Objective: The purpose of this study was to develop a scale to measure the decisional balance of elementary school children's health behavior, in which finishing off school lunch and tooth brushing were specifically focused upon, and to examine the reliability and validity of the scale. In addition, the relationship between the measured decisional balance and the stage of change was investigated.
Methods: A questionnaire survey was conducted to measure the level of the decisional balance among 880 elementary school children. After applying a factor analysis to the questionnaire answers, the reliability and construct validity of the questionnaire were estimated from the internal consistency and the confirmatory factor analysis. The scores of benefits (Pros) and costs (Cons) were compared in each stage of change.
Results: The factor analysis of the decisional balance scale indicated that it is constructed by two sub-scale labeled benefits (Pros) and costs (Cons). Five items for Pros and five items for Cons for finishing off school lunch and five items for Pros and three items for Cons for tooth brushing were effective. The Cronbach's alpha coefficients for Pros and Cons for finishing off school lunch were 0.75 and 0.76, respectively. And those for tooth brushing were 0.78 and 0.81, respectively.
The excellent goodness-of-fit indices were obtained by the confirmatory factor analysis.
The Kruskal-Wallis test revealed that the Pros and Cons scores differed significantly across the stages, that is, the Pros score increased as progressing stages and Cons score decreased.
Conclusions: The statistical analysis proved the reliability and validity of the proposed scale to measure the decisional balance of the elementary school children's health behavior with regard to finishing off school lunch and tooth brushing. The relationship between the decisional balance and the stage of change supports the original hypothesis.

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Objective: To assess practice of preventive behaviors at home and performance of roles in community prevention and control of avian influenza (AI) among village health volunteers (VHVs), and to examine factors correlated with the execution of such behaviors and roles.
Methods: This cross-sectional research was conducted in one district of Lop Buri Province, Thailand. Two hundred and twenty VHVs, selected by simple random sampling from all sub-districts with probability proportional to size, were interviewed using a structured questionnaire in September 2006. Data were analyzed using descriptive statistics, Pearson's product moment correlation coefficient, and linear regression.
Results: Most VHVs received AI information via television and from health personnel. They had good knowledge about AI and supportive attitudes toward AI prevention and control. After controlling for the effects of other variables, practice of preventive behaviors at home was significantly associated with performance of roles in community prevention and control of AI, and 5% of the variability in VHVs' scores on community roles performed is explained by the model. Meanwhile, attitude toward AI prevention and control was significantly associated with practice of preventive behaviors at home, and 12.4% of the variability in VHVs' practice of preventive behaviors at home is explained by the model.
Conclusion: VHVs demonstrated good knowledge about AI and supportive attitudes toward AI prevention and control. Practice of preventive behaviors at home was positively correlated with performance of roles in the community. Attitude toward AI prevention and control and knowledge about AI, meanwhile, was positively correlated with practice of preventive behaviors at home.

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Objectives: To analyse the drinking patterns of secondary school students and the relationship between drinking patterns, age at drinking onset, gender, personality traits and family drinking habits.
Methods: A descriptive, correlational study was performed with a randomly selected sample of 103 students in10^th, 11^th and 12^th grades, aged 15-20, in the Centre Region of Portugal. The Drinking Habits Questionnaire and the Portuguese version of the Eysenck Personality Inventory were used to collect data. Data collection was carried out by self-administered questionnaire in the first week of March 2008.
Results: On average, boys started drinking alcohol earlier (13.1years) than did girls (14.1years), but the current drinking pattern was identical across genders. Of 103 students, 85.4% were drinkers and 14.6% had never had alcohol. Of those who had already started to drink (n=88), 79.5% were occasional or light drinkers, particularly on weekends and with beer as the primary alcohol of choice. Additionally, 82.0% of current drinkers also drank spirits on weekends, 52.3% had been intoxicated at least once, and the mean age of first intoxication was around 16 years. Adolescent drinking pattern was positively associated with family drinking pattern (rs=0.31; p<0.001) and with extroversion (rs=0.24; p=0.013).
Conclusion: Both boys and girls attending secondary school in the Centre Region of Portugal tend to drink moderately and occasionally, especially on weekends. About half of the students have been intoxicated at least once. Drinking pattern is weakly correlated with family consumption pattern and with extroversion.

