Objective: Theory-based intervention programs are becoming increasingly important in health education and health promotion. However, little is known about the deliberate array of the numerous health behavior theories and models in Japan. We conducted this study to arrange the theories and models systematically and chronologically.

Methods: We extracted health behavior theories and models from six reputable literatures, chosen based on discussion among authors. These theories and models were then classified into three frameworks in line with the approach by Glanz et.al: individual, interpersonal, and collective/multi-level. We then outlined the historical transition of these classifications using in a figure.

Results: We classified health behavior theories and models in the individual framework into two systems: continuum model and stage model. The continuum model was based on the expectancy-value theory. The stage model included a temporal axis and modeled behavioral processes. In the interpersonal framework, we classified them into four systems: social cognitive theories, stress and salutogenesis, social relationships, and communication in health and medicine. In the collective or multi-level framework, we classified them into three systems: community engagement, problem-solving approach, and strategic planning approach.

Conclusions: By classifying three levels of major behavior theories and models into sub-levels and by organizing the evolution of theory development systematically, we can better understand the unique characteristics of these theories.

Objective: This study was conducted to develop a masticatory function scale incorporating bite force and behavior that affects this force, for use in elderly people.

Methods: This cross-sectional study involved the distribution questionnaire to 1,153 users of senior citizens' clubs and senior citizens' welfare centers. The valid responses of 897 elderly people were subject to analysis. Items were removed until Cronbach's alpha exceeded 0.7, followed by a factor analysis. Criterion-related validity was examined in relation to health, activities of daily living (ADL), and quality of life (QOL). A survey of a separate population was conducted and the data were compared with the original data.

Results: Three of the 14 items showed no correlation with any other items and they were removed. Items were then removed until Cronbach's alpha exceeded 0.7. Eight items were ultimately chosen for the masticatory function scale. Factors related to "masticatory state," "teeth," and "oral health behavior" were extracted from the factor analysis and named. The masticatory function scale scores showed significant correlations with health, ADL, and QOL. The criterion-related validity of this scale was confirmed because of an earlier study demonstrating associations between masticatory function and health, ADL, and QOL. When data with total masticatory function scale scores were compared with the factor scores of a separate population, no differences were detected, which additionally confirmed the external validity.

Conclusions: The developed masticatory function scale was a multifaceted and simple scale incorporating bite force and behavior that affects this force. Both the reliability and validity of this scale were confirmed.

Objective: This study aimed to examine the association between participation in sports and grit in school-aged children.

Methods: Participants were children aged 10–11 years (n=287, fifth grade), in all elementary schools in Koshu city, Yamanashi. Grit was evaluated through the 8-Item Grit Scale for children. The grit score, total point of the grit scale, and two subscale (perseverance and consistency) scores were calculated. Children's self-report of participation in sports was categorized into two groups: participation or non-participation. Children who participated in sports were further classified into two groups: team or individual sports group. Analysis of covariance adjusted for family socioeconomic status compared grit scores (including two subscale scores) across the sports participation groups. Exploratory and confirmatory factor analyses evaluated the reliability and validity of the Japanese version of the grit scale.

Results: The grit scale showed a 2-factor structure (perseverance and consistency), and adequate internal reliability and construct validity. Perseverance score of boys who participated in sports was significantly higher than those not participating in sports [3.3 (SE, 0.07) vs 3.0 (0.11), p<0.01)]. Comparison of the three categories of sports activities revealed that boys who participated in team sports showed significantly higher perseverance score than those not participating in sports [3.4 (0.08) vs 3.0 (0.11), p<0.01). There were no other significant differences.

Conclusion: This study suggested that sports participation may contribute to development of perseverance among school-aged boys. However, these results need to be confirmed through prospective studies and the other regions.

Objective: To investigate the cooking attitude of children and parents, the relationship between parent-child cooking attitude, and their relationship with cooking behavior.

Methods: A cross-sectional survey was conducted using a self-reported questionnaire on 312 third–fourth-grade children and their parents at two elementary schools in Tokyo, Japan in June and July 2017. About cooking attitude (e.g., "I like cooking"), nine items were included in the questionnaires, and descriptive statistics were used for answer distribution. Scores for the nine items were compared between children and parents by using a Wilcoxon signed rank test. The correlation coefficient was calculated. Mann-Whitney U and Kruskal-Wallis tests were used to investigate associations between cooking attitudes and characteristics or cooking behaviors.

Results: Questionnaires were completed by 273 children (response: 87.5%) and 257 parents (response: 82.3%). Among the nine items, items with response distribution exceeding 50% to "strongly agree" were six for children and two for parents. The median of the total score (25th, 75th percentile value) was 31.0 (27.0, 33.0) for children and 27.0 (25.0, 30.0) for parents. Children's total score was significantly higher than parents (p < 0.001). The correlation coefficient between parents and children was r_s = 0.14 (p = 0.047). Children and parents with high scores of cooking attitudes were more likely to cook food.

Conclusions: Cooking attitudes differed between parent-child, and the correlation coefficient was low. However, children and parents with positive cooking attitudes tend to cook food more frequently.

Objective: The aim of the present study was to examine the effects of anger management education integrating stress management and assertiveness training for junior high school students.

