Abstract

High-quality sleep is an important factor in sustaining health and improving well-being. Previous evidence has demonstrated the positive associations between increased physical activity and reduced sedentary behaviour (SB) with sleep quality. The substitutional relationships between SB, light-intensity physical activity (LPA), and moderate-to-vigorous physical activity (MVPA) need to be considered when examining how a particular behaviour may impact sleep quality. No studies, to our knowledge, have explored these substitutional relationships in middle-aged adulthood. Using an isotemporal substitution approach, this study examined the associations of replacing sedentary time with physical activity on sleep quality measures in a sample of middle-aged adults in Japan. Data from 683 adults aged 40–64 living in Japan were used. The average daily time spent in SB, LPA, and MVPA was objectively assessed by accelerometers. Two self-reported sleep quality measures were obtained using questionnaires, including rest by sleep and sleep quality. Multivariable linear regression models were used to assess the associations of SB, LPA, and MVPA with the sleep quality measures stratified by gender. We found that each 60 min unit of SB or LPA replaced with MVPA was favourably associated with rest by sleep among women (β = 0.16, 95% CI 0.07, 0.28, p < 0.001; β = 0.18, 95% CI 0.07, 0.32, p < 0.05, respectively). There were no significant associations between SB, LPA, and MVPA with sleep measures in men across all three models. These findings indicate that higher MVPA has a positive association with sleep quality in middle-aged women.

INTRODUCTION: A prior study showed an association between diversity in daily activities (type, frequency, evenness) and frailty in older adults. However, the causality of this relationship is unclear. Therefore, this study aimed to clarify the relationship between activity diversity and frailty through a 2-year longitudinal study conducted among community-dwelling older adults. METHODS: We evaluated data from the 2018 and 2020 waves of the Otassha Study. Frailty was assessed using the Cardiovascular Health Study criteria, with pre-frail and frail participants defined as frail and the other participants categorized into the robust group. We enrolled a total of 207 participants who were not frail at baseline. Activity type, frequency, and evenness scores were calculated using an Activity Diversity Questionnaire. The association between each activity diversity score and the incidence of frailty was evaluated using logistic regression modeling (each diversity score was entered the model after Z-transformation). RESULTS: Of the 207 enrolled participants (median age, 73 years; age range, 65-91 years; 60.4% women), 64 (30.9%) had incident frailty during the follow-up period. A logistic regression analysis adjusting for sociodemographic and psychosomatic factors revealed odds ratios for activity type and evenness scores of 0.64 and 0.61, respectively (P < 0.05). These factors were significantly associated with the incidence of frailty. DISCUSSION: Activity type and evenness (except frequency) within daily activities were predictors of frailty during 2 years of follow-up. Engagement in diverse activities appears to be more effective in preventing frailty than does engagement in a few activities.

[Purpose] In this pilot study, we investigated the effectiveness of physical therapist-delivered acceptance and commitment therapy in older outpatients with knee osteoarthritis and chronic pain. [Participants and Methods] This single-center, open-label, parallel-group pilot randomized controlled trial included 30 patients assigned to the physical therapist-delivered acceptance and commitment therapy group (n=15) and the usual care physical therapy-only group (n=15). Both treatments were administered once a week for 8 weeks. Evaluation was performed 4 weeks before intervention, pre-intervention, post-intervention, and 4 weeks after intervention. The primary outcome was diagnosis of a physical disability, and secondary outcomes included psychological inflexibility, pain intensity, anxiety, depression, physical function, and objectively measured physical activity. [Results] Physical therapist-delivered acceptance and commitment therapy had a limited effect on physical disability, although we observed a favorable tendency. With regard to secondary outcomes, physical therapist-delivered acceptance and commitment therapy did not show significant effects. Notably, 15 patients withdrew from this study and 6 were diagnosed with coronavirus disease. [Conclusion] Physical therapist-delivered acceptance and commitment therapy did not appear to show significant effects in the present study. It is necessary to correct these issues in this study, and future studies are warranted to investigate the effects of this therapy.

Understanding the correlates of sedentary behavior among children is essential in developing effective interventions to reduce sitting time in this vulnerable population. This study aimed to identify correlates of domain-specific sedentary behaviors and objectively assessed sedentary time among a sample of children in Japan. Data from 343 children (aged 6-12 years) living in Japan were used. Domain-specific sedentary behaviors were assessed using a questionnaire. Total sedentary time was estimated using hip-worn accelerometers. Twenty-two potential correlates across five categories (parental characteristics, household indoor environment, residential neighborhood environment, school environment, and school neighborhood environment) were included. Multivariable linear regression models were used to identify correlates of domain-specific sedentary behaviors and objectively assessed sedentary time. Eight correlates were significantly associated with children's domain-specific sedentary behaviors: mother's and father's age, mother's educational level, having a video/DVD recorder/player, having a video console, having a TV one's own room, home's Walk Score®, and pedestrian/cycling safety. No significant associations were found between potential correlates and accelerometer-based total sedentary time. These findings highlight that strategies to reduce children's sedentary time should consider the context of these behaviors. For example, urban design attributes such as perceived pedestrian and cycling safety can be improved to reduce children's car sitting time.

Background
Understanding factors contributing to an individual reducing screen time is essential for promoting a healthy weight. Parents’ behavior affects children by influencing their daily decision-making through modeling, rules or restrictions, social support, and co-participation. We examined how the direct and indirect effects of parents’ and children’s behaviors regarding screen time influenced body mass index (BMI) among Japanese elementary school children.

