[Re-exploring attitude toward community scale and its relationship to health status among the general population]

In order for community-based health promotion and prevention activities to be effective and efficient, it is important to assess the community consciousness among local residents. The purpose of this study was to review the reliability and validity of the Attitude toward Community Scale (ACS) and examine its association with health status among the general population.

A cross-sectional survey was conducted in February 2009 using a mail-in self-administered questionnaire. The target population comprised 4,123 randomly-selected local residents aged 20 years and over living in Kashiwa city, Chiba prefecture, Japan. The questionnaire encompassed the ACS (the wording of some items was modified), an also included data to allow assessment of demographics and health status.

Of 4,123 questionnaires, 1,735 could be analyzed (valid response rate: 42.1%). Confirmatory factor analysis supported the two-factor model of the original scale. The reliability of the scale was verified using the Cronbach's alpha coefficient. All item-total correlations were moderately or strongly positive. Logistic regression showed that a better attitude toward the community was associated with higher self-rated health, less anxiety about the future and less loneliness.

Although the original scale was developed in 1978, the ACS still appears applicable for modern research following some wording modifications of the items. In future studies, it will be necessary to clearly establish relationships between health status and community consciousness and to develop methodology for enhancing the latter.