[Comparison of the two methods of defining high-stress on the Japanese Stress Check Program].

OBJECTIVES: In Japan, companies are required to implement a "stress check program" to prevent mental health problems in workers. To identify "high-stress" workers, the Brief Job Stress Questionnaire (BJSQ) is recommended. According to the stress check program manual issued by the government, high-stress can be defined using two criteria, either the "sum method" (simply summing the scores for each scales) or the "score converted method" (using converted scores according to the conversion table for each scales). In this study, we examined the differences in results found using these two criteria on "stress check program" data. METHODS: We used data of 71,422 workers in 117 companies and organizations who conducted stress checks in 2016. The prevalence of high-stress was calculated by applying the two criteria simultaneously, and the chi-square test was used to compare the proportion of workers with high-stress. We subsequently divided participants into the four following groups and calculated the proportion of each group: group A was defined as having high-stress by both criteria; group B, only by the sum method; group C, only by the score converted method; and group D, not defined as high-stress by either criterion. We compared the average values of stress response among four groups using the Kruskal-Wallis test, and further compared the average values between group B and group C using the Bonferroni method. RESULTS: The average age of participants was 43.7 ± 11.1, and 66.8% were males. The proportion of those defined as having high-stress were 11.7% using the sum method and 13.2% using the score converted method; the proportion of high-stress workers was thus significantly higher when using the score converted method (p <.001). Physical stress response was higher in group B; however, lack of vigor, irritation, fatigue, and depression were higher in group C (p <.01). CONCLUSIONS: Compared to the sum method, 1.5% more high-stress workers were observed using the converted method, and this result was similar for individual and employment-related factors. Furthermore, workers were more likely to be judged as having "high-stress" when the score of the physical stress response was higher in the sum method. Hereafter, it is important to consider which criteria are applied when discussing proportions of high-stress. Further research is needed to examine which criteria will predict health disorders.

Association of overtime work hours with various stress responses in 59,021 Japanese workers: Retrospective cross-sectional study.

This study aims to clarify the relationships between length of overtime work and various stress responses using large-scale cross-sectional data of Japanese workers. This study's participants are 59,021 Japanese workers in 117 companies. Data was collected by self-reporting questionnaire. The Brief Job Stress Questionnaire was used to measure stress responses on six scales (i.e. "lack of vigor", "irritability", "fatigue", "anxiety", "depression", and "somatic responses"). Length of overtime work hours were classified as 0-20, 21-30, 31-40, 41-50, 51-60, 61-70, 71-80, and >80 hours/month. Multiple linear regression analyses were used to examine the association of stress responses with overtime while adjusting all possible confounders. In result, workers with longer overtime showed significantly higher "irritability", "fatigue", "anxiety", "depression", and "somatic responses" for both genders (p-for-trend <0.001), however, length of overtime was negatively associated with "lack of vigor" among men (p-for-trend <0.001). Men with 61-80 hours of overtime showed high fatigue with high vigor at the same time. Length of overtime was linearly associated with various stress responses, except for "lack of vigor". Length of overtime shows linear associations with various psychosomatic stress responses. However, "lack of vigor" was not consistently associated with overtime. Male workers with 61-80 hours of monthly overtime were more likely to feel vigorous than workers with shorter overtime. However, potential longterm effects of such extreme overtime should not be underestimated and must be paid attention to.

Infrainguinal Lesion of Peripheral Artery Disease and Levels of ω-3 Polyunsaturated Fatty Acids in Peripheral Artery Disease.

Background: Recently, reduced serum levels of ω-3 polyunsaturated fatty acids (PUFAs) including docosahexaenoic acid (DHA) and eicosapentaenoic acid (EPA), have been focused upon as newly recognized risk factors for peripheral artery disease (PAD). The present study investigated the association between disease location and serum levels of ω-3 PUFAs in patients with PAD. Methods: We retrospectively analyzed the data of patients at Tokyo Medical University between August 2011 and November 2015. The subjects included 98 patients who were categorized into two groups: those with (n=72) and without infrainguinal lesions (n=26). Results: Univariate analysis revealed that low ankle-brachial pressure index (ABI) values, low EPA levels, low DHA levels, low triglyceride levels, and diabetes mellitus were significant risk factors for infrainguinal lesions. Multivariate analysis indicated that low ABI values [p=0.018; odds ratio, 0.043; 95% confidence interval (CI), 0.003-0.579] and low DHA levels (p=0.003; odds ratio, 0.986; 95%CI, 0.977-0.995) were significant independent risk factors for infrainguinal lesions. Conclusion: Our study demonstrated that reduced serum level of DHA may underlie the presence of infrainguinal lesions in patients with PAD.

