Objectives: To examine the reliability and validity of the Japanese version of the Health Education Impact Questionnaire (heiQ-J) which measures the self-management ability for male workers with metabolic syndrome (MetS).
Methods: Between 2008 and 2012, a longitudinal survey was conducted for 525 men who received Specific Health Guidance (Tokutei Hoken Shido) at six sites from the Tokai to Kanto areas of Japan. heiQ-J was administered to the participants, and they were asked about their lifestyle using “Questionnaire on Specific Health Checkups” by the Ministry of Health, Labour and Welfare. The questionnaire was completed before and after the health guidance. Reliability analysis and factorial validity examination of heiQ-J were performed. Sensitivity was assessed on the basis of the relationship of the questionnaire with Specific Health Checkups. Changes in heiQ-J scores after the health guidance were examined using an effect size.
Results: The model GFI was 0.81, AGFI was 0.78, CFI was 0.84, and RMSEA was 0.060, and heiQ-J (model 2) was adopted with an error covariance set for 43 items in eight subscales. Comparison with heiQ-J showed the sensitivity to a healthy lifestyle of “Questionnaire on Specific Health Checkups”. Improvement was observed in approximately half of the participants in “health service navigation,” “skill and technique acquisition,” “self-monitoring and insight,” and “health-directed activity” after completing the health guidance (effect size ≧ 0.5).
Conclusion: The reliability and validity of heiQ-J (43 items) were confirmed as a metric for health guidance designed to improve metabolic syndrome. It suggests that the heiQ-J could be used in health guidance.

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Aim: The aim of this study was to evaluate the relationships of health literacy with coping behavior towards the side effects of complementary and alternative medicine (CAM) and with communication of patients with chronic diseases among physicians in Japan.
Method: In this cross-sectional study, self-administered questionnaires were distributed among 920 patients with chronic diseases registered at patients' associations from May to July 2011. Of 570 valid questionnaires (response rate: 62.0%), 428 individuals had used CAM and were selected as participants. The unpaired student's t-test was used to correlate health literacy with the presence or absence of side effects (side effects group and no side effects group), with coping behavior towards side effects (continuation group and discontinuation group), and with reporting treatment and side effect symptoms to physicians (report group and no report group). Multiple logistic regression analysis was performed to determine the relationship between health literacy and discontinuation and report groups.
Results: Of 428, 88 participants (20.6%) experienced CAM side effects. Of them, 45.9% continued to use CAM and 61.6% did not report their side effects to physicians. Health literacy was higher in the discontinuation and report groups than in continuation and no report groups, respectively. Multivariate analysis indicated a relationship of health literacy with the discontinuation group (OR = 2.75, 95% CI: 1.06-7.10) and with the report group (OR = 2.59, 95% CI: 1.01-6.65).
Conclusion: Health literacy is important for the safe use of complementary and alternative medicine because it facilitates appropriate coping behavior towards side effects.

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Objective: The purpose of this qualitative study was to identify features related to perception of falls among older adults living at home in a metropolitan area.
Methods: The participants comprised 10 older adults (4 men; 6 women; from 8 families) over 75 years of age who were currently receiving medication at a clinic in Tokyo. Data were collected through home observation visits and semi-structured interviews regarding falls and near-falls in the home, fall prevention measures, and the experience of their friends in relation to falls. All interviews were recorded and transcribed. Descriptions concerning perception of falls were extracted and then analyzed using the KJ method.
Results: Based on the analysis, we identified the following relationships regarding perception of falls among older adults living at home: “Fall prevention measures” was the opposite of “No fall prevention measures”; “Fall prevention measures” was associated with “Experience of their friends”, “Image of falls”, “Awareness of aging”, “Perception of carefulness”, and “Perception of carelessness”; and “No fall prevention measures” was associated with “Perception of safety”. “Carelessness” and “Misunderstanding” were also identified as descriptors related to perception of falls.
Conclusion: “Fall prevention measures” was primarily associated with anxiety and fear of falls, awareness of aging, and fall risk, whereas “No fall prevention measures” was associated with falls self-efficacy, overconfidence, and a priority on convenience. These issues should be considered when developing health education programs that promote the prevention of falls in older adults living at home.

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Objective: To examine leftover-related behaviors of junior high school students who were instructed to eat everything served to them at home and to explore associations between this instruction and confidence about eating unpalatable food in school meals, and positive feelings after finishing a meal.
Methods: We distributed a self-report questionnaire about food waste to a cross-sectional sample of 4,634 eighth-grade students in 33 public junior high schools in Tokyo, Japan, in December 2009. We used chi-square tests and Bonferroni's multiple comparisons to examine associations between rules at home and confidence about eating unpalatable food in school meals and positive feelings after finishing a meal. We also used chi-square tests to examine associations between positive feelings after finishing a meal and confidence about eating unpalatable foods in school meals.
Results: In total, 4,578 students answered the questionnaire (response rate: 98.5%). Compared with students who were not given instructions, those who were instructed to eat everything at home: 1) left less food during their daily meals (p = 0.002), 2) were more confident about eating unpalatable food in school meals (p = 0.016), and 3) had more positive feelings after finishing a meal (p < 0.001). Students with positive feelings after finishing a meal were more confident about eating unpalatable food in school meals (p < 0.001).
Conclusion: Junior high school students instructed not to leave leftovers at home left less food at their daily meals, were more confident about eating unpalatable food in school meals, and had more positive feelings about finishing a meal.

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Background: The health status of people is unequal despite extensive efforts on health improvements. Among factors that affect inequality in health, some factors can be mitigated by good policy interventions whereas others factors cannot. According to the concept of the social determinants of health, health status is strongly affected by political, economic, and social factors that could have been mitigated. This article introduces the political determinants of health as a concept of analyzing political factors among the social determinants of health.
Contents: No widely accepted definition is available about the political determinants of health. Researchers typically focus on the lack of capacity and political will among governments and non-state players in health. They also analyze conflicts of interest among players. The political determinants of health have been studied both at the global and state levels. Research in global health includes disparities in power among players and insufficient governance, such as the emergence of new players and conflicts with existing players. Other research addresses differences in political regimes and policy options that determine health inequity, including the influences of political instabilities on health inequity.
Conclusions: The political determinants of health are a relatively new academic concept although practitioners have long faced issues regarding politics and health. From different points of view on politics and health, researchers are expected to examine the available research critically and to investigate the underlying mechanisms of the political determinants of health.

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