Public officials’ attitudes towards public participation in policymaking by people with dementia

Abstract

Introduction: Public participation by people with dementia in relevant policymaking has been advocated to improve the quality of health systems and democratic processes. Public officials’ attitude is a key determinant of public participation. This study aimed to explore Japanese local-government officials’ attitudes towards public participation by people with dementia in policymaking and associated factors. Methods: This cross-sectional study, utilising an online survey conducted in December 2022, included public officials (n = 997) in charge of dementia policy in Japanese municipalities, with one respondent from each municipality. Participants’ certifications were administrative, public-health nurse, or other professionals. Univariate and mediation analyses were performed with attitudes towards public participation by people with dementia as a dependent variable, attitudes towards people with dementia as a mediating variable, and demographic characteristics, contact opportunities with people with dementia, and sources of dementia-related information as exploratory variables. Results: The mean attitude towards people with dementia and towards public participation was 45.1 (SD: 5.1) and 12.6 (SD: 1.8), respectively. Positive attitudes towards people with dementia were a significant determinant of supportive attitudes towards public participation. Participation in collaborative activities with people with dementia and a larger municipality population had positive and significant direct effects on attitudes towards public participation by people with dementia. Additionally, the public officials’ sex and exposure to information about dementia directly from people with dementia showed a significant positive indirect effect mediated by attitude towards people with dementia. Discussion: Attitudes towards people with dementia are the most significant factor influencing their public participation; therefore, reducing stigma among public officials is essential to foster public participation by people with dementia. Active involvement of public officials in collaborative activities with people with dementia at the micro level and valuing the perspectives of people with dementia as essential contributions can enhance public participation by in local policymaking.

Keywords

attitude dementia Japan policymaking public participation

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References

Alzheimer’s Disease International . (2016). Dementia friendly communities: Key principles. Alzheimer’s Disease International. https://www.alzint.org/u/dfc-principles.pdf

Alzheimer Society of British Columbia . (2016). Dementia-friendly communities local government toolkit. Alzheimer’s Disease International. https://www.kitshouse.org/wp-content/uploads/2020/05/Alzheimers-Toolkit.pdf

Awata

(2014). Current activities of medical centers for dementia in Japan. Geriatrics and Gerontology International, 14(Suppl 2), 23–27. DOI: 10.1111/ggi.12253.

Awata

(2017). The concept of Dementia Friendly Community and global developments [Dementia Friendly Community no rinen to sekai no ugoki]. Japanese Journal of Geriatric Psychiatry, 28(5), 458–465.

Brooke

Rybacka

(2020). Development of a dementia education workshop for prison staff, prisoners, and health and social care professionals to enable them to support prisoners with dementia. Journal of Correctional Health Care, 26(2), 159–167. DOI: 10.1177/1078345820916444.

Community Care Policy Network . (2022). Dementia supporter caravan. Community Care Policy Network. https://www.caravanmate.com

Conklin

Morris

Nolte

(2015). What is the evidence base for public involvement in health-care policy? Results of a systematic scoping review. Health Expectations, 18(2), 153–165. DOI: 10.1111/hex.12038.

Corrigan

P. W.

Morris

S. B.

Michaels

P. J.

Rafacz

J. D.

Rüsch

(2012). Challenging the public stigma of mental illness: A meta-analysis of outcome studies. Psychiatric Services, 63(10), 963–973. DOI: 10.1176/appi.ps.201100529.

Dupuis

S. L.

Gillies

Carson

Whyte

Genoe

Loiselle

Sadler

(2012). Moving beyond patient and client approaches: Mobilizing ‘authentic partnerships’ in dementia care, support and services. Dementia, 11(4), 427–452. DOI: 10.1177/1471301211421063.

10.

Gagliardi

A. R.

Lemieux-Charles

Brown

A. D.

Sullivan

Goel

(2008). Barriers to patient involvement in health service planning and evaluation: An exploratory study. Patient Education and Counseling, 70(2), 234–241. DOI: 10.1016/j.pec.2007.09.009.

11.

Gender Equality Bureau . (2024). The white paper on gender equality 2024. Gender Equality Bureau. https://www.gender.go.jp/about_danjo/whitepaper/index.html

12.

Hare

(2020). “Loud and clear!” exploring two decades of involvement, voice and activism by people with dementia in Scotland. Life Changes Trust. https://www.ed.ac.uk/files/atoms/files/loud_and_clear_final_web.pdf

13.

Hayes

A. F.

(2017). Introduction to mediation, moderation, and conditional process analysis. a regression-based approach (2nd ed.). Guilford Publications.

14.

Health, Labour and Welfare Statistics Association . (2021). Journal of health and welfare statistics [Kokumin eisei no doukou] 2018/2019. Health, Labour and Welfare Statistics Association.

15.

Herrmann

L. K.

Welter

Leverenz

Lerner

A. J.

Udelson

Kanetsky

Sajatovic

(2018). A systematic review of dementia-related stigma research: Can we move the stigma dial? American Journal of Geriatric Psychiatry, 26(3), 316–331. DOI: 10.1016/j.jagp.2017.09.006.

16.

Hitomachi-lab . (2023). Survey and research project on measures to reflect the voices of people with dementia in municipal policies [Ninchi sho hon-nin no koe wo sichoson sisaku ni han-ei suru housaku ni kansuru chousa kenkyu jigyou]. Hito to Machidukuri Kenkyujo. https://hitomachi-lab.com/

17.

Japan Dementia Working Group . (2017). Japan dementia working group. https://www.jdwg.org/english/

18.