Methods
We included 283 Japanese children, one child per household, aged 6–12 years, who were randomly selected from resident registries of two cities. The questionnaires were completed by children and their mothers and fathers. Screen time and sociodemographic attributes, including sex, age, employment status, height, and weight, were assessed using a mail-based survey. Path analyses were conducted to determine associations among children’s, fathers’, and mothers’ variables. It was hypothesized that after controlling for household income and children’s sex and age, mothers’ and fathers’ screen time on weekdays and weekends would be related to children’s weekdays and weekend screen time, respectively. In addition, we hypothesized that children’s weekday and weekend screen time was related to children’s BMI.

Results
Both fathers’ and mothers’ weekday screen times were associated with children’s weekday and weekend screen times. BMI was affected by children’s weekday screen time (0.117). The path coefficients for the indirect effects of mothers’ and fathers’ screen time on children’s BMI through children’s weekday screen time were 0.016 from the fathers’ weekday screen time and 0.024 from the mothers’ weekday screen time (GFI = .980, AGFI = .953, RMSEA = .030, AIC = 93.030).

Conclusions
Both fathers’ and mothers’ weekday screen times indirectly affected children’s BMI through children’s weekday screen time among Japanese elementary school children. The strongest indirect effects could be seen by examining the paths of a mother’s weekday screen time through children’s screen time to BMI. Mothers who spend much time with their children are role models, and their behavior could affect the child’s behavior. The findings imply that intervention strategies to reduce screen time in children should also focus on modeling the mothers’ behavior.

Abstract

Few studies have examined the association between coffee consumption and muscle mass; their results are conflicting. Therefore, we examined the association between coffee consumption and low muscle mass prevalence. We also performed an exploratory investigation of the potential effect modification by demographic, health status-related, and physical activity-related covariates. This cross-sectional study included 2085 adults aged 40–87 years. The frequency of coffee consumption was assessed using a self-administered questionnaire. Muscle mass was assessed as appendicular skeletal muscle mass/height² using a multifrequency bioelectrical impedance analyser. We defined low muscle mass using cut-offs recommended by the Asian Working Group for Sarcopenia. Multivariable-adjusted odds ratios for low muscle mass prevalence were estimated using a logistic regression model. The prevalence of low muscle mass was 5.4% (n = 113). Compared with the lowest coffee consumption group (&lt;1 cup/week), the multivariable-adjusted odds ratios (95% confidence intervals) of low muscle mass prevalence were 0.62 (0.30, 1.29) for 1–3 cups/week, 0.53 (0.29, 0.96) for 4–6 cups/week or 1 cup/day, and 0.28 (0.15, 0.53) for ≥2 cups/day (P for trend &lt;0.001). There were no significant interactions among the various covariates after Bonferroni correction. In conclusion, coffee consumption may be inversely associated with low muscle mass prevalence.

BACKGROUND: Time spent sitting is associated adversely with health outcomes in older adults. Nevertheless, it is not clear how sedentary time may be related to appendicular skeletal muscle mass (ASM) - a key attribute of sarcopenia. This cross-sectional study examined associations of total sedentary time with ASM among community-dwelling older Japanese males and females. METHODS: Participants (n = 281, 74.3 ± 5.2 yr) wore a tri-axial accelerometer for seven days. Body mass index-adjusted ASM (kg/BMI) was derived from bioimpedance measures. Multivariate linear and quadratic regression models examined the associations of ASM with total sedentary time, stratified by sex. Restricted cubic spline models were fitted to estimate non-linear associations. Isotemporal substitution (IS) models were used to estimate the impacts of replacing 30-minute of sedentary time with light physical activity (LPA) and moderate-to-vigorous physical activity (MVPA). RESULTS: After adjustment, total sedentary time had a significant linear and negative association with ASM among females (β = -0.014; p = 0.023). For males, total sedentary time had a significant quadratic association (p = 0.020). Spline models indicated a reverse U-shaped association (p < 0.001) with total sedentary time over 9.3 h/day being associated with lower ASM. The IS models indicated that replacing 30 min/day of sedentary time with LPA would be positively and significantly associated with older females' ASM (β = 0.007, p = 0.022). CONCLUSIONS: In older Japanese adults, higher volumes of time spent sedentary were associated with lower ASM. For males, only very high volumes of sedentary time appeared to be detrimental. These adverse relationships may in part be offset by more time spent in either LPA or MVPA.

BACKGROUND: Differences in accelerometer-measured sedentary behavior and different physical activity (PA) intensities between men and women have been poorly described. The authors examined gender differences in time-use activity composition and total volume of PA. METHODS: A cross-sectional mail survey was conducted from 2013 to 2015 with a randomized sample of 6000 middle-aged (40-64 y) community-dwelling Japanese adults living in urban and regional cities. Participants wore Active style Pro HJA-350IT on their waist for 7 consecutive days. Gender differences in activity time use was examined using compositional data analysis to control for time spent in all activity measures. RESULTS: In total, 757 participants (303 men, 52.3 [7.1] y) with valid data were included in the analysis. Women spent on average 12.6% less time in sedentary behavior and 23.4% more time in light-intensity PA than men, whereas no significant difference was found for moderate to vigorous PA. Women accumulated a significantly greater volume of PA than men (17.8 vs 15.0 metabolic equivalent of task h/d). CONCLUSIONS: Japanese middle-aged women showed higher levels of PA than men because they spent more time in light-intensity PA. Given the health benefits of light-intensity PA, evaluating only moderate to vigorous PA may lead to an underestimation of women's participation in PA.

