Science behind children's handwashing: action study of 9- to 10-years-old elementary school students in Japan.

Background: Hand washing instructions for children have been implemented in school education to establish good lifestyle habits. However, repeated hand washing through education from early childhood was common for both teachers and children. If this continues, children might assume they already know how to wash their hands, stop taking handwashing instructions seriously, and become increasingly lax about washing their hands. Purpose: This study aimed to develop a new handwashing education method for children. Methods: We applied the adenosine triphosphate (ATP) test to health education on hand washing in elementary schools. This study was conducted as part of a class for elementary school students in October 2023, in Hokkaido, Japan. The subjects were 157 third-grade (9-10 years old) elementary school students. After excluding absent pupils, 147 were included in the analysis. Results: Both pre- and post-education, ATP values after handwashing were lower than those before handwashing. Following the education, children's handwashing behavior improved, with an increase in the number of point washed and appropriate timing of handwashing. Conclusion: The new handwashing education program utilizing the ATP-test succeeded in promoting handwashing behavior among many children. Visualizing handwashing using ATP values was effective in motivating children.

Social role of the 'Bow-Wow Patrol' in urban areas of Japan: a qualitative study.

The 'Bow-Wow Patrol (BWP)', established to avert local crime by encouraging dog walking, may help build social relationships among individuals through dog walking. However, details of its social influence remain unclear. Thus, this study aimed to elucidate the social roles of BWP in the urban areas of Japan. A total of 18 BWP organisation members from two Tokyo municipalities were recruited using snowball sampling between November 2021 and July 2022. In an interview, participants were asked about their perceptions of changes in their social relationships through the BWP. Qualitative content analysis was conducted after text mining using the KH Coder software. The mean age of the participants was 63.9 years, and 83.3% engaged in BWP 7 days a week. The content analysis revealed six social roles of the BWP: establishment of social networks with schools as the centre, establishment of loose networks inside and outside the BWP organization, enhancement of a sense of trust among neighbours, enhancement of a sense of trust in communities, norms of reciprocity among dog owners, and dog and owner characteristics. This study found that the BWP in urban Japan strengthens social cohesion and expands social networks among dog walkers, encouraging them to continue walking.

Process of developing a cervical cancer education program for female university students in a Health and Physical Education teacher training course: an action research.

BACKGROUND: The purpose of this study was to develop a cervical cancer education program for students and evaluate the process for female students of an HPE teacher education university who were training to become Japanese Health and Physical Education teachers. METHODS: This study used Action Research (AR) methodology. In developing program, we analyzed the description of the teaching material development process, the lectures, and the students' report contents, which was the main activity in the program development. Thirty five third- and fourth-year students majoring in health promotion at a Health and Physical Education teacher education university, which trains Health and Physical Education teachers in Tokyo, Japan, participated in this study. RESULTS: After a review of the prototype version of the cervical cancer education material, six out of nine reviewers determined that it can be published. In the revised cervical cancer education materials, messages from students, university lecturers, and gynecologists have been added as a column in the section on 'how to prevent cervical cancer. Analysis of the contents of the texts (16,792 characters in total) of 35 student reports resulted in the generation of 51 codes, 3 categories, and 15 subcategories. CONCLUSIONS: This study reflects the intentions of female university students to contribute their knowledge to the development of educational materials on cervical cancer, which, alongside the lectures, have deepened the knowledge and awareness of cervical cancer. Based on this, the teaching material development process, lectures by experts, and students' mindset after learning about cervical cancer is reported in this study. There is a need for more educational programs on cervical cancer that are implemented through the education of female university students.

Factors promoting collaboration between community sports leaders and guardians in urban areas of Japan: A cross-sectional study.

