Objective: The purpose of this study was to examine the relationship between health information sources and eating behavior and physical activity among Japanese adults.
Methods: Participants were 898 Japanese male and female (average age 41.5 years) who had been registered with a social research company. The cross-sectional questionnaire survey was conducted via the Internet. The survey included items on health information sources as the independent variable, and eating behavior and physical activity as the dependent variables. Multivariate logistic regression analysis was used to examine the relationship between health information sources and eating behavior and physical activity, after adjusting for age, education status, income, and number of families. The analyses were stratified by gender.
Results: As the sources of health information magazines (OR = 1.70, 95% CI = 1.01, 2.86) and family (OR = 1.98, 95% CI = 1.05, 3.73) were positively associated with eating breakfast among the male. Newspapers (OR = 1.68, 95%CI = 1.04, 2.71) and family (OR = 2.40, 95%CI = 1.35, 4.27) were positively associated with eating well-balanced meals among the female. Magazines (OR = 1.77, 95%CI = 1.07, 2.95) and the Internet (OR = 1.55, 95%CI = 1.03, 2.35) were more likely to provide recommendations for physical activity among the male.
Conclusions: These results suggest that useful channels for the promotion of eating behavior are family and magazines among the male and family and newspapers among the female, and that health information obtained from magazines and the Internet is useful to promote physical activities among men.

View full abstract

Purpose: This study aimed at developing a scale that gauges perceived benefits from walking behavior.
Methods: This cross-sectional study was conducted among 3,000 Japanese people aged between 40 and 64 using an internet-based questionnaire. Eight factors with 5 items (40 items in total) were identified about the benefits from walking behaviour, and exploratory and confirmatory factor analyses were utilised to examine the validity and reliability of the scale.
Results: Seven factors with 3 items (21 items in total) were extracted which had acceptable construct validity (GFI = 0.942, AGFI = 0.921, RMSEA = 0.06). The results of internal consistency (Cronbach α = 0.80-0.88) suggested that this scale has acceptable reliability. Although the subscale was partially invalid, the scores from those who walked > 150 min/week were significantly higher than those who walked < 150 min/week. The positive consistent reliability with the test-retest was also identified (r = 0.74, p < 0.01).
Conclusion: The perceived walking benefits assessment scale of 7 factors with 21 items was developed and demonstrated acceptable validity and reliability.

View full abstract

Objective: To examine the relationship between Alcohol Use Disorders Identification Test (AUDIT) score and intention to reduce alcohol intake (sobriety intention) in male drinkers.
Methods: A cross-sectional survey of 363 male drinkers receiving health check-ups in a clinic was carried out by self-reported questionnaire. Participants were classified into three groups by AUDIT score (Group A: ≤7 points, Group B: 8-15 points, and Group C: ≥16 points). Basic characteristics, drinking status, perceived benefits and demerits of drinking, knowledge of appropriate drinking behavior, and sobriety intention were compared between the three groups. A logistic regression analysis was conducted to examine factors influencing sobriety intention. Independent values included in the model were age, number of perceived benefits to drinking, number of perceived demerits to drinking, and four items from the AUDIT (drinking frequency, effects from drinking felt the next day, guilt felt after drinking, and drinking-related concern or suggestion from others).
Results: The higher the AUDIT score, the higher the observed sobriety intention among participants; 42.9% of those from Group B, and 64.7% of those from Group C wanted to reduce their drinking. However, 73.8% of those from Group B, and 38.2% of those from Group C had heard no concern or suggestion regarding their drinking from others. Identification of the correct level of appropriate drinking, meanwhile, was observed in just 30-40% of participants. A logistic regression analysis showed that sobriety intention was associated with three items of the AUDIT: drinking frequency (odds ratio: 1.62), feeling guilty after drinking (odds ratio: 1.74), and hearing drinking-related concern from others (odds ratio: 1.38).
Conclusion: AUDIT scores were related to sobriety intentions among drinking men in this study. In designing behavioral education interventions, problem drinking and sobriety intentions should be incorporated in screening tests.

