Cross-sectional study to identify health literacy, health behavior, and quality of life in Chofu and Komae cities in Japan: Formative research in community-based nursing practice.

The Jikei Academic Nursing Practice Center for the Community developed a community nursing practice that matched community health problems and concerns in Chofu and Komae cities, suburban areas of the Tokyo Metropolis. This study aimed to identify health problems and high-risk populations via an understanding of the practice of health behaviors, health literacy, and quality of life. This was an online, cross-sectional study conducted in September 2023. In total, 1520 (Chofu: n = 1170; Komae: n = 350) participants were enrolled. Participants' demographic characteristics, health literacy, health behaviors, and quality of life scores were obtained. Sleep quality was poor compared with national data. Younger participants had higher poor health literacy, did not practice health behaviors, and had a lower quality of life. In addition, parenting and informal nursing care for family members were associated with unhealthy eating, smoking, drinking, and poor quality of life. This study found that health problems and concerns before planning were significant in increasing the salience of interventions for community residents. Based on the findings of this study, an action plan for community-wide nursing practice was created.

[Promotion of help-seeking intentions for balancing medical treatment and job content among employees of small companies: Focusing on cooperative work climate].

OBJECTIVES: This study examined the association between cooperative work climate and business owners' attitudes toward work climate and help-seeking intentions for balancing medical treatment and job (BTJ) by occupation among employees of small companies. METHODS: In January 2024, we conducted an online survey of 1,800 full-time employees aged 20-64 years with no work restrictions due to illness working in small companies. After participants were provided a leaflet regarding BTJ, they were asked to indicate their intention to seek help in an imaginary situation where they had been diagnosed with cancer. We conducted a multivariate logistic regression analysis using a combination of cooperative work climate (low or high) and business owners' attitudes toward work climate (low or high) as the primary explanatory variable and help-seeking intentions regarding BTJ as the dependent variable, adjusted for relevant job-related variables. As a subgroup analysis, logistic regression analyses by occupation (i.e., white- or blue-collar workers) were also conducted. RESULTS: Among the 1,800 participants (602 females and 1,198 males), 1,350 (75.0%) reported an active intention to seek help regarding BTJ. Those who reported higher levels of cooperative work climate and lower levels of business owners' positive attitudes toward work climate (odds ratio (OR) 1.5, 95% confidence interval (CI) 1.07-2.1), as well as those who reported higher levels of work climate and business owners' attitudes (OR 2.0, 95% CI 1.4-2.9), were significantly more likely to reveal help-seeking intentions regarding BTJ than those who reported lower levels of work climate and business owner attitudes. Analyses by occupation also showed that for both occupation categories, those who reported higher levels of cooperative work climate and business owner attitudes toward work climate more frequently revealed help-seeking intentions than those who reported lower levels of work climate and business owner attitudes. CONCLUSIONS: Among participants working for small companies, regardless of occupation, those who reported higher levels of cooperative work climate and business owners' attitudes toward work climate were significantly more likely to reveal help-seeking intentions regarding BTJ. Our findings imply that (1) cooperative work climate has a stronger effect on help-seeking intentions regarding BTJ than business owners' attitudes toward work climate, and (2) both work climate and business owners' attitudes have a synergistic impact on help-seeking intentions regarding BTJ. Enhancing a cooperative work climate may promote help-seeking intentions among employees working for small companies, regardless of occupation.

The link between involuntary non-regular employment and poor mental health: A cross-sectional study of Japanese workers.

Involuntary non-regular employment is a severe inequity problem worldwide, and it may significantly affect the mental health of employees. The present study aimed to examine the relationship between employment type and mental health. Additionally, the characteristics of involuntary non-regularly employed workers were explored. An online-based cross-sectional study was conducted in Japan, and 1566 participants were included in the data analysis. The eligible participants were divided into four categories: regularly employed (n = 1092), voluntary (n = 134), average (n = 233) and involuntary (n = 107) non-regularly employed individuals, respectively. Involuntary non-regular employment was associated with greater lack of vigour, anger-irritability, fatigue, anxiety, and depression. It was higher among women, those who were single or had no childcare, and those who had lower personal income or shorter working hours, or who tended not to practice relaxation activities. Lower personal income was associated with a risk of anxiety and depressive symptoms. Those individuals experiencing involuntary non-regular employment had a higher risk of poor mental health; subgroup analysis showed that this was particularly true among men. Both encouragement of employment stability via policy reform and workplace mental health support for involuntary non-regularly employed individuals are urgent health concerns.