Project contents: Anger management education integrating stress management and assertiveness training was implemented five times, with each lesson lasting 50 minutes in "special activity" classes. Participants were 68 (intervention class: 16 boys and 19 girls; control class: 15 boys and 18 girls) third grade students enrolled at a public junior high school in Okinawa, Japan. We assessed the students' psychological state before and after intervention and corrected feedback data for the anger management education through free description from teachers and students.

Project assessment: Measurement of psychological state before and after anger management education revealed, a significant reduction in "depression" for the intervention class; however, significant differences were not found in "stress response", "self-efficacy of stress management", and "anger control" between the intervention class and control class. Moreover, the results from the teachers' and students' feedback for the anger management education showed that the students' acquired anger management knowledge and skills.

Conclusions: Implementing anger management education in schools is a challenging issue. However, integrating stress management and assertiveness training into anger management education can be expected to result in depression-reduction effect for junior high school students. Furthermore, this program could contribute to improvement of the higher-order learning ability underlying anger management skills.

Objective: To develop and evaluate a dental health program for senior high school students with gingivitis, focusing on their self-management skills.

Methods: Using a dental health program, consisting of 4 sessions, A 1-year intervention was provided for 57 first-grade students of a senior high school, who were diagnosed with gingivitis through a periodic health examination. The outcomes were evaluated based on papillary, marginal, and attached gingival indexes (PMA Index) to assess inflamed gums, changes in brushing behavior skills and self-management skills. The following items related to dental and oral health were also evaluated: the lifestyle, dietary habits, self-diagnosis of the gums, brushing behavior, dental care-seeking behavior, and knowledge of teeth.

Results: The PMA-index continued to improve until 3 months after the intervention. However, when post-interventional evaluation was conducted after 1 year, unfavorable changes were detected in the lifestyle and brushing behavior skills with no improvements in the PMA-index.

Conclusion: The students' symptoms of gingivitis were improved after the intervention, which supports the effectiveness of the dental health program. However, such improvements were not observed at 1 year post-intervention, and how to sustain the short-term effect remains a challenge.

Objectives: The characteristics of school-based health education were exhibited using the examples of health education in elementary, junior high, and high schools in physical/health, physical education and life-skills education, respectively. The trends of school-based health education were also outlined towards problem-solving learning and the necessity for the evaluation of school health education.

Contents: School health education at elementary (physical education), junior high and high school (health and physical education) covers various health issues related to the present and future. It contains many sessions and aims to enhance children's understanding of health-related issues. On the other hand, life-skills education, by using a participatory approach, aims to increase children's abilities in decision-making and communication to cope with daily challenges. Through problem-solving learning, school-based health education is currently required to develop children's competency including knowledge and skills, abilities to think, judge, and express, and the desire to learn. Teaching methods are also influential for children to learn more proactively, interactively, and deeply while continuing to apply effective traditional methods. Therefore, we can utilize the contents and teaching methods of health and physical education focused on knowledge and of life-skills education towards the new school-based health education. Moreover, it is crucial to improve and develop an evaluation study with a useful method such as Transparent Reporting of Evaluations with Nonrandomized Designs (TREND). Furthermore, the new education is expected to improve the children's problem-solving skills and enhance not only conventional concepts and strategies but also the understanding of health promotion process.

Conclusion: School-based health education shifts the emphasis of knowledge-based learning to being competency-based through problem-solving learning with improvement in contents and teaching methods. Evaluation research and field reports on the new school-based health education are now expected.

Health inequality is defined as differences in health statuses by individual social characteristics, including residential area or country, race/ethnicity, gender, income, educational attainments, job, and employment status. In 2008, the World Health Organization published a report on the social determinants of health, which provided three recommendations for closing the gap in health as follows: 1) improve daily living conditions, 2) tackle inequitable distribution of power, money, and resources (and create good governance to achieve equitability), and 3) measure and understand the problem and assess the impact of action. However, how to change individual and organizational behaviors is also important to achieve the three recommended actions. For this, recent developments of behavior sciences may help. In particular, social marketing should also be implemented. The key practice in social marketing is to segment populations on the basis of their social backgrounds, to identify important segments to intervene, and to provide intervention programs that are attractive to the targeted populations. "Social prescribing" activity is another concept that has become popular in clinical settings. In the social prescribing process, staff members of hospitals or clinics evaluate the social risks of patients (e.g., financial insecurity), and, if patients are identified as being in need, the staff members will introduce the patients to service organizations in charge in their community. To manage health inequality, public health practitioners should support patients in need of social care and connect them to local resources, as well as help build healthy communities together with multiple sectors.

For human beings, life is a series of decisions to be made. Decision-making continues without interruption; we must make decisions about everything from everyday events, such as choosing what to eat and which clothes to wear, to serious life events, such as choosing whether to go to university and selecting a mate. We tend to think that such decisions are based on logical thinking and rational judgment; however, human decision-making depends largely on automatic and unconscious processes. That is, we humans are influenced by biases that cannot be readily resisted, no matter how deliberately we make our decisions. In this paper, based on the current knowledge obtained mainly from human psychology and neuroscience, we outlined the fundamental mechanism of decision-making and its underlying bias and present several concrete examples. Furthermore, based on these findings, we examined the strategies that can be used for better decision-making from the viewpoint of health education in particular.