Objective: This study aimed to clarify the effects of human support and different methods of human support in web-based weight-loss programs that assessed the effects of these programs for healthy adults.

Methods: We identified relevant articles using PubMed, Cumulative Index to Nursing and Allied Health Literature, and Japan Medical Abstracts Society databases with the following keywords: weight-loss, web, internet, and randomized controlled trials, among others. We selected articles using inclusion criteria such as outcome including body weight, randomized controlled trials, and exclusion criteria, such as weight maintenance after losing weight, effects of food and drug, etc.

Results: We selected 17 articles out of retrieved 216. Out of 7 studies that assessed the effects of human support in web-based weight-loss programs, 5 showed the effects of human support. Regarding the effects of different methods of human support, 4 studies showed no significant differences between remote and face-to-face human support. Among the studies reviewed, 2 studies assessed the effects of different elements of human support, 1 assessed the effects of different periods of human support, 1 assessed the effects of different frequencies and means of human support, and 2 compared the effects between human support and other support methods (e.g., incentive). Reported weight changes ranged from 1.5 (3-month program) to 8.8 (6-month program) kg.

Conclusions: Using human support to web-based weight-loss programs may enhance weight reduction, but little difference was observed between remote and face-to-face human support. Moreover, it remains difficult to conclude the effects of different elements, periods, and frequencies. More studies are awaited to assess the effects of different human support methods.

Objective: To examine the reliability and validity of a scale assessing "children's independent eating behavior at home".

Methods: Self-report questionnaires were administered to a cross-sectional sample of 434 parents of third- and fifth-grade children at 2 public primary schools in Tokyo, Japan, in 2014. In the questionnaire, 27 items about children's eating behavior at home were included. After item selection, an exploratory factor analysis and a confirmatory factor analysis were conducted. This study calculated Good of fit index (GFI), adjusted GFI (AGFI), comparative fit index (CFI), and root mean square of approximation (RMSEA) as the model fit indices. Then reliability of the scale was examined by using internal consistency (Cronbach's alpha coefficient) and validity, by using measures of children's picky eating, leftover-related behaviors, and appetite.

Results: The questionnaire was completed by 413 parents (response rate: 95%). After the item that showed bias in answer distribution was eliminated, exploratory factor analysis was conducted. Finally, 5 sub-scales with 20 items remained and the factors were named as "Communication about foods," "Eating skill," "Eating manner," "Preparing and cleaning up after meals," and "Positive attitude during meals." Results of confirmatory factor analysis showed good model fit index. In addition, the relationships with items about eating behavior and attitude had reasonable outcomes.

Conclusions: This study developed a scale assessing "children's independent eating behavior at home" including 5 sub-scales with 20 items and confirmed its reliability and validity.

Objective: To identify the effects of kodomo shokudo eateries through examination by its staff.

Methods: We conducted a qualitative study by employing an open-ended questionnaire. We sent a self-administered questionnaire to 273 kodomo shokudo eateries across Japan in March 2017. We asked the following question to the staff of the eateries to write a free description in response: What kind of effect do kodomo shokudo eateries have? We then collected a total of 120 questionnaires (44% response rate) and analyzed them. First, we coded the answers, then summarized sub-categories with the codes that had been utilized in similar context and finally, generated abstracted categories. We determined the code name by judging whether each code was effective for children, parents, or communities/local residents in the context. Furthermore, we classified the sub-categories based on the objects (children, parents, or communities/local residents) that the sub-category set to target, and reflected them in the category names.

Results: We classified the effects of kodomo shokudo eateries into nine categories, which comprised 40 sub-categories. The nine categories were as follows: increased life-skills of children and parents; mood improvement of children and parents; increased satisfaction of children, parents, and local residents; overall improvement of life of children, parents, and local residents; improvement of eating habits of children, parents, and local residents; improvement of childcare circumstances of parents; promotion of connection between children, parents, and local residents; crime prevention for children; and community development.

Conclusions: Kodomo shokudo eateries are likely to have effects not only on children but also on parents and communities/local residents.

Objective: This study aimed to determine the relation between the "Japanese well-balanced diet," composed of grain, vegetables, and main dish, and other eating behaviors among Japanese male workers.

Methods: In this cross-sectional study, questionnaire data were collected from 447 home-delivery service drivers in Tokyo, Japan, in June 2016. The data comprised information on eating behaviors, including "How often do you have a well-balanced diet per a week?" We also analyzed data from 360 male daytime workers who answered the item on the frequency of having a well-balanced diet. We split the workers into two groups according to a well-balanced diet frequency and then determined differences in demographics and health conditions using t-test and chi-squared test. We used logistic regression analysis to assess the relationship between eating behaviors and well-balanced diet frequency.