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The purpose of the article was to review the scientific program concerning physical activity promotion research at the 20th International Union for Health Promotion and Education (IUHPE) World Conference after launching the Toronto Charter for Physical Activity and to discuss current issues in implementing and disseminating physical activity promotion.
Twelve symposia, 5 workshops, 20 oral papers and 64 posters were reviewed with respect to their target population and study setting.
Papers presented at the conference were from Europe, North America and Western Pacific regions in which physical activity promotion has been implemented. Critical issues presented by participants from all over the world included the prevention and control of non-communicable diseases and pediatric obesity. To promote health through physical activity in the Japanese population, future research should determine: 1) environmental factors at the individual, interpersonal, local community and national levels based on an ecological model in diverse settings; 2) the effectiveness, economic efficiency and best practice of physical activity promotion intervention, especially among children and the elderly; and 3) ways to implement, disseminate and evaluate healt policy based on scientific evidence.
These actions are expected to contribute to improved health and to the promotion of a sustainable society through active living in Japan.

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This article reviews the symposium and presentations on food and nutrition at the 20^th World Conference on Health Promotion in Geneva held by the International Union for Health Promotion and Education (IUHPE). Also reviewed is the therapeutic program at the Division of Therapeutic Education for Chronic Diseases (SETMC) of the University Hospital of Geneva.
The 20^th IUHPE conference consisted of one symposium, one workshop, and 71 presentations related to food. As evidenced by the main theme of the conference “health equity and sustainable development,” sustainability was emphasized in the context of food choice, food education, and food safety. To achieve the sustainable development of society, the food cycle must be integrated into a food system that includes the economy, ecology, and other social factors.
Another emphasis was made on the role of universities as “healthy universities”. Universities represent communities in which students, researchers, and workers live, study, and work. Universities have the potential to make significant contributions to health given their roles as centers of learning, development, creativity, and innovation.
The therapeutic patient education program at SETMC appeared resourceful as an individual patient-based approach on diet. The program includes cognitive-behavioral, motivational interviewing, and art therapies. These therapies were found to be more effective than simple pharmaceutical interventions against obesity and diabetes.
The issues discussed above would be beneficial if incorporated into health promotion activities in Japan.

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The purpose of this article was to review the health literacy studies reported at the 20^th IUHPE World Conference, and to suggest future studies on health literacy in Japan.
The concept of health literacy has been evolving. The main discussion points during the conference were exploring the concept of health literacy (-the cognitive and social skills which determine the motivation and ability of individuals to gain access to, understand and use information in ways which promote and maintain good health), how to increase these skills, and how to evaluate them. Also, the affects of health literacy on health and factors/ barriers to increase health literacy were discussed both in the clinical setting and public health setting.
It is important for Japan 1) to develop culturally adapted framework that helps to understand the comprehensive concept of health literacy and measurement scale, 2) to explore the relationships between health literacy and health, 3) to comprehend the effects of health promotion and education intervention on health literacy, in future.

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At the 18^th IUHPE World Conference and the 19^th IUHPE World Conference, the needs of domains of core competencies for health educators and health promoters were proposed and the discussion was continued among the leaders of the IUHPE and stakeholders from different countries. In June, 2008, Galway consensus conference was held at Galway, Ireland, as an international collaboration process to share values, issues and needs and identify the domains of core competencies in health education and promotion. The following is the eight domains of core competencies: 1. Catalyzing change, 2. Leadership, 3. Assessment, 4. Planning, 5. Implementation, 6. Evaluation, 7. Advocacy, 8. Partnerships. This discussion was continued at the 20th IUHPE World Conference held in Geneva, Switzerland. Four panelists from the countries that were not able to come to the Galway Consensus Conference were invited to the session, and mainly discussed with other attendees of the session about 2 focused points: 1) the needs and possibility of a consensus on domains of core competencies on health education and promotion, and 2) the implications of the development for health-promotion capacity building. This article summarized the review of the sessions related to Competency at the 20th IUHPE World Conference held in Geneva, Switzerland.

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