BACKGROUND: Outside activity is one of the most important factors affecting self-rated health, which is a strong predictor of mortality in elderly community dwellers. The frequency of going outside could be one of the most useful health care measures. However, very few studies have been conducted to clarify the effect of regular open-air outings in tems of life satisfaction.
OBJECTIVE: The aim of this study was to explore the structure of“going outside”and subjective health related factors such as, medical care, pain, social activities, and instrumental activity of daily living (ADL) .
DATA SOURCES AND STUDY SETTING: A total number of 13, 067 community dwelling elderly people were identified from the 2001 T-City Health Survey.
STUDY DESIGN: A cross-sectional population based study was carried out using urban Japanese over 65 years of age. Data were collected through self-administered questionnaires, including frequency of outing, types of medication, grade of pain, social activities and instrumental ADL. An association between“going outside”and self-rated health related factors was analyzed using the structural equation modeling (SEM, AMOS 5.0, SPSS) to test a hypothetical model.
PRINCIPLE FINDINGS: In the present study, we found three latent variables of“going outside”, “participation”and“health status”. The latent variable“going outside”was established by frequency of outing, going shopping and time of walking. On the other hand, “health status”was confirmed by“subjective health”, “medication”and“grade of pain”.“Participation”was confirmed by“association”, “interest”, “volunteer activities”.“Going outside”was directly affected by“health status”, and directly/indirectly affected by “participation” (RMSEA=0.022, CFI=0.854, ) .
CONCLUSIONS: Greater attention should be given to the beneficial effects of“going outside”and“participation”for maintaning QOL in the elderly.
Practitioners and policy markers should develop community-based programs, that improve“health status”and provide opportunities to“going outside”for elderly people.

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The purpose of this study was to examine the effect and feasibility of a non face-to-face program “Internet Health up System; IHS” using the computer, Internet and mail to stimulate nutritional and physical activity changes in the community. The public health nurses sent the computer-tailored print materials to all participants by mail four times every two weeks. The tailoring software was placed on the server of the university laboratory which developed IHS. The public health nurses input necessary information for computer-tailored materials making and output print materials via the Internet. The mean age of 49 participants was 49.8±11.9 years (43% male; 71% employed) . IHS can be useful by public health to intervene with new groups, such as comparatively young people, males, and workers. The compliance rate, defined as the completion of the post-questionnaire and the medical examination, was 63.3% (n=31) . The attainment rates of the target behaviors ranged from 66%-75%. There were significant decreases in body weight, systolic blood pressure, total cholesterol, triglycerides, and LDL cholesterol, and an increase in exercise time per week. The participants appreciated that this program was intelligible and useful. In addition, the public health nurses noted that this program was convenient and efficient. Therefore, IHS was effective and feasible for nutritional and physical activity changes in the community health setting.

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