Social participation among older adults not engaged in full- or part-time work is associated with more physical activity and less sedentary time.

AIM: Social participation provides health benefits for older adults. However, there is the need to identify whether higher social participation is associated with older adults being more physically active and less sedentary (sitting time). We examined the associations of social participation with physical activity, and sedentary time, in a population-based sample of older Japanese adults. METHODS: A population-based, cross-sectional mail survey carried out in 2010 was used to collect data on social participation, physical activity, sedentary time and sociodemographic characteristics. Data were examined from 1146 community-dwelling, unemployed older adults (mean age 70.1 years, 43% men). Multivariate logistic regression analyses were used to calculate odds ratios (OR) for associations of social participation with physical activity and total sedentary time; and, for associations with passive and mentally-active sedentary (sitting) time. RESULTS: For both men and women, those with higher social participation were more physically active (OR 2.10, 95% CI 1.44-3.06 among men; OR 1.93, 95% CI 1.39-2.68 among women). Total sedentary time had significant associations among men (OR 0.62, 95% CI 0.42-0.90), but not among women (OR 0.80, 95% CI 0.58-1.11). Social participation was associated with less passive sedentary time (OR 0.55, 95% CI 0.38-0.81 for men; OR 0.72, 95% CI 0.51-0.99 for women). CONCLUSIONS: Promoting social participation among older adults could contribute to increasing physical activity and reducing sedentary time, with potential benefits for chronic disease. Further research is required to elucidate the deleterious and beneficial roles of passive and mentally-active sedentary time for older adults. Geriatr Gerontol Int 2017; 17: 1921-1927.

Organizational justice and insomnia: a prospective cohort study examining insomnia onset and persistence.

PURPOSE: Insomnia is one of the most common health problems and causes a large social burden. Psychosocial work-related factors are reported to be associated with both insomnia onset and insomnia persistence. However, the association between organizational justice (OJ) and insomnia remains unclear. The objective of this study was to examine the effect of OJ on insomnia persistence, as well as insomnia onset. METHODS: A prospective cohort study with a 1-year observational period was conducted. Self-reported questionnaire data from 1588 employees were analyzed. OJ was measured using the Japanese version of the OJ questionnaire, which has four components (distributive, procedural, interpersonal, and informational). Insomnia was assessed with the Athens Insomnia Scale. Logistic regression analysis was used to explore the effects of OJ on insomnia. RESULTS: Among non-insomniac subjects at the baseline (n = 1236), low overall OJ was a risk of insomnia onset even after adjustment for lifestyle and work-related variables (adjusted odds ratio 0.66; 95% confidence interval 0.51-0.85). The procedural, interpersonal, and informational justice components were also associated with insomnia onset. Among insomniac subjects at the baseline (n = 352), low overall OJ, as well as the procedural and interpersonal justice components, was associated with insomnia persistence. Although these associations became insignificant after adjustment, the interpersonal justice component showed a marginally significant association with insomnia persistence (p = 0.058). CONCLUSIONS: OJ, especially interpersonal justice, was revealed as an associated factor for both insomnia onset and persistence. These findings may provide useful information for prevention of insomnia among working population.

A cross-sectional study of the association between city scale and daily steps in Japan: Data from the National Health and Nutrition Survey Japan (NHNS-J) 2006-2010.

