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.

Objectives　This study aimed to evaluate Japanese smokers’ perceptions of health warnings on tobacco packaging by comparing text-only and pictorial warnings.

Methods　Data were sourced from the Japan Society and New Tobacco Internet Survey (JASTIS), an online, self-reported study conducted in February and March 2020. Participants included current smokers aged 15–74 years in Japan (n＝2,372). Perceptions regarding five packaging samples were assessed: the old package (text-only warning covering 30% of the pack’s front and back before April 2020), the current package (text-only warning covering 50% of the pack’s front and back), and three packages with pictorial warnings covering 50% of the front and back. Respondents were asked four questions on a 5-point Likert scale regarding the effectiveness of these warnings in terms of discouraging young people from starting to smoke, encouraging them to quit, communicating the dangers of smoking, and comfort level with the warnings. A t-test was conducted to compare each pair of packages.

Results　There were no significant differences observed between the “text only 30%” and “text only 50%” packages in terms of preventing young individuals from starting to smoke, encouraging quitting, or communicating the dangers of smoking (P＝0.740–0.987). Conversely, packages with pictorial warnings were perceived as more effective than text-only packages (P＜0.01) in all aspects. A significant difference was observed in the respondents’ perceptions of comfort levels with the packages, with the pictorial ones deemed more uncomfortable (P＜0.01).

Conclusion　The findings indicated that pictorial health warnings are significantly associated with increased awareness of smoking risks, motivation to quit smoking, and prevention of smoking initiation among young people. Accordingly, Japan should consider adopting pictorial health warnings in accordance with the Framework Convention on Tobacco Control.

Objectives　In response to the spread of COVID-19, a state of emergency was declared on April 7, 2020. People were asked to stay at home unless necessary, and studies conducted in Japan and other countries have investigated the impact of these restrictions on the lives and health of older adults. While some studies have focused on sleep, a crucial aspect of the health of older adults, little is known about the relationship between sleep and various lifestyle changes experienced by older adults in Japan during the COVID-19 pandemic. Herein, we aimed to investigate the factors associated with changes in sleep duration among older adults before and after the spread of COVID-19.

Methods　A random sample of 1,808 men and women aged 65–84 years who lived in Fukushima City, Fukushima Prefecture, Japan was selected. A self-administered anonymous survey was mailed to the participants. Logistic regression analysis was used to identify the factors associated with decreased sleep duration compared to the COVID-19 pre-pandemic. Factors such as basic attributes, lifestyle changes compared with that during pre-pandemic period, stress levels, and involvement with the community were considered in the analysis.

Results　Of the 1,808 distributed surveys, 1,305 were returned (response rate: 72.2%). After excluding participants with missing data (n＝108), 1,197 responses were included in the final analysis (valid response rate: 66.2%). Among these, 155 participants (12.9%) reported decreased sleep duration. Decreased “social activities/connectedness” (odds ratio [OR]: 2.55, 95% confidence interval [CI]: 1.54–4.22), reduced “average duration of exercise on exercise days” (OR: 2.69, 95% CI: 1.38–5.24), and self-reported “stress in the past month” (OR: 2.41, 95% CI: 1.43–4.06) were significantly associated with decreased sleep duration.

Conclusion　The spread of COVID-19 was associated with decreased sleep duration among older adults. This decrease was linked to reduced social activity and participation, decreased exercise, and increased stress. To mitigate these effects, maintaining social participation and activities, scheduling regular and manageable exercise routines, and implementing effective stress management strategies while adhering to infection control practices are important.

Objective　Ota City, located in southeastern Tokyo, including Haneda Tokyo International Airport, has numerous scattered lodging facilities. Shortly after the first case of SARS-CoV-2 B.1.1.529 (Omicron) variant was reported abroad, the Japanese government strengthened border control measures, including quarantine procedures and public health official involvement, for incoming travelers. This study aims to propose effective and efficient border control measures to prevent future outbreaks of emerging and re-emerging infectious diseases.

Methods　Border control measures implemented between November 2021 and mid-January 2022 were analyzed from three perspectives: chronological changes in government notifications, the situation of in-flight contacts and Omicron cases, and the support system for coronavirus-disease 2019 control department of the Ota City Public Health Center. Additionally, a questionnaire survey was conducted among public health centers with jurisdiction over the top four international airports. This survey aimed to assess the effectiveness of the support system, evaluate cooperation with related organizations, identify common issues faced by public health concerns, and gather suggestions for improvements in future border control measures.

Results　The definition and treatment of in-flight contacts of Omicron-positive individuals were initially outlined on November 30, 2021, and underwent frequent revisions until January 14, 2022. Between December 1, 2021, and January 12, 2022, only one Omicron case was identified among the 470 tests conducted on in-flight contacts. However, out of 136 additional domestic specimens collected (including 57 positives for genetic analysis), 40 were confirmed Omicron positive. The results of the questionnaire survey across the four public health centers largely mirrored the issues and suggestions identified by Ota City officials. A significant portion of these issues arose from managing temporary non-Japanese residents staying near international airports.

Conclusion　Border control measures should be implemented to delay the domestic spread of the virus. In this reason, it is crucial to avoid placing an undue burden on public health officials responsible for handling domestic infections. Since response policies and target definitions may need to adapt to unknown pathogens, they may be changed frequently, baffling the officials; however, a system for collecting real-time data from frontline sites and making evidence-based decisions is essential. Additionally, deploying liaisons from national and prefectural governments to focal points of emergency response would strengthen the support system by promoting unified instructions and information sharing.