[The effects of social networks on health check-up service use among pre-frail older adults (candidate so-called "specified elderly individuals") compared with older people in general].

OBJECTIVES Nursing care prevention programs cannot accomplish their goals without effective screening of pre-frail older people. Health check-up services provide a very opportunity for this purpose. In the present study we examined not only the direct and indirect effects of social networks on check-up service use among candidate pre-frail older people, but also whether these effects differ from those among older people in general. METHODS Subjects for this study were respondents of a survey for probability sampled aged 65 and over living in a city, Tokyo. Individuals who gave effective responses to items used in our analysis made up 55.8 percent of the sample. 734 candidate pre-frail older people were selected using the screening criteria provided by the ministry of Heath, Labor and Welfare. The general category of older people numbered 2,057, excluding the candidates and elderly certified for long-term care. Social networks were measured from five aspects: family size; contact with children or relatives living separately; contact with neighbors or friends; involvement in community activities; and seeing a doctor. Our model of indirect effects of social networks on check-up use included awareness of nursing care prevention programs as a mediating factor. Information about whether the subjects used the health check-up service was provided.by the regional government. Magnitude of the effects was evaluated from two aspects; using statistical tests and focusing on marginal effects. RESULTS Although none of the social network indicators had direct significant impacts on check-up use, contact with children or relatives living separately, contact with neighbors or friends, or involvement with community activities demonstrated significant indirect influence. Contact with neighbors or friends, involvement with community activities, or seeing a doctor had direct significant effects on use among the general category of older people, but none of the social network indicators demonstrated significant indirect effects. Involvement with community activities had the strongest total (direct plus indirect) effects on the use in the social networks indicators among the candidates when viewed with the focus on marginal effects. However, it was estimated that the rate of use would raise only about 5 percent even if average frequency of contacts with community activities were to increase from less than one time to one time over a month among the candidates. CONCLUSION It is suggested that effects of social networks on health check-up service use among candidates of pre-frail older people could be produced by improving awareness of nursing care prevention programs.