Objective: The purpose of this study was to evaluate the impact of capacity-building short-term mission service trips to Sierra Leone on local health education and perspectives.Methods: This was a prospective, mixed-methods study. During three mission trips between June 2017 and December 2019, health professional students taught multiple locally selected patient care-related topics. Local staff completed knowledge questionnaires and were surveyed or interviewed on mission service impact along with the cultural competence of missionaries. Mission team members completed the Intercultural Effectiveness Scale (IES) and surveys to determine their cultural competence.Results: After initial education, 90% passed the knowledge questionnaire with at least a 50% and the correct response rate was 57.9 vs. 66.7% after 6 months and 2.5 years, respectively (p = 0.40). Local staff ranked education/training as most valuable (84%) and highly desired (53%). Mean IES score and survey responses of both missionaries and local staff rated mission team cultural competence as average.Conclusions: Education-focused mission trips in Sierra Leone seem to have long-lasting benefits and a positive impact on local staff, though improved intercultural competence is needed.

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Background Motorized transport access and out-of-home activities are two potential correlates of Life-space mobility (LSM), a common research topic in mobility studies of older adults. These correlates remain mostly unexplored in previous literature and relating them with LSM can reveal directions for improving the LSM of older adults. Methods The associations between motorized transport access, out-of-home activities, and LSM were examined using data from 1,333 older adults (mean age = 70.63) living in 15 cities and towns in Japan. LSM was assessed using composite life-space assessment (LSA) scores. Motorized transport access was measured using dummies showing whether a person had car access (divided into five levels) and used public transport (bus and railway), and out-of-home activities were measured using the number of various activities that were conducted during the most recent weekday and weekend day. Generalized linear models were used to assess the associations. Results The sample was dominated by males (74.42%), with more than half of the sample had their own cars. On average, each respondent had four activities during two survey days, and shopping was the most common activity. The results showed that owning a car and using railway, as well as various activities were associated with increased composite LSA scores, whereas no cars or only shared cars in home were associated with decreased composite LSA scores. However, these associations differed between males and females. Conclusions In this study, different levels of motorized transport access and different types of out-of-home activities were found to associate differently with composite LSA scores. Based on these findings, we suggest that policymakers should provide more transport access, pay more attention to the LSM of older adults with high clinics/hospital activities, and trigger more shopping and daily leisure activities for older adults to improve the LSM of this population.

Understanding factors regarding individual variability in human mobility during the COVID-19 pandemic would help inform future political and medical decisions. Particularly, understanding environmental factors would provide effective evidence for future urban development and the construction of a mobility service. Given the limited related evidence thus far, we investigated inter-individual variability in human mobility regarding life space during COVID-19 in Japan. We conducted an online survey to assess human mobility, demographics, and personality, and city structure surveys for objective environmental factors. Human mobility was assessed using the Life Space Assessment (LSA) questionnaire. Result revealed that the total LSA score was significantly higher in people who were men, middle-aged, working, living with their children, public transportation users, bicycle users, and car drivers, and those having a higher score for extraversion and ego resiliency and a lower score for conscientiousness. People living in the city with high traffic on the roads between plains and mountains had a higher LSA score, and had a lower score where there were many plains with a consistent road density, revealing diverse individual and environmental factors associated with human mobility during the pandemic. Thus, political decisions for urban development should consider these characteristics, the pandemic, and individual convenience.

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