Evidence suggests that neighbourhood street connectivity is positively associated with physical activity, yet few studies have estimated its associations with sedentary behaviour. We estimated the associations between space syntax derived street integration, a novel measure of street connectivity, and sedentary behaviours among Canadian adults. Data were sourced from a population-based study–Alberta’s Tomorrow Project (n = 14,758). Items from the International Physical Activity Questionnaire captured sedentary behaviour, including sitting and motor vehicle travel time and walking. Street integration was measured within a 1600m radius of participants’ homes. Covariate-adjusted linear regression models estimated the associations between street integration and sedentary behaviour. Street integration was significantly positively associated with daily minutes of sitting on week (b 6.44; 95CI 3.60, 9.29) and weekend (b 4.39; 95CI 1.81, 6.96) days, and for week and weekend days combined (b 5.86; 95CI 3.30, 8.41) and negatively associated with daily minutes of motor vehicle travel (b -3.72; 95CI -3.86, -1.55). These associations remained significant after further adjustment for daily walking participation and duration. More research is needed to understand the pathways by which street integration positively and or negatively affects sedentary behaviour.

In the context of rapid urbanization, public open spaces in dense urban areas are critical built environment elements to support active lifestyles. Several reviews have explored the associations of public open space attributes with physically active and sedentary behavior. However, few reviews have included studies from Asia, and no studies have focused on dense urban areas. This systematic review analyzed 18 observational studies investigating associations between public open space attributes with physical activity and sedentary behavior in dense urban areas of East Asian countries, including Japan, Taiwan, China, and Hong Kong. We found that closer distance to and a greater number of public open spaces and features within them were positively associated with leisure-time physical activity. Places near water features and corridors within public open spaces were associated with more sedentary behavior. These findings inform landscape and urban design guidelines for (re)designing public open spaces to support active lifestyles in high dense urban areas.

BACKGROUND: Although the negative relationship between cardiorespiratory fitness (CRF) or muscular fitness and diabetes mellitus were respectively observed in many previous studies, there is still a lack of studies that include CRF and muscular fitness simultaneously. Therefore, this study aimed to investigate the relationship between the combination of CRF and muscular fitness and diabetes through a cross-sectional study.  METHODS: This study was part of WASEDA'S Health Study, a cohort study launched in 2014. We used a part of the baseline data collected for this study. Maximal exercise test using a cycle ergometer and leg extension power (LEP) test were respectively used to evaluate CRF and muscular fitness. Since LEP is affected by body weight, relative LEP (rLEP) which is LEP per body weight, was used as an index of muscular fitness. 796 men (56.5 ± 10.4 years old) who completed a medical examination and fitness tests, were divided into two groups based on CRF and rLEP, respectively. The prevalence of diabetes was collected based on a self-reported questionnaire or blood test. Odds ratios and 95% confidence intervals (CIs) for the prevalence of diabetes were obtained using logistic regression models while adjusting for age, body mass index, exercise habits, family history of diabetes, smoking habits, and drinking habits. RESULTS: 55 (7%) participants had diabetes. Compared to participants with lower CRF or rLEP, the odds ratio (95% CIs) of diabetes in those with higher CRF or rLEP was 0.46 (0.21-0.98) or 0.34 (0.16-0.74), respectively. Furthermore, using the lower CRF and lower rLEP group as the reference, the odds ratio (95% CIs) for the lower CRF and higher rLEP group was 0.32 (0.12-0.88), and higher CRF and higher rLEP group was 0.21 (0.07-0.63), after adjusting for potential confounding factors. CONCLUSIONS: CRF and rLEP have independent and joint inverse associations with diabetes prevalence. In addition, participants with high CRF and high rLEP had a lower prevalence of diabetes compared to those with only high CRF or only high rLEP.

Aim: This study examined the associations between psychological inflexibility (PI) and physical disability (PD) among older patients with chronic low back and knee pain. Methods: Pain avoidance and cognitive fusion were assessed in outpatients as components of PI and PD, and sociodemographic and pain-related variables were used as covariates. Hierarchical multiple linear regression was used. The covariates were first entered, followed by PI. Results: Age and pain intensity had significant positive associations with PD. After adding PI, only pain avoidance was significantly and positively associated with PD. Conclusion: Focusing on pain avoidance may be effective for physical disability when acceptance and commitment therapy is administered to older patients with chronic low back and knee pain.

Workplace settings-both internal and external-can influence how workers are physically active or sedentary. Although research has identified some indoor environmental attributes associated with sitting at work, few studies have examined associations of workplace neighbourhood built-environment attributes with workplace sitting time. We examined the cross-sectional associations of perceived and objective workplace neighbourhood built-environment attributes with sitting time at work and for transport among desk-based workers in Japan. Data were collected from a nationwide online survey. The Abbreviated Neighborhood Environment Walkability Scale (n = 2137) and Walk Score® (for a subsample of participants; n = 1163) were used to assess perceived and objective built-environment attributes of workplace neighbourhoods. Self-reported daily average sitting time at work, in cars and in public transport was measured using a Japanese validated questionnaire. Linear regression models estimated the associations of workplace neighbourhood built-environment attributes with sitting time. All perceived workplace neighbourhood built-environment attributes were positively correlated with Walk Score®. However, statistically significant associations with Walk Score® were found for sitting for transport but not for sitting at work. Workers who perceived their workplace neighbourhoods to be more walkable reported a longer time sitting at work and in public transport but a shorter sitting time in cars. Our findings suggest that walkable workplace neighbourhoods may discourage longer car use but have workplaces where workers spend a long time sitting at work. The latter finding further suggests that there may be missed opportunities for desk-based workers to reduce sitting time. Future workplace interventions to reduce sitting time may be developed, taking advantage of the opportunities to take time away from work in workplace neighbourhoods.

