Objective: To structurally examine the relationship between eating vegetables and attitudes, subjective norms, self-efficacy, and behavioral change stages and verify whether the structure differed based on household income.

Method: This cross-sectional study conducted an Internet survey in February 2014. The participants were men and women aged 30–59 years. Survey variables included sex, age, marital status, residence status, employment status, educational level, and household income. We also enquired regarding the observed variables; the main item pertained to eating vegetables. There were 16 additional items that pertained to attitudes, subjective norms, self-efficacy, and behavioral change stages. These variables pertained to the four eating behaviors of eating a meal with “a staple food, main dish, and side dish,” “side dishes,” “dark green vegetables,” and “fruits.” A simultaneous multi-population analysis was conducted based on household income categorized into three groups: <3 million yen, 3–<7 million yen, and ≥7 million yen.

Results: In the final model of the simultaneous multi-population analysis, standardized path coefficients of self-efficacy to eating vegetables were higher than that of behavioral change stages to eating vegetables for all household income groups. Moreover, values of the standardized path coefficients of self-efficacy to behavioral change stages were also higher than those of attitudes and subjective norms.

Conclusion: Self-efficacy was the factor most closely associated with eating vegetables, regardless of differences in household income. Population approaches aiming to enhance vegetable consumption should target and improve self-efficacy.

Objective: To examine the combined impact of insomnia and skipping breakfast on labor productivity.

Methods: Cross-sectional data were collected from the “WELWEL” study, which surveyed 20,000 Japanese workers in February 2022. The participants were categorized into two groups: those who had insomnia, and others. They were also divided into two groups: those who skipped breakfast, and others. The relationships between insomnia, skipping breakfast, and labor productivity were examined using Pearson’s chi-square test, two-way ANOVA, and two-way ANCOVA.

Results: Among the participants, 5,883 (37.4%) exhibited insomnia and 5,260 (33.4%) skipped breakfast. Individuals with both insomnia and breakfast-skipping habits were more likely to be young, living alone, and working more than 50 hours per week. The two-way ANCOVA revealed the main effects of insomnia and skipping breakfast, as well as an interaction effect (insomnia: F=964.43, skipping breakfast: F=24.39, each P<0.001, interaction: F=4.94, P=0.026).

Conclusion: Those who had insomnia and skipped breakfast had the lowest labor productivity. Therefore, it is necessary to improve work environments in order to support better sleep and regular breakfast intake.

Objective: This study aimed to clarify the content and practicality of workshop for community organizations of health promotion volunteers, classify the organizations based on the frequencies of workshop contents provided, and identify the factors influencing the workshop programs.

Methods: We conducted a cross-sectional study using mailed questionnaires of public health nurses in 1718 municipalities nationwide from October to November 2017. The survey items asked to community organizations, workshop program and contents, and the autonomy in volunteer activities. The degree of frequencies of the 35 workshop contents was assessed on a 5-point scale.

Results: Of 489 responses returned, 444 organizations were subjected to the analyses, and 126 organizations (29.2%) had the workshop programs. Factor analysis using the rating for frequencies of 35 workshop contents extracted five factors: “dialogue and sharing of health issues and activity goals,” “provision of learning resources,” “methods and evaluation of activity development,” “explanation of activity objectives and roles,” and “explanation of practical activities.” The cluster analysis based on these factors classified the organizations into six subgroups. Individual workshop contents were more often provided and the autonomy in volunteer activities were higher when the workshop programs were available. Multiple regression analysis revealed that the city (town/village=0) and the frequencies of workshop regarding “methods and evaluation of activity development” were significantly related to the autonomy in volunteer activities.

Conclusion: The workshop contents for health promotion volunteers were classified into five categories. The benefits of having a workshop program for community organizations of health promotion volunteers were apparent.

Objective: This study aimed to develop a scale to assess the burden experienced by teachers when managing infectious diseases in schools (the teacher burden scale) and investigate its association with teachers’ attributes and infectious disease management practices.

