Individual, family and community factors linked to loneliness in mothers raising children under 3: a cross-sectional study | BMC Women’s Health
The 10-item version of the University of California Los Angeles Loneliness Scale version 3 (UCLA-LS3-J SF-10 ) was used to assess loneliness. Each of the 10 articles of the UCLA-LS3-J SF-10 [20, 28] has 4 choices: (1) never, (2) rarely, (3) sometimes and (4) always. The total score ranges from 10 to 40, with higher scores indicating a higher level of loneliness. The reliability and validity of this scale have been established by the authors  after the second author (ET) obtained permission to translate UCLA-LS3-J from its original author (Dr. Russell). The Cronbach’s alpha of the translated Japanese version of the scale was 0.888 .
Social isolation (size of the social network)
The Japanese version of the Lubben social network ladder (LSNS-6 [29, 30]) was used to rate social networks. This scale was chosen because it allows comparisons between the size and quality of social networks. The LSNS-6 consists of 6 elements each with 6 response options of 0 (nobody) at 5 (more than 9 people) who evaluated the mother’s social network in her family (3 items) and among her friends (3 items). The total score ranges from 0 to 30, with higher scores indicating a larger social network. A score below 12 marks the threshold for social isolation. Based on the LSNS-6 threshold value of 12 points, the LSNS-6 was converted to a binary variable where 1 = isolated and 0 = non-isolated. The reliability and validity of the Japanese version has been established [29, 30]. Cronbach’s alpha for LSNS-6 was 0.82 in the Japanese translated version . This scale is not licensed, but permission has been obtained for its use.
Several independent variables have been explored as factors potentially linked to loneliness from a model of ecological systems. . These variables were selected on the basis of literature reviews of previous studies [4,5,6,7,8,9, 15,16,17,18,19,20,21] and 3 targeted group interviews with 41 professionals or community volunteers, and 31 individual interviews with mothers raising children under 3 years old.
Demographic data, such as age, family structure (nuclear family; parents and children, extended family and single parent family), employment status (housewife, full-time office worker, part-time worker, contract / temp and self-employed ), the number of years of residence (less than a year, more than a year and less than 5 years, more than 5 years and less than 10 years, more than 10 years), the age of the children eligible for medical screening, number of children, and employment status of spouse / partner was collected.
Individual and family factors understands parental concerns and caregiver health behaviors. The number of parental concerns was created from 12 items classified dichotomously (1 =Yes and 0 =no), reflecting stressors on parenting and life (e.g. children’s toilet problems, how to play with and pamper their child, financial worries, and work-childcare balance) . Mothers’ health behaviors were measured using the Good Health Habits Scale developed by Breslow  which were dichotomously noted elements (1 =Yes and 0 =no) regarding the respondent’s health behaviors (eg, sleep, smoking, diet, exercise, alcohol consumption).
Supportive behaviors of partners for household and childcare were assessed using the supportive behaviors of partners for the household and childcare scale . This scale includes 29 items that were rated on a 4 point scale of 1 ( not at all) to 4 (do often) who assessed the supportive behaviors of mothers’ partners in terms of emotional support (14 items) and household and childcare (15 items). The scale score is calculated by dividing the sum of the raw scores of all items by the number of items, with higher scores indicating more favorable behaviors on the part of the partners. The reliability and validity of this scale have been established . This scale is not licensed, but permission has been obtained for its use.
Community factors made up of people consulted on parenting, interest and desire to interact with neighbors, use of community childcare resources and community recognition (community engagement). The number of people the mother consulted about parenting was created using 12 dichotomous items (1 =Yes and 0 =no) reflecting the social support of parents (eg, consultation with parents, friends, family doctor, child welfare commissioner). One dichotomous element was used to measure interest in neighbors and one to assess desire to interact with neighbors. Community childcare resource use was created from 5 dichotomous elements (1 =Yes and 0 =no) that measured resources (eg, community center for children’s education, full community support center, volunteer-sponsored park games, parent-child group).
The community engagement scale  was used to assess community recognition. This scale includes 8 items noted on a 4-point Likert-type scale of 0 (not agree at all) to 3 (Totally agree), each evaluating the recognition of the community as an opportunity for socialization (4 items) and belonging (4 items). The total score ranges from 0 to 24, with higher scores indicating higher community engagement. The reliability and validity of this scale have been established . Cronbach’s alpha for CCS was 0.78 on the original scale . This scale is not licensed, but permission has been obtained for its use.
Based on the LSNS-6 cutoff value of 12 points, participants were classified into two groups, which were then compared. After calculating descriptive statistics for each item for all participants and comparing the two groups using chi-square and independent testst-tests, we analyzed the data for differences in loneliness between demographic variables using t-tests and one-way analysis of variance (ANOVA). Following the ANOVA, multiple Tukey comparisons were made.
Next, the correlations between loneliness and items that had ordinal and continuous scores were examined using Pearson’s correlation coefficients. Among the items with significant correlations (p