Objective: To clarify the components of self-efficacy for self-care behaviors in pregnant women, and to examine the effects of generalized self-efficacy attentiveness toward health during pre-pregnancy, health-promoting behaviors, and psychosomatic symptoms.
Methods: A cross-sectional study was conducted among 590 pregnant women through a written questionnaire. 589 valid responses were collected. The survey comprised items concerning self-efficacy for self-care behaviors in pregnant women, generalized self-efficacy, attentiveness toward health during pre-pregnancy, health-promoting behaviors, subjective symptoms, and basic attributes. An exploratory factor analysis was conducted on the survey items concerning self-efficacy for self-care behaviors in pregnant women. A regression analysis was conducted using the scores of each question item as independent variables, and the three factors of self-efficacy for self-care behaviors in pregnant women as dependent variables.
Results: Three factors were identified as the components of self-efficacy for self-care behaviors in pregnant women: “confidence in health management and life adjustment,” “confidence in the self-awareness of one's daily physical condition,” and “confidence in a normal course of pregnancy and delivery.” These three factors were influenced by generalized self-efficacy (β = 0.36, 0.16, 0.32, p < 0.01), attentiveness toward health during pre-pregnancy (β = 0.25, 0.12, 0.26, p < 0.01), health-promoting behaviors (β = 0.22, 0.13, 0.12, p < 0.01), and the pre-pregnancy self-awareness score (β = -0.07, p < 0.10, β = 0.18, p < 0.01, β = -0.22, p < 0.01).
Conclusion: To increase self-efficacy for self-care behaviors in pregnant women, focus should be put on health awareness, health-promoting behaviors, and subjective symptoms in the pre-pregnancy period. Health guidance and support for reducing subjective symptoms should be provided for them from this period.

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Objective: We investigated the association of young single males' current frequency of breakfast intake with their recollections of childhood dietary habits.
Methods: In this cross-sectional study, 229 recently hired male employees from 5 different companies filled out a questionnaire. First, exploratory factor analysis was done to examine responses to the questionnaire, which consisted of 43 items about respondents' childhood dietary habits. Internal reliability for each dimension was also calculated. Second, three-step hierarchical multiple regression analysis was conducted to assess the relationship between childhood dietary habits and current eating behavior. As independent variables, demographics and health status were entered in Step 1, lifestyle habits in Step 2, and childhood dietary habits in Step 3.
Results: Of 229 participants, 215 responded to the questionnaire in full, with a mean age of 22.8 (SD 1.5) years. Exploratory factor analysis identified 30 items contributing to 6 factors: “meal preparation,” “varied meals,” “meals with family,” “eating manner,” “child-centered meals,” “regular meals,” with the solution accounting for 56.4% of the total variance. Internal reliability for each dimension was satisfactory. Three-step hierarchical multiple regression analysis found that “regular meals” in childhood was significantly associated with increased frequency of eating breakfast in adulthood (β = 0.355, Step 3). In addition, this association was stronger than that of current family structure or degree of physical activity, late dinner with frequency of eating breakfast.
Conclusion: Young single males who eat meals regularly in childhood are more likely to eat breakfast more frequently when they become adults. Regular meals in childhood might have a long-term impact on healthy eating among adult men.

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Objectives: 1) To determine whether food frequency differed by the behavior of taking care of one's diet for health. 2) To evaluate the association between such dietary behavior and desirable food intake behavior among individuals with physical disabilities.
Methods: In this cross-sectional study, an anonymous questionnaire was distributed to 739 individuals with physical disabilities at two sports centers in Tokyo; In total, 652 individuals responded, and data from 381 (51.6%) were analyzed; this was mostly because of excluded responses owing to crucial missing data related to sex, age, type of disability, living arrangements, and responses to two questions regarding “taking care of one's diet for health” and “food intake”. Food frequency scores were compared between those who “took very good care of diet” and “others” by using the Mann-Whitney U test. The associations between dietary behavior and the food frequency of 10 food items were then analyzed using binomial logistic regression.
Results: Individuals who “took very good care of their diet” had higher food frequency scores than others, and were significantly associated with a higher intake frequencies of green vegetables (OR: 2.57, 95% CI: 1.65-4.00), other vegetables (OR: 2.23, 95% CI: 1.43-3.45), and fruit (OR: 2.29, 95% CI: 1.47-3.57).
Conclusions: In a nutrition education program for individuals with physical disabilities, the dietary behavior of “taking very good care of diet” could lead to their desirable food behavior of eating more vegetables and fruits.

