biostudies-literatureKashiwagi MMinistry of Health, Labour and WelfareJapan Society for the Promotion of Science303https://www.ebi.ac.uk/biostudies/studies/S-EPMC11686830biostudies-literatureUnknown23(1)<h4>Background</h4>Japan is implementing awareness-raising of advance care planning for older adults; however, only 451 out of 1 741 municipalities were engaged in advance care planning awareness-raising activities among residents, according to a 2017 survey. This study examined advance care planning awareness-raising activities among community residents by local governments after the 2018 revision of the government guidelines, as well as utilization of the revised guidelines, issues in awareness-raising activities, and directions for future activities.<h4>Methods</h4>This cross-sectional questionnaire survey was conducted in prefectures and municipalities nationwide in 2022. Questions included the status, content, and issues of advance care planning awareness-raising activities for community residents. A multi-level logistic regression analysis was used to examine the characteristics of municipalities engaged in activities.<h4>Results</h4>Responses were received from 43 prefectures (response rate: 91.5%) and 912 municipalities (response rate: 53.1%). Of the municipalities, 63.6% (n = 580) reported "active" advance care planning awareness-raising. A high financial capability index and implementation of awareness-raising activities in the prefecture where the municipality was located were significantly associated with its awareness-raising activities. Municipalities engaged in awareness-raising activities reported experiencing issues related to the objectives, methods, and outcome evaluation of the activities.<h4>Conclusions</h4>Five-hundred eighty municipalities engaged in awareness-raising activities-a number that had increased significantly since the 2017 survey. Municipalities that could not engage in awareness-raising activities should receive financial support and other forms of support from prefectures. Furthermore, to ensure that municipalities clarify the purpose of awareness-raising and the desired outcomes, indices for quantitatively measuring results and achievements should be developed.BMC palliative careAwareness-raising activities of advance care planning for community residents: a nationwide cross-sectional survey in Japan.PMC1168683022CA2028JP20H04011Tamiya NMorioka NInokuchi RKashiwagi MSugiyama TTerajima MHanari KfalseAwareness-raising activities of advance care planning for community residents: a nationwide cross-sectional survey in Japan.<h4>Background</h4>Japan is implementing awareness-raising of advance care planning for older adults; however, only 451 out of 1 741 municipalities were engaged in advance care planning awareness-raising activities among residents, according to a 2017 survey. This study examined advance care planning awareness-raising activities among community residents by local governments after the 2018 revision of the government guidelines, as well as utilization of the revised guidelines, issues in awareness-raising activities, and directions for future activities.<h4>Methods</h4>This cross-sectional questionnaire survey was conducted in prefectures and municipalities nationwide in 2022. Questions included the status, content, and issues of advance care planning awareness-raising activities for community residents. A multi-level logistic regression analysis was used to examine the characteristics of municipalities engaged in activities.<h4>Results</h4>Responses were received from 43 prefectures (response rate: 91.5%) and 912 municipalities (response rate: 53.1%). Of the municipalities, 63.6% (n = 580) reported "active" advance care planning awareness-raising. A high financial capability index and implementation of awareness-raising activities in the prefecture where the municipality was located were significantly associated with its awareness-raising activities. Municipalities engaged in awareness-raising activities reported experiencing issues related to the objectives, methods, and outcome evaluation of the activities.<h4>Conclusions</h4>Five-hundred eighty municipalities engaged in awareness-raising activities-a number that had increased significantly since the 2017 survey. Municipalities that could not engage in awareness-raising activities should receive financial support and other forms of support from prefectures. Furthermore, to ensure that municipalities clarify the purpose of awareness-raising and the desired outcomes, indices for quantitatively measuring results and achievements should be developed.2024-01-01T00:00:00Z2024 Dec2025-04-04T02:48:22.761Z2025-04-04T02:48:22.761ZS-EPMC116868303973659710.1186/s12904-024-01635-9