Effectiveness of using humor appeal in health promotion materials: evidence from an experimental study in Japan.

BACKGROUND: Public health professionals have prepared and distributed many messages and materials to convince the public to adopt healthy behaviors or reduce risky behaviors. However, health promotion materials do not always have the desired effect due to a lack of ability to engage target audience. This study examined the effectiveness of humor appeal (i.e. using humor as an advertising technique to attract attention and increase acceptance of the message) in health promotion materials and how to use it effectively. METHODS: Total 17 printable posters with different frames (loss- vs. gain-framed) × tones (humorous vs. non-humorous) × topics (advance care planning, cancer screening, donor registry, smoking cessation, and physical activity) were created and evaluated for comprehensibility, persuasiveness, and resistance through two web-based surveys. Participants who were Japanese adults aged 25-64 years were randomly assigned one of the posters (200 people each) and asked to rate it. The overall score was calculated as the persuasiveness score (EHPM 2017;22:69) minus the resistance score (EHPM 2022;27:20). RESULTS: In the advance care planning case, the highest overall score was found in the gain-framed humorous poster, followed by the loss-framed humorous poster, and the non-humorous poster (p = 0.007). In the other 4 cases, the posters using humorous illustrations received a significantly lower scores than the non-humorous poster(s). CONCLUSION: The use of humor appeal can help improve the acceptability and persuasiveness of the message when dealing with a little-known resistance-prone health topic. Humor appeal will provide an effective hook to direct public attention to what they do not know or care about in public health communication.

Analysis of all non-fatal self-harm cases in an urban area of Japan during pre- and peri-pandemic periods of COVID-19: a population-based study.

BACKGROUND: This study aimed to examine population-based characteristics of non-fatal self-harm in an urban area during pre- and peri-pandemic periods of COVID-19 by sex, age, and severity of self-harm, using pre-hospital medical emergency records. METHODS: We used a registry of all pre-hospital medical records of self-harm cases that occurred in Kawasaki City, Japan, between January 2018 and December 2021. Adjusted incidence rate ratios (IRRs) with 95% confidence intervals (CIs) were calculated using Poisson regression models with the log-transformed population by year, sex, age group, and ward as an offset term. RESULTS: During the 4-year study period, 1,534 patients were transported by ambulance due to non-fatal self-harm and were alive on arrival at the hospital. Among women, the number of non-fatal self-harm cases increased by 1.2-fold in 2021 compared with that in 2018. The incidence rate of "severe" non-fatal self-harm among men aged 19 years or younger in 2021 (IRR 4.82, 95% CI 1.25-18.65) and that among women aged 50-59 years in 2020 (IRR 2.51, 95% CI 1.06-5.95) significantly increased compared with that 2018 and 2019. The incidence rate of "mild" self-harm among women aged 20-29 years tended to be higher in 2021 than in 2018 and 2019 (IRR 1.42, 95% CI 0.95-2.12, P = 0.085). CONCLUSIONS: During the peri-pandemic period of COVID-19, the incidence rate of "severe" non-fatal self-harm among men aged 19 years or younger and women aged 50-59 years, as well as that of "mild" self-harm among women aged 20-29 years, sharply increased compared with that during the pre-pandemic period. Our findings suggest that in urban areas during public health crises such as a pandemic, it is important to take measures to reduce the risk of non-fatal self-harm in young women, in addition to strengthening counseling and support for young women at risk for completed suicide.

Formal and informal help-seeking intentions/behaviors among students and workers during the COVID-19 pandemic: a scoping review.

