Association between Municipal Health Promotion Volunteers’ Health Literacy and Their Level of Outreach Activities in Japan

<div><p>Objectives</p><p>To explore the association between health literacy and levels of three types of core activities among health promotion volunteers (developing a healthy lifestyle, outreach to family, and outreach to community members).</p><p>Study Design</p><p>A cross-sectional, anonymous, self-administered postal survey of registered health promotion volunteers in the Konan area in Shiga Prefecture in Japan, conducted in January 2010. The study sample was 575 registered health promotion volunteers.</p><p>Methods</p><p>The survey collected data on health literacy, gender, age, education, self-rated health, perceptions about the volunteer organization, and perceptions of recognition in the community. The level of engagement in health promotion activities was measured by the extent to which the participants engaged in seven healthy behaviors and promoted them to family members and the community. The authors compared the health literacy level and other characteristics of the participants by core health promotion activities, using a chi-squared test, to examine the associations between demographic and other variables and the three core activities (healthy lifestyle, outreach to family, and outreach to community).Logistic regression analysis was conducted to examine the association between the degree to which the volunteers engaged in core activities (“healthy lifestyle,” “outreach to family,” “outreach to community”) and the levels of health literacy (low, medium, high) among health promotion volunteers, controlling for the effects of age, gender, health condition, education which may also have an impact on volunteers’ outreach activities.</p><p>Results</p><p>Four hundred and fifty-four questionnaires were returned, a 79.0% response rate. Excluding 16 cases with missing values on health literacy or the degree of health promotion activities, 438 research subjects were included in the analysis (valid response rate: 76.2%). Health literacy and a few demographic and other characteristics of the volunteers were associated with the three core health promotion activities. In bivariate analyses, active participation in the core activities was more prevalent among older volunteers (p<0.001 for all three activities). Self-rated health condition was associated with both outreach to family (p = 0.018) and community (p = 0.046). Years of experience as volunteer and perception of being recognized in the community also had statistically significant association with outreach to the community (p<0.001). In multiple logistic regression, those with higher level of health literacy were more likely than others to actively engage in outreach to family (OR = 1.70, 95% CI 1.03 to 2.80; OR = 1.76, 95%CI 1.04 to 3.00 for medium and high, respectively) and outreach to community (OR = 2.26, 95%CI 1.34 to 3.83; OR = 2.61 95%CI 1.49 to 4.58 for medium and high, respectively). Perception of being recognized in the community also had a statistically significant and positive impact on outreach to the community (OR = 1.52, 95%CI 1.17 to 1.99).</p><p>Conclusions</p><p>Volunteers with higher health literacy were more likely to actively engage in outreach to family and outreach to community. Providing educational programs to improve volunteers’ health literacy may facilitate their work.</p></div

Results of logistic regression analysis for core health promotion activities.

<p>Results of logistic regression analysis for core health promotion activities.</p

Baseline characteristics of the study participants and their association with change in functional competence (2008–2012).

<p>Baseline characteristics of the study participants and their association with change in functional competence (2008–2012).</p

For how many days and what types of group activities should older Japanese adults be involved in to maintain health? A 4-year longitudinal study

<div><p>Objective</p><p>Studies have suggested that frequent participation in social groups contributes to the well-being of older people. The primary aim of this study was to identify the number of days older adults should participate in the activities of social groups to maintain their health for 4 years. This study also aimed to examine whether the effective frequency differs by the type of social group activity.</p><p>Method</p><p>We examined a prospective cohort of 1,320 community-dwelling older adults over 65 years of age, who responded to both a baseline and a follow-up mail survey, in a suburban city of Tokyo, Japan. The dependent variable was the change in functional competence during 4 years. Logistic regression analyses were conducted to examine the effects of participation in the activities of the 5 most common social groups among older Japanese on maintaining functional competence.</p><p>Results</p><p>Nine hundred and ninety-four participants (76.5%) maintained their functional competence for 4 years. The results of the logistic regression analyses showed that participating in alumni groups less than once a month and being an inactive member were associated with higher odds of maintaining functional competence, after controlling for socioeconomic, demographic and baseline health status. Additionally, the odds of maintaining functional competence for 4 years increased upon participating in volunteer groups once a month or more. These results were also confirmed using logistic regression analysis, even after adjustment for the effects of participation in other social groups.</p><p>Discussion</p><p>The results indicated the effectiveness of volunteer activities that fulfill a social role in maintaining health. Therefore, older adults should be encouraged to participate in activities of volunteer groups at least once a month. Additionally, older adults can obtain positive health outcomes through less frequent participation in alumni groups, compared with the activities of volunteer groups.</p></div

