Japanese Journal of Health Education and Promotion Vol. 25(2017) No. 3

Objective: To investigate the correlation between late-night meals/snacks and obesity for adults and children in Japan.

Method: We searched two Japanese databases ("Igaku chuo zasshi" and CiNii) for articles published between 2005 and 2014. For the search, the following keywords were used: late-night meals/snacks and obesity/metabolic syndrome. After screening titles, abstracts, and full texts, 21 articles were included in this review.

Results: Of 21 articles, one was a longitudinal study, 18 were cross-sectional studies, one included both types of studies, and one was an intervention study. As participants, 15 articles included adults and six articles included children. Twelve articles examined late-night meals of adults. Among them, seven articles found that obesity and late-night meals were related; two articles found that this relationship depends on gender; and three articles found no relation. Ten articles examined snacks of adults: four articles found that obesity and snacks were related; three articles found that this relationship depends on gender; and three articles found no relation. On the one hand, only one article reported on children's late-night meals, and no relationship was detected with obesity. Children's snacks was investigated in six articles: two articles found that people with high BMI had a low rate of snacks; one article found that snack consumers had more obesity; and three articles found no relation.

Conclusion: Among adults, late-night meals had a positive association with obesity. For children, many articles found that snacks and obesity were unrelated or negatively related. However, many of these studies were cross-sectional, and almost no articles adjusted confounding factors.

Objectives: Development of a self-evaluation scale for undergraduates in community-based interprofessional education (CBIPE).

Methods: [Study 1] Participants who were undergraduates at 2 universities in the Kanto region, responded to a questionnaire before and after the CBIPE. There were 597 valid responses: Nursing (189), Physical therapy (50), Occupational therapy (60), Social Welfare (86), Health behavioral sciences (54), Laboratory sciences (59), Oral health sciences (44), and Medical sciences (55). Cross-sectional data before the practice were used for exploratory factor analysis and the calculation of Cronbach's α and ω. Two-way ANOVA was conducted for the eight majors and research times, using longitudinal data before and after the practice. [Study 2] Participants who were undergraduates at 3 universities in the Kanto region, responded to a questionnaire before the another CBIPE. Confirmatory factor analysis was conducted with 121 valid responses: Physical therapy (18), Medical sciences (78), Pharmacy (17), and Medical nutrition (9).

Results: [Study 1] Four factors emerged: team building skills (6), patient-centered mind (5), mutual understanding among team members (3) and esteem for team members (2). Cronbach's α was 0.80~0.92 and ω, 0.81~0.91. All factor scores after the CBIPE were significantly higher than the scores before. Interaction was detected between majors and research times for the first and second factors. Factor scores after the practice were significantly different among some majors. [Study 2] The goodness of fix index for the four-factor model was acceptable (χ²=0.07, df=123, CFI=0.99, TLI=0.99, RMSEA=0.03 [90%CI 0.00~0.06]).

Conclusion: The validity and reliability were examined and the scale was developed.

Objective: To evaluate the effectiveness of the e-learning training program for smoking cessation support and treatment which aims at the acquisition of practical knowledge and skills, and obtain basic data for future smoking cessation programs.

Methods: The training program consisted of three versions: smoking cessation treatment, smoking cessation advice, and smoking cessation support. A total of 1,526 health professionals, who completed the program between 2010 and 2013, were used for analysis. Comparisons were made to investigate the changes in knowledge, attitude, self-efficacy, and behaviors related to the support and treatment in smoking cessation. Also examined was whether the previous disparities in knowledge and other indicators were reduced after training.

Results: Knowledge, attitude, self-efficacy, and behaviors improved significantly with all three versions of the training program upon its completion. By dividing participants into three groups based on the scores prior to the training and comparing the changes after training, those in the lowest scoring group demonstrated significantly greater improvement in knowledge, attitude, self-efficacy and behavior compared with the other groups. After training, the disparity was reduced for all indicators as well.

Conclusion: The results of evaluating the training program, which utilizes e-learning to incorporate practical knowledge and skills, suggest that it is effective in improving the knowledge, attitude, self-efficacy and certain interventional behaviors among those completing the program. It also reduced disparity in knowledge and other indicators after training.

Objective: In Europe, cluster analysis has been used to report three types of personalities, i.e., resilients, overcontrollers, and undercontrollers, referred to as "personality prototypes". Such personality prototypes are known to be related to physical and mental health. This study aimed to investigate whether these personality prototypes would be also found in Japanese college students.

