Objective: The objective of this study was to clarify the relationship between the competencies for living possessed by children in upper grades of elementary school and their parents’ attitudes and behaviors regarding eating habits.

Methods: A questionnaire survey was conducted among children who were in the fourth, fifth, and sixth grades of elementary school, and their parents concerning both the children’s competencies for living and parental attitudes and behaviors regarding eating habits. The relationship was examined through multiple regression analysis using a stepwise method, with scores for competencies for living (psychosocial ability, moral ability, and physical ability) as dependent variables, and the parental attitudes and behaviors regarding eating habits were examined as independent variables.

Results: The scores for competencies for living were related to parental concern about children’s lack of exercise (β=−0.15 P=0.001), parents’ perceptions of children skipping breakfast (β=−0.10 P=0.018), and the teaching of mealtime greetings (β=0.10 P=0.016) as the parental attitudes and behaviors. Similar associations were found for moral ability and physical ability. The scores for psychosocial ability were also related to parents skipping breakfast and the time they spent preparing breakfast.

Conclusion: Parental concern about children’s lack of exercise and parental perceptions regarding children skipping breakfast were negative factors for children’s competencies for living, while teaching mealtime greetings was a positive factor. It was suggested that improving parental attitude and behavior regarding eating habits may promote the development of children’s competencies for living.

Objective: To determine the association between household income and changes in the diet of young children during the state of emergency declared in Japan due to COVID-19 from April to May 2020.

Methods: A cross-sectional survey was conducted using a self-completion questionnaire. We recruited 2,041 parents of children aged 3–5 years enrolled in nursery schools in five districts in Japan, from September to December 2020; 589 parents responded to the survey (response rate: 28.9%). Data were collected for basic demographic information, household income, and dietary changes in young children during the COVID-19 state of emergency. Income per household member was calculated and the households were divided into low-, medium-, and high-income groups. Logistic regression analyses were conducted using dietary changes in young children during the COVID-19 state of emergency as the dependent variable and household income as the independent variable.

Results: In the low-income group, there were numerous single-parent households as well as those whose education level was lower than high school. Compared to children in the high-income group, significantly more children in the low-income group consumed snacks, sweet drinks, instant foods, and canned foods in the emergency period.

Conclusion: The results suggest an association between household income and changes in the diet of young children during the emergency period. Households in the low-income group consumed snacks, sweet drinks, and instant foods than households in the high-income group during the emergency period.

Objective: We evaluated the eating habits of people with respect to their stress level and alcohol consumption, to suggest improvement in their habits.

Methods: Data from an online survey conducted in November 2020 were used. The participants included 2092 men and 1526 women aged 20–64 years. They were divided into four groups: High Stress/High risk Drinkers: HS/HD group, High Stress/Moderate Drinkers: HS/MD group, Low Stress/High risk Drinkers: LS/HD group, and Low Stress/Moderate Drinkers: LS/MD group. We investigated the relationship between them, the amount of consumption of sweets and snacks, and the frequency of fried food consumption, well-balanced diet, and vegetable dish consumption per day using logistic regression analysis by sex.

Results: Adjusting for demographics, smoking status, and body type, as compared to LS/MD group, participants in HS/HD group consumed more fried food, four or more times a week (adjusted odds ratio of men: 3.19, women: 3.68). Men consumed sweets and snacks consisting 200 or higher kcal per day (adjusted odds ratio: 2.91); only a few among women participants in HS/HD group had a well-balanced diet per day (adjusted odds ratio: 0.68). Among both genders in LS/HD group, most had undesirable eating habits like consuming fried food; specifically, men consumed more snacks. A few participants in HS/MD group had a well-balanced diet per day.

Conclusions: Undesirable eating habits were observed among participants with high stress and high alcohol consumption. We found that eating habits differ depending on the combination of stress and alcohol consumption.

Objective: A Twitter account called “Experts of the COVID-19 Cluster Taskforce” was created by a communications team belonging to the “Cluster Taskforce” organized by the Japanese Ministry of Health, Labor, and Welfare. Here, we report on the operation and issues involving this Twitter account.

Field activity: The Twitter account, which was used for emergency risk communication, had up to 400,000 followers in Japan. The account disseminated information on risk management based on epidemic forecasting and cluster analysis. Researchers created tweets in the form of text and media (videos and images). On June 10, 2020, we acquired data from Twitter, Inc. using the Twitter analysis function to analyze the tweets. Within a 55-day period, from April 3 to May 29 of 2020, 89 tweets were posted. The first day generated the highest number of tweets for a single day (17 tweets). Out of the 89 tweets, 42 were text-only, 28 contained images, and 19 contained videos. The leading tweet had more than 10 million impressions. Additionally, the tweets up to the fifth rank had videos or images attached.

Future implications: The Twitter account enabled professionals to communicate directly with the public without going through the media, and thus share information with large audiences. For this account to work, public trust in the experts was required. We found that effective operation of this account necessitated prior discussion of how to deal with inappropriate posts.

Objective: To examine the relationship between working from home (WFH) and family meal frequency among adult workers, for the purpose of promoting an increase in occurrence of family meals.

Methods: Data from an online survey, conducted in November 2020 among adult men and women nationwide, were utilized. Of the 6,000 subjects, 3,507 (excluding those who were not working and those who lived alone) were included in the analysis. The items analyzed were demographics (age, gender, education level, household income, marital status, living with children or elderly, and employment status), WFH, and family meal frequency. Multinomial logistic regression analysis was conducted with family meal frequency (more than twice daily / once daily / less than once daily (reference category)) as the dependent variable, and influencing attributes and WFH as the independent variables.

