Key factors for implementation research · duration, marriage status, cohabitant, treatment for DM...
Transcript of Key factors for implementation research · duration, marriage status, cohabitant, treatment for DM...
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Key factors for
implementation research
lessons from JAGES
Katsunori Kondo, PhD, MD
JAGES:Japan Agency Gerontological Evaluation Study
Center for Preventive Medical Sciences, Chiba University
National Center for Geriatrics and Gerontology, Japan
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Japan Gerontological Evaluation Study
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http://www.who.int/kobe_centre/mediacentre/jages/en/
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JApan Gerontological
Evaluation Study (JAGES)
• One of the few population-based gerontological surveys in Japan
• Focused on social determinants of health (SDH)
and social environment
• In 2010- 112,000 older people across
31 municipalities responded
(response rate: 66.3%)
・ In 2013- 138,000 older people
responded. (RR: 70.3%)
・ Another dataset includes
105 municipalities’ data
with less items
・ In 2016- about 200,000
responded (RR: 70%)
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Yokobayashi K, Kawachi I, Kondo K, Kondo N, Nagamine Y, Tani Y, et al. (2017) Association between Social Relationship and Glycemic Control among Older Japanese: JAGES Cross-Sectional Study. PLoS ONE 12(1): e0169904. doi:10.1371/journal.pone.0169904 4
Risk (ORs) for poor controlled DM
Several or less/year 1-4 times/month 2 or more/week
Frequency of meeting with friends
Adjusted for age, sex, BMI, depression, income, education, walking duration, marriage status, cohabitant, treatment for DM alcohol, smoking
Odds ratios Diabetes meritus
People meeting with friends often shows better control
P< 0.01
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Publications
• Papers in English: 96
• Papers in Japanese: 290
• Books: 7
• Academic Awards: 36
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NHK総合2016年9月19日(月)19:30~20:43
Lower education and income are risks for mortality and functional decline
education education
Low income High income
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http://www.mhlw.go.jp/file/05-Shingikai-12601000-Seisakutoukatsukan-Sanjikanshitsu_Shakaihoshoutantou/0000021717.pdf
National council for social security 第47回社会保障審議会介護保険部会資料
Group participation is good for health Sports group participations and falling
Hobby club participations and depressionSocial participations and dementia risk
Provided by JAGES
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volunteering (1/month+)65-74 y.o. 75 y.0. +
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http://sdh.umin.jp/heart/Double_map.html
社会参加が少ない地域ではガン死亡率が高い(女性)
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Chapter 2Challenges of science and technology innovation
Ⅱ.Realization of a healthy society with longevity of life, as a forerunner of international society
Promotion of comprehensive care in the community including health, medical, and social care using IT
・Promotion of "visualization" of health and social care information
Comprehensive Strategy for Innovation of Science and Technology
(2013. 6.7 Cabinet decision)
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Various programsMaking
a Short Poem→led by volunteers
Physical Exerciseinstructed by volunteers
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Participants keep functions
0
2
4
6
8
10
12
14
16
Participants Not Participants
% of persons function declined%
Comparison between
Participants and Non-
Participants in
Taketoyo Project
6.3% point reduction
during 5 years
followed up
Taketoyo project, 2014
N = 2178 312
Hikichi, H., Kondo, N., Kondo, K.,et. All: Effect of
community intervention program promoting social
interactions on functional disability prevention for older
adults: propensity score matching and instrumental
variable analyses, JAGES Taketoyo study.
Journal of Epidemiology and Community Health
doi: 10.1136/jech-2014-205345
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The town decided to add the
program into their general plan
2008-2012
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Incubator platform(Linking social capital)
Researcher Government Others
Multi-disciplinary
teamManagement support tools
JAGES HEART (Health Equity Assessment and Response Tool)
Publication/Media Funding
Large scale surveys multi-site & multi-level large scale survey
CBPRCommunity
based participatory
researchWin-Win relationships
Key factors of JAGESJapan Gerontological Evaluation Study
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Lessons from JAGES
• Mind sets of researchers are essentials
– Risk factor epidemiology is not enough
– Evidence creation for society/policy
management
• Platform for co-creation facilitate
knowledge translation/implementation
– Researcher, local/central government
– CBPR, management/translation tools
• Funding to such collaborated team are
needed.