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Objective: This study aimed to develop a scale to assess public health nurses' (PHNs') advocacy practices in groups and communities in Japan and determine its reliability and validity. Design and Sample: This study is a cross‐sectional investigation. The sample comprised PHNs across various municipalities in Japan. Measurements: Anonymous self‐administered questionnaires were conducted, including the attributes of PHNs, a preliminary scale, and external criteria. Reliability was assessed by calculating the alpha coefficient. To ascertain construct validity, exploratory and confirmatory factor analyses were conducted. Results: A total of 432 questionnaires were analyzed. The scale comprised 27 items divided into five factors: "Raising awareness of the challenging situation faced by disadvantaged individuals," "Empowering disadvantaged individuals to improve their situation autonomously," "Establishing a foundation in local governments and community groups of disadvantaged individuals for advocacy initiatives," "Working toward policy changes," and "Collaborating with stakeholders and organizations to enhance the effectiveness of activities." The Cronbach's alpha coefficient for this scale was 0.945. Model fit indices included a comparative fit index of 0.907, a goodness‐of‐fit index of 0.840, an adjusted goodness‐of‐fit index of 0.806, and a root mean square approximation of 0.067. Conclusions: The developed scale demonstrated satisfactory reliability and validity. [ABSTRACT FROM AUTHOR]

Aim: To explore public health nurses' competence (namely knowledge, skills, and attitudes) in relation to long‐term breastfeeding and their experience of the need for additional training on the subject. Design: The study design was quantitative, descriptive, and cross‐sectional. Sample: Public health nurses (n = 270). Methods: Data were collected with the Long‐Term Breastfeeding Competence Scale (LBCS) online survey. Data analysis was done with Spearman's correlation analysis and binary logistic regression analysis. Results: Slightly more than half of the respondents had a good level of knowledge and skills. The majority had a baseline positive attitude toward long‐term breastfeeding, but the attitude became more negative as the age of the breastfed child increased. Better competence was associated with younger age, parenthood, an additional degree in midwifery, and breastfeeding specialist certification. Knowledge and skills, and attitudes revealed a high correlation: the higher the knowledge and skills level, the more positive attitudes. Respondents with better knowledge and skills experienced more often the need for additional training on the subject. Conclusions: This study addresses that public health nurses lack competence in relation to long‐term breastfeeding. This may compromise the quality of breastfeeding guidance for families in healthcare settings. [ABSTRACT FROM AUTHOR]

Objective: This study examined the indirect effects of the number of Japanese municipal public health nurses (PHNs) on cancer standardized mortality ratios (SMRs), using cancer screening and diagnostic follow‐up rates as mediators. Design: Ecological study using municipalities as the unit of analysis Measurements: Aggregate, municipal‐level government data were analyzed using a linear model with empirical Bayes estimates of SMRs (EBSMRs) for gastric, colorectal, and lung cancers as the dependent variables, and the number of PHNs, cancer screening rate, diagnostic follow‐up rate, and adjustment variables as independent variables. Structural equation modeling (SEM) was used to examine the indirect effects of PHNs. Results: Cancer screening rates were significantly negatively associated with EBSMR, except for gastric cancer in women. No significant association was observed between the EBSMR and diagnostic follow‐up rates. SEM revealed a significant indirect effect of the number of PHNs, most of which was due to the cancer screening rate. Conclusions: From a population‐based public health perspective, increasing the number of PHNs and focusing on improving cancer screening rates may effectively reduce cancer SMRs. [ABSTRACT FROM AUTHOR]

Mobile health clinics (MHCs) have the potential to enhance primary care in low-resource communities. This article describes an initiative spearheaded by public health nurses that utilized MHCs to provide affordable, equitable, and culturally appropriate primary healthcare services to a rural community in Haiti. [ABSTRACT FROM AUTHOR]

Objective　We conducted an ecological analysis of the structures and processes of municipalities implementing countermeasure-type colorectal cancer screening services, which are associated with high mortality and morbidity rates. We analyzed the populations' demographic characteristics, number of public health nurses (PHNs), and human base for such services. The process was evaluated using the screening uptake rates for countermeasure-type cancer screening and detection indices.Methods　The data included municipal population figures, areas, and national health insurance enrolments, all sourced from a government statistics portal (e-Stat). We obtained the number of PHNs per 100,000 population from PHN activity area surveys, information on municipal colorectal cancer screening from public health centers (PHCs) and health promotion project reports, and cancer detection indices from the National Cancer Registry data. The analysis covered 1,234 municipalities with populations of ≥10,000 and ≥50,000, categorized into three groups based on the presence of PHCs. The internal structures were compared using multiple regression analysis.Results　The number of PHNs per 100,000 population was categorized as follows; <50,000 population group (42.9), ≥50,000 population group (24.3), and PHC-present city group (16.4).Among these groups, the mass and individual screening rates were 96.2% and 47.7%, 69.1% and 91.5%, and 83.7% and 69.9%, respectively. The average uptake rates of countermeasure-type screenings and detailed examinations were 10.6-13.7% and 68.4-75.3%, respectively. In both cases, the <50,000 population and PHC-present city groups exhibited high and low values, respectively. However, the proportion of patients with "early cancer" detection was approximately 42% in all groups.Multiple regression analysis, using the countermeasure-type screening uptake rate and colorectal cancer detection indices as dependent variables, revealed that in the <50,000 population group, in which mass screening was prevalent, the number of PHNs was significantly positively correlated with the countermeasure-type screening uptake rate and proportion of "new cancers" detected by screening.Contrastingly, the PHC-present city group showed no correlation between the number of PHNs and countermeasure-type screening uptake rate, but a highly detailed examination uptake rate was significantly positively correlated with the proportion of "early cancer" detection.Conclusion　In municipalities without PHCs, countermeasure-type screening uptake rates, particularly mass screening rates, were positively correlated with the number of PHNs and cancer detection indices. In cities with PHCs, in which individual screening was prevalent, the detailed examination uptake rate through countermeasure-type screening was correlated with detection indices.

Objectives　This study aimed to clarify the core values and competencies of public health nurses (PHNs) who contribute to improve health issues in transitioning societies, based on a consensus among PHN-related organizations, including practitioners and education researchers.Methods　A draft defining the core values and competencies of PHNs was developed through five consultation sessions with 20 executives and nominees of organizations in each area of PHN practice, education, and research to collect, categorize, and refine the items. The expert panel comprised 534 nominees from six PHN-related organizations, and three rounds of Delphi surveys were conducted. The consensus criteria were ≥70% for agreement and ≥80% for firm agreement.Results　In the first round, 272 expert panel nominees (50.9%) responded, and 217 responded in all rounds. The draft was revised based on the feedback from each round. By round 3, >90% agreed on the core value and competency frameworks and definitions.Conclusion　The Delphi survey revealed the three core value frameworks and definitions of "social justice in health," "human rights and autonomy," and "health and safety" and eight core competencies of "professional autonomy and responsibility," "scientific research and use of information science and technology," "population-based assessment and analysis," "practices for health enhancement and prevention," "building systems to improve public health," "management of healthy community development," "person/community-centered collaboration and cooperation," and "communication for consensus and solutions," with a firm agreement. Eventually, these frameworks would be the bases for creating national standards of practice, education, and research to satisfy the consensus levels of PHNs and PHN-related organizations.