BACKGROUND: Students and workers have been subjected to increased levels of psychological distress due to the quarantine policy and containment measures during the COVID-19 pandemic. This scoping review aimed to present an overview of published evidence regarding formal and informal help-seeking intentions/behaviors for non-mental health-related issues as well as mental health-related issues among students and workers during the pandemic. METHODS: In June 2022, we searched MEDLINE, APA PsycNet, and CINAHL for articles reporting the state of help-seeking intentions/behaviors among students and workers during the pandemic. Peer-reviewed original articles published in English were selected. RESULTS: In total, 150 articles were identified, and 12 articles were selected for final analysis after removing articles that met the exclusion criteria. Three studies targeted university students, and nine targeted healthcare workers. Study settings were restricted to Western countries and China. Of the 12 studies, 11 were observational and predominantly cross-sectional studies. Two longitudinal studies using student samples suggested that university students became more reluctant to seek help from both formal and informal sources during the COVID-19 pandemic compared to before, despite the increased need for support during the pandemic. Among healthcare workers, the proportions of those who sought help from formal sources in person were low (7-26%), even among those with mental health issues, despite the increase in the need for mental health services. One randomized controlled study reported that a brief video-based intervention increased treatment-seeking intentions among healthcare workers in the intervention group compared with the non-intervention group. CONCLUSIONS: The present review revealed that, although most studies included in the final analysis were cross-sectional, intentions/behaviors to seek help from both formal and informal sources decreased among university students, even those with mental health issues. Among healthcare workers, while the frequency of help-seeking from formal sources in person was low, a brief online intervention was suggested to be useful for promoting help-seeking from formal sources. During public health crises such as the COVID-19 pandemic, system and infrastructure development of online help-seeking services could potentially promote formal and informal help-seeking intentions/behaviors for diverse issues, including non-mental health-related issues, among university students and healthcare workers/providers.

[Provision of information about and changes in help-seeking intentions for balancing medical treatment and job content among employees of small- and medium-sized companies: Focusing on cooperative work climate].

OBJECTIVE: The present study aimed to examine the association between a cooperative work climate and a positive attitude toward seeking help from others and the change in help-seeking intentions for balancing medical treatment and job (BTJ) before and after providing information about the support system to employees of small- and medium-sized companies. METHODS: In October 2021, we conducted an online survey among 3,200 full-time employees aged 20-64 years who worked in small- and medium-sized companies, had no experience of work restriction due to illness, and did not know the contents of the support system for BTJ in Japan. First, as a condition of "before information provision," respondents were asked to imagine a situation in which they suffered from cancer or stroke and their doctor indicated that it would be difficult for them to work regularly and, subsequently, were asked about their help-seeking intentions for BTJ under such circumstances. Next, as a condition of "after information provision," they were shown a leaflet on the support system for BTJ in Japan and asked about their help-seeking intentions for BTJ again. A binomial logistic regression analysis was conducted with help-seeking intentions for BTJ as the dependent variable. RESULTS: In total, 2,531 respondents (79.7%) indicated that they would seek help for BTJ both before and after receiving information. In logistic regression analyses, help-seeking intentions for BTJ were more frequently reported when there was a strong cooperative climate and a precedent for support in the workplace. Among participants who indicated that they would not seek help for BTJ before receiving information, those who worked in a company with 50-299 employees and experienced a cooperative climate and/or a precedent of support in the workplace demonstrated significantly more changes in their responses that they would seek help for BTJ after receiving information. CONCLUSIONS: Approximately 80% of employees in small- and medium-sized companies indicated that they would seek help for BTJ both before and after receiving information. In employees who had a cooperative climate and had a precedent of support regarding BTJ in their workplace, there was a significant change in the response that they would seek help for BTJ after receiving information. These findings suggest that workplace environmental factors such as a cooperative work climate and supported cases regarding BTJ may increase the usefulness of information provision on BTJ and help-seeking intentions for BTJ among employees working for small businesses.

The process of behavioral change in individuals who are uninterested in health: a qualitative study based on professional health knowledge.