Objective There is little evidence showing that inhabitants of urban areas engage in more physical activity than do rural ones, although accumulating evidence concerning the best neighborhood environments conducive to physical activity supports the idea. This study sought to fill the research gap by examining the association between city scale and daily steps using data from Japan's National Health and Nutrition Survey (NHNS).Methods We analyzed data from 15,763 men and 18,479 women aged 20 years and older who participated in a one-day pedometer measurement during any part of the NHNS between 2006 and 2010. The data obtained for these years were combined into a single data set. City scale was categorized into 5 groups based on population: 1) 12 large cities and 23 wards, 2) population greater than 150,000, 3) population 50,000-150,000, 4) population less than 50,000, and 5) towns and villages. Differences in daily steps among city scale groups were analyzed using an ANCOVA, adjusting for age by gender. The Bonferroni method was employed for multiple comparisons, and linear regression was used to test for linear trends. Subgroup analyses were performed by age (20-39, 40-64, older than 64), and job status. The study was approved by the Tokyo Medical University ethics committee, and use of these data complied with the Statistics Act of Japan.Results The steps per day for men after adjusting for age were Group 1 : 7,494±4,429 (mean±SD), Group 2 : 7,407±4,428, Group 3 : 7,206±4,428, Group 4 : 6,911±4,428, and Group 5 : 6,715±4,429. Women's daily steps according to city scale group were 6,767±3,648, 6,386±3,647, 6,062±3,646, 6,069±3,649, and 6,070±3,649 for Groups 1 through 5, respectively. There were overall statistically significant differences (ANCOVA, P<0.001) between both genders. The larger the city scale, the more mean daily steps that were taken by both men and women (P values for both trends <0.001). Subgroup analyses revealed significant differences in the mean daily steps by city scale, regardless of age or job status for both genders. There were no significant differences among Groups 3, 4, or 5 among unemployed men, men older than 64, or overall women, which differed from the results for men with jobs, who took fewer steps in smaller cities.Conclusions Our study showed that men and women living in larger cities took more steps compared to those living in smaller cities. Subgroup analyses further revealed that the associations between city scale and physical activity differed according to gender, age, and job status.

[The association between the presence of occupational health nurses at Japanese worksites and health promotion activities].

OBJECTIVES: The purpose of this study was to determine the association between the presence of occupational health nurses and health promotion activities, relative to the number of employees, and the health promotion policies of the companies. METHODS: We investigated 3,266 companies with at least 50 employees listed on the Tokyo Stock Exchange. Questionnaires were sent by mail, and employees in charge of health management or promotion were asked about health promotion activities at their own worksites. Logistic regression analysis was performed with each type of health promotion activity (nutrition, exercise, sleep, mental health, smoking cessation, alcohol consumption reduction, and oral health) as dependent variables, and the presence of an occupational health nurse as the independent variable. The results were adjusted for the type of industry, total number of company employees, presence of company health promotion policies, and the presence of an occupational health physician. RESULTS: Responses were received from 415 companies (response rate: 12.7%). Occupational health nurses were present at 172 companies (41.4%). Health promotion activities such as (in order of frequency) mental health (295 companies, 71.1%), smoking cessation (133, 32.0%), exercise (99, 23.9%), nutrition (75, 18.1%), oral health (49, 11.8%), sleep (39, 9.4%), and alcohol consumption reduction (26, 6.3%) were being conducted. Setting worksites with no occupational health nurse as a reference, the odds ratios of each health promotion activity of a worksite with one or more occupational health nurses were calculated. The odds ratios of mental health (2.43, 95% confidence interval: 1.32-4.48), smoking cessation (3.70, 2.14-6.38), exercise (4.98, 2.65-9.35), nutrition (8.34, 3.86-18.03), oral health (4.25, 1.87-9.62), and alcohol consumption reduction (8.96, 2.24-35.92) were significant. Stratified analysis using the number of worksite employees, 499 or fewer and 500 or more, also showed significantly higher odds ratios of smoking cessation, exercise, and nutrition activities at worksites of both groups. However, the odds ratios were significant for mental health and oral health activities only at worksites with 499 or fewer employees. CONCLUSIONS: At worksites of listed companies around Japan, those with an occupational health nurse carried out more health promotion activities such as nutrition, exercise, mental health, smoking cessation, alcohol consumption reduction, and oral health than those without, even after adjusting for scale of the company and presence of health promotion policies. This result suggests that the posting of an occupational health nurse to a worksite is associated with the conduct of health promotion activities.

Organizational justice and insomnia: Relationships between justice components and insomnia symptoms among private company workers in Japan.

