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. 2025 Oct 22;24(1):1312.
doi: 10.1186/s12912-025-03820-4.

Construction of a practice model of evidence-based health service development for public health nursing in Japan: a Delphi survey

Reiko Okamoto  1 , Hisako Izumi  2 , Michiyo Hirano  3 , Saori Iwamoto  4 , Keiko Koide  5
Affiliations

Construction of a practice model of evidence-based health service development for public health nursing in Japan: a Delphi survey

Reiko Okamoto et al. BMC Nurs. .

Abstract

Background: An effective and efficient response to health needs requires the development of an evidence-based health service. Public health nurses are considered to be key practitioners of health service development in Japanese health administration, increasing the importance of the role of health service development. The purpose of this study is to build a practice model for evidence-based health service development adapted to the context of public health nursing in Japan ("Practice Model").

Methods: The draft Practice Model consisted of 17 items grouped into three stages, was developed through literature research and regular consultations by the study team and feedback at two public gatherings. The framework and item-pool of the initial draft were built on implementation science models meeting one or more of the criteria set by the study team. The survey was conducted using the Delphi method, a consensus formation technique, and consisted of three rounds of self-administered questionnaires. The expert panel was formed by sending a request letter to supervising PHNs and PHN training course professors nationwide, and selecting those who expressed their willingness to cooperate and met the selection criteria.

Results: 99 expert panel joined in Round 1 (52 practitioners and 47 faculty), of whom 81 cooperated in all three surveys. As a result of three rounds of opinion gathering and revision, high percentages of agreement of 80% or over were obtained in all rounds for all items. In particular, in Round 3, the percentages of agreement of 95% or over were achieved for all items.

Conclusions: The results of the Delphi survey showed that the Practice Model, which underwent revisions after each round, achieved a high level of consensus and was modified. The Practice Model clearly outlined the structure of evidence-based health service development. The novelty of this model lies in its structure, which includes three stages-the preparation stage (Type 1 evidence focus), the implementation stage (Type 2 evidence focus), and the dissemination stage (Type 3 evidence focus)-and incorporates important processes such as the Plan‑Do‑Check‑Act cycle and implementation science, while also positioning continuing professional development as the foundation for practice. In the future, the utilization of this Practice Model will serve as on-the-job training to enhance the health service development capabilities of public health nurses, which in turn is expected to improve the quality of evidence-based public health in the field.

Clinical trial number: Not applicable.

Keywords: Delphi survey; Evidence-based public health; Health service development; Practice model; Public health nurse.

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Conflict of interest statement

Declarations. Ethics approval and consent to participate: The study was conducted with the approval of the Ethics Committee for Observational Study, Osaka University Hospital (Approval No. 23484(T3–2) dated 18 April 2024). All the procedures were followed in accordance with the Declaration of Helsinki. As informed consent, we confirmed all expert panel/participants gave consent to participation in the survey by ticking the appropriate box in the questionnaire form and returning it. All authors have read and approved the submission of the manuscript. Consent for publication: In the document on ethical considerations, we clearly stated that we would anonymize the data and protect personal information in the analysis and publication of the data, and obtained consent from the research participants. All authors have agreed for the publication of the manuscript. Competing interests: There are no companies with which all authors have a COI relationship that should be disclosed in relation to the contents of this paper. All authors have declared no conflicts of interest associated with this research.

Figures

Fig. 1
Fig. 1
Evidence based practice model for health service development in public health nursing
See this image and copyright information in PMC

References

    1. World Health Organization. Adelaide Statement on Health in All Policies. 2010. https://iris.who.int/bitstream/handle/10665/44365/9789241599726_eng.pdf?.... Accessed 01 Mar 2025.
    1. Japanese Law Translation. Act on Public Health Nurses, Midwives, and Nurses. Act No. 203 of 1948. Ministry of Justice, Japan. July 30. https://www.japaneselawtranslation.go.jp/ja/laws/view/3993. Accessed 01 Mar 2025.
    1. Ministry of Internal Affairs and Communications. Standard occupational classification of Japan. 2009. https://www.soumu.go.jp/toukei_toukatsu/index/seido/shokgyou/. In Japanese, Accessed 01 Mar 2025.
    1. Ministry of Health. Labour and Welfare. Survey on Public health Nurses’ Activity. In Japanese, Accessed 01 Mar 2025. https://www.mhlw.go.jp/toukei/saikin/hw/hoken/katsudou/09/index.html.
    1. Ministry of Health. Labour and Welfare. Public health Nurses’ health activities in the community. 2013. In Japanese, Accessed 01 Mar 2025. https://www.mhlw.go.jp/web/t_doc?dataId=00tb9310%26dataType=1%26pageNo=1.

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