Although many studies have reported that a posteriori dietary pattern is associated with metabolic health, there is little evidence of an association between dietary patterns and different metabolic phenotypes. The present study aimed to examine the association between major dietary patterns and different metabolic phenotypes (metabolically healthy non-obese [MHNO], metabolically unhealthy non-obese [MUNO], metabolically healthy obese [MHO], and metabolically unhealthy obese [MUO]) in middle-aged and elderly Japanese adults. This cross-sectional study enrolled 2,170 Japanese adults aged ≥40 years. The four different metabolic phenotypes were determined based on the presence of obesity, abdominal obesity, hypertension, hyperglycemia, and dyslipidemia. The major dietary patterns were determined using principal component analysis based on energy-adjusted food intake. Two dietary patterns were identified: the healthy dietary pattern, which was characterized by a high intake of vegetables, fruits, potatoes, soy products, mushrooms, seaweeds, and fish; and the alcohol dietary pattern, which was characterized by a high intake of alcoholic beverages, liver, chicken, and fish. The healthy dietary pattern was associated with the MHNO and MHO phenotypes (MUNO and MUO as reference groups, respectively), and the multivariate-adjusted odds ratios (ORs) (95% confidence intervals [CIs]) in the highest quartile of healthy dietary pattern score with the lowest quartile as the reference category were 2.10 (1.40-3.15) and 1.86 (1.06-3.25), respectively. Conversely, the alcohol dietary pattern was inversely associated with the MHNO and MHO phenotypes, while the multivariate-adjusted ORs (95% CIs) in the highest quartile of the alcohol dietary pattern score with the lowest quartile as the reference category were 0.63 (0.42-0.94) and 0.45 (0.26-0.76), respectively. There were no significant interactions between sex and healthy/alcohol dietary patterns in the prevalence of the MHNO and MHO phenotypes. In conclusion, the present study's findings suggest that major dietary patterns are associated with different metabolic phenotypes in middle-aged and elderly Japanese adults. These findings provide useful evidence for maintaining metabolic health through diet regardless of obesity status.

<title>Abstract</title>Evidence for social pathways to health benefits for dog owners appears positive but less well-developed. Our study aimed to estimate the differences in social capital by dog ownership and dog walking status among young-to-middle-aged adults and older adults in Japan. Data from 3606 residents living in Japan were used. Data on social capital, dog ownership, and dog walking were collected by questionnaires. Age-stratified multivariable linear regression models were used to estimate differences in social capital scores by dog ownership and dog walking status. Among young-to-middle-aged adults, the mean of the activities with neighbours score, adjusted for covariates, was significantly higher (<italic>p</italic> &lt; 0.05) for the dog owner walkers group compared to the non-dog owners group. Among older adults, no significant differences in the marginal means of social capital scores were observed between the three groups of non-dog owners, dog owner non-walkers, and dog owner walkers. While the benefits of social capital for a healthy lifestyle have been well-documented, few means have been identified to intervene in social capital. Building on and expanding the known health benefits of dog ownership and dog walking, this study revealed modest support for the link between dog walking and activities with neighbours among young-to-middle-aged adults, but no meaningful associations were found for older adults. Additionally, no significant link was observed between dog walking and social cohesion among either age group. Future research can further improve the use of dog-based behavioural health interventions for fostering social capital.

目的:都市部における地域スポーツ事業推進に資する資料を得るため,スポーツ推進委員の連絡調整機能の特徴を明らかにすることを目的とした.方法:2020年11月〜12月に,東京都内3自治体のスポーツ推進委員18名を対象とする半構造化インタビューを実施した.スポーツ推進委員の活動内容や連絡調整の役割について尋ねた.解析にはKH Coderを用い,テキストデータより共起ネットワークを作成した.次に,Mayringの方法論に基づき,共起ネットワークによる識別を踏まえたテキストデータの比較分析により,サブカテゴリおよびカテゴリの命名を行った.結果:テキストデータから1,601語が抽出された.最も頻出していた語は「色々」であり,次いで「スポーツ推進委員」「地域」「学校」「子ども」「小学校」の順に多く出現していた.テキストデータの比較分析により,スポーツ推進委員の連絡調整機能の特徴として,42のコード,18のサブカテゴリ,7のカテゴリ(【社会資源の活用】【事業化】【動機づけ】【ネゴシエーション】【組織化】【有機的な連携】【継続的な協働】)が生成された.結論:スポーツ推進委員内部の協力的な組織体制の構築を重視するとともに,組織外部との相互作用を通じた地域への主体的な働きかけが確認された.それらの特徴は,自治体の事業推進のための機能を兼ね備えていることが明らかとなった.(著者抄録)

<title>Abstract</title>
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<title>Background and Objectives</title>
This study aimed to examine the associations between time spent in six different domains of sedentary behavior and happiness and whether social capital mediated such associations among adults and older adults living in a rural area of Japan.


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<title>Research Design and Methods</title>
Cross-sectional data from 3357 participants (mean age: 60±16 years) were used. Six domains of sedentary behavior, happiness, and social capital were assessed using a self-report questionnaire. Age-stratified multivariable linear regression models adjusted for covariates were used to examine the associations between six domains of sedentary behavior and happiness. For relationships where the direct effect was significant, we tested the mediating effects of two social capital measures.


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<title>Results</title>
Among both adults and older adults, more time spent viewing television was significantly associated with lower happiness scores, and more time spent engaging in other leisure activities was significantly associated with higher happiness scores. In addition, more time spent using cell phones and computers was significantly associated with lower happiness scores among the adults. Engaging in activities with neighbors significantly mediated the relationship between other leisure activities and happiness in the adults and older adults and between television viewing and happiness in the older adults.


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<title>Discussion and Implications</title>
Our findings indicated that less television viewing and more mentally active sedentary behavior (e.g., talking with others and engaging in hobbies) were associated with greater happiness. One aspect of social capital, engaging in activities with neighbors, acts as a potential mediator for relationships between sedentary behavior and happiness.


