Objective To clarify the actual state of activities conducted by public health nurses (PHNs) during normal times and assess factors related to the implementation of such activities for the promotion of residents' mutual support during disasters, across different municipalities in Japan.Methods We conducted a nationwide cross-sectional self-report questionnaire survey of PHNs in 1,463 municipalities. The questionnaires included descriptions of municipalities, activities related to disaster prevention and the rationale for them, and the details of activities that were being conducted to promote residents' mutual support in times of disaster. We conducted multiple logistic analyses to examine the associated factors.Results We analyzed 535 responses (valid response rate of 36.6%). The proportion of municipalities in which oriented district activity systems and oriented business activity systems were used jointly by PHNs was 81.7%. The proportion of municipalities in which PHNs participated in the formulation of regional disaster prevention plans was 31.6%. "Individual support" would be implemented for persons requiring support in evacuation activities in 41.7% of municipalities; "cooperative support for community organizations," in 34.8%; and other "activities for the purpose of residents' mutual support," in 29.9%. Reasons for not implementing such measures included "outside the division of duties" and "having no contact with residents' organizations." Logistic regression analyses showed that the oriented district activity system, participation of PHNs in the formulation of regional disaster prevention plans, and preparation of an activity manual on disaster countermeasures for PHNs were significantly associated with the performance of activities during normal times for promotion of residents' mutual support during disasters.Conclusion Our findings clarified that the PHNs' activities during normal times for the promotion of residents' mutual support during disasters were not carried out sufficiently. It is important to review activities according to the district, to ensure supervisory PHNs play a greater role, to provide external support to municipalities for the participation of PHNs in the formulation of regional disaster prevention plans, and to prepare an activity manual on disaster countermeasures for PHNs.
Keywords: disaster prevention; municipality; mutual assistance; normal times; public health nurse; rerated factors.