The purpose of this study is to identify the challenges to citizens and to identify the role of public health nurses (PHN) to ensure participation of the citizens in the establishment of a community health and welfare plan. From the process of establishing a care insurance project plan practices in a town for two years and a month, the activities of PHN and their intention were identified and analyzed from the viewpoint of promoting the participation of the citizens. The results were as follows ;
1) On the challenges to the citizens of participating, it is important that the administrators and the citizens talk on equal terms with each other to clarify issues they must tackle with.
2) PHN had to work not only with the citizens but also with the administrators to have a shared view about the participation of the people. At the same time, they also had to work with the town mayor to secure the system for organized activities.
3) The methods to promote citizens' participation were identified, including how to hold conferences, how to select topics of discussion, how to present information to the level of their understanding and to their interests and how to give them feedback.
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