Objectives: The purpose of this study was to elucidate the causal structural effects of socio-economic variables on the “three health factors”, as defined through exploratory factor analysis, among elderly urban dwellers.
Methods: A self-reported questionnaire was administered to elderly urban dwellers aged 65 years or more in a city in September 2001. A total of 13,916 questionnaires were returned, yielding a response rate of 80.2%. A follow-up survey including 8,162 participants aged 65 to 84 years was conducted in September 2004. Exploratory factor analysis was used to define “three health factors” (where the quotation marks designate a latent variable) correlated with Basic Activities of Daily Living (BADL), Instrumental Activities of Daily Living (IADL), social activities, lifetime disease history, and subjective health. Structural equation modeling was conducted to clarify the causal relationships between the “three health factors” and “socio-economic factors”. The theoretical model was formulated using SPSS 16.0J, AMOS 16.0J for Windows.
Results: The “three health factors” were directly affected by the “socio-economic factors” correlated with educational status and yearly income, with standardized estimates ranging from 0.002 to 0.096 for men and 0.119 to 0.137 for women for the parameters with the largest magnitude of effect. However, only a weak direct pathway from the “three health factors” to the “socio-economic factors” was in evidence for both sexes. Notably, educational status and yearly income influenced the “three health factors”. These findings indicate that basic factors affecting the “three health factors” could include educational status and yearly income. Goodness of fit indices showed an acceptable fit of our model to the data (NFI = 0.924, RMSEA = 0.043), and adjusted determination coefficients for the “three health factors” were 55-99 percent across both sexes.
Conclusion: This study suggests that “socio-economic factors” determine the “three healthy factors” in a three-year span of time. Further research is necessary to devise a model with higher levels of both internal and external validity.

View full abstract

Objective: To examine the relation between self-efficacy to resist situational temptations in weight control and coping strategies.
Methods: A self-reported, cross-sectional questionnaire was administered to 994 Japanese employees in July 2008. Of 994 respondents, data from 622 employees (mean age: 42.2 years; 419 [67.4%] men) were analyzed. The questionnaire included items on self-efficacy to resist situational temptations in weight control (availability, social pressure, relaxation, reward, negative emotion, and hunger), coping strategies (counter-conditioning, eating style, stimulus control, social support, and cognitive coping), and demographic characteristics. Pearson correlation coefficients were calculated to determine the relationship between self-efficacy and coping strategies. Multiple regression analyses were then used to further investigate the associations between self-efficacy (treated as the dependent variable), and demographic characteristics and coping strategies (treated as the independent variables).
Results: Results of single correlation analyses indicated that self-efficacy to resist situational temptations posed in the form of availability and hunger was positively correlated with three of the five coping strategies (eating style, stimulus control, and cognitive coping). In multiple regression analyses, significant positive correlations were found between self-efficacy in five of the six measured domains (regarding availability, relaxation, reward, negative emotion, and hunger) and one of the five coping strategies (cognitive coping). Self-efficacy to resist social pressure was correlated with age, gender, and social support. Additionally, gender was correlated with self-efficacy in terms of availability, relaxation, negative emotion, and hunger.
Conclusion: Results of single correlation analyses indicated that the extent to which coping strategies relate to situational self-efficacy may vary according to the situations and temptations with which an individual is confronted. Accounting for the influence of demographic characteristics and the mutual effects of coping strategies, cognitive coping was positively correlated with self-efficacy to resist many temptations. Moreover, this study suggests that demographic characteristics may also play a role in situational self-efficacy.

View full abstract

Objective: Environmental factors are related to physical activity among youth on a long-term. The purpose of the present study was to develop a neighborhood physical activity environment scale and to examine the relationship between neighborhood physical activity environment and out-side of school physical activity and school commuting among Japanese elementary students.
Methods: Internet-based survey was administered to 1,074 Japanese guardians aged 20-59 years who had elementary school child. Sociodemographic attributes (gender and age of guardians, gender, age, hight and weight of children), neighborhood physical activity environment scale including 16 items and time of physical activity during out-side of school for leisure and walking to school commuting were assessed by the self-administered questionnaire.
Results: Exploratory factor analyses identified 4 factors labeled “safety” with 5 items, “pleasing aesthetic” with 4 items, “crime safety” with 2 items and “uncomfortable aesthetic” with 2 items. Confirmatory factor analyses to examine the construct validity revealed acceptable fit indices (GFI = 0.969, AGFI = 0.949, RMSEA = 0.052, AIC = 288.360). The reliability of the subscale was found good internal consistency (r = 0.67-0.79) and moderately high inter-rater reliability (r = 0.55-0.68). Those who perceived good “safety”, “pleasing aesthetic” and “uncomfortable aesthetic” environments were significantly more likely to spent of physical activity during out-side of school for leisure and school commuting.
Conclusion: The valid and reliable neighborhood physical activity environment scale was developed and it is applicable to the assessment of neighborhood environmental perceptions relevant to physical activity in Japanese elementary school children.