BACKGROUND: In Japan and elsewhere, there is major concern over individuals who are uninterested in health and reluctant to change their health behaviors. While previous studies have investigated cognitive and behavioral characteristics in this population, there is limited evidence on whether they recognize the significance of health, nor is it clear how to motivate necessary behavior changes. This study identified specific characteristics of positive psychological and behavioral change in individuals who were uninterested in health, then constructed a model for their behavior change process, as advised via professional health expertise in the Japanese context. METHODS: This qualitative survey study was conducted among 86 health professionals (public health nurses, registered dieticians, and city/prefectural employees). These participants reported their demographic characteristics (gender, age, job, and length of service) and entered free descriptions concerning perceived cognitive and behavior changes in individuals who were uninterested in health. Finally, we thematically analyzed the contents on psychological/behavioral change and constructed a thematic map. RESULTS: We obtained 409 relative descriptive codes and four main themes, including (1) Health awareness: Recognize the significance of health via personal experience and/or illness among family/friends; (2) Psychological readiness: Preparative psychological state toward health behavior; (3) Gateway behavior: Precursory behavior leading to health behavior; and (4) Health behavior: Traditional healthy lifestyle behavior, with 45 subthemes. We constructed the abovementioned thematic map according to the Transtheoretical Model. Herein, health awareness may catalyze changes in health behavior, while changes in both psychological readiness (e.g., new interest in health behaviors and attitude toward appearance) and gateway behaviors (e.g., new points of discussion and information gathering) may arise before changes in health behavior. CONCLUSIONS: This study clarified positive cognitive and behavior changes in individuals who were uninterested in health and elucidated their behavior change process. As behavior changes in such individuals tend to be rigid, they are often left behind by health care systems and programs. In this regard, we identified pertinent cognitive and behavioral characteristics during the behavior change process and constructed a relevant model. These findings should be useful in developing interventions that can motivate the desire for behavior change.

Development of a rating scale for measuring resistance to persuasive health messages.

BACKGROUND: Pretesting is the key to understanding how the intended audience will react to the message. Resistant reactions affect message processing or can lead to undesirable boomerang effects. The objective of this study was to develop a rating scale for measuring active (reactance) and passive (disengagement) resistance to persuasive health messages. METHODS: Six candidate items (3 items for disengagement and 3 items for reactance) were generated based on literature review. A web-based survey was conducted among Japanese adults aged 25-64 years to verify the reliability and validity of the 6-item resistance scale. Participants were asked to rate one of the advance care planning (ACP) promotion messages. All scale items were scored on a 1-to-5 point Likert scale and they were averaged to produce the resistance score. RESULTS: Explanatory factor analysis revealed a two-factor solution that agreed with the disengagement and reactance domains, respectively. Correlation coefficients between each set of items ranged between 0.30-0.69. Cronbach alpha (0.86) indicated satisfactory internal consistency of the set of items. Confirmatory factor analysis showed a good fit of the two-factor model with CFI = 0.998, SRMR = 0.011, and RMSEA = 0.041. The resistance score showed a moderate positive correlation with negative emotional responses (displeasure γ = 0.55, anger γ = 0.53) and was significantly inversely related to the persuasiveness score (γ = -0.50). Multivariable logistic regression analysis showed that the odds ratio for ACP intention per 1-point increase in the resistance score was 0.47 (95% confidence interval 0.40-0.56) with adjustment for the persuasiveness score. CONCLUSION: The 6-item resistance scale exhibited adequate reliability and validity for measuring audience resistance when applied to the ACP promotion messages in Japanese people. The scale will be useful for pretesting health messages to make them more acceptable to the intended audience. TRIAL REGISTRATION: Not applicable; this is not a report of intervention trial.

Increased Health Risk in Office Workers in the COVID-19 Era: Comparison of One-Year Incidence of Health Problems Before and During the COVID-19 Pandemic.

OBJECTIVE: To examine whether the incidence of health problems increases during the COVID-19 pandemic. METHODS: Using the health examination data (April 2018-March 2021) of Japanese workers aged 15 to 64 years, the 1-year incidence of five health problems (overweight, hypertension, hypercholesterolemia, hyperglycemia, and liver damage) and four unhealthy habits (snacking, heavy drinking, physical inactivity, and sleep deprivation) were compared before and during the COVID-19 pandemic. RESULTS: The 1-year incidence of overweight, hypertension, hyperglycemia, and liver damage increased by 15% to 65% during the COVID-19 pandemic. Increased weight gain, related to decrease physical activity during the COVID-19 pandemic, was significantly associated with increased incidence of health problems. CONCLUSIONS: The COVID-19 pandemic have deteriorated workers' health even without the COVID-19 infection. Lifestyle interventions should be promptly started particularly targeting workers with gained weight to avoid more serious consequences.

Emotional experiences of reading health educational manga encouraging behavioral changes: a non-randomized controlled trial.