Keogh

Carney

O’Shea

(2021). Innovative methods for involving people with dementia and carers in the policymaking process. Health Expectations: An International Journal of Public Participation in Health Care and Health Policy, 24(3), 800–809. DOI: 10.1111/hex.13213.

19.

Kim

Kuroda

(2011). Factors related to attitudes toward people with dementia: Development attitude toward dementia scale and dementia knowledge scale. Bulletin of Social Medicine, 28(1), 43–56.

20.

Kurita

(2024). Significance of the Basic Act on Dementia and expectations for the future [Ninchi-shou kihon hou no igi to kongo eno kitai]. Igakkai Shimbun. https://www.igaku-shoin.co.jp/paper/archive/y2024/3547_04

21.

Liao

Schachter

H. L.

(2018). Exploring the antecedents of municipal managers’ attitudes towards citizen participation. Public Management Review, 20(9), 1287–1308. DOI: 10.1080/14719037.2017.1363903.

22.

Mathie

Antony

Killett

Darlington

Buckner

Lafortune

Mayrhofer

Dickinson

Woodward

Goodman

(2022). Dementia-friendly communities: The involvement of people living with dementia. Dementia, 21(4), 1250–1269. DOI: 10.1177/14713012211073200.

23.

Matsumoto

Hagiwara

Yamamoto-Mitani

Igarashi

(2023). A randomized control trial for ReDeSign: A dementia-friendly mobile microlearning training for store workers in Japan. The Gerontologist, 63(8), 1300–1310. DOI: 10.1093/geront/gnac182.

24.

Matsumoto

Igarashi

Sakka

Takaoka

Kugai

Ito

Yamamoto-Mitani

(2022). A two-step model for encouraging the general public to exhibit helping behaviors toward people living with dementia. Innovation in Aging, 6(3), igac023. DOI: 10.1093/geroni/igac023.

25.

Matsumoto

Igarashi

Suzuki

Yamamoto-Mitani

(2020). Dementia education is the first step for cooperation: An observational study of the cooperation between convenience stores and community general support centers. Geriatrics and Gerontology International, 20(10), 956–960. DOI: 10.1111/ggi.14000.

26.

Migchelbrink

Van de Walle

(2022a). A systematic review of the literature on determinants of public managers’ attitudes toward public participation. Local Government Studies, 48(1), 1–22. DOI: 10.1080/03003930.2021.1885379.

27.

Migchelbrink

Van de Walle

(2022b). Increasing the cost of participation: Red tape and public officials’ attitudes toward public participation. International Review of Administrative Sciences, 88(3), 644–662. DOI: 10.1177/0020852320942311.

28.

Ministerial Committee for the National Framework for the Promotion of Dementia Policies . (2019). National framework for promotion of dementia policies. Ministerial committee for the national framework for the promotion of dementia policies. https://www.mhlw.go.jp/stf/seisakunitsuite/bunya/0000076236_00002.html

29.

Nguyen

(2020). Understanding public-stigma and self-stigma in the context of dementia: A systematic review of the global literature. Dementia, 19(2), 148–181. DOI: 10.1177/1471301218800122.

30.

OECD . (2023). Government at a glance 2023. OECD Publishing. DOI: 10.1787/3d5c5d31-en.

31.

Quick

K. S.

Bryson

J. M.

(2022). Public participation. In Christopher

Jacob

(Eds.), Handbook on theories of governance (pp. 158–168). Edward Elgar Publishing. DOI: 10.4337/9781800371972.00022.

32.

Seetharaman

Chaudhury

(2020). “I am making a difference”: Understanding advocacy as a citizenship practice among persons living with dementia. Journal of Aging Studies, 52, Article 100831. DOI: 10.1016/j.jaging.2020.100831.

33.

Shanley

Quirke

Shaw

Sammut

(2004). Working with organizations to implement dementia awareness training for public contact staff. American Journal of Alzheimer's Disease and Other Dementias, 19(3), 166–171. DOI: 10.1177/153331750401900312.

34.

The Scottish Government . (2023). New dementia strategy for Scotland: Everyone’s story. https://www.gov.scot/publications/new-dementia-strategy-scotland-everyones-story/pages/1/

35.

Igarashi

Matsumoto

Takaoka

Suzuki

Ito

Yamamoto-Mitani

(2023). The effect of a VR educational programme to experience dementia on the attitudes of administrative staff towards people with dementia: Pre- and post-test study. Proceedings of Japanese Society for Medical Virtual Reality, 2023(1), 14–15. DOI: 10.24764/jsmvr.2023.0_14.

36.

Yang

(2005). Public administrators’ trust in citizens: A missing link in citizen involvement efforts. Public Administration Review, 65(3), 273–285. DOI: 10.1111/j.1540-6210.2005.00453.x.

37.

Yang

Callahan

(2007). Citizen involvement efforts and bureaucratic responsiveness: Participatory values, stakeholder pressures, and administrative practicality. Public Administration Review, 67(2), 249–264. DOI: 10.1111/j.1540-6210.2007.00711.x.

38.

Yang

Pandey

S. K.

(2011). Further dissecting the black box of citizen participation: When does citizen involvement lead to good outcomes? Public Administration Review, 71(6), 880–892. DOI: 10.1111/j.1540-6210.2011.02417.x.

39.

Yoshioka-Maeda

Taguchi

Murashima

Asahara

Anzai

Arimoto

Miyazaki

Sato

Sakai

Oomori

Magilvy

J. K.

(2006). Function and practice of public health nursing in Japan: A trial to develop the Japanese purpose-focused public health nursing model. Journal of Nursing Management, 14(6), 483–489. DOI: 10.1111/j.1365-2934.2006.00688.x.