Objectives　The study aim was to explore effective measures to promote job seekers' participation in the Care Worker Initial Training course provided by Hello Work.

Methods　In this study, we adopted the nudge approach as a method to promote behavioral changes based on a knowledge of behavioral economics. Additionally, we tested the effectiveness of nudge-based measures compared to that of conventional measures. The survey was conducted through two rounds of Web distribution. In the first Web distribution, we consistently implemented the following, in order: 1) recruited individuals who agreed to participate in the study, 2) distributed the first Web questionnaire regarding basic attributes and eligibility criteria in terms of the target individuals, and 3) distributed course guidance. Individuals who responded to the first Web questionnaire (n=50,000) were randomly assigned to eight groups. The intervention groups were presented with course guidance based on loss-aversion nudge, empathy nudge, long-term gain nudge, and their combinations. The control group was presented with traditional course guidance used by the Ministry of Health, Labour and Welfare over the Web. Two weeks after the intervention, we identified 2,404 individuals who met the eligibility criteria and assessed their behavioral changes (pre-contemplation, contemplation/preparation, information-gathering, action); we received responses from 1,995 individuals. Binomial logistic regression analyses were performed using nudge-based interventions and behavioral change stages as dependent and independent variables, respectively. Sex, age, education level, marital status, interest in caregiving before the intervention, and behavioral change stages before the intervention were included as moderator variables.

Results　A total of 1,995 individuals were included in the analysis. Among the 1,756 participants in the intervention groups, 321 (18.3%) took on contemplation/preparation behavior, 102 (5.8%) took on information-gathering behavior, and 50 (2.8%) took action by participating in the course. Among the 239 individuals in the control group, 38 (15.9%) took on contemplation/preparation behavior, 31 (13.0%) took on information-gathering behavior, and 2 (0.8%) took action by participating in the course. Binomial logistic regression analyses showed that while traditional measures were effective in promoting information-gathering behavior toward participation, nudge-based measures combining loss-aversion nudge, long-term gain nudge, and empathy nudge were effective in motivating individuals to participate in the course (odds ratio: 5.39, 95%CI: 1.18-24.74, P=0.03).

Conclusion　The introduction of measures combining multiple types of nudges is necessary to promote participation in the Care Worker Initial Training course, rather than traditional measures or a nudge in isolation.

Objective　This study was intended to develop a “High-School Students' Version of the Daily Conversation Scale with Classroom Teachers” to measure the frequency of daily conversations between high-school students and their classroom teachers.

Methods　The study consisted of Surveys I and II. Survey I was intended to validate the structural validity and reliability of the “High-School Students' Daily Conversation Scale with Classroom Teachers (Prototype Version).” It measured the frequency of high-school students' daily conversations with classroom teachers using the prototype scale and employed confirmatory factor analysis and item response theory to assess the factor measurement model and item performance, respectively. Internal consistency was evaluated using McDonald's ω (omega) reliability coefficient. Study II was intended to validate the prototype scale through hypothesis testing. The survey assessed daily conversation frequency, teacher support perception, depression/anxiety, and the teacher-student relationship. Two models were constructed: one predicting the impact of daily conversation frequency on support perception and depression/anxiety and the other predicting the impact on the teacher-student relationship. It was hypothesized that both models would fit well, with daily conversation frequency positively associated with support perception and relationship, and depression/anxiety negatively associated with support perception and relationship.

Result　The sample analyzed in Survey I consisted of 1,394 students in grades 1–3. The results of confirmatory factor analysis, item response theory, and McDonald's omega reliability coefficient met the criteria. The sample for Survey II consisted of 1,688 students in grades 1–3. The results of the analysis supported the hypothesis.

Conclusion　The results of this study suggest that the prototype version of the scale was conceptually unidimensional and that the difficulty level of each item was well-balanced, indicating the successful development of a “High-School Students' Version of the Daily Conversation Scale with Classroom Teachers.” By using this scale and examining the effects of the frequency of daily conversation with homeroom teachers on the psychology and behavior of high-school students, we believe that it will be possible to contribute to an understanding of primary prevention measures that homeroom teachers can take to address mental health problems among their high-school students. We believe that this scale will contribute to future school health activities in the field of public health.

Objectives　The mental health condition of care staff in Japan is becoming problematic. Older assistant workers are currently being employed to assist care staff with their jobs and alleviate their job burden. This employment of older assistant workers is drawing attention; however, their influence on the job facilitating and inhibiting factors of care staff and the association with the care staff's emotional exhaustion remains unclear. In this study, we aim to examine how the employment of older care assistant workers relates to the job-facilitating and job-inhibiting factors of care staff and explore that association with the care staff's emotional exhaustion.

Methods　Data from a mail survey of geriatric health services facilities with older assistant workers were analyzed. Among the answers obtained from the care staff, answers from 5,185 who reported working in facilities that employ older assistant workers (over the age of 60) were analyzed. The Emotional Exhaustion subscale of the Japanese Version of the Burnout Questionnaire was used as the dependent variable. The change in job-facilitating and job-inhibiting factors of care staff due to the employment of older assistant workers (improve, maintain/exacerbate) was explored for nine contents.

Results　Care staff reported a decrease in the total volume of the task (63.6%), less stress during daily tasks (39.8%), and more concentration on the tasks that require expert care knowledge (38.0%). The results of multiple regression analysis showed that the emotional exhaustion score of care staff was low when the total volume of tasks decreased (β=－0.383, 95%CI=－0.719, －0.047), when less stress was perceived during daily tasks (β=－0.432, 95%CI=－0.796, －0.068), when concentration on tasks that required expert care knowledge increased (β=－0.574, 95%CI=－0.937, －0.210), and when human relationships among staff improved (β=－0.871, 95%CI=－1.263, －0.480). Conversely, an increase in tasks requiring work with regional personnel and organizations (β=0.800, 95%CI=0.162, 1.437) was associated with a high emotional exhaustion score.

Conclusion　The employment of older care workers was related to the job-facilitating or job-inhibiting factors of care staff, and the change in these factors was associated with lower emotional exhaustion. The employment of older personnel may lower the risk of burnout among care staff.