Competency model for public health nurses working on tobacco control in local governments in Japan: A qualitative study

Aim In Japan, public health nurses play a major role in tobacco control at the local government level. However, the competencies required are not clear. This study aimed to identify competencies of public health nurses working on local tobacco control in Japan. Methods Twelve expert public health nurses from nine local governments in Japan participated in semi-structured interviews using the Behavioral Event Interview. Data analysis used the Iceberg Model and qualitative descriptive methods. Results The competencies of the public health nurses were driven by three "motives": strong motivation to pioneer and change tobacco control; unwavering determination to remove barriers to tobacco control; and strong drive to achieve tobacco control. Public health nurses also showed three "attitudes": a partnership-oriented stance to delivering tobacco control; enthusiasm for evidence-based goals; and commitment to developing expertise and roles. These underpinned eight "skills": advocating to raise awareness of the need for tobacco control; positioning tobacco control as a policy issue based on regional and social situations; creating an organizational system for tobacco control; pioneering opportunities for intervention and delivering effective and locally appropriate activities; evaluating and improving the quality of tobacco control measures; developing and establishing community-based measures for tobacco-free communities; expanding activities by strategically collaborating with stakeholders; and coordinating and negotiating to avoid conflicts. Conclusions Public health nurses who promote tobacco control share characteristics, despite barriers such as resistance inside and outside the organization. In the future, these could be used as indicators of the competency of public health nurses working on local tobacco control.