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Objective: The present study aimed to develop, implement, and evaluate a nutrition education program for home economics in junior high school that is consistent with the curriculum of home economics in elementary school. It focuses on “enjoyable learning,” which increases motivation to learn and encourages students to learn on their own.
Methods: Our program was consistent with the government's curriculum guidelines, set learning goals based on assessment, and then examined the program contents. The program, consisting of three lessons, was implemented for 136 students in the 7^th grade in W junior high school in S-city, Saitama Prefecture, in October and November 2011. Students' self-check cards and teacher's self-reports were used for process evaluation. Changes before and after the program were evaluated based on the students' self-administered questionnaire.
Results: More than 70% of boys (n = 59) and more than 80% of girls (n = 74) enjoyed each of three programs. Students' free answers and teacher's self-reports also showed that the program was sufficiently enjoyable for students. The median scores of all five items on attitudes towards learning about food and nutrition, including “I like learning about food and nutrition” and “I think it is important to learn menu planning” significantly increased after the program.
Conclusion: The nutrition education program with “enjoyable learning” encouraged students to learn about food and nutrition on their own initiative and increased their motivation to practice what they learnt in their daily life.

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Objective: To show a practical definition of advocacy and to illustrate the characteristics of AIDS advocacy at global level as an example of its practice.
Contents: Advocacy is an activity to facilitate the formation of public policy and its changes. It consists of four major activities: protection of rights, policy recommendations, lobbying, and advocacy marketing. At global level, AIDS advocacy is a well-known activity and it has helped to achieve a huge increase of AIDS financing from a few hundred thousand dollars in 2000 to about 15 billion dollars in 2013. Moreover, the rate of new infection has been decreased by 38% from 2000 to 2010. To evaluate such advocacy activities, 6-point framework is available. Out of six, ‘shift in social norm’ and ‘changes in impact’ are comparatively easy to measure and we have seen how effective it is to use these two. However, this strong advocacy seems to affect other disease control measures such as non-communicable diseases, as they are not equally financed for developing countries.
Conclusion: Advocacy is powerful, but it is not a panacea. An advocacy might create an unbalanced situation of budget allocation for the whole health sector. Mediation is still lacking for this at global level. When we conduct advocacy activities, we should consider both the positive and negative aspects of advocacy.

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The biggest findings in epidemiologic research in the twentieth century were to identify the health hazards of smoking. To bridge the gap between the epidemiologic research findings and practice, it is necessary to develop effective methods for smoking intervention based on theoretical background of behavior science. The five-phase model for cancer control proposed by Greenwald and Cullen is useful for planning intervention studies. It consists of hypothesis generation, methods development, individual-based controlled intervention trials, intervention studies in defined populations, and demonstration projects.
Although effective intervention methods have been developed, it does not lead to a nation-wide increase of practice. To bridge the gap between the scientific evidence from intervention studies and the practice, it is necessary to promote policy research, which create the evidence for policy making and develop effective methods for advocacy.
Tobacco control in Japan is behind internationally. Smoking is still the most preventable cause of death in Japan. Policy research is strongly needed to promote tobacco control and prevent the serious health damage due to smoking.