Methods: We conducted a cross-sectional study by administering a questionnaire to public elementary school teachers. In total, 224 respondents who completed all items of the scale were included. We performed exploratory and confirmatory factor analyses, calculated Cronbach’s α coefficient, and evaluated criterion-related validity. We conducted t-tests and one-way analysis of variance (ANOVA) for scale scores based on attributes and management practices.

Results: The scale was structured into three factors and ten items. The factors included “effort spent on preventing infection,” “busyness due to infectious disease management,” and “effort spent on collaboration between staff members.” The fitness values were as follows: GFI=0.938, AGFI=0.893, CFI=0.949, and RMSEA=0.080. Cronbach’s α ranged from 0.72–0.85. Investigation of criterion-related validity revealed weak-to-moderate correlations. Teachers working at schools with <200 students scored significantly lower on “busyness due to infectious disease management.” Teachers in their 20s scored significantly higher on “effort spent on collaboration between staff members.” The group that did not practice instructing students or working with parents/guardians scored significantly higher on “effort spent on collaboration between staff members.”

Conclusion: The teacher burden scale comprised three factors and ten items and was found reliable and valid. Associations were observed between the teacher burden scale and school size, teachers’ age, and interpersonal infectious disease management.

This special report is based on the symposium presentation at the last Japanese Health Education Conference in 2023 regarding behavior change with motivational incentives. This report starts with a general outline of behavior change with motivational incentives that have gradually been utilized in healthcare settings, leading to the description of tips to implement motivational incentives in terms of the definition of behavior and also the incentive content. Furthermore, the limitations of using motivational incentives and research examples are described. It will be a delight to find the approach of using motivational incentives for behavior change implemented in real-world healthcare settings.

The development of health literacy (hereafter referred to as HL) is required in school health education. The purpose of this study is to clarify the significance, strategies, and issues of developing HL in school health education.

HL refers to the knowledge, motivation and competences to access, understand, appraise, and apply health information including health information services. Analytical materials were selected from articles and books on the definition, content, and development of HL in Japan as well as from review articles on HL development in other countries. In addition, the author referred to the U.S. National Health Education Standards (hereafter referred to as NHES) and a U.S. program for middle and high school students that corresponds to NHES standards. The author also analyzed school health education in Japan, focusing on the goals and contents of “health classes,” and compared the HL-related contents of the Courses of Study in Health and Physical Education for junior high and high schools with those of the NHES and U.S. program.The results confirmed that health classes emphasize problem-solving. Commonalities were also found between the process from identifying the problem to finding a solution (i.e., problem-solving) and the process from information collection to utilization of HL. Therefore, problem-solving and HL development will be required in the future. However, to learn how to solve problems, the descriptions of specific measures in the solution process were judged to be insufficient in both the commentary on curriculum guidelines and their practical application. To improve problem-solving abilities, specific strategies in the HL process and the learning processes of skills-based health education in other countries can be used as references, and participatory learning needs must be enhanced as a learning method.

In modern society, there is an abundance of health information whose veracity is unclear, and it is becoming increasingly difficult to obtain appropriate health information. In order to live in the information society of the future, it is important to develop the ability to critically examine health information and select appropriate information in school education before becoming a patient or a person concerned, rather than the ability to collect information. Health information literacy is the core of health literacy, which judges, selects, and makes decisions about health information. Media literacy, science literacy, and statistical literacy, along with critical thinking, support health information literacy. On the other hand, judgment of health information through critical thinking is expected to be influenced by belief bias, and there are concerns about its limitations. Therefore, we proposed a future health information literacy education model that incorporates the components of critical thinking and the correction of belief bias. In order to deal with the current situation in schools where it is not possible to secure sufficient time for health education due to reductions in the number of class hours, and to respond to new health issues that may arise in the future, we believe that it is effective to utilize health information literacy education in which children themselves collect and critically examine health information, select appropriate information based on scientific evidence, and use it to solve health issues, rather than providing health education for each health issue. We hope that this educational model will be utilized in primary and secondary education settings to further examine the practical application of health information literacy education, leading to the development of improved health information literacy education that is appropriate for each developmental stage.