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OBJECTIVES: To examine the associations between domain-specific sedentary and active behaviors and workers' presenteeism and absenteeism in a sample of company employees. METHODS: This study recruited participants (n = 2466) from a nationwide online survey database (Japan, 2019). Participants completed a questionnaire that captured data on relative and absolute presenteeism and absenteeism and domain-specific physical activity and sedentary behaviors. RESULTS: Daily minutes of work-related physical activity were negatively associated with relative absenteeism. Daily minutes of leisure-related physical activity were positively associated with absolute presenteeism (ie, better productivity). Daily minutes of total physical activity were negatively and positively associated with relative absenteeism and absolute presenteeism (ie, better productivity). There was also a positive association between car sitting time and absolute absenteeism. CONCLUSIONS: A change in work culture and practices that support active behaviors at work and outside of work may improve employee's productivity indices.

BACKGROUND & AIMS: A limited number of studies have developed simple anthropometric equations that can be implemented for predicting muscle mass in the local community. Several studies have suggested calf circumference as a simple and accurate surrogate maker for muscle mass. We aimed to develop and cross-validate a simple anthropometric equation, which incorporates calf circumference, to predict appendicular skeletal muscle mass (ASM) using dual-energy X-ray absorptiometry (DXA). Furthermore, we conducted a comparative validity assessment of our equation with bioelectrical impedance analysis (BIA) and two previously reported equations using similar variables. METHODS: ASM measurements were recorded for 1262 participants (837 men, 425 women) aged 40 years or older. Participants were randomly divided into the development or validation group. Stepwise multiple linear regression was applied to develop the DXA-measured ASM prediction equation. Parameters including age, sex, height, weight, waist circumference, and calf circumference were incorporated as predictor variables. Total error was calculated as the square root of the sum of the square of the difference between DXA-measured and predicted ASMs divided by the total number of individuals. RESULTS: The most optimal ASM prediction equation developed was: ASM (kg) = 2.955 × sex (men = 1, women = 0) + 0.255 × weight (kg) - 0.130 × waist circumference (cm) + 0.308 × calf circumference (cm) + 0.081 × height (cm) - 11.897 (adjusted R2 = 0.94, standard error of the estimate = 1.2 kg). Our equation had smaller total error and higher intraclass correlation coefficient (ICC) values than those for BIA and two previously reported equations, for both men and women (men, total error = 1.2 kg, ICC = 0.91; women, total error = 1.1 kg, ICC = 0.80). The correlation between DXA-measured ASM and predicted ASM by the present equation was not significantly different from the correlation between DXA-measured ASM and BIA-measured ASM. CONCLUSIONS: The equation developed in this study can predict ASM more accurately as compared to equations where calf circumference is used as the sole variable and previously reported equations; it holds potential as a reliable and an effective substitute for estimating ASM.

Walk Score® is a free web-based tool that provides a walkability score for any given location. A limited number of North American studies have found associations between Walk Score® and perceived built environment attributes, yet it remains unknown whether similar associations exist in Asian countries. The study's objective is to examine the covariate-adjusted correlations between the Walk Score® metric and measures of the perceived built environment in ultrahigh density areas of Japan. Cross-sectional data were obtained from a randomly selected sample of adult residents living in two Japanese urban localities. There was a large correlation between Walk Score® and access to shops (0.58; p < 0.001). There were medium correlations between Walk Score® and population density (0.38; p < 0.001), access to public transport (0.34; p < 0.001), presence of sidewalks (0.41; p < 0.001), and access to recreational facilities (0.37; p < 0.001), and there was a small correlation between Walk Score® and presence of bike lanes (0.16; p < 0.001). There was a small negative correlation between Walk Score® and traffic safety (-0.13; p < 0.001). There was a medium correlation between Walk Score® and overall perceived walkability (0.48; p < 0.001). This study's findings highlight that Walk Score® was correlated with several perceived walkable environment attributes in the context of ultrahigh density areas in Asia.

Sedentary behaviour is associated with risks of detrimental health outcomes. It is crucial to understand how much time people spend in sedentary behaviour and what factors affect too much sedentary time for effective intervention. However, few studies examined the prevalence and the correlates of sedentary behaviour in Japan. Therefore, we assessed total sedentary time and its sociodemographic correlates using a nationally representative sample of adults in Japan. Cross-sectional data from Sports-Life Survey in 2016 and 2018 conducted by Sasagawa Sports Foundation was used. Participants' sociodemographic factors and total sedentary time were collected by questionnaires. We classified those with <8 h/day of total sedentary time as "low-sedentary" and those with ≥8 h/day of total sedentary time as "high-sedentary". A multiple logistic regression model was applied to calculate adjusted odds ratios and 95% confidence intervals (95% CIs) for the association of each variable with the "high-sedentary" group (≥8 h/day). In total, 5,346 participants were included in the analyses. On average, time spent in sedentary behaviour was 5.3 h/day (SD = 3.7) among Japanese adults. The percentage of "high-sedentary" was 25.3% (95% CI: 24.1-26.4) and higher body mass index (≥25 kg/m2), being unmarried, unemployment, and higher educational level (graduate school or university) were positively associated with being "high-sedentary". In conclusion, higher sedentary time was among people with higher body mass index, being unmarried, unemployed, and higher education. Intervention for reducing sedentary time should be developed, targeting people with these characteristics.

