We investigated the effects of enabling Osekkai, the traditional Japanese behavior of creating a helping culture, on social participation among rural people in rebuilding social connections that can be vital during the coronavirus diseases 2019 (COVID-19) pandemic. The subjects of this cross-sectional study were people interested in the Osekkai conference (control group) and those actively involved in Osekkai activities (exposure group). The primary outcome of social participation was measured as the frequency of meeting and the number of friends or acquaintances. The demographic data of the participants and process outcomes were measured using a questionnaire provided to all 287 registered participants. The effective response rate was 64.5% (185 responses). The involvement in Osekkai conferences was statistically associated with a high frequency and number of meetings with friends or acquaintances (p < 0.001 and 0.048, respectively). A health check was significantly associated with the number of friends or acquaintances met in the previous month, while high social support was significantly associated with loneliness. Thus, we confirm that Osekkai contributes to high social participation, although we see no relationship with loneliness. Future studies should investigate this cause-and-effect relationship and promote culturally sensitive activities to improve social and health outcomes in rural Japan.

Social prescribing is an essential solution to the lack of social connection and interaction and provides a key approach to problems faced by communities during the COVID-19 pandemic. One social prescription used in Japan is the Osekkai conference, which has the potential to increase social participation in rural communities. The revitalization of Osekkai can improve social interactions among people involved in the conference, thereby reducing loneliness. This interventional study was conducted with people who participated in the Osekkai conference. The primary outcomes of the degree of loneliness were compared between 2021 and 2022 using the Japanese version of the three-item UCLA Loneliness Scale. The demographic data and process outcomes of participants were measured using a questionnaire. The participants’ roles in the Osekkai conference increased between the two periods. Loneliness scores tended to decrease during the study period (4.25 to 4.05, p = 0.099). In the questionnaire on loneliness, the scores for item 2 decreased significantly during the study period (1.36 to 1.25, p = 0.038). In conclusion, this study shows that the continual provision of Osekkai conferences as a social prescription may reduce the degree of loneliness among participants with improved social participation in rural communities. Future studies should investigate comparative interventions to show the effectiveness of social prescription on loneliness in communities.

Social prescribing can promote the creation of new relationships, which may then promote the building of social capital in communities. One example of a social prescribing tool in Japan is Osekkai conferences, which increase social participation and mitigate the degree of loneliness in rural communities. A clarification of the changes in social interaction and intensity of connections among people through Osekkai conferences could contribute to better social prescribing in rural communities. This social network study was conducted among people who have participated in an Osekkai conference. The primary outcomes of degrees and centrality were measured as the degree of social capital. The primary outcomes were compared between April and September 2021 and between October 2021 and March 2022. The continuous performance of Osekkai conferences as social prescribing tools led to an increase in conference participation, mainly by middle-aged women in the communities. Based on a social network analysis, the average direct connection with each person did not increase; the network density decreased gradually; the network diameter decreased from 6 to 5. Regarding the node-level statistics, harmonic closeness centrality and eccentricity decreased, and modularity increased. Social prescribing initiatives should focus on improving social capital in communities, which may improve the number and meaningfulness of the collaborations among organizations and indigenous communities.