Objective: The purpose of this study was to develop a scale to measure the self-efficacy of elementary school children’s health behavior, in which finishing school lunch and brushing teeth were specifically focused upon, and to examine the reliability and validity of the scale. In addition, the relationship between the measured self-efficacy and the stage of change was investigated.
Methods: A questionnaire survey was conducted to measure the level of self-efficacy among 880 elementary school children. After applying a factor analysis to the questionnaire answers, the reliability and construct validity of the questionnaire were estimated according to the internal consistency, the repeatability of scale score, and the confirmatory factor analysis. In addition, the relationship between the scale score and the re-categorized stage of change was investigated using a one-way analysis of variance.
Results: The factor analysis of the self-efficacy scale indicated that six items for finishing school lunch and four items for brushing teeth were effective. The Cronbach’s alpha coefficients for finishing school lunch and brushing teeth were 0.81 and 0.81, respectively. The correlation factor of the scale score by retest (Pearson’s r ) proved a high level of repeatability; r for finishing school lunch was 0.84 and r for brushing teeth was 0.67(p<0.01). The excellent goodness-of-fit indices were obtained by the confirmatory factor analysis. (finishing scool lunch: GFI=0.974, AGFI=0.961, CFI=0.966, RMSEA=0.055, brushing teeth: GFI=0.981, AGFI=0.961, CFI=0.976, RMSEA=0.062) The ANOVA revealed that the self-efficacy scores differed significantly across the re-categorized stages and the scale score increased as the stages progressed. (finishing scool lunch: F (2/846)= 155.16, brushing teeth: F(2/791) = (2/791)= 50.98, p<0.01)
Conclusions: The statistical analysis proved the reliability and validity of the proposed scale to measure the self- efficacy of the elementary school children’s health behavior with regard to finishing school lunch and brushing teeth. The relationship between the self-efficacy and the stage of change supports the original hypothesis.

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Objective: One-shot education interventions can be effective to change health behavior, as in periodic health promotion prompts targeting workers. The objective of this study was to evaluate the effect of a stage-based health education program utilizing correspondence teaching materials.
Methods: A health education trial was carried out on 63 workers (aged 20 to 60) who completed a baseline questionnaire in a university cooperative. Participants were divided into two groups, a health education intervention group and a control group. Of the 63 participants, 40 workers (17 from the intervention group, 23 from the control group) completed the post-intervention questionnaire and were included in the final analysis.
Results: The health education intervention group showed a significant increase from baseline to post-intervention levels of performance in terms of mean score on measures of dietary behavior, consciousness raising, environmental reevaluation, self-reevaluation, and helping relationships. However, no significant changes were seen in either of the two groups on stages or processes of dietary behavior or on exercise behavior. In the intervention group, 10 out of 17 participants undertook and completed more than 50% of the teaching materials; most of these 10 were in the preparation and post-preparation stages of change. Most participants who were unable to complete the exercises stated the reason as being pressed for time.
Conclusion: The observed positive changes suggest that the correspondence teaching materials were effective for individuals reaching the preparation stage of change, who are interested in improving their health and in need of applicable methods and information.

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The two WHO Collaborating Centers on Safety Promotion and Injury Prevention, which were based at the Ministry of Health, Quebec, Canada and the WHO Collaborating Centre on Community Safety Promotion at the Karolinska Institute, Stockholm, Sweden, achieved a consensus on the concepts of safety and safety promotion in 1998. According to the consensus, safety is a state in which hazards and conditions leading to physical, psychological or material harm are controlled in order to preserve the health and well-being of individuals and the community. It is an essential resource for everyday life, needed by individuals and communities to realize their aspirations. Safety promotion can be defined as a process that aims to both ensure the presence of, and to maintain the conditions that are necessary to reach and sustain an optimal level of safety.
Both ideas, safety promotion and health promotion, were proposed in the 1980s from Europe. Safety promotion was derived from injury prevention, whereas health promotion was derived from disease prevention. Though the goals are different, they share common characteristics such as the importance of the cross-sectional approach and of individual assistance and environmental support. It is essential for the people of a community to understand the meaning of safety and to carry out safety promotion in daily life. As a manifestation of specific safety promotion activities in the community, the Safe Community Movement is gradually spreading all over the world.

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Injury has long been one of the most important public health problems. Since 1960, injury has been the leading cause of death among children aged 1 to 15 in Japan. Moreover, as injury deaths affect a much younger segment of the population than is true for most other health problems, they have a considerable effect on the Years of Potential Life Lost (YPLL).
In years past, the commonly used term ‘accident prevention’ has often led to misdirection. These days, many researchers prefer the term ‘injury control’, which was derived from the conceptual shift in this field occurring over the past few decades. In this article, we argued for general principles of injury control, such as the Haddon matrix, passive-versus active-strategies, and the “three E's”approach (Education, Engineering, Enforcement).
Furthermore, brief mention was also made of the recent development of behavioral and community- based approaches relevant to injury control, such as the injury iceberg of the ecological model, the PRECEDE-PROCEDE model, the third axis of the Haddon matrix, and the safe-community movement.

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This paper aimed to articulate the process of development of the model of “Safe Community,” an approach to community safety promotion through injury prevention at the community level. The author offered an analysis from various perspectives of the features and tendencies of the communities designated as members of the International Safe Community Network. In the 1980's, success in injury prevention at the level of a Swedish community started to stimulate injury prevention programs as a solution to health problems in Nordic communities. The successful results observed in those Nordic communities also drew attention from the World Health Organization (WHO), which ranked injuries among the primary factors affecting health at the time. The WHO regarded the prevention of injuries as a potent solution to promote people's health. Therefore, the WHO and the Karolinska Institutet, which houses a group of researchers specializing in injury prevention, set up a collaborating center to promote community safety worldwide through injury prevention. The center, named “the Collaborating Center on Community Safety Promotion,” has developed a framework of safety promotion programs for action at the community level. The framework consists of 6 criteria leading communities in different situations to establish systems of safety promotion with existing social resources. Because the framework can be carried out in diverse settings, an increasing number of communities have been adopting “Safe Community” initiatives for community development through various approaches as well as safety promotion adapted to their own specific contexts.

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This paper outlined both the concept and the practices of safety promotion and the WHO Safe Community to Japan. It included a discussion of how community safety promotion may work to improve the safety of inhabitants, and also suggested certain challenges. First, the historical process behind the introduction of safety promotion and the WHO Safe Community were described. Prof. Leif Svanstrom first introduced these concepts to Japan during his 2002 visit to the country. A safety promotion (SP) research group, composed of public health doctors and the Kyoto Research Association on Safe Community (SC) were both established in 2004 and played key roles in combining the concept and practices of SP/SC. Second, the development of SC activities in several municipalities in Japan-Kameoka, Towada and Atsugi cities-were outlined, and both divergent and common characteristics were discussed. The SC activities in Kameoka, Atsugi and Towada cities seemed to vary greatly in terms of processes of initiation, promotion and priority issues. However, there were also certain commonalities in evidence. For instance, it has been observed that the SC activities in these 3 municipalities grew out of 3 basic strategies of health promotion: advocacy, enabling, and mediation. Finally, SC activities in Japan were discussed in terms of their potential to improve safety and quality of life among inhabitants, and several challenges were suggested.

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