OBJECTIVE: Educational health manga are used to promote health behavior change. This study thus seeks to achieve the following objectives: identify the emotional experience of reading educational health manga, understand the effects of facilitating the psychological mediators of behavior change through emotional experiences, and compare the effectiveness of educational health manga with conventional materials. DESIGN: A non-randomized controlled trial with six conditions was conducted. Target behaviors were physical activity and healthy diet. Individuals aged 20-69 years (n = 1,680) were assigned three manga intervention conditions and three control conditions (visual image-based, narrative text, and general text material). MAIN OUTCOME MEASURES: Participants were asked about their emotional experience while reading either intervention material or control material and its perceived positive influence on enhancing psychological mediators. RESULTS: Four factors relevant to emotional experiences were identified: risk perception, familiarity, satisfaction, and realism. Emotional experience strongly predicted the psychological mediators of behavior change. Analysis of differences among the six conditions revealed that exposure to educational health manga led to greater satisfaction and increased knowledge. Participants assigned manga conditions experienced superior emotional experiences and outcomes. CONCLUSIONS: Those assigned manga conditions experienced superior emotional experiences and outcomes. The efficacy of educational health manga in encouraging psychological mediators of change was confirmed.Trial registration: UMIN Japan identifier: UMIN000034369.

Functional Diversity of Glycinergic Commissural Inhibitory Neurons in Larval Zebrafish.

Commissural inhibitory neurons in the spinal cord of aquatic vertebrates coordinate left-right body alternation during swimming. Their developmental origin, however, has been elusive. We investigate this by comparing the anatomy and function of two commissural inhibitory neuron types, dI6dmrt3a and V0d, derived from the pd6 and p0 progenitor domains, respectively. We find that both of these commissural neuron types have monosynaptic, inhibitory connections to neuronal populations active during fictive swimming, supporting their role in providing inhibition to the contralateral side. V0d neurons tend to fire during faster and stronger movements, while dI6dmrt3a neurons tend to fire more consistently during normal fictive swimming. Ablation of dI6dmrt3a neurons leads to an impairment of left-right alternating activity through abnormal co-activation of ventral root neurons on both sides of the spinal cord. Our results suggest that dI6dmrt3a and V0d commissural inhibitory neurons synergistically provide inhibition to the opposite side across different swimming behaviors.

[Neural Mechanisms Underlying Bilaterally Asymmetric Behavior].

Lateralized behaviors are key movements of symmetrically organized animals. These behaviors are controlled by asymmetric activity of the bilateral brain. The neural mechanisms underlying these activities were recently revealed.

Behavioral Role of the Reciprocal Inhibition between a Pair of Mauthner Cells during Fast Escapes in Zebrafish.

During many behaviors in vertebrates, the CNS generates asymmetric activities between the left and right sides to produce asymmetric body movements. For asymmetrical activations of the CNS, reciprocal inhibition between the left and right sides is believed to play a key role. However, the complexity of the CNS makes it difficult to identify the reciprocal inhibition circuits at the level of individual cells and the contribution of each neuron to the asymmetric activity. Using larval zebrafish, we examined this issue by investigating reciprocal inhibition circuits between a pair of Mauthner (M) cells, giant reticulospinal neurons that trigger fast escapes. Previous studies have shown that a class of excitatory neurons, called cranial relay neurons, is involved in the reciprocal inhibition pathway between the M cells. Using transgenic fish, in which two of the cranial relay neurons (Ta1 and Ta2) expressed GFP, we showed that Ta1 and Ta2 constitute major parts of the pathway. In larvae in which Ta1/Ta2 were laser-ablated, the amplitude of the reciprocal IPSPs dropped to less than one-third. Calcium imaging and electrophysiological recording showed that the occurrence probability of bilateral M-cell activation upon sound/vibration stimuli was greatly increased in the Ta1/Ta2-ablated larvae. Behavioral experiments revealed that the Ta1/Ta2 ablation resulted in shallower body bends during sound/vibration-evoked escapes, which is consistent with the observation that increased occurrence of bilateral M-cell activation impaired escape performance. Our study revealed major components of the reciprocal inhibition circuits in the M cell system and the behavioral importance of the circuits.SIGNIFICANCE STATEMENT Reciprocal inhibition between the left and right side of the CNS is considered imperative for producing asymmetric movements in animals. It has been difficult, however, to identify the circuits at the individual cell level and their role in behavior. Here, we address this problem by examining the reciprocal inhibition circuits of the hindbrain Mauthner (M) cell system in larval zebrafish. We determined that two paired interneurons play a critical role in the reciprocal inhibition between the paired M cells and that the reciprocal inhibition prevents bilateral firing of the M cells and is thus necessary for the full body bend during M cell-initiated escape. Further, we discussed the cooperation of multiple reciprocal inhibitions working in the hindbrain and spinal cord to ensure high-performance escapes.

