Objectives: This study aimed to make a chronological evaluation between physical, psychological and social health for the urban elderly dwellers.
Methods: The questionnaire survey was conducted to al l16,462 urban elderly dwellers of 65 years old or more in A City. The answer was obtained from 13,195 people(response rate of 80.2%). The follow-up survey of 8,558 members was done in September, 2004. By using Finkel's Cross- Lagged Effects Models based on the Structural Equation Models, the causal relationships were analyzed.
Results: In results of this analysis, chronological three years trend of the ADL (Activities of Daily Living) was shifted from 80.8% to 77.2%. Trend of the self-rated health with healthy was shifted from 87.6% to 76.2%. All the elderly were seen that “physical factor” (“ ” means latent variable) and “social factor” conducted on the follow-up survey in 2004 would be significantly affected by the “psychological factor” which was investigated in 2001 based on the chronological evaluation. Total number of 76% for the old elder men, 63% for the same women of the “physical factor” were explained by these model with height validity level with NFI=0.964, IFI=0.968, RMSEA=0.016.
Conclusions: Both physical health and social health would be affected by the psychological health during three years follow-up in the urban elderly dwellers. Future research is needed to make clear the research fact for the another generation with external validity of these results.

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Objective The objective of this study was to examine the relationship between perceived environment and achieving recommended level of walking, moderate to vigorous physical activity excluding walking or moderate to vigorous physical activity among Japanese adults.
Methods Internet-based cross-sectional survey was conducted using the sample of 3,000 Japanese adults aged 30-59 years. Physical activity and neighbourhood environment were assessed by the short version of International Physical Activity Questionnaire (IPAQ) and IPAQ Environment Module. Participants were assigned to either “meeting recommendation” or “not meeting recommendation” according to criteria; ≥150 minutes per week of walking, moderate to vigorous intensity activity excluding walking or moderate to vigorous physical activity. Odds ratio of meeting physical activity recommendation was calculated in relation to environmental variables by gender, adjusted for sociodemographic attributes (gender, age, marital status, employment status, living status, educational attainment and household income).
Results Convenient access to shops (male: OR=1.44, female: OR=1.73), public transportation (OR=1.75, 1.88), recreational facilities (OR=1.51, 1.37), good street connectivity (OR=1.32, 1.44), having destinations (OR=1.62, 1.44), and having household motor vehicles (OR=1.66, 1.85) were significantly related to meet the recommended level of walking. Access to recreational facilities (OR=1.33, 1.47), social environment (OR=1.48, 1.35) and aesthetics (OR=1.30, 1.39) were significantly related to meeting the recommended level of moderate to vigorous physical activity excluding walking. Convenient access to shops(OR=1.46, 1.36), public transportation (OR=1.60, 2.03), recreational facilities (OR=1.54, 1.41), having a destination (OR=1.54, 1.33), and good aesthetics (OR=1.41, 1.43) were significantly related to meet the recommended level of moderate to vigorous physical activity.
Conclusion The moderate to vigorous physical activity excluding walking were associated with environment for exercising such as recreational facilities and social environment. The walking and moderate to vigorous physical activity including walking were associated with environment for lifestyle physical activity such as convenient access to shop and public transportation. Perceived environment influence was different depending on types of physical activities among Japanese adults.

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Objective: The purpose of this study was to clarify the characteristics of structure and pattern of health promotion volunteers'(HPVs)role explained by public health nurses(PHNs).
Methods: A self-rating questionnaire was mailed to 404 PHNs. It consisted of 11 items regarding the contents of HPVs' activities and fundamental attributes. The quantification method of the third type was applied to the eligible data to analyze the structure and pattern of the explanation of HPVs' role.
Results: As the multidimensional spatial structure, two phases were extracted. One was “policydaily life” and another was “individual-community”. By combining these phases,we evaluated the explanation of HPVs' role by PHNs from a multidimensional viewpoint. Furthermore, we grasped the characteristics of the explanation of HPVs' role as the pattern which well classified into four partial spaces. It consisted of “contributed to a community”, “encouraged the individual”, “supported to an organization”, and “advanced the policy”. The pattern indicated by PHNs was composed of two elements which were “contributed to a community” and “advanced the policy”. As a result, we found that the development of practical competence among PHNs was associated with experiences related to their social activities.
Conclusion: As the multidimensional spatial structure, two phases were extracted, which consisted of “policy-daily life” and “individual-community”. It was suggested that the explanation of HPVs' role indicated four patterns using these phases.

