016, respectively, and 4.5±2.4 points and 4.1±2.4 points in 2018, respectively. The DVS showed a significant interaction between checking experience and time (p<0.001). The rates of DVS ≤3 points in 2018 were 35.2% and 43.8% among the checked and non-checked groups, respectively. The multivariate adjusted odds ratio (OR) of DVS ≤3 points was 0.68 (95% confidence interval [95% CI] 0.56-0.83) in the checked group versus the non-checked group. The rates of DVS ≥7 points in 2018 were 21.7% and 16.8% among the checked and non-checked groups, respectively. The multivariate adjusted OR (95% CI) of DVS ≥7 points was 1.40 (1.10-1.78) in the checked versus the non-checked group.

Conclusions　These results suggest that checking the “Tabepo Check Sheet” may improve dietary variety. However, the effects of dietary variety improvement may be weakened by the incidence of skipped meals, social isolation, frailty, and lack of social participation.

Objectives　This study aimed to clarify the relationship between economic disparity and eating habits of young children to explore the support that should be provided to families with young children.

Methods　We conducted an anonymous self-administered questionnaire survey of parents who brought their children to the 3-year-old health checkup in four wards in City A. Questionnaire items examined the children's eating habits and the childrearing environment, such as the parents' socioeconomic status. Of 1,150 parents asked to participate in the survey, 616 responded (response rate: 53.6%). Invalid questionnaires (e.g., with missing answers) were eliminated. The remaining 498 parents (effective response rate: 80.8%) were classified into two groups to examine the association of household financial status with their 3-year-old eating habits: the relative poverty group and the non-relative poverty group. The groups were divided according to the poverty line of the Comprehensive Survey of Living Conditions. Statistical analysis was performed using Fisher's exact test and the Mann-Whitney U test. Eating habits that were identified to be associated with relative poverty were further tested using logistic regression analysis.

Results　Analysis of the children's eating habits in the two groups revealed that, compared with the non-relative poverty group, there was a higher proportion of 3-year-olds who ate vegetables less than 6 days a week (P=0.003) and who consumed snacks 6 days or more per week (P=0.034) in the relative poverty group. The associations of relative poverty with vegetable intake less than 6 days a week and snack consumption 6 days or more a week remained significant after adjusting for parents' age, highest educational attainment, and subjective views on the everyday economic situation. Regarding the childrearing environment, the relative poverty group had a higher proportion of parents who were younger than 30 years of age (P<0.001) and in single-parent households (P=0.007). The relative poverty group had a higher proportion of parents whose highest education level was high school (P<0.001). Furthermore, the subjective view of the everyday economic situation was more negative in the relative poverty group (P<0.001).

Conclusion　Economic disparity was related to the eating habits of 3-year-old children. The study results indicate that identifying families with financial difficulties during pregnancy and childbirth is necessary to support them early on so that young children can acquire healthy eating habits.