Use of health promotion manga to encourage physical activity and healthy eating in Japanese patients with metabolic syndrome: a case study.

BACKGROUND: The present case study investigated the feasibility of using manga (Japanese-style comic books) to promote physical activity and healthy eating behavior in Japanese patients with metabolic syndrome. METHODS: A one-arm pre-post intervention was conducted in a Japanese suburban community. Twenty participants with a diagnosis of metabolic syndrome were recruited via health checkups. Health promotion manga were developed by the researcher, a publishing specialist, and a professional illustrator. We measured participants' self-reported physical activity, eating behavior, and psychological readiness to change toward engaging in healthy behavior. RESULTS: At 1 month after the intervention there were no significant differences in physical activity scores, but small positive changes in vigorous (R2 = 0.02) and moderate (R2 = 0.01) physical activity scores were observed. Total healthy eating behavior scores were significantly improved (p < 0.05, R2 = 0.47). In addition, participants reported positive change in psychological readiness, such as increased intention to engage in healthy behavior, enhanced self-efficacy, and benefits of using manga. CONCLUSIONS: This study demonstrates that manga interventions have potential to encourage healthy eating in patients with metabolic syndrome.

Coordinated Expression of Two Types of Low-Threshold K+ Channels Establishes Unique Single Spiking of Mauthner Cells among Segmentally Homologous Neurons in the Zebrafish Hindbrain.

Expression of different ion channels permits homologously-generated neurons to acquire different types of excitability and thus code various kinds of input information. Mauthner (M) series neurons in the teleost hindbrain consist of M cells and their morphological homologs, which are repeated in adjacent segments and share auditory inputs. When excited, M cells generate a single spike at the onset of abrupt stimuli, while their homologs encode input intensity with firing frequency. Our previous study in zebrafish showed that immature M cells burst phasically at 2 d postfertilization (dpf) and acquire single spiking at 4 dpf by specific expression of auxiliary Kvß2 subunits in M cells in association with common expression of Kv1.1 channels in the M series. Here, we further reveal the ionic mechanisms underlying this functional differentiation. Pharmacological blocking of Kv7/KCNQ in addition to Kv1 altered mature M cells to fire tonically, similar to the homologs. In contrast, blocking either channel alone caused M cells to burst phasically. M cells at 2 dpf fired tonically after blocking Kv7. In situ hybridization revealed specific Kv7.4/KCNQ4 expression in M cells at 2 dpf. Kv7.4 and Kv1.1 channels expressed in Xenopus oocytes exhibited low-threshold outward currents with slow and fast rise times, while coexpression of Kvß2 accelerated and increased Kv1.1 currents, respectively. Computational models, modified from a mouse cochlear neuron model, demonstrated that Kv7.4 channels suppress repetitive firing to produce spike-frequency adaptation, while Kvß2-associated Kv1.1 channels increase firing threshold and decrease the onset latency of spiking. Altogether, coordinated expression of these low-threshold K+ channels with Kvß2 functionally differentiates M cells among homologous neurons.

Cross-cultural validity of the theory of planned behavior for predicting healthy food choice in secondary school students of Inner Mongolia.

AIMS: Unhealthy eating behavior is a serious health concern among secondary school students in Inner Mongolia. To predict their healthy food choices and devise methods of correcting unhealthy choices, we sought to confirm the cross-cultural validity of the theory of planned behavior among Inner Mongolian students. MATERIALS AND METHODS: A cross-sectional study, conducted between November and December 2014. Overall, 3047 students were enrolled. We devised a questionnaire based on the theory of planned behavior to measure its components (intentions, attitudes, subjective norms, and perceived behavioral control) in relation to healthy food choices; we also assessed their current engagement in healthy food choices. RESULTS: A principal component analysis revealed high contribution rates for the components (69.32%-88.77%). A confirmatory factor analysis indicated that the components of the questionnaire had adequate model fit (goodness of fit index=0.997, adjusted goodness of fit index=0.984, comparative fit index=0.998, and root mean square error of approximation=0.049). Notably, data from participants within the suburbs did not support the theory of planned behavior construction. Several paths did not predict the hypothesis variables. However, attitudes toward healthy food choices strongly predicted behavioral intention (path coefficients 0.49-0.77, p<0.01), regardless of demographic characteristics. CONCLUSION: Our results support that the theory of planned behavior can apply to secondary school students in urban areas. Furthermore, attitudes towards healthy food choices were the best predictor of behavioral intentions to engage in such choices in Inner Mongolian students.