OBJECTIVES: Organizational justice (OJ) is an important psychosocial factor and it consists of several components. Previous studies have shown that low perceived OJ is associated with various health problems. However, the relationships between each justice component and health outcomes have not been fully examined. The purpose of this study was to clarify the relationships between OJ and insomnia, including OJ components and insomnia symptoms. METHODS: Cross-sectional self-reported questionnaire data from 1,893 employees (92.2% of subjects) were collected. OJ was measured using the Japanese version of the OJ questionnaire, which has four components (distributive, procedural, interpersonal and informational). Insomnia was assessed with the Athens Insomnia Scale. Logistic regression analysis, with insomnia as a dependent variable and OJ as an independent variable, was conducted. RESULTS: Subjects with low overall OJ had a higher risk of insomnia (adjusted odds ratio (AOR), 2.37; 95% confidence interval (CI), 1.59 to 3.53) and two insomnia symptoms (AOR of 2.47 and 95% CI of 1.68 to 3.65 for sleep induction problem; AOR of 1.73 and 95% CI of 1.21 to 2.48 for sleep maintenance problem). The four justice components were all associated with insomnia and sleep induction problems. Sleep maintenance problems were associated with only the distributive justice component. CONCLUSIONS: All four justice components were associated with both insomnia and sleep induction problems. Sleep maintenance problems, however, showed different features. Specifically, the distributive justice component seemed to be a key factor in the relationship between OJ and insomnia. These findings might provide useful information for preventing the adverse effects of insomnia.

Gender differences in association between psychological distress and detailed living arrangements among Japanese older adults, aged 65-74 years.

PURPOSE: Past studies have shown that living alone is detrimental to older adults' mental health. However, there has been little focus on how older adults' psychological distress differed by more detailed living arrangement, as well as by gender. The present study investigates various living arrangements in association with psychological distress among older men and women. METHODS: Data from community-dwelling Japanese older adults were collected through a mail survey (n = 1,807, aged 65-74 years, 51.5 % men). Psychological distress level was measured using Kessler's six-item psychological distress scale. Living arrangements were categorized into four groups; "living with spouse only", "living with spouse and other family", "living with other family without spouse" or "living alone". Multiple logistic regression analyses were used to examine the associations of living arrangements with psychological distress level. RESULTS: Older adults living alone were observed to have higher psychological distress. In addition, gender-stratified analyses showed that higher distress levels were observed among older men living with family, but without a spouse (OR: 2.85, 95 % CI: 1.51-5.39). In contrast, higher distress was observed among older women living with spouse and other family (OR: 1.53, 95 % CI: 1.03-2.28). CONCLUSIONS: Psychological distress in older Japanese adults was associated with living arrangements, but such associations differed by gender. The association of living with a spouse on older men's mental health was striking, while living with any family was found to be rather important for older women, aged 65-74 years.

Mental illness and a high-risk, elderly Japanese population: characteristic differences related to gender and residential location.

PURPOSE: Examining the sociodemographic determinants of psychological distress is important in identifying specific subgroups in need of further intervention. However, there are few studies focusing on older populations and on the role of gender or location of residence. To try to clarify characteristics of a population at high risk for mental illness, we examined the sociodemographic determinants of psychological distress in older adults living in three different locations. METHODS: A mail survey was used to collect data on levels of psychological distress and sociodemographic characteristics from a population-based sample of 1894 older adults who lived in Bunkyo (urban setting), Fuchu (suburban setting) and Oyama (rural setting) in Japan (aged 65-74 years, 51.3% men). Psychological distress level was measured based on Kessler's six-item psychological distress scale (K6) and dichotomized into two groups with a cut-off score of 5 (0-4 or 5-24). Multiple logistic regression analyses were used to examine the associations between sociodemographic factors, specifically gender and location of residence, and psychological distress levels. RESULTS: The variables of older age, living in Bunkyo, living in Oyama and living alone were significantly associated with high psychological distress. Although these associations were observed in men, no associations were observed in women. Location-specific analyses showed significant associations between sociodemographic and psychological distress among men living in Oyama, but not among those in Bunkyo or Fuchu. CONCLUSIONS: Sociodemographic factors were significantly correlated with psychological distress, particularly among older men in rural areas. Characteristics of a population at high risk for mental illness may vary based on gender and location of residence. Health promotion initiatives for older adults may be more effective if they take these demographic factors into account.

Effect on mental health of a participatory intervention to improve psychosocial work environment: a cluster randomized controlled trial among nurses.