View full abstract

Objective: This study was conducted to evaluate revised instruction to promote understanding and support of children with chronic diseases, especially those with type 1 diabetes, among peers.
Methods: Primary aspects of the revised instruction to be evaluated encompassed simplifications in the instruction content, valuation method, and leader's unification. This study also assessed the program's execution in a public junior high school, including subsequent implementation of a follow-up survey.
Participants were 222 second-year students of a public junior high school. All students read a pamphlet about type 1 diabetes, after which instruction was delivered to intervention classes in lesson format. Lessons were designed to promote understanding and support of children with chronic diseases, especially type I diabetes. Intervention classes were assessed immediately before and after the lesson, and again one month later. Control classes were also evaluated at each of these intervals.
Results: Male students' scores on “understanding an ailing friend” (p = 0.001), and “supporting an ailing friend” (p < 0.001), and female students' scores on “understanding an ailing friend” (p = 0.003), “supporting an ailing friend” (p = 0.016), and “cognitive and sympathy questions” (p < 0.001) increased after receipt of the revised instruction. Assessed 1 month later, male students' scores on “understanding an ailing friend” (p = 0.041) and female students' scores on “supporting an ailing friend” (p = 0.047) remained higher than before.
Conclusion: These results suggest that this mode of revised instruction is useful for improving understanding and support of children with chronic diseases.

View full abstract

Objective: We provided support to develop community activity groups for retired men and investigated factors related to promotion of group activities based on the progress of their activities.
Methods: In 2007 and 2008, we conducted a program for men aged 55 to 65 years to develop groups that would enable them to strengthen ties to the community through activities. We followed the progress of group activities through participant observation of activities and interviews with group members, and summarized the progress of activities. Factors related to promotion of group activities were identified based on the progress of activities.
Results: A total of 19 of 23 applicants in 2007 and 12 of 12 applicants in 2008 participated continuously in the program. After the program in 2007 and 2008, each group was established as the participants hoped to continue the group activities.
The following five facilitating factors of the group activities were identified during the activities: (1) Getting to know each other well without minding titles, (2) Pursuit of challenges that are within reach and recognition of their outcomes, (3) The freedom and joy, (4) Exchanges and collaborations with various organizations, and (5) Having a base of operation. Obtaining a sufficient number of members was considered an issue for future group activities.
Conclusion: We identified five facilitating factors to promote group activities and need for obtaining more members as issue for future group activities.

View full abstract

Background: Since 1994, when population health first emerged as a major concept in public health, health promotion has lost considerable currency in this field. From the outset, discussions on the value of health promotion have been particularly prominent in Canada. This article introduces three points as food for thought in their potential relevance to the Japanese context. The first point is on the difference between promotion of health and health promotion. The second addresses the kind of evidence needed for health promotion. The third and final point describes the unique evolution process of health promotion.
Contents: First, promotion of health is a discourse that can be shared among those trying to promote the health of a population, whereas health promotion can be more narrowly defined as the process of planned changes in lifestyle or living conditions conducive to health. Second, evidence regarding promising practices is generally more relevant to health promotion, which is delineated in illuminating and inspiring positive behaviors though they might not be scientifically as rigorous as best practices. Finally, compared with a tree-type evolution process, the spread of health promotion can be understood best by conceiving of its evolution process as essentially rhizomatous - taking root and spreading out horizontally. Greater attention should be paid to this quality of the health promotion development course rather than seeing it as a simple tree-type evolution.
Conclusion: Health promotion should be perceived as a more specialized area of public health by using an appropriately narrowed-down definition. Promising practices are now more recommended in health promotion strategies, and the evolution of health promotion can be better understood when we see its process as more like a rhizome than a tree.

View full abstract

Background: Behavior change is one of the most important tasks of health education and health promotion. However, even by using established strategies in this field, it is not always easy to change behaviors. This article introduces the positive deviance approach as one of the more effective ways to bring about behavior change.
Contents: A positive deviant is one who can outperform or solve a problem better than others facing the same problem and equipped with the same resources. In 1990, when Save the Children-USA conducted a nutrition survey in four rural villages in Vietnam, they found that 64% of children under 3 years were suffering from malnutrition. Rather than focusing on this high prevalence, they honed in on the remaining 36% who were well nourished and identified positive deviants among them. The characteristic behaviors of the positive deviants' caregivers were as follows: feeding their children with freely available small shrimp and other food from the rice field, washing their children's hands whenever they touched dirty materials, and increasing the feeding frequency from 2 to 4-5 times daily. Based on these findings, the organization took a positive deviance approach and actively disseminated these practices in other villages, as a result of which 50,000 children experienced improved malnutrition status over seven years. Since then, this approach has been effectively applied to realize improvements in in-hospital infection, infant and child mortality, obesity, nutrition of pregnant mothers, and a host of other public health challenges.
Conclusion: The positive deviance approach is an effective way to overcome major public health challenges that require behavior change. Though not yet popular in Japan, this approach may be useful to tackle national issues such as aging, post-disaster response needs, and school-based bullying.

View full abstract