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Objective: To identify the level of depression in Yogo teachers and examine the relationship between stressor factors and their depression.
Method: Group surveys were conducted using an anonymous self-reported questionnaire composed of attribute items, a depression scale (CES-D), and job stressor scales. Respondents consisted of 293 participants at public primary and secondary school Yogo teacher workshops held in three cities in one prefecture in the Kanto region between September 2004 and January 2005. Level of depression in 184 effective responses was assessed based on CES-D score, and the relationshipbetween the presence or absence of a depressive state and attributes and job stressors was investigated.
Results: Mean CES-D score of effective responses (n=184) was 13.5(SD8.0). Sixty-three (34.2%) participants scored ≥16 and were considered to be depressed. The results of logistic regression analysis showed that “having or not having children” and “role conflict” at work were significantly related to the presence or absence of depression. The odds ratios for a depressive state were 2.4 for those with children against those without, and 2.5 for those with a high level of role conflict against those with a low level of role conflict.
Conclusion: By the examination at public primary and secondary schools in urban areas, 34.2% of Yogo teachers were considered to be depressed. Factors that individually affected depression were found to be having or not having children and role conflict at work.

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Objective: To examine the influence of follow-up support for participants who completed an exercise program on the continuation of exercise.
Methods: Participants were sixteen persons who completed an exercise program for individuals with metabolic syndrome over 40 years old. After the completion of the program, we supported participants by telephone calls and home visits for 3months. Participants were tested for weight, BMI, confidence in physical exercise, social support for exercise, health-promoting activities, and contents of physical activity before and after the support. Changes during support were compared with the paired t-test and Wilcoxon signed-rank test. The differences between the continuation (n=6) and the non-continuation (n=10) groups were compared with the 2-sample t-test and Mann-Whitney U-test.
Results: The mean BMI significantly decreased from 23.7(SD2.5) to 23.3(SD2.3) kg/m²(p=0.029) in all participants. In the exercise continuation group, the mean BMI showed a greater downward trend after support, and the mean level of confidence in physical exercise was higher than in the non-continuation group (p=0.049) before support. In addition, in not only the exercise continuation but also the non-continuation group, the mean contents of physical activity significantly increased from 15.6(SD10.6) to 24.5 (SD14.8) (p=0.013) after support.
Conclusion: The results indicate that follow-up support for participants and blood tests to explain about the physical state involving bodyweight measurements, and giving encouragement and praise after the completion of health education, led to an increase in the levels of physical activity.

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Objectives: The purposes of this study were: 1) to develop an attribution scale for health counseling and to identify any cognitive style that can cause success or failure of health counseling in public health nurses and: 2) to examine relationships between attributional style and self-efficacy for implementing health counseling.
Methods: Two hundred and ninety-eight public health nurses completed a questionnaire inquiring about causes of the success and failure in their health counseling and about the self-efficacy for the health counseling implementation. The answers were analyzed by using factor analysis to clarify their characteristics of cognitive style for health counseling. Significant correlation efficiencies were identified between their attributional style and self-efficacy for implementing health counseling.
Results: Exploratory factor analysis revealed following three factors for the cause of success:1) client- centered interview methods, 2) interview skills, and 3) changing factors, also three factors for the cause of failure were revealed:1) health counselor factors, 2) uncontrollable problem, and 3) poor client-centered interview methods. The factors for the cause of success positively correlated with self-efficacy for implementing health counseling, while the factors for the cause of failure (health counselor's factors) negatively did.
Conclusion: This study identifies the attributional style to the cause of success or failure in health counseling among public health nurses, and reveals the relationships between attributional style and self-efficacy.

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Objective: To examine the reliability and validity of the Irrational Eating Beliefs Scale (IEBS) among those at risk for lifestyle-related diseases whether the IEBS would apply for subjects at risk for lifestyle-related diseases.
Method: Participants were recruited from a Tokyo medical clinic during April-August 2007. Participants completed questionnaires, including the IEBS and questions from the Multidimensional Health Locus of Control (MHLC) scale. Those exceeding the diagnostic norm for abdominal circumference associated with metabolic syndrome or cautioned about having at least one disease were defined as at risk for lifestyle-related diseases, and the analysis were conducted by the subjects at risk or not at risk.
Results: Of 378 participants, we excluded those who did not respond to questions about abdominal circumference or diagnoses (n=79). Responses from 299(79.1%) participants were analyzed (at risk: 167; not at risk: 132). Results showed moderate reliability in at risk(Cronbach's α=0.60~0.83). Weak positive correlations emerged between CHLC and all subscales in at risk (r=0.23~0.25, p <0.05). Weak negative correlations emerged between“avoidance of making changes to eating habits” and the importance of behavioral change (r=−0.35, p <0.01) and between “barriers to changing eating habits” and confidence in behavior change (r=−0.25, p <0.01) in at risk. The same results were confirmed in subjects not at risk. Correlations emerged between “avoidance of making changes to eating habits” and “barriers to changing eating habits” and unhealthy lifestyle in subjects at risk for lifestyle-related diseases, and “barriers to changing eating habits” and unhealthy lifestyle in subjects not at risk for lifestyle-related disease. Conclusion: Because the only correlations between “negative thoughts about weight loss” and MHLC were found among the subjects at risk for lifestyle-related diseases, the validity of “negative thoughts about weight loss” was not confirmed, but the validity of “avoidance of making changes to eating habits” and “barriers to changing eating habits” were confirmed in this study.

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