Development of a community's self-efficacy scale for preventing social isolation among community-dwelling older people (Mimamori Scale).

BACKGROUND: Among older people in developed countries, social isolation leading to solitary death has become a public health issue of vital importance. Such isolation could be prevented by monitoring at-risk individuals at the neighborhood level and by implementing supportive networks at the community level. However, a means of measuring community confidence in these measures has not been established. This study is aimed at developing the Community's Self-Efficacy Scale (CSES; Mimamori scale in Japanese) for community members preventing social isolation among older people. METHODS: The CSES is a self-administered questionnaire developed on the basis of Bandura's self-efficacy theory. The survey was given to a general population (GEN) sample (n = 6,000) and community volunteer (CVOL) sample (n = 1,297). Construct validity was determined using confirmatory factor analysis. Internal consistency was calculated using Cronbach's alpha. The Generative Concern Scale (GCS-R) and Brief Sense of Community Scale (BSCS) were also administered to assess criterion-related validity of the CSES. RESULTS: In total, 3,484 and 859 valid responses were received in the GEN and CVOL groups, respectively. The confirmatory factor analysis identified eight items from two domains-community network and neighborhood watch-with goodness of fit index = 0.984, adjusted goodness of fit index = 0.970, comparative fit index = 0.988, and root mean square error of approximation = 0.047. Cronbach's alpha for the entire CSES was 0.87 and for the subscales was 0.80 and higher. The score of the entire CSES was positively correlated with the GCS-R in both the GEN (r = 0.80, p < 0.001) and CVOL (r = 0.86, p < 0.001) samples. CONCLUSIONS: The CSES demonstrated adequate reliability and validity for assessing a community's self-efficacy to aid in its preventing social isolation among older people. The scale is potentially useful for promoting health policies, practices, and interventions within communities. This may help prevent social isolation among older people and contribute to overall well-being in aging societies in Japan and abroad.

Development of a community commitment scale with cross-sectional survey validation for preventing social isolation in older Japanese people.

BACKGROUND: Elderly social isolation could be prevented by facilitating communication or mutual helping at the neighborhood level. The helping of elderly neighbors by local volunteers may relate to their community commitment (CC), but ways to measure CC have not been identified. The aim of the present study was to develop a Community Commitment Scale (CCS) to measure psychological sense of belonging and socializing in the community among local volunteers, for research in prevention of elderly social isolation. We also tested the CCS in a general population of the elderly. METHODS: A pilot test of 266 Japanese urban residents was conducted to examine face validity for 24 identified items, of which 12 items were selected for the CCS, based on a 4-point Likert-type scale. The CCS was developed via self-report questionnaires to 859 local volunteers in two suburban cities and to 3484 randomly sampled general residents aged 55 years or older living in one of the cities. To assess concurrent validity, data were collected using the Brief Sense of Community Scale (Peterson; 2008) and two types of single questions on self-efficacy for helping elderly neighbors. RESULTS: Item analysis and factor analysis identified 8 items, which were classified between two datasets under the domains of "belonging" and "socializing" in the local volunteers and the general residents. Cronbach's alpha (which conveyed the internal consistency of the CCS) was 0.75 in local volunteers and 0.78 in general residents. The correlation coefficients between the scores of the CCS and BSCS were 0.54 for local volunteers and 0.62 for general residents. ANOVA comparing the CCS between the confidence levels of the two types of single question of self-efficacy on helping elderly neighbors showed a strong relationship in the volunteers and residents. CONCLUSIONS: These results demonstrate acceptable internal consistency and concurrent validity for the CCS, with the two dimensions "belonging" and "socializing", among the local volunteers and general residents in urban Japanese areas. Community commitment measured by the CCS was related to the degree of confidence for self-efficacy in helping elderly neighbors to prevent elderly social isolation.

Six month outcomes of an innovative weekly intergenerational day program with older adults and school-aged children in a Japanese urban community.

AIM: To describe the nature of the progression of intergenerational interactions among and between older people and children in a weekly intergenerational day program (IDP) in an urban community and to evaluate the older people's health-related quality of life (HRQOL) and depressive symptoms, compared to the program volunteers, as well as the children's perspectives of older people, during the first 6 months of the program's implementation. METHODS: This longitudinal study, with a convenience sample of older people (n = 14), program volunteers (n = 8), and school-aged children (n = 7), used mixed methods to analyze the results. Participant observations and interviews were used to describe the interactions between the generations over the 6 months. An ANOVA with repeated measures was used to determine the statistical effects over time (initially and at 3 months and 6 months) for HRQOL (Medical Outcomes Study 8-Item Short-Form Health Survey) and depression (Geriatric Depression Scale, GDS-15). Semantic differential scales identified the children's perspectives of older people. RESULTS: The intergenerational interactions were grouped into thirteen categories; for example, "The IDP provided a meaningful sense of place." The quality of life in relation to the mental health of the older people's group improved significantly between the first involvement and after 6 months, while the GDS-15 scores significantly decreased at the three time points in the more depressed older people's subgroup. The children's initial generally positive perspectives of older people showed no statistically significant change over time. CONCLUSION: The intergenerational interactions in the IDP yielded a meaningful place for both generations, improved the HRQOL of the older people's group, and decreased the depressive symptoms in the more depressed older people's subgroup.

[Study on dilemma and strategy of community support network by community organization for prevention of isolated death in an urban area].

OBJECTIVES: Isolated death of elderly is recognized as a severe social problem in public health and it is an urgent requirement that a supportive community network be organized so that its occurrence is minimized. The purpose of this research was to analyze actual issues of a supportive community network for elderly within the community and to obtain clues for useful actions to prevent isolated death of elderly individuals in the future. METHODS: The subjects were 14 representatives of a supportive community network for elderly in A City, B Ward and C District (as a junior high school segment). The research was conducted with a qualitative inductively approach using the Focus Group Interview (FGI). Interviews were focused on difficulties and perspectives within their daily support activities in the community, and were held three times during October 2009 to March 2010. The FGI records were then analyzed with meaningful minimal words and sentences, categorized codes, and then those codes were classified into subcategories or categories. RESULTS: Three categories, Individual, Neighborhood and Community network for elderly resulted from the analysis. Regarding difficulties, "Refusing supports or indifference", "Isolation or Tojikomori in the youth generation", "Lack of family support", "Relationships among their residents weakening gradually", "Unfamiliar newcomers and residents", "Residence feels burden on association with neighborhood", "Limitation of support activities under personal security", "Lack of resources for persons and places of gathering" were identified. On the other hand, perspectives in the community network for elderly were "Building relationships personally", "Invitation to community meetings as companions", "Development of safety confirmation", "Helping each other in the neighborhood", "Stimulate enforcement of bonding in daily life", "Making arrangements for regional administration and residents for supportive activites", "Fostering the trust and connection of residence". CONCLUSION: To further promotion and effective activities for community network for elderly by community residents, it is necessary that information be exchanged among resident organizations regarding their activities in achievement of social cooperation.