Background: Community sports leaders (CSLs) are expected to play an important role in promoting regional sports in Japan. Increased opportunities for CSLs to work in schools and engage with guardians could encourage middle-aged adults to participate in regional sports activities. However, few CSLs work with guardians, and there is no evidence regarding what CSL characteristics encourage collaboration. The present study aimed to ascertain the aspects of coordination for CSLs collaborating with guardians in urban areas. Methods: A self-administered questionnaire survey was mailed to all 1,489 CSLs through 59 municipalities using the CSL out of 62 in Tokyo, Japan, from July to November 2021. The questionnaire covered sociodemographic data, variables related to CSL activities, coordination functions, and experience collaborating with guardians. We conducted a binomial logistic regression analysis using experience collaborating with guardians as the dependent variable, coordination function as the explanatory variable, and gender, age, residence duration, years of CSL experience, and the number of activities as covariates. Results: The analyzed sample comprised 478 CSLs. Binomial logistic regression analysis revealed a significant relationship between experience collaborating with guardians and the coordination function of internal/external CSL organizations, such as participation in non-CSL community activities, experience teaching and supporting their own children's sports, activity initiatives, number of times they used the school gymnasium, awareness of the regional sports plan, and cooperation with the chairman of the neighborhood association. Conclusions: Collaboration with guardians was related to CSL's individual experience engaging in regional sports from parenting and community collaboration, such as participation in non-CSL community activities and their relationship with the chairman of the neighborhood association. CSL activities may have the potential to encourage middle-aged adults to participate in regional sports.

The Effect of a Learning Partner Model-Based Program on Spreading Cancer Prevention Knowledge Using Community Health Volunteers in Japan.

OBJECTIVES: This study examines the implementation and short-term effects of a Learning Partner Model (LPM)-based educational program on cancer prevention and control information for community health volunteers in Japan. METHODS: The program was undertaken by 3 local governments in collaboration with a government initiative and offered a 90-min group workshop to community health volunteers. Community health volunteers (primary participants) recruited in turn friend or family members (secondary participants) with whom they were prepared to share the content of the workshop with the help of printed materials received in the workshop. We conducted self-administered paper and pencil questionnaire surveys before, immediately after, and 3 months after the workshop. The t-test, Fisher's exact test, paired t-test, and McNemar test were used to compare the 2 groups' demographic characteristics and healthy habits at pretest. Repeated measures ANOVA was used to compare cancer prevention knowledge between groups and over time. RESULTS: Of 142 participants, 107 pairs of learning partners (primary and corresponding secondary participant) completed all questionnaires. All primary participants and 37.4% of the secondary participants were women, and 57.9% of the learning partners were spouses. The results showed significantly higher correct answers on the cancer-prevention knowledge questions in the post-workshop and follow-up surveys compared to the pre-workshop survey (P < .001). The increase in knowledge was observed in all learning-partner groups in all 3 sites. CONCLUSION: The study demonstrates a promising strategy that can be adapted to the health needs of the community beyond cancer prevention and control, building on the efforts of local governments and government health initiatives.

Cancer Awareness and Understanding of Students in Japan: What Do Students Having Close Relatives with Cancer Think About the Disease?

Students have become more familiar with cancer because of media, such as television or the Internet, reporting on celebrity cancer cases. Moreover, with Japan's increasing age and cancer rates, the number of students whose parents/relatives develop cancer is likely to increase. This study examined cancer awareness and understanding among students aged 10 to 16 or more. A cross-sectional nationwide survey was conducted using a self-administered questionnaire. Cancer awareness and cancer understanding were assessed using a self-administered questionnaire. We collected a total of 9139 questionnaires and excluded those with missing data. Thus, we analyzed the responses of 8701 students: 2135, 2902, and 3664 from elementary, junior, and high school, respectively. Data were analyzed using a multivariable model adjusted for gender and grade. Approximately 30% of respondents had parents/relatives with cancer. In addition, there was a significant association between having parents/relatives with cancer and cancer awareness; however, students having parents/relatives with cancer had more negative awareness (i.e., "I think cancer is scary," "I think I will get cancer in the future," and "I think cancer is preventable"). Furthermore, there was a significant association between cancer understanding and awareness. These findings suggest that cancer education could have a desirable effect on students whose parents/relatives have cancer. Further, cancer education offers benefits to students who are naive about cancer and ill prepared to cope when a family member discloses a cancer diagnosis.