Results: Regarding the frequency of eating a well-balanced diet, 154 (42.8%) of the workers answered "more than four days," whereas 206 (57.2%) reported "under three days." The former tended to be married. After adjusting age, marital status, academic background, daily working hours, and eating behavior categories, the following three factors significantly related to higher well-balanced diet frequency: they were "taking a lunch" (OR: 2.26, 95% CI: 1.37-3.74), "no skipping meals" (OR: 1.91 95% CI: 1.18-3.08), and "no late evening meals" (OR: 1.87, 95% CI: 1.17-3.00).

Conclusion: The daily behaviors of taking lunch, adequate meal frequency, and no late evening meals related to higher frequency of having a well-balanced diet. Encouraging workers to take these three behaviors may improve their diet.

Objective: We conducted a health literacy project for high school students in a city of the Aomori Prefecture in FY 2014-2016. During its process, we urged them to create their own ideas for health promotion and expected them to transmit the ideas to the community. This article evaluated the process of this project.

Project contents: We set up an occasion for high school students to present their own ideas for health promotion to the community, which we called the "Mini Mini Health Nurse Idea Contest." Specifically, three actions were taken to foster the creation of the students' own ideas: a workshop incorporating viewpoints on food, exercise, and rest; a "mini-mini health nurse stamp rally" (including a student health examination); and finally a bus tour (food exploration, exercise exploration tour) .

Project assessment: We carried out an anonymous self-written questionnaire survey for the high school students, their guardians, and contest voters. Of total participating students (N=118), 60% changed their thoughts and behaviors concerning health after the project. More than 30% of the students' parents noticed changes in the lifestyle of their children, and conveyed health information acquired from children to people, families and friends in the workplace.

Future challenges: Improvement of health literacy for high school students can be expected to have a ripple effect for parents and communities.However, it may take time to see the results in the community. Therefore, cooperation between schools and community health efforts is necessary, which could be achieved by developing a system outside the sectionalism typically seen in local government agencies.

Objective: We examined the feasibility of food and nutrition education (FNE) for junior high school students by incorporating an evaluation with the Plan-Do-Check-Act (PDCA) cycle model at the school site.

Program: The theme of the FNE was iron and calcium intake, which tends to be insufficient among junior high school students. Based on the "Food and Nutrition Education Evaluation in school aiming at Forming a Preferable Dietary Habit" proposed by the Nutrition Education Committee of the Japanese Society of Health Education and Promotion, we provided FNE once a year, in each grade. In total, 262 students from a public school in Chiba participated in this study.

Assessment: By adopting the PDCA cycle and setting systematic education goals and plans, the program contents became clear, and we were able to manage the FNE effectively. After FNE, students who could correctly select iron-rich foods increased by 26.2%, 15.6%, and 20.9% in the first, second, and third grades, respectively. Similarly, those who could correctly select calcium-rich foods increased by 4.9%, 18.8%, and 21.8%, in the first, second, and third grades, respectively. The present evaluation indicated that the outcomes of the FNE could be shared with parents and teachers through newsletters and at the staff meeting.

Future implications: In addition to securing minimum class hours for FNE, a meal survey is necessary to understand the actual eating habits of students. FNE evaluation has a great potential to promote students' awareness regarding their own health and dietary habits and help them improve and acquire appropriate dietary behaviors.

Objective: The present study aimed to examine the health behaviors and awareness of health management which facilitated the success of adult men who had lost weight under specific health guidance and maintained weight loss throughout the following self-management period.

Methods: The participants of this qualitative study were ten adult men who had received special health guidance to lose weight and maintain weight loss throughout the following self-management period. A semi-structured interview was conducted, and the results were analyzed using the Modified Grounded Theory Approach (M-GTA).

Results: The results were classified into 26 concepts, and six categories and one core category were extracted. As the adult men voluntarily learned methods for weight control, self-assessment of their weight was conducted. Daily health behaviors included subjective self-control to reduce the sense of burden. As a result, they felt a sense of satisfaction and confidence when they controlled their own weight, as well as it led participants to feel determined towards maintaining their weight loss and increasing their self-determination to take actions. By utilizing their self-management ability to lose weight, they were able to successfully maintain their weight loss.

Conclusion: The adult men gained a sense of self-determination to make decisions and became motivated to maintain their weight loss through their daily health behaviors during the self-management period. In addition, they lost weight through developing self-management skills. Therefore, it is necessary to provide specific health guidance to help them achieve self-management skills for adult men.

Objective: Reducing long working hours is a primary goal of the government's "Work-style reform." This paper reviewed major studies exploring the relationship between working long hours, quick return to workplace, and worker's mental health to clarify findings with respect to this relationship and several methodological problems.

Contents: Many articles have been produced on the relationship between working hours and worker's mental health in the fields of epidemiology and social sciences. However, most of them use cross-sectional data and mainly examined health care workers. Therefore, their results can include various biases. Furthermore, most studies examined how the intervals between shifts are associated with worker's mental health, but they have focused on only night-shift workers. Therefore, the relationship still remains unclear between quick return to work and mental health of daily workers.