The association between a dietary pattern characterised by high alcohol intake and dyslipidaemia has not been fully investigated. Therefore, the present study aimed to investigate the association between alcohol dietary patterns and the prevalence of dyslipidaemia and its components. This cross-sectional study enrolled 2,171 men and women aged ≥40 years who were alumni of a Japanese university. To identify dietary patterns, a principal component analysis was performed based on the energy-adjusted food intake estimated by a brief-type self-administered diet history questionnaire. Three dietary patterns were identified, the second of which was named the alcohol dietary pattern and was characterised by a high intake of alcoholic beverages, liver, chicken, and fish. This alcohol dietary pattern was associated with reduced low-density lipoprotein cholesterol (LDL-C) levels. The fully adjusted odds ratios (95% confidence intervals) of high LDL-C for the lowest through highest quartile of alcohol dietary pattern score were 1.00 (reference), 0.83 (0.64-1.08), 0.84 (0.64-1.10), and 0.68 (0.49- 0.94), respectively. Subgroup analysis showed that the alcohol dietary pattern was inversely associated with the prevalence of dyslipidaemia in women, whereas it was positively associated with high triglyceride levels in men. In conclusion, the alcohol dietary pattern, characterised by a high intake of alcoholic beverages, liver, chicken, and fish, was associated with the prevalence of dyslipidaemia and its components. This finding provides useful information for the prevention and treatment of dyslipidaemia by modifying the diet.

BACKGROUND: Preventing social isolation is essential for promoting healthy aging. This study aims to 1) systematically review and synthesize the predictors of objectively measured social isolation from observational studies that have treated isolation as an outcome in community-dwelling older adults, and 2) overview previous studies in this area and reveal an agenda to develop future research. METHODS: Peer-reviewed primary studies published in English or Japanese were identified from PubMed, ScienceDirect, PsycINFO, Igaku-Chuo-Zasshi, and CiNii. We followed the PRISMA statement. Risk of bias of included studies was assessed using the Newcastle-Ottawa Scale. RESULTS: Of the 1,161 studies identified, 10 were included in the review. Most studies were cross-sectional and published in the past 20 years. The risk of bias score ranged from 3 to 6 for the individual studies, indicating a moderate to high risk. The assessment measures for social isolation and proportion of isolated subjects varied greatly across studies. Findings on the predictors of social isolation from each study were clustered into four categories: socio-demographic factors, physical health factors, psychological and cognitive factors, and social and cultural factors. CONCLUSIONS: It was difficult to confirm these predictors conclusively because of the cross-sectional study design and a huge variety of assessment tools for social isolation. This result suggests the need to build consensus on the appropriate scales and standard cut-off points for assessing social isolation. Furthermore, longitudinal studies are urgently required. When considering predictors of social isolation, it is also essential to consider the regional and ethnic background of the samples studied.

BACKGROUND: Sedentary behaviors and physical activity are likely to be affected by the COVID-19 outbreak, and sedentary lifestyles can increase subjective fatigue. The nonpharmaceutical policies imposed as a result of the COVID-19 pandemic may also have adverse effects on fatigue. OBJECTIVE: This study has two aims: to examine the changes in sedentary behaviors and physical activity of company workers in response to the COVID-19 pandemic in Japan and to examine relationships between changes in these sedentary behaviors and physical activity and changes in fatigue. METHODS: Data from a nationwide prospective online survey conducted in 2019 and 2020 were used. On February 22, 2019, an email with a link to participate in the study was sent to 45,659 workers, aged 20 to 59 years, who were randomly selected from a database of approximately 1 million individuals. A total of 2466 and 1318 participants, who self-reported their occupation as company workers, answered the baseline and follow-up surveys, respectively. Surveys captured fatigue, workday and daily domain-specific sedentary behaviors and physical activity, and total sedentary behaviors and physical activity. We used multivariable linear regression models to estimate associations of changes in sedentary behaviors and physical activity with changes in fatigue. RESULTS: Increases in public transportation sitting during workdays, other leisure sitting time during workdays, and other leisure sitting time were associated with an increase in the motivation aspect of fatigue (b=0.29, 95% CI 0-0.57, P=.048; b=0.40, 95% CI 0.18-0.62, P<.001; and b=0.26, 95% CI 0.07-0.45, P=.007, respectively). Increases in work-related sitting time during workdays, total sitting time during workdays, and total work-related sitting time were significantly associated with an increase in the physical activity aspect of fatigue (b=0.06, 95% CI 0-0.12, P=.03; b=0.05, 95% CI 0.01-0.09, P=.02; and b=0.07, 95% CI 0-0.14, P=.04, respectively). The motivation and physical activity aspects of fatigue increased by 0.06 for each 1-hour increase in total sitting time between baseline and follow-up (b=0.06, 95% CI 0-0.11, P=.045; and b=0.06, 95% CI 0.01-0.10, P=.009, respectively). CONCLUSIONS: Our findings demonstrated that sedentary and active behaviors among company workers in Japan were negatively affected during the COVID-19 outbreak. Increases in several domain-specific sedentary behaviors also contributed to unfavorable changes in workers' fatigue. Social distancing and teleworking amid a pandemic may contribute to the sedentary lifestyle of company workers. Public health interventions are needed to mitigate the negative effects of the COVID-19 pandemic or future pandemics on sedentary and physical activity behaviors and fatigue among company workers.

OBJECTIVES: Neighbourhood characteristics can impact the health of residents. This study investigated associations between objectively derived neighbourhood characteristics, including novel space syntax metrics, and self-reported body mass index (BMI) among Canadian men and women. METHODS: Our study included survey data collected from a random cross-section of adults residing in Calgary, Alberta (n = 1718). The survey, conducted in 2007/2008, captured participants' socio-demographic characteristics, health, and weight status (BMI). Participants' household postal codes were geocoded and 1600-m line-based network buffers estimated. Using a geographical information system, we estimated neighbourhood characteristics within each buffer including business destination density, street intersection density, sidewalk length, and population density. Using space syntax, we estimated street integration and walkability (street integration plus population density) within each buffer. Using adjusted regression models, we estimated associations between neighbourhood characteristics and BMI (continuous) and BMI categories (healthy weight vs. overweight including obese). Gender-stratified analysis was also performed. RESULTS: Business destination density was negatively associated with BMI and the odds of being overweight. Among men, street intersection density and sidewalk length were negatively associated with BMI and street intersection density, business destination density, street integration, and space syntax walkability were negatively associated with odds of being overweight. Among women, business destination density was negatively associated with BMI. CONCLUSION: Urban planning policies that impact neighbourhood design have the potential to influence weight among adults living in urban Canadian settings. Some characteristics may have a differential association with weight among men and women and should be considered in urban planning and in neighbourhood-focussed public health interventions.