Cross-cultural validation of the Cancer Stigma Scale in the general Japanese population.

BACKGROUND: The stigma associated with cancer has negative impacts on cancer patients as well as the general public, who have a potential risk of cancer. To the best of our knowledge, a validated measure to assess cancer stigma among the general Japanese population does not exist. METHOD: We translated the Cancer Stigma Scale (CASS) - a 25-item self-administered scale to evaluate stigma related to cancer - into Japanese and examined its psychometric properties. The Japanese version of CASS (J-CASS) was validated among a sample of the general Japanese population through an online survey to validate its test-retest reliability, internal consistency, and concurrent validity. RESULTS: A total of 319 responses were included in the analysis. An exploratory factor analysis eliminated two original items but showed a six-factor model (Awkwardness, Severity, Avoidance, Policy Opposition, Personal Responsibility, and Financial Discrimination), which was similar to the original scale. Cronbach's alpha for each factor was satisfactory, ranging from 0.81 to 0.91. The internal correlation coefficients were above 0.70, except for Policy Opposition. The total and subtotal scores of each factor of the J-CASS were significantly associated with respondents' age, gender, familiarity with cancer patients, and social desirability, demonstrating the scales' good concurrent validity. A substantial proportion of the participants selected "unsure" for some items of the scale, suggesting a further need for refining the scale. SIGNIFICANCE OF RESULTS: This study demonstrated that J-CASS is a reliable and valid measure for evaluating misconceptions and stigma toward cancer in the general Japanese population.

Japanese translation and modification of the Oslo Sports Trauma Research Centre overuse injury questionnaire to evaluate overuse injuries in female college swimmers.

The purpose of the present study was to translate and modify the Oslo Sports Trauma Research Centre (OSTRC) overuse injury questionnaire into Japanese and validate it among Japanese athletes through a longitudinal survey. A modified back-translation method was used to translate the questionnaire from English to Japanese. The longitudinal survey was performed in 29 female college swimmers who were followed up for more than 24 consecutive weeks. The response rate to the 24 weekly questionnaires was 88.8% (95% confidence interval [CI]: 85.2-92.3). Internal consistency was measured by using Cronbach's alpha (0.73 (0.69-0.77)). The anatomical areas most frequently affected by overuse injuries were the lower back (average weekly prevalence: 27.6%, 95% CI: 25.1-30.1), shoulder (16.0%, 95% CI: 13.7-18.2), knee (9.9%, 95% CI: 7.7-12.0), and ankle (9.0%, 7.6-10.5). The severity score showed that knee (22.5, range: 6-65), ankle (21.5, range: 6-67), and lower back (20.7, range: 6-80) injuries had the greatest impact. The Japanese version of the modified OSTRC overuse injury questionnaire demonstrated reliability and validity based on the results of internal consistency and trend of injury of the swimmers. The participants in the present study did not have substantial injuries or time-loss injuries and continued practicing and competing, despite these minor injuries. Although knee and ankle injuries do not occur as often as lower back and shoulder injuries, these injuries often had a greater impact on swimmers when they did occur.

Children's Knowledge of Cancer Prevention and Perceptions of Cancer Patients: Comparison Before and After Cancer Education with the Presence of Visiting Lecturer -Guided Class.

