This study aimed to understand trends associated with Japanese HPVs through an analysis of satisfaction level and perceived burden, to examine how levels of satisfaction/burden affect them in their daily lives, and to explore factors associated with different levels. We obtained three main findings in accordance with our research purposes.
First, HPVs who enjoyed high satisfaction coupled with a low level of perceived burden made up the largest group (38.4%). However, it was notable that other combinations of satisfaction/burden levels were also prevalent. Because the response rate for this survey was good, we posit that the results realistically reflect actual HPV conditions. Daniels et al. implied the coexistence of positive feelings such as accomplishment, and negative feelings such as suffering in lay health workers because of the dual demands of caring for their families and working on community activities . Similarly, satisfaction and burden related to HPV activities are not mutually exclusive. Understanding the characteristics of each group is important for organizational management. Surprisingly, approximately a quarter of participants (27.5%) were categorized into group D. Although HPVs in this group had low satisfaction and high burden, their years of experience did not statistically differ from those in the other groups. HPV activities are performed in all areas of the community, indicating the importance of organized programs as well as individual initiatives. However, major difficulties that HPVs experienced in their daily work included recruitment of new members and a decrease in number of members who could flexibly engage in activities because of an increasing number who had jobs . Therefore, there may be times when HPVs cannot easily leave their volunteer work, even though they feel less satisfied and experience burden related to their activities.
Second, HPVs who were satisfied with their activities (groups A and B) had greater activity involvement, and those with high satisfaction and low burden (group A) had greater life satisfaction. In terms of activity involvement, being satisfied with their activities was important, whether or not HPVs felt the activity was a burden. This result is consistent with findings from a study of volunteers using the Volunteer Process Model . However, from the aspect of quality of life, HPVs’ satisfaction with the activity as well as less perceived burden is even more desirable. Several longitudinal studies have reported that greater involvement in volunteer activities often increases the participants’ well-being and life satisfaction [15–17]. Both activity satisfaction and burden were possible confounding factors between activity involvement and life satisfaction. To our knowledge, there are no studies that have examined the association between levels of activity satisfaction and burden with quality of life among volunteer workers. We conclude that having high satisfaction and low burden related to the activity has a beneficial effect on not only activity involvement but also the volunteers’ quality of life, although an examination of causal relationships among these variables should be conducted in future studies.
Third, to understand the characteristics of the groups, we explored associated factors for each, setting group A as a reference group. We found that environmental factors related to HPV activities such as a more facilitative organizational climate, increased social support, and a more cooperative relationship with the neighborhood association were associated with high volunteer satisfaction and low burden (group A), as well as individual factors such as higher initial motivation. This implies that improvement of the activity environment increases HPVs’ satisfaction and decreases their sense of burden associated with the activity. Their relationship with the neighborhood association appears to be particularly important. HPVs in group A enjoyed a more cooperative relationship with the head of the neighborhood association compared with those in other groups. Because HPVs engage in community-based health promotion activities, volunteers are expected to mobilize community members and resources [3, 4, 25]. For HPVs to meet such expectations regarding their role, the relationship with the head of the neighborhood association is arguably highly important. Therefore, HPVs who enjoy a good relationship with that person feel more satisfaction and less burden related to their activities.
HPVs in groups B and D had lower initial motivation for activities than those in group A. Previous studies on HPV activity reported the importance of increasing initial motivation to enhance activity persistence and satisfaction, thereby decreasing perceived burden and strengthening community health outreach initiatives [8–10]. In addition to improving the organizational environment, the development of strategies to train highly motivated new volunteers is essential in energizing current HPVs.
Overall, we discovered one main, overriding answer to our research question. The ideal situation for HPVs is experiencing a high level of satisfaction coupled with a low level of self-perceived burden when participating in an activity. This is illustrated by the results in Table 2. Although this finding might seem obvious, until now there have been no studies undertaken to support this hypothesis. The study also showed that HPVs in the other three groups, in addition to HPVs in group A (high satisfaction/low burden), were present in each organization. Thus, it is important to assess the prevalence of members with differing individual satisfaction/burden levels in each organization and set a high-priority target group for intervention. Moreover, based on the characteristics of each group, development of strategies for each one could be effective.
Several limitations of our research should be noted. First, this was a cross-sectional study. Hence, we cannot explain causal relationships. In this study, we set the variables based on the Volunteer Process Model. However, a longitudinal study design could provide more robust and useful evidence. Second, we used combined data from Koka and Kona because the HPV organizations of those cities work in cooperation with each other. However, we adjusted for the differences between the two cities in the analysis. Third, this study was conducted only on Japanese HPVs, with the target HPV organizations limited to those in two areas. The activities of HPVs in Japan are similar to those performed by CHWs in the United States, but the cultural backgrounds of communities are different between the two countries. Although this study provides clear evidence regarding ways to encourage HPVs, to increase the generalizability of the findings future studies should include different settings (e.g., different countries or municipalities with different cultural backgrounds). Fourth, the study data were collected in 2005. Although there have not been any significant changes in HPV activities related to policy, organizational management, or their role in the community, we must carefully interpret the findings in this study, taking into consideration the data collection period.