Results: Nine hundred and four (25.8%) respondents indicated that they WFH almost every day, and 2,603 (74.2%) WFH four or fewer days a week. Multinomial logistic regression analysis showed no relationship between WFH and either “once daily” or “two or more times daily” family meal frequency (OR [95% CI]=0.95 [0.78, 1.16] and 1.20 [0.99, 1.46], respectively).

Conclusion: In this study, no relationship between WFH and family meal frequency was identified. The result suggests that simply promoting WFH may not be enough to increase family meal frequency.

The main theme of the 29th Conference of the Japanese Society of Health Education and Promotion was “How can we motivate persons who know in their heads, but never bring themselves to do it.” This thesis is important for the health education practice and research, especially, at the venue for the conference, Aomori prefecture, which has the shortest average life expectancy among the 47 prefectures, and is thought to have unhealthy lifestyles as a society. Therefore, we aimed to create an opportunity for the “achievement of a healthy society through the cooperation of people engaged in practice and research.” The conference was initially scheduled for July 2020, however, it was postponed twice because of the COVID-19 pandemic and the recurring declaration of a state of emergency. Finally, it was held virtually from September, 11 to 12, 2021.

The conference had approximately 400 participants. During the two-day programs, we emphasized opportunities for discussion in oral/poster presentations and communications among participants. Ten papers were awarded for excellent oral/poster presentations, which were expected to promote more active presentation and discussion in 98 papers. In the main symposium, there was an active discussion on the issue; “How can we motivate persons who know in their heads, but never bring themselves to do it?—A nudge toward promoting physical activities.”

Although we made an effort to invite participants to Aomori, postponed twice, and seek for a proper physical venue, eventually, we had to hold the conference entirely online. However, despite many restrictions, we found it possible to engage the participants in novel academic activities through online presentations, discussions, and communications by cherishing face-to-face contacts from remote places.

Aim: To examine ethical issues and devise effective measures for intervention in the eating behaviors of free-living people in the activities of health education and promotion with special considerations for social changes and rapid technological innovation.

Contents: Discussions were conducted around the following six points; 1) eating as a basic human right and ethics of intervention; 2) view points to capture the aspects of nutrition and health (aspects of nutritional sciences); 3) various factors determining eating behaviors; 4) understanding the physiology of human eating behaviors; 5) socioeconomic determinants of eating behaviors; and 6) development in a new era of digital transformation.

Future views: Based on the assumption of nutrition as a basic human right and freedom of food choices, it is necessary to consider ethics and social justice in the effort to intervene in individuals’ choices. Furthermore, when governments try to intervene in the economic activities of the food companies to protect citizens’ health, special attention should be paid to children who are not responsible for their own food choices with consideration for its rationale. However, given the rapid innovations in digital technologies, we need to make more efforts to understand the factors and mechanisms involved in eating behaviors from novel perspectives, and to promote health literacy in societies. The author would like to continue the practices and research for health education and promotion that can lead to value-creation by forecasting the future of food and nutrition.

In recent years, “Nudges” by governments, local governments, and companies have attracted attention. However, nudges are often misunderstood and misused. This paper aims to introduce the basic concepts of economics underlying nudges and the ethical issues in nudge research. I hope that this paper will contribute to the spread of good “Nudges.” In this paper, I argue that nudges which change someone's behavior without his/her knowledge should not be used in terms of the ethical importance of informed consent and the finding that nudges with endorsement have significant effect. We also need to pay attention to the fact that Japan is classified as a “cautiously pro-nudge nations” (Sunstein & Reisch, 2019) when we conduct nudge interventions. Finally, I introduce some studies that focus the personalized nudges related to the health promotion. Many studies have shown that personalized nudges are more effective than uniform nudges, however, personalizing means close interventions, which may require more ethical caution.

Purpose: First. To summarize the presentations and discussions at the 29th Annual Conference of the Japanese Society for Health Education and Promotion, “How to promote people who procrastinate healthy behaviors even though they know the benefits for health: Nudges to promote physical activities.” Second, to promote physical activity and continuous exercise.

Current situation and issues: Nudge is one of the methods to promote behaviors based on psychological and social characteristics. Previous studies suggested that “prompting” may influence physical activity. For example, building a staircase as a piano keyboard pattern that produces sounds when people walk on the stairs. However, few previous studies explore physical activity and exercise with nudges. In particular, studies of behavioral continuation are insufficient in Japan.

Considerations: To promote the process from initiation to continuation of behavior, combining the nudge framework of FEAST (Fun, Easy, Attractive, Social, Timely) with health literacy improvement might stimulate physical activity. For example, the “Medico Trim” project conducted by Aomori Prefectural Central Hospital suggested that the participants continue improving their lifestyle after a health class that incorporates laughter. Further research and practice are necessary to establish a strategy for promoting physical activity and continuous exercise.

Many people want to change their behavior to improve their health, lose weight, quit smoking, etc., but they usually cannot do that contrary to what they want. In study, work, and other social activities, there are many people who wish to transform themselves related to their mental state, such as to become more sociable or active, or to escape from sadness. Wearable devices are powerful weapons in recognizing, recording, and encouraging transformation of such people's behaviors and lifestyles. Here, wearable devices mean smart watches, smart glasses, hearables, and other information devices worn on the body. Compared to conventional desktop and mobile information devices, they can be used by users at all times, enabling new uses in work and daily life. In this paper, we discuss how these wearable devices can be effectively used to promote behavioral change in people, including recent wearable trends.