View full abstract

Objective: The purpose of this study was to examine the associations of family meal frequency and voluntary communication during mealtime with dietary attitudes, dietary behaviors, and quality of life among fifth-grade students.
Methods: This is a cross-sectional study with 1,752 fifth-graders from a total of 13 elementary schools in Sakado City, Saitama. Data of 1,445 students (boys: n = 770, girls: n = 675) among those who answered self-administered questionnaires in 2006 and 2007 were used in this analysis. Students were divided into four groups based on their answers on family dinner frequency and voluntary communication during mealtime. Differences in dietary attitudes, dietary behaviors, and quality of life by four groups were analyzed.
Results: A total of 242 boys (31.4%) and 288 girls (42.7%), who has family dinner ≥4 times /week and have much voluntary communication, were included in Group A. Students in Group A were more likely to have positive dietary attitudes, dietary behaviors, and quality of life, compared to those in Group B (i.e., family dinner ≥4 times /week and little voluntary communication) and Group D (i.e., family dinner ≤3 times /week and little voluntary communication). Few significant differences were found between groups A and C (i.e., family dinner ≤3 times /week and much voluntary communication), or between groups B and D.
Conclusion: This study suggests that regular family meal occasions, as well as much voluntary communication during mealtime, are associated with better dietary attitudes, dietary behaviors, and quality of life in students.

View full abstract

Objective: The purpose of this study was to examine the reliability and validity of a dietary-related media literacy scale among junior high school students.
Methods: A cross -sectional questionnaire survey was conducted among 2,064 junior high school students in Tokyo and Saitama between June and July in 2011. Referring to previous studies on the general media literacy and dietary behaviors, we hypothesized that media literacy consists of 2 core concepts: “critical thinking” and “autonomous judgment”. A total of 29 items were included as a dietary-related media literacy scale. A total of 29 items on dietary-related media literacy scale were included. The reliability was examined by internal consistency (Cronbach's alpha coefficient) and the test-retest method. The validity was tested by examining the associations with the snack choice questionnaire, the general scale for media literacy, and media use.
Results: Totally, valid responses were 1,456 (valid response rate:70.5%). Exploratory factor analysis revealed four factors with sixteen items: “food label use”, “influence from food advertisements and sales promotions”, “critical perception towards dietary-related media information”, and “judgment of nutritional balance.” Goodness-of-fit of the model was high using the confirmatory factor analysis (GFI = 0.96, AGFI = 0.95, CFI = 0.96, RMSEA = 0.05). Cronbach's alpha coefficient of each construct was satisfactory (α = 0.76-0.83) and the test-retest scores were significantly correlated (r = 0.48-0.67, p < 0.01). Multiple regression analysis revealed that “influence from food advertisements and sales promotions” was negatively associated with television viewing on weekdays and parents' positive mediation on television, whereas other three constructs were positively associated with parents' negative mediation on television.
Conclusion: This study indicated that the reliability and validity of the dietary-related media literacy scale among junior high school students were satisfactory.

View full abstract

Purpose: In a rapid developing Internet society, eHealth literacy becomes important to promote eHealth and aid in health care among individuals and groups. However, little is known about eHealth literacy in Japan. The present study reviewed the concept and issues of eHealth Literacy to promote eHealth effectively through recent trends of eHealth literacy.
Methods: Medline, CINHAL, ERIC and “Igaku-chuo-zasshi” were searched for studies published in English and Japanese before September 30, 2011. “eHealth literacy”, “e-Health literacy”, “e- literacy”, “eHEALS” and “Health literacy & Internet” were used as key words. A total of 161 publications were identified and 14 publications and 4 publications from reference lists met the inclusion criteria.
Results: Twelve publications introduced the Lily model of eHealth literacy developed by Norman et al. in 2006 as follows: the ability to seek, find, understand, and appraise health information from electronic sources and apply the knowledge gained to addressing or solving a health problem. Furthermore, one study advocated the concept of eHealth literacy, three studies developed the scale of eHealth literacy and five studies examined the effect of eHelath literacy interventions and the eHealth literacy levels on people needing eHealth literacy.
Conclusion: Lily model of eHealth literacy is the most prevalent concept. It is necessary to revise the concept of eHealth literacy to include the skills of use Web 2.0 tools (e.g. Social Networking Service) in eHealth literacy and conduct the studies using the valid scale of eHealth literacy.

View full abstract

Objective: To determine how functional health-related social support from the husband correlates with Japanese women's adherence to health checkups, as measured among adult Japanese married men.
Methods: In this cross-sectional study, questionnaire data were collected from 4,861 health insurance union members of a company in Japan, from August to September 2010. Collected information included spouse's health insurance coverage as a dependent, spouse's health checkup adherence during the previous year, husbands' provision of health-related social support to the spouse (one item each for emotional, informational, appraisal, and instrumental support), sex, and age. A total of 966 married male union members were included in the analysis (response rate: 19.9%). Stratified by spouse's union membership status as a dependent, bivariate and multivariate logistic regression analyses were then conducted using spouse's health checkup adherence as the dependent variable, social support items as independent variables, and age as a control variable (forced entry method).
Results: In bivariate analysis, among wives who were covered as dependents under their husband's health insurance (n = 626), those who received more emotional and instrumental support from their husbands underwent health checkups more frequently than those who received less such support (emotional-odds ratio [OR]: 1.60, 95% confidence interval [CI]: 1.04-2.46; instrumental-OR: 2.27; 95% CI: 1.56-3.32). In multivariable analysis, instrumental support was significantly associated with wives' health checkup adherence (OR: 2.23, 95% CI: 1.50-3.32). However, among the wives who were not covered as dependents (n = 340), no such correlations were observed.
Conclusion: The findings suggest that health-related instrumental social support provided by a husband might encourage Japanese women of dependent status to undergo health checkups.

View full abstract