Methods: In this cross-sectional study, 400 college students (students enrolled in colleges, vocational schools, junior colleges, and graduate schools) completed online questionnaires regarding the big five personality traits and mental health in May, 2016. Data were analyzed through hierarchical cluster analysis using the ward method, calculation of standard scores, and one-way ANOVA. Furthermore, the standard scores were compared with the results of former studies.

Results: Hierarchical cluster analysis revealed that the participants can be categorized into four clusters: Resilients, Overcontrollers, Undercontrollers, and Not identifiables. Moreover, one-way ANOVA indicated that participants in the Resilients and Not identifiables clusters had better mental health than those in the Overcontrollers and Undercontrollers clusters.

Conclusion: Like other 3 countries, the clusters corresponding to the personality prototypes were also found in Japanese college students. In addition, the state of students' mental health categorized into each type supported the results of previous studies.

Background: In Japan, there are strong continuous demands to build a sustainable social security system to ensure a society where everyone can live with a sense of safety and security. These efforts will work toward establishing an affluent and vigorous older society.

Contents: It is important to accumulate evidence of health promotion, specifically of population strategies for all people. In practicing population strategy, comprehensive interventions use the dissemination of health information via media outlets, health education for individuals and groups, and environmental improvement through community empowerment. This should be implemented for the entire population or for the targeted populations with higher risk of contracting diseases. For population strategies in communities, it is better to develop and implement intervention strategies based on the logic models proposed by the Cochrane Public Health Group.

Conclusion: Two important issues must be resolved to achieve societal benefits from health promotion. First, processes need to be established towards the practical use of information of health promotion; i.e., accumulation, transfer, and use of evidence of health promotion via population strategy. The second issue is to restructure the academic environment to enable interdisciplinary and multidisciplinary studies for health promotion. Particularly for the latter, there are strong hopes that scientific organizations related with health promotion will cooperate and collaborate towards establishing the Japanese Council of Scientific Unions for Health Promotion as a new academic organization.

Objective: To provide an overview of the key concepts, and issues of definition and measurement in health literacy, before considering approaches to improving health literacy in populations, and the implications for policy and practice.

Contents: Health literacy describes the possession of literacy skills that are required to make health-related decisions in a variety of different environments (home, community, health clinic). These skills vary from individual to individual, and poor health literacy has been consistently associated with adverse health outcomes. Health literacy can be improved through effective communication and education, and is moderated by the environment in which communication occurs. In clinical settings, research has consistently shown that low health literacy can be successfully identified, and can be improved through effective patient education to deliver better health outcomes. In the wider community, improving health literacy requires more than the transmission of new information, it also involves the development of empowering personal skills that enable participation in a range of actions that can protect and improve health. New communication technologies provide both challenges and opportunities for health education.

Conclusion: More personalised forms of communication, and active educational outreach will best support the goal of promoting greater independence in health decision-making. This requires more sophisticated understanding of the potential of education to strengthen both personal and community action to improve health. The use of relevant theories and models can provide important guidance on content, sequencing and delivery of health and patient education programs.

Background: The Nutrition Education Committee of the Japanese Society of Health Education and Promotion has been working for the research about "food and nutrition education (FNE) evaluation in school" since 2013. This article reports a summary of the open round-table discussion titled "How to introduce evaluation method of health education and promotion into FNE in school?"

Contents: Mr. Yokoshima introduced the material titled "FNE in school-centered nutrition teachers" and stated the importance of introducing FNE into school evaluations. Mr. Ohta emphasized the importance of setting specific goals to evaluate FNE in school, and of evaluating outcome and process separately. Professor Akamatsu proposed three points to evaluate FNE in school. These points were as follow: 1) the goal of FNE in school is to develop a healthful eating habit; 2) FNE evaluation in school should be conducted based on the PDCA (Plan-Do-Check-Act) cycle; and 3) FNE in school should adopt theories of behavioral science. After the open discussion, 30 participants responded that they were "very satisfied" and 29 were "satisfied" with it (valid responses were 62).

Conclusions: We found it is important to use the evaluation method proposed by the Nutrition Education Committee. We will continue challenging to introduce FNE into school evaluations and diffuse an evaluation method of health education and promotion for the FNE in school.