OBJECTIVES: Improvement of psychosocial work environment has proved to be valuable for workers' mental health. However, limited evidence is available for the effectiveness of participatory interventions. The purpose of this study was to investigate the effect on mental health among nurses of a participatory intervention to improve the psychosocial work environment. METHODS: A cluster randomized controlled trial was conducted in hospital settings. A total of 434 nurses in 24 units were randomly allocated to 11 intervention units (n=183) and 13 control units (n=218). A participatory program was provided to the intervention units for 6 months. Depressive symptoms as mental health status and psychosocial work environment, assessed by the Job Content Questionnaire, the Effort-Reward Imbalance Questionnaire, and the Quality Work Competence questionnaire, were measured before and immediately after the 6-month intervention by a self-administered questionnaire. RESULTS: No significant intervention effect was observed for mental health status. However, significant intervention effects were observed in psychosocial work environment aspects, such as Coworker Support (p<0.01) and Goals (p<0.01), and borderline significance was observed for Job Control (p<0.10). CONCLUSIONS: It is suggested that a 6-month participatory intervention is effective in improving psychosocial work environment, but not mental health, among Japanese nurses.

Step-defined physical activity and cardiovascular risk among middle-aged Japanese: the National Health and Nutrition Survey of Japan 2006.

BACKGROUND: Pedometers are becoming widely accepted for physical activity measurement. To use step data effectively, an index which categorizes steps/day by < 5000, ≥ 5000, ≥ 7500, ≥ 10,000, and ≥ 12,500 steps/day has been previously proposed. However, evidence is insufficient to validate this index compared with health outcomes. This study examined the association of steps/day categories with cardiovascular (CVD) risk. METHODS: Cross-sectional data from the National Health and Nutrition Survey of Japan 2006, including 1166 men and 1453 women aged 40-64 years, were analyzed to calculate odds ratios (OR) for having CVD risk including overweight/obesity, blood pressure, high density lipoprotein cholesterol, hemoglobin A1c, and clustered risk factors by steps/day categories. RESULTS: Among men, inverse gradient associations between steps/day categories and CVD risk (overweight/obesity, blood pressure, HbA1c, and clustered risk factors) were observed. Among women, those taking ≥ 5000 steps/day had substantially lower risk of overweight/obesity and high blood pressure compared with those taking < 5000 steps/day. However, additional decreases of OR by taking more steps were modest among women. CONCLUSIONS: CVD risk was generally lower with higher steps/day categories. Given the limitations of cross-sectional design, further studies, especially using longitudinal designs, are needed to precisely calibrate the association between steps/day and CVD risk.

Perceived neighborhood environment and walking for specific purposes among elderly Japanese.

BACKGROUND: Recent research has revealed the importance of neighborhood environment as a determinant of physical activity. However, evidence among elderly adults is limited. This study examined the association between perceived neighborhood environment and walking for specific purposes among Japanese elderly adults. METHODS: This population-based, cross-sectional study enrolled 1921 participants (age: 65-74 years, men: 51.9%). Neighborhood environment (International Physical Activity Questionnaire Environmental Module) and walking for specific purposes (ie, transportation or recreation) were assessed by self-report. Multilevel logistic regression analyses with individuals at level 1 and neighborhoods at level 2 were conducted to examine the association between environment and walking, after adjustment for potential confounders. RESULTS: Access to exercise facilities, social environment, and aesthetics were associated with total neighborhood walking. Odds ratios (95% CI) were 1.23 (1.00-1.51), 1.39 (1.14-1.71), and 1.48 (1.21-1.81), respectively. Regarding walking for specific purposes, social environment and aesthetics were consistent correlates of both transportation walking and recreational walking. Environmental correlates differed by specific types of walking and by sex. Transportation walking significantly correlated with a greater variety of environmental attributes. Sex differences were observed, especially for transportation walking. Bicycle lanes, crime safety, traffic safety, aesthetics, and household motor vehicles were significant correlates among men, while access to shops, access to exercise facilities, and social environment were important among women. CONCLUSIONS: Specific environment-walking associations differed by walking purpose and sex among elderly adults. Social environment and aesthetics were consistent correlates of both transportation walking and recreational walking. Improving these environmental features might be effective in promoting physical activity among elderly Japanese.

Association of social skills with psychological distress among female nurses in Japan.

Nursing is a highly stressful occupation. Because nursing work involves interaction with patients and colleagues, competence in social skills may be a key issue in stress management among nurses. However, there are very few studies among nurses focused on social skills together with social support, both of which are important aspects of job stress. The aim of this study was to examine the interrelationships between social skills and social support with job stressors, problem-solving coping, and psychological distress among Japanese nurses. Data from a self-administered questionnaire of 1,197 female nurses who worked for 5 general hospitals in Japan were analyzed. Covariance structure analysis with structural equation modeling techniques showed that social skills and social support were positively related to each other, while they were negatively associated with psychological distress and job stressors, and positively associated with problem-solving coping. Furthermore, the direct association between social skills and psychological distress was stronger than the association between social support and psychological distress. These findings suggested that improving not only social support at work but also individual social skills is important for nurses' mental health.

