Factors associated with decreased physical activity levels among community-dwelling residents during the coronavirus disease 2019 pandemic: a long-term observational study.

[Purpose] The purpose of this study was to determine the factors associated with decreased physical activity levels among community residents over a long-term observation period during the coronavirus disease 2019 (COVID-19) pandemic. [Participants and Methods] We conducted a cross-sectional study using a self-administered questionnaire and daily steps as an indicator of physical activity levels. The study population consisted of 704 community-dwelling residents aged 40 years and older who participated in the health program from 2019 to 2020. We compared the daily steps from March-December 2019 to March-December 2020 and performed multivariate analysis to identify the factors associated with decreased daily steps. [Results] Of all participants, 447 (63.5%) returned the questionnaire and 309 (43.9%) were included in the analysis. During the COVID-19 pandemic, 133 (43.0%) respondents had decreased physical activity levels. The multivariate analysis showed that working (odds ratio, 2.08; 95% confidence interval, 1.10-3.94) was significantly associated with decreased daily steps during the COVID-19 pandemic. [Conclusion] There was a significant association between decreased physical activity levels and working during the COVID-19 pandemic. When restrictive measures such as teleworking are implemented, it may be necessary to take measures to prevent a decline in physical activity levels.

Gender-Related Differences in Social Participation Among Japanese Elderly Individuals During the COVID-19 Pandemic: A Cross-Sectional Survey.

INTRODUCTION/OBJECTIVES: The health of elderly individuals is known to benefit from maintaining societal involvement and relationships with other people, such as through social participation. We aimed to determine trends in the percentage of Japanese elderly people who engaged in social participation before and during the coronavirus disease 2019 (COVID-19) pandemic in one municipality in Japan, and compared differences in this status by gender. METHODS: We conducted a cross-sectional questionnaire survey. Questionnaires were sent by mail to 3000 people aged 65 to 85 years who were randomly selected by the administrative staff of the city. Participant characteristics (age, gender, working status, residential status) and their economic status, daily physical activity, and social participation status were obtained at 3 time points: (1) before the COVID-19 pandemic in January 2020; (2) immediately prior to the declaration of a state of emergency in April 2020; and (3) in January 2021, 1 year after (1). RESULTS: A total of 1301 people responded to the survey. The mean age was 73.3 (SD 5.5) years, and 690 (53.0%) were women. There were significant gender differences in terms of living alone, employment status, and amount of physical activity. The number of people reporting social participation gradually decreased from 543 respondents (41.7%) at (1) to 319 (24.5%) at (2) and 251 (19.3%) at (3). Women were more likely to demonstrate reduced social participation. CONCLUSIONS: Elderly individuals, particularly women, reported decreased social participation during the pandemic.

COVID-19 Vaccination Willingness and Associated Factors in Japanese Primary Care Patients: A Cross-Sectional Study.

INTRODUCTION/OBJECTIVES: COVID-19 vaccination is important to stop the pandemic. It has been reported that willingness to be vaccinated is associated with system factors as well as individual attitudes and beliefs. Primary care patients include individuals at increased risk of poor outcomes after COVID-19 infection, such as elderly people and those with comorbidities. This study investigated attitudes in this population toward COVID-19 and COVID-19 vaccination, including willingness to be vaccinated and associated factors. This study was conducted in Japan, where the population has low vaccine confidence, during the initial phase of COVID-19 vaccination. METHODS: Patients from 1 primary care clinic in Kitaibaraki City, Ibaraki, Japan, participated in this study from March to April 2021. They were administered a self-reported questionnaire exploring factors such as willingness to undergo COVID-19 vaccination, perceived susceptibility, and perceived vaccine efficacy. Multivariable logistic regression analysis was conducted to identify factors associated with vaccination. RESULTS: Of the 717 patients (response rate, 88.3%), 512 (70.0%) reported they were willing to be vaccinated for COVID-19. Multivariate analysis revealed that vaccination willingness was associated with older age (odds ratio [OR] 1.03, 95% confidence interval [CI] 1.01-1.05), male gender (OR 1.95, 95% CI 1.15-3.30), influenza vaccination in in the 2020/2021 season (OR 2.54, 95% CI 1.49-4.32), recommendation from others (OR 3.11, 95% CI 1.58-6.18), high perceived susceptibility (OR 2.51, 95% CI 1.45-4.33), belief in vaccine efficacy (OR 3.83, 95% CI 1.54-9.56), high perceived susceptibility to vaccine-related adverse events (OR 0.37, 95% CI 0.22-0.64), and high espousal of social norms (OR 8.00, 95% CI 2.78-23.0). CONCLUSIONS: COVID-19 vaccination was widely acceptable to Japanese primary care patients. In addition to factors such as vaccine efficacy, and past influenza vaccination, social norms may be important in determining COVID-19 vaccination willingness.

Frailty and social participation in older citizens in Japan during the COVID-19 pandemic.

Background: This study examined the frailty status of older individuals in Japan at 1 year after the onset of the coronavirus disease 2019 (COVID-19) pandemic based on involvement in social activities before and during the pandemic. Methods: This cross-sectional study analyzed citizens aged 65 and 84 who did not require long-term care in January 2021. A self-administered questionnaire was mailed to 3000 citizens in Kitaibaraki City, Japan. The questionnaire included social participation status in January 2020 and January 2021, the Kihon Checklist, working status, and economic status. We classified the respondents into the following groups: Nonparticipating, no participation at either time point; Discontinued, participation only in 2020; and Continued, participation at both time points. We compared the Discontinued and Continued groups in terms of Kihon Checklist items using the t-test. Results: Of 2963 individuals who received the questionnaire, 1307 (44.1%) returned it, and 1047 were analyzed. Of the respondents analyzed, 586 (56.0%) were in the Nonparticipating group, 254 (24.3%) were in the Discontinued group, and 207 (19.8%) were in the Continued group. On the Kihon Checklist, oral function and mood differed significantly between the Discontinued and Continued groups. The proportion of those with impairment in multiple categories of the Kihon Checklist was 12.3% in the Nonparticipating group, 5.5% in the Discontinued group, and 3.4% in the Continued group. Conclusions: Older individuals who continued participating in social activities at 1 year into the COVID-19 pandemic might have a lower risk of frailty in terms of oral function and depressed mood.

What Affected Primary Care Patients' Decisions to Receive the Seasonal Influenza Vaccine in the 2020 to 2021 Season?

INTRODUCTION/OBJECTIVES: A primary care patient's decision to undergo seasonal influenza vaccination may have been different during the global COVID-19 pandemic in the 2020 to 2021 season. The purpose of this study is to investigate what affected primary care patients' decisions to undergo seasonal influenza vaccination in the 2020 to 2021 season. METHODS: Semi-structured interviews were conducted in a primary care clinic in Ibaraki, Japan. We used a purposive sampling strategy to reach individuals aged 20 years or older who underwent influenza vaccination. The transcripts were analyzed using thematic analysis. RESULTS: Twenty-one patients completed the interview. Two main themes emerged: the desire to avoid risks to one's health and being a part a community in coexistence with others. The first theme included desire to avoid influenza and expectations that vaccination will prevent severe disease. The second theme included concerns about the consequences of one's own influenza infection on others in the community and necessity of vaccination based on the surroundings and others. CONCLUSIONS: Raising awareness of risk factors such as older age and comorbidities, and the expectations of community members might be effective in promoting influenza vaccination.