In the revised Courses of Study, “information literacy” is indicated as a fundamental quality and ability for learning, and health literacy is expected as an information literacy to be cultivated in health education. This paper presents the relationship between information literacy and health literacy, introduces health literacy research in Japanese school education, and discusses the results and challenges. In the Courses of Study, a shift from a content-based to a competency-based view of academic skills is expected, as capacities for adapting to the needs of an increasingly uncertain society are needed. In Japanese school education, health literacy research has been successful in many content-based class studies on specific subjects. Future research that contributes to comprehensive curriculum management and the cultivation of general-purpose abilities from a competency-based perspective is expected.

Health literacy is the ability to “access,” “understand,” “evaluate,” and “make decisions” appropriately based on the necessary health-related information. Literacy is a fundamental human right, much like the right to live one’s own life, and the same is true for health literacy. Compared to people in Europe and other parts of Asia, Japanese people tend to have difficulty with “evaluation” and “decision-making.” Therefore, the challenge is to improve these skills by adopting practices from countries that emphasize the habit of constructive discussion and decision-making from the school education stage.

Research reveals that Japanese high school students are more likely to engage in desirable health behaviors when they can evaluate the reliability of information and make more deliberative, rational decisions. The skills of not only information evaluation, involving the ability to discern evidence and narratives by checking the five points “Ka-Chi-Mo-Na-I,” but also rational decision-making, involving “O-Chi-Ta-Ka” components, which represent options, pros, cons, and values, are necessary. We hope that students beginning to make life choices will have the opportunity to acquire these skills, enabling them to make unique decisions and clarify their own values.

We created a video to promote these two skills and hope that students will use it. We also encourage evaluation studies to determine the effectiveness of their implementation in schools.

Background: The NOVA system was developed to classify foods and international dishes based on their degree of processing. It has been used globally to examine relationships between processed food consumption, food intake, and health outcomes. We classified Japanese diets based on the NOVA system and assessed the relationship between nutrient intake and health status. Our results of previous research may provide potential insights into future research for their applications in health education and promotion.

Contents: In Japan, consumption of ultra-processed foods (UPF), such as ready-to-eat foods (e.g., commercial lunch boxes), may be associated with unhealthy diets and obesity. It is necessary to consider whether salt sources are from in or out of the home and to focus on salt reduction among men who consume ready-to-eat meals. The NOVA system can potentially monitor reductions in salt intake.

Conclusions: For UPF to be effectively combined with homemade meals, it is necessary to provide both health education and create an environment in which health-conscious UPFs are developed. Our previous research may provide potential insights into future research for applications in health education and promotion. I aim to continue my research on UPF, contribute to nutrition policies to foster a healthier food environment and support further research that advances initiatives to create an environment that facilitates health promotion.

Objective: Presented at the 32nd Japan Society of Health Education and Research Academic Conference, this report covers health promotion practices using social capital involving the University of the Ryukyus Health Promotion Support Project Lib (2010–2018), municipalities, and residents.

Practice: In City A, participants became health promotion committee members after the class, leading resident-driven activities such as promoting health checkups and improving the local environment by planting flowers in vacant lots. In City C, participants used “Dohsa-hou” in preventive long-term care services to help each other reduce pain among older adults. Additionally, three projects collaborated to create a support network for the daily lives of older adults using “Dohsa-hou.” In Village D, a health promotion strategy model based on Kusunoki’s theory was established, focusing on “partner building” and “race.” This strategy change increased the resident participation and encouraged others to join the projects.

Conclusion: Promoting health through partnerships among practitioners, researchers, and residents can potentially spread health promotion throughout the community. Moreover, the interaction with residents provides practitioners and researchers with valuable insights and ideas for health promotion.