Sociodemographic determinants of pedometer-determined physical activity among Japanese adults.

BACKGROUND: Although previous studies have reported physical activity and its sociodemographic determinants using self-report measures, there have been few studies using pedometers. PURPOSE: To ascertain pedometer-determined physical activity and its sociodemographic determinants among community residents living in four Japanese cities. METHODS: A cross-sectional mail survey was conducted from February 2007 to January 2008 with a sample of 4000 residents (aged 20-69 years and 50% male) who were randomly selected from the registry of residential addresses. Complete responses for both questionnaire and pedometer were obtained from 790 residents (48.3±13.7 years, 46.7% male). Associations of 11 sociodemographic variables with steps per day were examined using multiple logistic regression analyses. Data were analyzed in 2010. RESULTS: Men averaged 8763±3497 steps/day and women averaged 8242±3277 steps/day. Further, 29.0% of men and 27.8% of women walked ≥10,000 steps/day. City of residence, good self-rated health, low educational attainment, and not owning a car were associated with taking ≥10,000 steps/day in men, whereas employed status and dog ownership were associated with walking ≥10,000 steps/day in women. CONCLUSIONS: The results contribute to understanding of step-defined physical activity and its sociodemographic determinants. A diversity of step counts by sociodemographic variables clarifies specific populations among Japanese who are in need of intervention to promote physical activity.

Time trends for step-determined physical activity among Japanese adults.

PURPOSE: The study's purpose was to describe the most recently reported (2007) step-determined physical activity and trends from 1995 to 2007 among Japanese adults. METHODS: Data were extracted from published reports of the Japan Heath and Nutrition Survey, which has been conducted annually by the Ministry of Health, Labour and Welfare of Japan using a nationally representative Japanese adult sample of 6502-9833 participants (≥20 yr) each year. Pedometer data were collected on an individually specified weekday in November each year. Because of the change in age distribution of the sample, steps per day were adjusted by age to examine time trends. RESULTS: Men took 7321 ± 4588 (mean ± SD) steps per day and women took 6267 ± 3827 steps per day in the Japan Heath and Nutrition Survey 2007. Men took more steps per day than women in all age groups. Steps per day were lower with older age groups among men, whereas among women, the 40- to 49-yr-old age group took the highest steps per day relative to other ages. Time trends displayed a decline of age-adjusted mean steps per day (-529 steps per day among men and -857 steps per day among women) from peak values in 1998-2000 to 2007. Decreases in percent of people classified as active (age-adjusted proportion taking ≥10,000 steps per day = -5.1% among men and -5.0% among women) and increases in percent classified as sedentary (age-adjusted proportion taking <4000 steps per day = +4.8% among men and +8.2% among women) were also observed during the same period. CONCLUSIONS: Japanese steps per day have decreased over time from a peak around 1998-2000. The increase in the percent taking <4000 steps per day was especially noticeable among women.

Organizational justice, willingness to work, and psychological distress: results from a private Japanese company.

OBJECTIVES: This study assessed the risk of low organizational justice (OJ) on psychological distress as well as on low willingness to work, and also investigated the underlying factors between OJ and these outcomes. METHODS: Cross-sectional questionnaire data of 1804 employees (93.6% of subjects) of a Japanese company were collected. Logistic regression analysis was conducted to explore the objectives. RESULTS: Subjects with low overall OJ had a higher risk of psychological distress compared with their counterparts (odds ratio: 4.93; 95% confidence interval: 3.17 to 7.68). The corresponding odds ratio for low willingness to work was 2.87 (95% confidence interval: 2.06 to 4.00). Job satisfaction and organizational citizenship behavior play a role of mediation between OJ and these outcomes. CONCLUSION: Low OJ was a notable risk factor for psychological distress as well as for low willingness to work. High OJ might prevent psychological distress and promote willingness to work.

Characteristics of accelerometry respondents to a mail-based surveillance study.

