[Cross-sectional study of factors related to declining participation in community gathering places providing communal meals: A social marketing framework].

Objectives　While Community gathering places known as "kayoi-no-ba" providing communal meals play a crucial role in promoting the health of older adults, the researches supporting their operations and maintenance is limited. Social marketing has been successful in implementing strategic public health programs. This study aimed to identify factors associated with declining participation in kayoi-no-ba providing communal meals using a social marketing framework based on the 4Ps marketing mix (product, promotion, place, and price).Methods　In November 2019, this cross-sectional study surveyed kayoi-no-ba providing communal meals nationwide via a mail. A total of 580 kayoi-no-ba organizers with complete data participated. Changes in the number of participants were assessed using a questionnaire in order to determine the decrease since their establishment. Survey items were organized based on the 4Ps marketing mix framework and treated as independent variables. Multivariate Poisson regression analysis was conducted with participant decrease as the dependent variable, and prevalence ratios (PR) were calculated. The opening period and the number of participants at the time of the survey were included as covariates.Results　A total of 154 kayoi-no-ba experienced the decline in participants (26.6%). Multivariate analysis revealed the following. For product variables, a high frequency of monthly events was significantly associated with a lower PR for participant decrease (0.92). Among promotion variables, kayoi-no-ba with a registration system had a significantly higher PR for participant decrease (1.49). For place variables, a higher population density in the region was significantly associated with a lower PR (0.90), whereas a higher ratio of the population aged 65 years and older was significantly associated with a higher PR (1.05). The price variables did not show a significant association with the decrease in participants.Conclusions　Except price, the other three marketing 4Ps were significantly associated with decreases in participants at kayoi-no-ba providing communal meals. Future efforts should focus on developing and evaluating kayoi-no-ba strategies to ensure sustained participant engagement and promote the health of older adults through communal meals.