Objective: To determine the feasibility of implementing a nutrition education program based on the stage of change model in an elementary school by impact and process evaluation.
Methods: A nutrition education program based on the stage of change model was conducted from 2005-2006 in an elementary school in Tokyo, Japan. All teachers who taught the program during regular classes and lunch time hours cooperated with the children's parents and community partners. An impact evaluation was based on the amount of food left uneaten and the percentage of goal accomplishment. A process evaluation of possible program extension and the suitability of the stage of change model was based on questionnaires filled out by parents and reports made by teachers.
Results: A total of 197 children reported the number of food they left uneaten in June 2005 and May 2006. The results indicated that of 13 foods, children were less likely to leave 10 foods uneaten, particularly small fish and fruits (p<0.05) . After the program, third grade children, who had studied mushrooms, answered that, of the foods, they were least likely to leave mushrooms uneaten. Although it was not possible to extend the program to all families, some eager parents set up volunteer groups promoting the nutrition program. Teachers commented that they could conduct the program using specific objectives in every lesson by using the stage of change model.
Discussion: This was a practical study, so it was limited in some ways such as study design and evaluation. However, the results indicate the feasibility of implementing a nutrition education program based on the stage of change model in elementary schools.

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The purpose of study was to examine the relation between personality characteristics of action control (action versus state orientation) and health behaviors. Action orientation was defined as a metastatic model of control, which facilitated the enactment of change-oriented intention. In contrast, state orientation was defined as a catastatic model of control, which preserved the status by inhibiting the enactment of change-oriented intention.
A survey was conducted in 339 university students in July, 2004. The Japanese version of the Action Control Scale (ACS90) and the health behavior check list were used. The Japanese version of ACS90 consisted of 3 subscales (“Preoccupation”, “Hesitation”, “Volatility”), and the health behavior check list consisted of 4 factors (“health care”, “well-regulated life”, “rest”, “food life”) . The logistic model was used to demonstrate for OR and 95%CI the correlation between the action-state orientation and health behaviors.
As a result, female students had been performing health behaviors about food life more than male students. In the action-state orientation, “hesitation” was related to all factors of health behaviors, and these with a tendency to be easy to put an intention into an action often performed health behaviors. In contrast, “preoccupation” was related to health cares, suggesting that the control of negative affects and the swift change of one's way of thinking were also related to health behaviors. From these results, it was suggested that health behaviors and students of the action-state orientation were related. The role of the action-state orientation should be investigated further in subjects with illness or health problems.

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