Objective: The purpose of this study was to review the worksite intervention program for promoting vegetable intakes, and to clarify the intervention program and behavioral science theories systematically.
Methods: We searched Pub Med in an English database, “Igaku chuo zasshi” and JDream II in a Japanese database in January 2010. Search keywords were “vegetables”, “worksite”, “intervention”. The selection criteria of the studies were 1)the study design was Randomized Controlled Trial (RCT) or Controlled Trial (CT), 2)intervention was for nutrition or health education, 3)the study examined increasing or decreasing vegetable intakes, 4)the participants were employees, 5)the text was written in English or Japanese. A total of 134 overseas articles were selected by the keywords searched. After an initial screening of the title and abstract, 82 articles were rejected. After reviewing the full text of the remaining articles, 21 articles were retained. The reliability of the outcomes were checked and the evaluation of vegetable intakes changes were setup.
Results: For the evaluated of changing vegetable intakes, ten articles were selected. Five studies reported increasing vegetable intakes after intervention (increased by 0.18- 0.77SV, or 0.18 cup). These five studies dealt with health information, environment (improvement of cafeterias, peer support, etc.) and IT programs. Behavioral science theories were used in these five articles, and four of them were transtheoretical models.
Conclusion: There were not enough articles for promoting vegetables intakes at worksites. It is necessary to develop the effectiveness intervention program. It might be better to conduct not only health information programs but also environmental and IT programs, and to adapt behavioral science theories of worksite intervention programs for promoting the intake of vegetables.

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Abstract
Purpose: The physical, psychological, and social elements of health status for elderly dwellers of a local city were investigated to ascertain long-term health status changes and their causation.
Methods: Data from 2,520 returned self-reported questionnaires mailed to all 3,717 dwellers aged 60 years or over in a local city in March 1999 (recovery rate:67.8%) were input into a basic database. A follow-up questionnaire was sent to 1,796 individuals still living in the region in July 2009 and data from 1,070 respondents (1,070/1,796=59.6%) was analyzed. Covariance structure analysis was performed to determine any association of the three elements with dwellers' actual efforts toward healthy living, how they had changed over 10 years, and any causation between the elements and behaviors toward healthy living.
Results: Physical and psychological health status significantly deteriorated over the 10-year period, while social health status was maintained or improved. A causal structure model that started with “psychological health status in 1999”, via “physical health status in 2009” toward an endogenous variable “social health status in 2009” was revealed. The model fitting was good (NFI=0.977, CFI=0.990, TLI=0.981, and RMSEA=0.027).
Conclusion: Psychological health status serves as a foundation for social health status over the next 10years. Placing special emphasis on dwellers psychological health is an important duty of public health nurses to help dwellers lead a healthy life.

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Objective: The purpose of this study was to examine the reliability and validity of the healthy eating literacy (HEL) scale among Japanese adults.
Methods: The cross-sectional questionnaire survey was conducted via the Internet in December 2010. The participants were 6045 Japanese male and female adults(20- 59 years) who were registered with a social research company. Construct validity was estimated from confirmatory factor analysis and criterion-related validity. Criterion-related validity was determined by examining the relationship between HEL and the stages of change. The reliability was evaluated by assessing the internal consistency (Cronbach's alpha coefficient) and a 14-days test-retest(n=100).
Results: Totally, 1252 respondents completed the survey (response rate: 20.7%). The good goodness-of-fit indices were obtained using the confirmatory factor analysis (GFI=0.988, AGFI=0.957, CFI=0.990, RMSEA=0.080). Analysis of Covariance revealed that HEL was positively associated with the stages of change (F=19.7, p<0.001). Both the internal consistency (α=0.87) and the test-retest reliability (r=0.742, p<0.001) were good.
Conclusions: This study indicated the reliability and validity of the proposed scale to evaluate HEL among Japanese adults.

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Objective: To compare the characteristics of people classified into a high-self-efficacy-precontemplation stage of change for weight control with those in other stages.
Methods: A self-reported cross-sectional questionnaire, which is addressing the stage of change for weight control, self-efficacy, perceptions of current weight, and demographic characteristics, was administered to 994 employees in July 2008. Those in the precontemplation stage were divided into two groups using their median scores for self-efficacy, yielding high-self-efficacy and low-self-efficacy groups. The scores for self-efficacy, lifestyle, and demographic characteristics were compared according to the stage using the Kruskal-Wallis or x² test by sex. Bonferroni's multiple comparisons were conducted with high-self-efficacy-precontemplation stage as a reference.
Results: Men in the high-self-efficacy-precontemplation stage had a lower body mass index (BMI) than people in other stages (p<0.01), those who did not eat snacks were more likely than those who did to be placed into the low-self-efficacy-precontemplation stage and the contemplation stage (p=0.003), and a higher percentage of those who did not eat 2hours before bedtime than people classified into the contemplation stage (p=0.009). Women in the high-self-efficacy-precontemplation stage had a lower BMI than people classified in the preparation stage (p=0.002).
Conclusion: These results suggest that individuals in the high-self-efficacy-precontemplation stage differ from those placed in the precontemplation stage in defined in the transtheoretical model. Men in the high-self-efficacy-precontemplation stage had a lower BMI and were appropriate eating habits for weight control.

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Objective: This study assessed the effectiveness and feasibility of a health education program developed for workers, in which data was exchanged with participants via e-mail, and cell phone- based technologies.
Methods: This randomized controlled trial was conducted among 22 men and 17 women (BMI≥25kg/m² or waist circumference>85 or 90 cm) with an age and sex-stratified random sample. The participants were divided intointervention and control groups. During the 3-month weight-loss support program, we sent e-mails to participants detailing diet and exercise strategies to be followed twice a daily throughout the intervention. The participants were instructed to send cell- phone camera-acquired photographs of their meals for 3 days and received personal dietary guidelines from a dietitian during the support period. The control group received the advice by dietitian at baseline only. We evaluated the change in weight; waist circumference; blood pressure; and plasma triglyceride (TG), high-density lipoprotein (HDL), low-density lipoprotein (LDL), fasting blood sugar (FBS), and glycosylated hemoglobin HbA1c) and nutrition intake of participants in the intervention group compared with the control group using the Mann-Whitney test.
Results: Both male and female participants in the intervention group successfully decreased their intentional energy intake over the course of study. The average resulting weight reduction was 3.4 kg in men and 1.3 kg in women. Additionally, FBS levels in women improved among women exposed to the intervention (p<0.05).
Conclusion: This program showed a positive effect on weight control and FBS in women by prompting a decrease in the average dietary energy intake of participants.

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Objective: This article discusses the suitable application of social marketing principles in health education through a review of recent research.
Methods: The resources of the National Social Marketing Center (NSMC), the Center for Disease control and Prevention (CDC), and Weinreich Communications are cited as the main references.
Results: According to NSMC's reports, social marketing is defined according to eight criteria: “customer oriented”, “behavior”, “theory”, “insight”, “exchange”, “competition”, “segmentation”, and “method mix”. By utilizing these elements, an effective procedure to conduct social marketing will involve the following: “preliminary research”,“strategy”, “program development”, “implementation”, and “evaluation”.
Conclusions: With the rapid advances in information technology since the 1990s, a large budget is no longer necessary to conduct research that applies social marketing. As the use of social marketing in research is expected to increase in the future, referring to these criteria and procedures of social marketing will be useful.

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