1.Development of a short version of wealth index and its application in research on maternal health knowledge and behavior
Satoko Yanagisawa ; Ayako Soyano ; Hisato Igarashi ; Vuthy Hang ; Sophal Oum ; Midori Ura
Journal of International Health 2012;27(2):141-149
Objectives: In developing countries, measuring household income is difficult. The Wealth Index is an alternative to household income; however, it contains too many items making its use in a healt-related study difficult. Thus, we developed a shorter version of the index appropriate for rural areas in Cambodia and analyzed the relationship between economic status and maternal health knowledge and behavior using the index.
Methods: We conducted the study in four health center areas in Kampong Cham Province. We administered structured questionnaires to 640 women who had delivered babies within a year prior to the study. The development of the Cambodian Wealth Index-Rural version (CWI-R) followed the procedures of the Demographic and Health Survey (DHS) Wealth Index. Out of 69 items in the Cambodian DHS, we selected 18 items by assessing the distribution and correlation between the items and then performed principal component analysis. Those items that had principal component scores (PCS) below 0.4 were removed. As a result, we created an 11-item wealth index weighted by PCS; Cronbach’s α was 0.81. We tabulated economic status using quintiles and calculated health behavior and the women’s healt-related knowledge for each quintile.
Results: The mean age (SD) of the women was 27.0 (6.4) years. The rate of antenatal and postnatal care and skilled birth attendant increased as economic status improved. Knowledge of risk factors during pregnancy and delivery varied according to item. For prolonged labor and edema, knowledge increased as economic status improved; however, we observed no significant differences for vaginal bleeding. More women who had a higher economic status knew the benefits of Vitamin A and the causes of intestinal parasitic infections.
Conclusion: The pattern of maternal knowledge and behavior analyzed with the CWI-R was parallel to the original wealth index, indicating its usefulness as an alternative to the original wealth index.
2.Relationship between healthy elderly individual social capital and health according to ward level in Tomi City, Nagano Prefecture: an ecological study
Sangjun PARK ; Haruhiko IMAMURA ; Ayako SOYANO ; Shinpei OKADA ; Fuki HORIUCHI ; Tsuyoshi HAMANO
Journal of Rural Medicine 2019;14(1):64-72
Objectives: The aims of this study were 1) to elucidate the relationship between social capital and health by ward in Tomi City, Nagano Prefecture, in order to clarify the regional social resources available to support long-term care prevention utilizing self- and mutual support of regional residents and 2) to comprehensively investigate the activation of regional networks.Materials and Methods: We analyzed elderly (aged 65 years or older) individual survey data from 7,199 residents from all wards within Tomi City in 2014 (number of valid responses: 5,546; valid response rate: 77.0%). The social capital indicators used for the analysis included participation in community activities, regional managerial position experience, and general trust. The health indicators included self-rated mental health, activities of daily living, and depression. Standards for a “good” result for each indicator were established, and the percentages of each were tallied up by ward. Spearman’s rank correlation coefficient and principal component analysis were used to investigate correlations between social capital and health.Results: The results for overall respondents indicated correlations between participation in sports and hobbies and activities of daily living (p<0.01) and self-rated mental health (p<0.05). Participation in nonprofit organizations/volunteer activities and participation in community center workshops exhibited correlations with activities of daily living (both p<0.05). In respondents aged 65–74 years, participation in community center workshops and general trust were found to be correlated with activities of daily living (both p<0.05). Meanwhile, in respondents aged 75 years or older, correlations were noted between participation in sports and hobbies and participation in nonprofit organizations/volunteer activities and activities of daily living (p<0.05 and p<0.01, respectively). By creating a distribution map using principal component analysis, we were able to grasp the characteristics of the distribution of “community participation/connections with people” and “health” in each ward.Conclusions: Our results point the way forward for future long-term care prevention support in Tomi City by clarifying the correlation between social capital and health by ward.