Conclusions: Investigations are required to exclude the possibility of omitted variables' bias and reverse causality using quasi-experimental approach. Such interventions will precisely examine the relationship between working hours and worker's mental health, which has been suggested in the previous literature.

Objective: Health and productivity management can reduce overall health-related costs by managing both the health and productivity of employees. We aimed to describe the current situation of health and productivity management and work-style reform based on research trends concerning the relationships among productivity, working conditions and health risks.

Contents: Health-related workplace productivity has come to be defined in terms of absenteeism (sick days) and presenteeism. The latter is indicating "the loss in productivity that occurs when employees come to work but function at less than full capacity because of ill-health." The magnitude of presenteeism-related productivity loss is attracting attention recently. For example, a certain correlation is known to exist between health-related employee productivity and health-risk factors: as health-related employee productivity decreases, the health-risk level increases. Working conditions are included in the research framework in relation to health and productivity, and it has been shown that work conditions have both direct and indirect relationships with productivity.

Conclusion: To manage health and productivity, interventions are necessary to improve working conditions by the working-style reforms. By visualizing health issues in each company/organization and using data to verify the relevance of these issues to different working environments and conditions, an evidence-based Plan-Do-Check-Act (PDCA) cycle can be carried out.

Objective: This article provided an overview of the issues related to long working hours of teachers based on the statistics from the Local Government Employees Accident Compensation Fund. We examined the health conditions of teachers facing long working hours from the results of the Fund's compensation activities.

Contents: According to the 2016 "Survey of Teachers' Actual Working Conditions," teachers' working hours had increased compared to 2006. Teachers' average on-campus working hours per week were 57 hours 25 minutes for elementary school teachers, and 63 hours 18 minutes for junior high school teachers; both results had increased compared with those recorded from the same survey in 2006. Furthermore, 33.5% of elementary school teachers and 57.6% of junior high school teachers worked 60 hours a week or over, exceeding the critical threshold for determining karoshi (death by overwork) of 80 hours of overtime per month. In 2016, the number of recorded incidents of karoshi among teaching staff was a total of 7 deaths due to cerebrovascular diseases and ischemic heart diseases and 14 deaths due to mental illnesses. Teachers' labor reform has been proposed, including "time management card" and "restriction of activity time".

Conclusion: The long working hours for teachers is an issue affecting workers both inside and outside the education system. Increasing efforts are being made to create a more supportive working environment. Therefore, it is necessary for teachers to propose healthier working practices, while utilizing the supportive environment for the future.

Goal: The goal of the present study was to examine the advantages and concerns about on-going patient work support programs derived from the government-led "work-style reform", which was primarily intended to stimulate the economy at a time of decreasing birthrate and of increasing aging population.

Background and Discussion: Approximately 325,000 patients continue to work during cancer treatment period and their working environment is one of the main topics of the cancer control policy in Japan. Supporting such cancer patients has been an important task for cancer information support centers since the 2^nd Cancer Control Policy was introduced in 2012, or 4 years ahead of the Council for the Realization of Work Style Reform that started in 2016. The "work-style reform" movement redefines the support programs from their previous focus on "special accommodation for the cancer patients" to a more common interest approach toward working issues. This reform emphasizes encouraging a flexible work style for facilitating women's participation in the labor market and it is also helpful for the qualified cancer patients to keep their job. However, the unstable or unskilled laborers with low economic status may not be changed even after this reform.

Conclusion: The "work-style reform" movement might encourage the social participation of the cancer patients. However, the shift towards "work-style reform" could disproportionately favor advantaged patients while overlooking other less fortunate patients, thereby creating new disparities among cancer patients at working age.

Background: In the Japanese Society of Health Education and Promotion, its Nutrition Education Committee has been conducting research under the theme, "Evaluation of school-based food and nutrition education (FNE)," since 2013. In June 2017, many participants at a round-table discussion reported that they expected to know more about specific procedures for FNE. Therefore, we conducted a baseline assessment before conducting FNE. This article reports a summary of the 2017 annual committee workshop about the baseline assessment, which was held in March 2018.

Contents: For 88 participants, we first introduced the baseline assessment items used by the national-level investigations and by two super shokuiku schools for 2017. After that, the participants discussed items already used in the field, introduced ideas for the future, and identified difficulties ahead. In response to the questionnaire, 46 participants reported they were "very satisfied", 35 were "satisfied", and one was "neither satisfied nor dissatisfied" with the evaluation (82 valid questionnaires).

Conclusion: At the annual workshop, participants found it important to perform baseline assessment to FNE. However, it is difficult to perform it in the field due to limited budget, lack of sufficient academic support, and other factors. Some regions, however, reported that baseline assessment was performed annually an as a routine at the prefecture and municipal levels. The establishment of such a system for baseline assessment is a challenge for other regions.