Background–Several non-pharmaceutical policies, which include stay-at-home orders, mobility restrictions, and quarantine, have been implemented to reduce the spread of novel coron-avirus disease 2019 (COVID-19). The present study examines work style changes among company workers after COVID-19 and analyses their effects on workers’ domain-specific sedentary and active behaviours. Methods-We analysed data from a nationwide prospective online survey in Japan. The data were obtained in February 2019 (n = 3200) and in July 2020 (n = 1709) from the registered individuals of a Japanese internet research service company. The participants reported work style patterns before and after the outbreak of COVID-19 in the follow-up survey. Domain-specific sedentary behaviours and physical activities were assessed by questionnaires. Paired t-tests were used to compare work styles before and after the outbreak of COVID-19. Multivariable linear regression models were used to assess the associations between changes in work style and changes in sedentary behaviours and physical activities. Results. Workers had more working from home days and fewer office-based working days after the outbreak of COVID-19 (p < 0.001 and p < 0.001, respectively). The increase in the number of working from home days per week was significantly associated with increases in work-related sitting time and total sitting time (b = 0.16, 95% CI 0.08, 0.24, p < 0.001 and b = 0.23, 95% CI 0.11, 0.36, p < 0.001, respectively). However, it was also associated with a decrease in car sitting time (b = −0.04, 95% CI −0.06,-0.01, p < 0.001). In addition, the increase in the number of working from home days was associated with a decrease in work-related moderate physical activity (b =−0.06, 95% CI −0.10, −0.02, p < 0.001). Conclusions. Our study provided preliminary evidence of an increase in working from home days in response to COVID-19 in Japan and of how this increase in the number of working from home days has affected workers’ sedentary behaviours and physical activities. These findings shed light on the effects of COVID-19 on work styles and workers’ sedentary behaviours and physical activity.

PURPOSE: Deterioration of daily activities increases frailty risk. Most of the previous research has examined the association between frailty and specific activities; nevertheless, the diversity of daily activities is also important. Although the type, frequency, and evenness of daily activities have been proposed as indicators of activity diversity, the association between these indicators and frailty remains unclear. In this study, we examined the association between activity diversity and frailty in community-dwelling older adults. MATERIALS AND METHODS: This cross-sectional study comprised 658 community-dwelling older adults aged ≥ 65 years who participated in comprehensive health check-ups in 2018. Frailty was defined using the Japanese version of the Cardiovascular Health Study criteria. Three indicators, type, frequency, and evenness of daily activities, were used to assess activity diversity across one week. Multiple logistic regression analyses were performed, with frailty as the dependent variable and the three activity diversity indicators as independent variables. Socio-demographic, physical, and mental functioning factors were adjusted as covariates. RESULTS: Of the 658 participants (median age: 72 years; age range: 65-91 years; 60.5% women), 27 (4.1%) met the criteria for frailty. The frail group had significantly lower scores for type, frequency, and evenness of daily activities, as well as Mini-Mental State Examination scores (all at p < 0.01). We found significant independent associations in all activity diversity indicators with frailty, in multiple logistic models. CONCLUSION: Activity diversity is independently associated with frailty in community-dwelling older adults.

Purpose: The aim of this study was to translate the Psychological Inflexibility in Pain Scale Japanese version (PIPS-J) and inspect its validity and reliability in older patients with chronic low back pain and knee pain. Materials and Methods: The PIPS was translated into Japanese by a bilingual linguistic expert and three researchers and administered to 120 outpatients with low back pain and knee pain (61.7% women, age 73.8±7.8 years). Construct validity and criterion validity were evaluated using confirmatory factor analysis and the correlations with the Acceptance and Action Questionnaire-II Japanese version (AAQ-II-J) and the Cognitive Fusion Questionnaire Japanese version (CFQ-J), respectively. Internal consistency using Cronbach's alpha and test-retest reliability (n=43) were also examined. Results: Of all, 78.3% had low back pain, 55.6% had knee pain, and 44.2% both. The confirmatory factor analysis reproduced the original PIPS structure with two factors and indicated good model fit (GFI = 0.915, CFI = 0.970, RMSEA = 0.060). All items' standardized regression weights ranged from 0.35 to 0.80. Criterion validity was shown by correlations of r = 0.58 for PIPS-J pain avoidance with the AAQ-II-J, and r = 0.45 between PIPS-J cognitive fusion and the CFQ-J. Cronbach's alpha for the PIPS-J total score was α=0.85 (pain avoidance: 0.87; cognitive fusion: 0.68). The test-retest correlation for all 12 items was r = 0.54 (pain avoidance: 0.48; cognitive fusion: 0.54). Conclusion: Although a less relevant item was found on each of subscales, the PIPS-J appear to be fairly valid and reliable to evaluate psychological inflexibility in chronic pain among Japanese older adults.