BACKGROUND: Differences in the characteristics of respondents and nonrespondents to a survey can be a cause of selection bias. The aim of this study was to determine the sociodemographic and lifestyle characteristics of respondents to a field-based accelerometry survey. METHODS: A cross-sectional mail survey was sent to 4000 adults (50% male; age 20 to 69 years) who were randomly selected from the registries of residential addresses of 4 cities in Japan. There were 1508 respondents (responding subsample) to the initial questionnaire. A total of 786 participants from the responding subsample also agreed to wear an accelerometer for 7 days (accelerometer subsample). Age, sex, and city of residence were compared between the accelerometer subsample and all 3214 nonrespondents, including those who did not respond to the initial questionnaire. In addition, multiple logistic regression analyses were used to compare the sociodemographic and lifestyle characteristics of the accelerometer subsample and the 722 respondents who participated in the questionnaire survey but not the accelerometry (questionnaire-only subsample). RESULTS: As compared with all nonrespondents, the accelerometer subsample included significantly more women, middle-aged and older adults, and residents of specific cities. Multiple logistic regression analyses comparing the accelerometer and questionnaire-only subsamples revealed that participation in the accelerometry survey was greater among nonsmokers (odds ratio, 1.35; 95% confidence interval, 1.02-1.79) and persons who reported a habit of leisure walking (1.56, 1.21-2.01). CONCLUSIONS: Sex, age, city of residence, smoking status, and leisure walking were associated with participation in accelerometry. This response pattern reveals potential selection bias in mail-based accelerometry studies.

Association between perceived neighborhood environment and walking among adults in 4 cities in Japan.

BACKGROUND: Recent research highlights the importance of environment as a determinant of physical activity; however, evidence among Japanese is sparse. The aim of this study was to examine the association between perceived neighborhood environment and neighborhood walking for multiple purposes among Japanese. METHODS: We conducted a population-based, cross-sectional study of 1461 Japanese adults (age: 48.2 +/- 14.1 years, men: 44.8%). Neighborhood environment and walking were assessed by a validated questionnaire. The odds ratio of active walkers was calculated in relation to environmental characteristics after adjustment for age, sex, and other potential confounders. RESULTS: Participants were more likely to walk when they perceived that there was high residential density (odds ratio, 1.47; 95% confidence interval, 1.11-1.96), fair land use mix-diversity (1.37, 1.04-1.81), good walking/cycling facilities (1.56, 1.19-2.04), and attractive aesthetics (1.49, 1.14-1.95). Environmental factors associated with walking differed with respect to the purpose for walking. The environmental characteristics associated with walking for daily errands and with walking for commuting were similar, and included residential density and land use mix. Walking for leisure was associated with walking/cycling facilities, aesthetics, and traffic safety. Stratified analyses showed some sex-specific associations. Among women, there was an unexpected inverse association of leisure walking with both residential density and land use mix-diversity. CONCLUSIONS: The association between neighborhood environment and walking differed by walking purpose. The results were generally consistent with those of studies conducted in Western countries, except for the association of high residential density and good land use mix-diversity with less leisure walking in women. These results suggest possible targets for environmental interventions to promote walking.

Sociodemographic variation in the perception of barriers to exercise among Japanese adults.

BACKGROUND: The perception of barriers to exercise is an important correlate of exercise participation. However, only a limited number of studies-mostly from Western countries-have attempted to describe the perceptions of barriers to exercise in specific population groups. This study examined the associations between sociodemographic attributes and perceived barriers to exercise in Japanese adults. METHODS: A population-based cross sectional study of 865 participants (age: 20-69 years old, men: 46.5%) was conducted in 4 cities in Japan. Nine sociodemographic attributes (sex, age, location of residence, educational attainment, marital status, employment status, presence of dependents in the household, self-rated health, body mass index), along with exercise frequency and perception of barriers to exercise (discomfort, lack of motivation, lack of time, lack of social support, poor environment) were assessed by self-administered questionnaire. RESULTS: The most strongly perceived barrier was lack of time. Five of 9 sociodemographic attributes were significantly related to certain types of perceived barriers. Participants who more strongly perceived barriers were younger, more highly educated, more likely to be employed, and had relatively poor self-rated health and a high BMI. The specific types of barriers that were strongly perceived varied with the sociodemographic attributes of the participants. CONCLUSIONS: The results show that the perception of barriers to exercise varies among specific population groups, which indicates the importance of targeting exercise promotion strategies to specific populations.