The purpose of this study was to investigate the effect of the presence of visiting lecturer-guided class on children's knowledge of cancer prevention and perceptions of cancer patients, conducting surveys before and after the cancer education classes at local elementary schools that are pioneering cancer education. We implemented self-administered questionnaire surveys with 571 sixth-grade children at nine elementary schools receiving cancer education in the Tokyo metropolitan area from September 2013 to February 2014. The surveys were conducted twice in each classroom: 1 week before the cancer education class and 1 week after. The questionnaire items included participants' gender, cancer prevention information, and perceptions of cancer patients with the following description: "looks pitiful," "always depressed," "bedridden and hospitalized," "excessive smoking and drinking," "looks thin and pale," "no visible change despite cancer," and "always bright and cheerful." Children who had not attended the cancer education day, or had not completed both the pre- and post-test, were excluded from the analysis. Regardless of whether there visiting lecturer-guided class was provided, the possibility of improving children's knowledge of cancer prevention was demonstrated. On the other hand, in the post-class surveys, compared to the group with visiting lecturer-guided class, the group without it had a significantly lower percentage of persons selecting "Looks pitiful" (76.2%/63.5%, p = 0.002) and significantly higher percentages for "Too much smoking and drinking," and "Looks thin and pale" (50.2%/63.5%, p = 0.002; 18.8%/31.1%, p = 0.001). Therefore, study is needed into cancer education coordinated with relevant institutions in order to more effectively utilize visiting lecturers and the like.

Anterior cruciate ligament injury: Identifying information sources and risk factor awareness among the general population.

INTRODUCTION: Raising awareness on a disorder is important for its prevention and for promoting public health. However, for sports injuries like the anterior cruciate ligament (ACL) injury no studies have investigated the awareness on risk factors for injury and possible preventative measures in the general population. The sources of information among the population are also unclear. The purpose of the present study was to identify these aspects of public awareness about the ACL injury. MATERIALS AND METHODS: A questionnaire was randomly distributed among the general population registered with a web based questionnaire supplier, to recruit 900 participants who were aware about the ACL injury. The questionnaire consisted of two parts: Question 1 asked them about their sources of information regarding the ACL injury; Question 2 asked them about the risk factors for ACL injury. Multivariate logistic regression was used to determine the information sources that provide a good understanding of the risk factors. RESULTS AND DISCUSSION: The leading source of information for ACL injury was television (57.0%). However, the results of logistic regression analysis revealed that television was not an effective medium to create awareness about the risk factors, among the general population. Instead "Lecture by a coach", "Classroom session on Health", and "Newspaper" were significantly more effective in creating a good awareness of the risk factors (p < 0.001).

A Cross-sectional Investigation of Cancer-Screening Intentions, Sources of Information, and Understanding of Cancer in Japanese Adolescents.

The purpose of this study was to describe the cancer-screening intention, sources of cancer information, and cancer understanding among Japanese adolescents. A cross-sectional nationwide survey involving a self-administered questionnaire was conducted. Response rates of the target schools were 46.4 % (n = 103) for junior high schools and 55.8 % (n = 116) for high schools. From these, we analyzed the data of 2960 junior high school students (1520 males, 1440 females) and 3703 high school students (1546 males, 2157 females) to examine the association between cancer-screening intention and sources of cancer-related information and understanding. A significant association between cancer-screening intention and sources of cancer information and cancer understanding was observed. The screening intention group identified more sources of cancer information than the no-screening intention group did. Understanding about cancer was reported by a higher proportion of students in the screening intention group compared with the no-screening intention group. Recognition that healthy people must take part in cancer screening was significantly associated with screening intention in both junior high (odds ratio (OR), 1.859; 95 % confidence interval (CI), 1.582-2.185; P < 0.001) and high school (OR, 2.485; 95 % CI, 2.139-2.887; P < 0.001) students. Health education at school was indicated by a high proportion of students as a source of cancer-related information, although the association was not significant. The present survey indicated that those in of our sample who intended to undergo future cancer screening (67.8 %) had more sources of information and understanding regarding cancer. Thus, schools should enrich health education curricula with more information and understanding about cancer to promote cancer-screening intention among Japanese adolescents.

Practical use of cancer control promoters in municipalities in Japan.