Exploring physical activity with a low psychological burden and high feasibility in Japan: a qualitative study.

Previous research has shown that physical activity with a low psychological burden and high feasibility (i.e. a focus on small lifestyle changes) contributes to the adoption of and long-term success in behavior change intervention. The present study aims to explore the physical activity with a low psychological burden and high feasibility in which people already engage in their everyday life in Japan. Sixty-four participants (22 males and 42 females ranging in age from 36 to 89) participated in a qualitative research survey that asked what type of physical activity they engaged in on a daily basis to maintain good health. Results of a thematic analysis revealed nine themes (behavioral categories), which included four core themes of exercise, gymnastic exercises, stretch exercises, sports, and strength training, and five core themes of nonexercise activity, walking, cleaning, using the stairs, engaging in agriculture, and gardening based on a description analysis. A thematic map was constructed based on Japanese physical activity guidelines. Key findings of this study are as follows: (1) walking has a low psychological burden and high feasibility; (2) gymnastic exercise is efficacious from a physical and psychological perspective; (3) nonexercise activities are more acceptable than exercise activities; and (4) a focus on intervention with nonexercise activities has the potential for high engagement in the Japanese population. The study indicates that significant resources are available for promoting health behavior change interventions that would increase physical activity in the Japanese population.

Construction of a short form of the healthy eating behaviour inventory for the Japanese population.

INTRODUCTION: The present study constructed a short form of the Healthy Eating Behavior Inventory suitable for use in the Japanese culture (HEBI-J) and confirmed the scale's preliminary reliability and validity. METHODS: In Study 1, Japanese adults (N=75) completed a free-response questionnaire about healthy eating behaviours. Thematic analysis was used to identify three factors-balance, pattern, and restriction-associated with healthy eating behaviours and 12 items related to these healthy eating behaviours. In Study 2, Japanese office workers (N=784) completed two questionnaires regarding 12 items of healthy eating behaviours and the dietary stages of change. RESULTS: Confirmatory factor analysis demonstrated that the three-factor model was appropriate (GFI=.94, AGFI=.90, CFI=.90, RMSEA=.08, SRMR=.53). Reliability was confirmed by alpha coefficients and the Spearman-Brown formula. Concurrent validity was confirmed by the relationship between the healthy eating stages. CONCLUSIONS: This study demonstrated the preliminary reliability and validity of the HEBI-J.

Evaluation of Intervention Reach on a Citywide Health Behavior Change Campaign: Cross-Sectional Study Results.

Little is known about dissemination strategies that contribute to health information recognition. This study examined (a) health campaign exposure and awareness (slogan and logo recognition); (b) perceived communication channels; (c) differences between perceptions of researcher-developed and enhancement community health information materials; and (d) differences in campaign awareness and communication channels, according to Japanese community demographic characteristics. A cross-sectional survey (N = 508) was conducted in Tokigawa, Japan, in 2013. The Small Change Campaign focused on increasing physical activity and improving dietary habits. Information dissemination was carried out using leaflets, newsletters, posters, website, local public relations magazines, health classes, events, and online newsletters. The participants completed a survey assessing their campaign awareness (i.e., slogan and logo) and exposure to the informational materials presented during the campaign. Fewer than half (45.4%) knew the slogan, and only 24.4% were aware of the logo. Public relations magazines, leaflets, and newsletters were significantly better-perceived health communication channels. Researcher-developed and enhancement community health information materials were equally recognized (p = .34, w = .08). Furthermore, women and those who were employed were significantly more aware of the slogan, logo, and communication materials. Further research should explore effective communication strategies for community-based health promotion intervention via randomized control trials.