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

HC costs of subjects for both MC and LTC costs in 2009 in city A, Japan.

<p>HC costs of subjects for both MC and LTC costs in 2009 in city A, Japan.</p

Characteristics of subjects in 2008 in city A, Japan.

<p>Characteristics of subjects in 2008 in city A, Japan.</p

Comparison of sample subjects and excluded subjects.

<p>Comparison of sample subjects and excluded subjects.</p

HC costs of subjects for both MC and LTC costs in 2007 in city A, Japan.

<p>HC costs of subjects for both MC and LTC costs in 2007 in city A, Japan.</p

Characteristics of subjects in 2009 in city A, Japan.

<p>Characteristics of subjects in 2009 in city A, Japan.</p

Tobit analysis: Effects of interaction terms on HC costs of subjects in city A, Japan.

<p>Tobit analysis: Effects of interaction terms on HC costs of subjects in city A, Japan.</p

HC costs of subjects for both MC and LTC costs in 2008 in city A, Japan.

<p>HC costs of subjects for both MC and LTC costs in 2008 in city A, Japan.</p

Evaluation of doctoral nursing education in Japan by students, graduates, and faculty: A comparative study based on a cross-sectional questionnaire survey

Evaluation of doctoral education in nursing is needed with the rapid increase in doctoral nursing programs in Japan. This study aimed to compare the evaluations of doctoral nursing education by students, graduates, and faculty. All 46 doctoral nursing programs in Japan were target settings. 127 students who had been in the doctoral program, 24 graduates and 87 faculty members had responded to the survey. A questionnaire with 17 items for program evaluation, 12 items for faculty evaluation, 9 items for resource evaluation, and 3 for overall evaluations was distributed in November and December 2008. Responses to 1 program evaluation item, 2 faculty evaluation items and 4 resource evaluation items indicated significant differences among evaluators. While 79.2% of graduates responded positively that the number of faculty members was sufficient to facilitate learning, only 36.1% of faculty members and 49.6% of students responded affirmatively. Graduates' ratings were the most positive and faculty members were the least positive, especially for infrastructure or equipment such as libraries, computers, and the number of technical and support staff. The significant differences among the evaluators suggested that having evaluators in various roles is important to evaluate the quality of doctoral nursing education