The Cancer Control Act in Japan became effective in 2006. In Ibaraki, Toyama, and Hyogo prefectures, the Cancer Control Promoter (CCP) plan was created to strengthen partnerships for cancer prevention. This study aimed to examine the curre nt status of CCP utilization and analyze relationships with intersectoral collaboration, both within the government and with outside partners. In 2008, we mailed questionnaires to 100 administrators responsible for disease prevention and health promotion in municipal governments of the three prefectures. Ninety-one administrators responded (response rate, 91.0%). We analyzed responses to questions regarding whether or not the municipalities had used CCPs. Items assessing intersectoral collaboration examined municipality characteristics and relationships with outside partners and sectors specializing in areas other than community health. Among 90 administrators with valid data, 33 municipalities (36.7%) used CCPs while 57 (63.3%) did not. The Fisher's exact test revealed that intersectoral collaboration for using CCPs was associated with communication with all of the municipal government sectors not related to health. The present study indicated that CCPs were not consistently used in municipalities. However, we found that intersectoral collaborations, especially within the local government, may be related to the practical use of CCPs. This, in turn, may result in effective cancer control and prevention, as well as improvement in community health.

Cancer understanding among Japanese students based on a nationwide survey.

OBJECTIVE: The objective of this study was to determine cancer understanding among Japanese primary and secondary school students. METHODS: The study design was a cross-sectional nationwide survey using a self-administered questionnaire. The prefecture with the lowest student population was set to 1, and that with the highest student population was set to 18 for elementary schools and 19 for junior high and high schools based on the ratio of the student population. In this way, 213 elementary schools, 222 junior high schools, and 208 high schools were selected from all 47 prefectures in Japan, and questionnaires were sent to each school. The questionnaire listed the names of 15 cancers and asked respondents to choose one answer from three: "Never heard of," "Heard of/Don't understand," or "Heard of/Understand." RESULTS: Response rates for schools were 44.1 % (n = 94) for elementary schools, 46.4 % (n = 103) for junior high schools, and 55.8 % (n = 116) for high schools. A total of 8,876 questionnaires were used for the analysis. Our survey suggests that the most commonly understood types of cancer differed by grade, with lung cancer the most commonly understood in elementary school, leukemia in junior high schools, and breast cancer in high schools. Girls tended to demonstrate greater cancer understanding than boys, with particularly large differences by gender in rates of understanding of breast and uterine cancer at each assessed grade level. CONCLUSIONS: Here, we examined Japanese primary and secondary school students. Marked differences in cancer recognition by grade and gender suggest that educational efforts are needed at various grade levels and gender-specific cancer education. Further, more than 50 % of students at any school level were not familiar with most cancers. It suggests that cancer education is deficient.

Breast cancer clustering in Kanagawa, Japan: a geographic analysis.

BACKGROUND: The purpose of the present study was to determine geographic clustering of breast cancer incidence in Kanagawa Prefecture, using cancer registry data. The study also aimed at examining the association between socio-economic factors and any identified cluster. MATERIALS AND METHODS: Incidence data were collected for women who were first diagnosed with breast cancer during the period from January to December 2006 in Kanagawa. The data consisted of 2,326 incidence cases extracted from the total of 34,323 Kanagawa Cancer Registration data issued in 2011. To adjust for differences in age distribution, the standardized mortality ratio (SMR) and the standardized incidence ratio (SIR) of breast cancer were calculated for each of 56 municipalities (e.g., city, special ward, town, and village) in Kanagawa by an indirect method using Kanagawa female population data. Spatial scan statistics were used to detect any area of elevated risk as a cluster for breast cancer deaths and/ or incidences. The Student t-test was performed to examine differences in socio-economic variables, viz, persons per household, total fertility rate, age at first marriage for women, and marriage rate, between cluster and other regions. RESULTS: There was a statistically significant cluster of breast cancer incidence (p=0.001) composed of 11 municipalities in southeastern area of Kanagawa Prefecture, whose SIR was 35 percent higher than that of the remainder of Kanagawa Prefecture. In this cluster, average value of age at first-marriage for women was significantly higher than in the rest of Kanagawa (p=0.017). No statistically significant clusters of breast cancer deaths were detected (p=0.53). CONCLUSIONS: There was a statistically significant cluster of high breast cancer incidence in southeastern area of Kanagawa Prefecture. It was suggested that the cluster region was related to the tendency to marry later. This study methodology will be helpful in the analysis of geographical disparities in cancer deaths and incidence.