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Objective: This study reviewed the advocacy activities conducted by researchers during their research activities that served to influence policymaking in local government and thereby to improve social issues.
Contents: University researchers are often closely connected with policymaking in the local community because they frequently involve in policymaking processes at local government level. In 2013, after having been involved in nutrition policymaking in the local community for the past 15 years, we started working on improving the efficacy of sodium restriction policies in the Niigata Prefecture. For this, we have established working relationships with public health nutritionists and other professionals in the prefectural and municipal governments. Then we have surveyed and analyzed the current situation, planned appropriate measures through the Plan-Do-Check-Act cycle, and finally developed an evaluation program. In particular, we elucidated the characteristics of food that contribute to a high sodium intake among the residents of Niigata Prefecture. It allowed us to clarify the roles of the prefectural and municipal governments, and we have been discussing educational and environmental plans with residents.
Conclusion: These advocacy activities helped us to narrow down the targets for certain low-sodium measures and also to improve and empower the process of policymaking by public health nutritionists and researchers. The advantage of this approach is that one advocacy activity continues to influence future policymaking. The development of public policies from the perspectives of health and independent groups, including local business owners, is eagerly awaited for health promotion.

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Objectives: We described the concept of advocacy at the enterprise (i.e., organizational) level from the practitioner's perspective, taking the implementation of occupational health activities within an enterprise as an example. More specifically, we clarified how factors related to international academic societies and findings from specific health screenings and guidance (which are state measures) are applied to the advocacy of healthy companies and healthy management through occupational health activities.
Content: Participation in the International Union for Health Promotion and Education or other conferences or cooperation with policy-oriented occupational health and safety measures (e.g., specific health screenings and guidance or stress checks) are seemingly unconnected to occupational activities in actual settings. But we demonstrated these experiences provide considerable insight and relevant knowledge in actual settings from the perspective of “think globally, act locally.” To successfully integrate these findings and put them into practice, it is important to constantly consider the best occupational health activities that can be implemented in one's work domain and to set workplace health goals. In this article, we examined advocacy at the enterprise level by presenting cases of workplace health promotion (WHP) based on needs assessment and development of healthy companies involving management and labor unions.
Conclusion: Based on the practice of two cases, it was revealed that time and effort are required to persuade key persons including management to comply with the transformation of the enterprise or organization. To reach this goal, it was necessary to “look for the key persons and form a group to engage in WHP together in good faith, stably, on the basis of evidence as much as possible, and taking the position of other parties into consideration.” Advocacy is not separate from daily occupational health activities; rather, it is an extension of such activities.

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Background: The Japanese Society of Health Education and Promotion (JSHEP) conducted a seminar to explain and discuss advocacy in the field of health education and promotion. The aim of this paper was to report on the content of the discussions between participants and speakers during the second part of the seminar.
Contents: During the first part, the speakers made presentations about advocacy work from a global, national, local, and company-point of view. Then in the second part, the speakers and participants discussed the content of the lectures. During the discussion, they first spoke about the driving force behind advocacy. Then they argued about who should be the advocates and how JSHEP should implement advocacy activities. The challenges for advocacy were also discussed. Two major ones were: the development of human resources in the administrative branch of the Japanese government and the expected but difficult roles of advocacy by the universities. In addition, a participant who belongs to a government agency spoke about the need for more advocacy by academic societies.
Conclusion: We shared JSHEP's future direction of advocacy during discussion. We also discovered the challenges for strengthening advocacy work by JSHEP. Future actions should be taken to promote JSHEP's advocacy.

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Background: The Japanese Society of Health Education and Promotion (JSHEP) conducted a seminar on advocacy on January 25, 2015. This paper reports the contents of discussion throughout this seminar.
Contents: To contribute to society as researchers, we need to enhance our capacity for advocacy in addition to gaining research and practice implementation skills. Although we understood the importance of advocacy in this seminar, it remains difficult for us to envision a specific procedure of conducting advocacy just by attending it. To adequately execute advocacy, we found we should acquire more basic knowledge about the policy itself and understand the process of policy making by the government.
Conclusions: We learned a great deal about advocacy in this seminar. For the next step, we expect to know more about basic knowledge about the policy. We also expect to learn about policy making process from the policy makers in the government in the coming opportunities.

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