Adjusted odds ratios of the types of social activity for predicting the improvement or maintenance of functional competence for 4 years, by entering the social activities obtained p<0.05.

<p>Adjusted odds ratios of the types of social activity for predicting the improvement or maintenance of functional competence for 4 years, by entering the social activities obtained p<0.05.</p

Baseline characteristics of the study participants and their association with change in functional competence (2008–2012). Continued.

<p>Baseline characteristics of the study participants and their association with change in functional competence (2008–2012). Continued.</p

Baseline characteristics of the study participants and their association with change in functional competence (2008–2012).

<p>Baseline characteristics of the study participants and their association with change in functional competence (2008–2012).</p

Adjusted odds ratios for predicting improvement or maintenance of functional competence during the 4-year follow-up period, by 5 models (2008–2012).

<p>Adjusted odds ratios for predicting improvement or maintenance of functional competence during the 4-year follow-up period, by 5 models (2008–2012).</p

Adjusted odds ratios for predicting improvement or maintenance of functional competence during the 4-year follow-up period by 5 models (2008–2012). Continued.

<p>Adjusted odds ratios for predicting improvement or maintenance of functional competence during the 4-year follow-up period by 5 models (2008–2012). Continued.</p

Reference Values and Age Differences in Body Composition of Community-Dwelling Older Japanese Men and Women: A Pooled Analysis of Four Cohort Studies

<div><p>Objectives</p><p>To determine age- and sex-specific body composition reference values and investigate age differences in these parameters for community-dwelling older Japanese men and women, using direct segmental multi-frequency bioelectrical impedance analysis.</p><p>Methods</p><p>We conducted a pooled analysis of data collected in four cohort studies between 2008 and 2012: Kusatsu Longitudinal Study, Hatoyama Cohort Study, Itabashi Cohort Study, and Kashiwa Cohort Study. The pooled analysis included cross-sectional data from 4478 nondisabled, community-dwelling adults aged 65-94 years (2145 men, 2333 women; mean age: 72.9 years in men and 72.6 years in women). Body weight, fat mass (FM), percentage FM, fat-free mass (FFM), and appendicular lean soft tissue mass were measured using the InBody 720 and 430 (Biospace Co. Ltd, Seoul, Korea). The values were then normalized by height in meters squared to determine body mass index (BMI), FM index (FMI), FFM index (FFMI), and skeletal muscle mass index (SMI).</p><p>Results</p><p>Simple means (standard deviation) of BMI, percentage FM, FMI, FFMI, and SMI were 23.4 (2.9) kg/m², 24.9 (6.3)%, 5.96 (2.09) kg/m², 17.4 (1.5) kg/m², and 7.29 (0.76) kg/m², respectively, in men and 22.7 (3.3) kg/m², 31.7 (7.1)%, 7.40 (2.61) kg/m², 15.3 (1.2) kg/m², and 5.86 (0.67) kg/m², respectively, in women. We then calculated quartiles and quintiles for these indices after stratifying for sex and 5-year age group. FFMI and SMI decreased significantly with age in both sexes (<i>P</i> < 0.001 for trends), but FFMI remained constant among the women with only a 1% decrease up to age 84 years. Percentage FM increased significantly, with age (<i>P</i> < 0.001 in men and <i>P</i> = 0.045 in women for trends), but FMI was unchanged in both sexes (<i>P</i> = 0.147 in men and <i>P</i> = 0.176 in women for trends).</p><p>Conclusion</p><p>The present data should be useful in the clinical evaluation of body composition of older Japanese and for international comparisons. The small age-related decrease in FFMI may be a noteworthy characteristic of body composition change in older Japanese women.</p></div