The purpose of this study was to identify typologies of diurnal sedentary behavior patterns and sociodemographic characteristics of desk-based workers. The sedentary time of 229 desk-based workers was measured using accelerometer devices. The within individual diurnal variations in sedentary time was calculated for both workdays and non-workdays. Diurnal variations in sedentary time during each time period (morning, afternoon, and evening) was calculated as the percentage of sedentary time during each time period divided by the percentage of the total sedentary time. A hierarchical cluster analysis (Ward's method) was used to identify the optimal number of clusters. To refine the initial clusters, a non-hierarchical cluster analysis (k-means method) was performed. Four clusters were identified: stable sedentary cluster (46.7%), off-morning break cluster (26.6%), off-afternoon break cluster (8.3%), and evening sedentary cluster (18.3%). The stable sedentary cluster had the lowest variations in sedentary time throughout the day and the highest amount of total sedentary time. Participants in the off-morning and off-afternoon break clusters had nearly the same sedentary patterns but took short-term breaks during non-workday mornings or afternoons. The evening sedentary cluster had a completely different pattern, with a longer sedentary time during the evening both on workdays and non-workdays. Sociodemographic attributes such as sex, household income, educational attainment, employment status, sleep duration, and residential area, differed significantly between groups. Initiatives to address desk-based workers' sedentary behavior need to focus not only on the workplace but also on the appropriate timing for reducing excessive sedentary time in non-work contexts depending on the characteristics and diurnal patterns of target subgroups.

Previous studies have not investigated the determinants of resting oxidative stress, including physical fitness, as it relates to redox regulation. The present study therefore was aimed at identifying lifestyle and biological factors that determine resting oxidative stress, including objectively measured physical fitness. In 873 middle-aged and elderly men and women, age and anthropometric parameters, lifestyle-related parameters, medication and supplementation status, physical fitness, biochemical parameters, and nutritional intake status, as well as three plasma oxidative stress markers: protein carbonyl (PC), F2-isoprostane (F2-IsoP), and thiobarbituric acid reactive substances (TBARS), were surveyed and measured. The determinants of PC, F2-IsoP, and TBARS in all participants were investigated using stepwise multiple regression analysis. In PC, age (β = -0.11, P = 0.002), leg extension power (β = -0.12, P = 0.008), BMI (β = 0.12, P = 0.004), and HDL-C (β = 0.08, P = 0.040) were included in the regression model (adjusted R 2 = 0.018). In the F2-IsoP, smoking status (β = 0.07, P = 0.060), BMI (β = 0.07, P = 0.054), and HbA1c (β = -0.06, P = 0.089) were included in the regression model (adjusted R 2 = 0.006). In TBARS, glucose (β = 0.18, P < 0.001), CRF (β = 0.16, P < 0.001), age (β = 0.15, P < 0.001), TG (β = 0.11, P = 0.001), antioxidant supplementation (β = 0.10, P = 0.002), and HbA1c (β = -0.13, P = 0.004) were included in the regression model (adjusted R 2 = 0.071). In conclusion, the present study showed that age, anthropometric index, lifestyle-related parameters, medication and supplementation status, objectively measured physical fitness, biochemical parameters, and nutritional intake status explain less than 10% of oxidative stress at rest.

© 2019 Most walkability indices do not capture the topological structure of urban forms. Space syntax models these topological relationships. We estimated associations between the space syntax measure of street integration and walkability (SSW) and neighborhood-specific leisure (LW) and transportation (TW) walking among 4422 Canadian adults. Street integration and SSW were found to be positively associated with TW and LW participation in a usual week. A one-unit increase in SSW was associated with a 6-min increase in usual weekly minutes of TW. Street integration and SSW were also positively associated with TW participation in the last week. Higher street integration and walkability conceptualized using space syntax support neighborhood walking.

<title>Abstract</title>
In addition to intensity and quality, diversity of activity will be an important factor to explain health outcomes among older adults. Few studies, though, examined an association between activity diversity and health outcomes. This study aimed to examine the association between activity diversity and frailty among community-dwelling older Japanese. Participants were community-dwelling older adults who participated in a cohort study, the “Otassya-Kenshin” in 2018 . The participants were asked frequency of 20 daily activities, inside/outside chores, leisure activities with/without physically, direct/indirect contact with friends and so on, in a week and activity diversity score were calculated using the formula of Shannon’s entropy. Frailty was defined by the Japanese version of the Cardiovascular Health Study criteria. The difference in diversity score between frail and non frail were examined by t-test. Logistic regression analysis with covariates, age, sex, economic status, living alone, BMI, Mini-Mental State Examination, and IADL was adopted to find association between activity diversity score and presence of frailty. Of 652 participants (age: 72.8±6.3, women: 60.6%) analyzed, 27 (4.1%) were defined as frail. Frailty group revealed significantly lower activity diversity score than non-frailty group (0.66±0.11 vs 0.75±0.08, P&amp;lt;0.01). 0.2 point of decrease in diversity score increase 5 times chance of frailty after controlling covariates. We found significant relationship between activity diversity and health outcome among older subjects. The activity diversity may provide additional information to number or intensity of activity.

BACKGROUND: Few studies have examined the associations between urban design attributes and older adults' physical function. Especially, it is not well known how built-environment attributes may influence physical function in Asian cities. The aim of this study was to examine associations between objectively measured environmental attributes of walkability and objectively assessed physical function in a sample of Japanese older adults. METHODS: Cross-sectional data collected in 2013 from 314 older residents (aged 65-84 years) living in Japan were used. Physical function was estimated from objectively measured upper- and lower-body function, mobility, and balance by a trained research team member. A comprehensive list of built-environment attributes, including population density, availability of destinations, intersection density, and distance to the nearest public transport station, were objectively calculated. Walk Score as a composite measure of neighborhood walkability was also obtained. RESULTS: Among men, higher population density, availability of destinations, and intersection density were significantly associated with better physical function performance (1-legged stance with eyes open). Higher Walk Score was also marginally associated with better physical function performance (1-legged stance with eyes open). None of the environmental attributes were associated with physical function in elderly women. CONCLUSION: Our findings indicate that environmental attributes of walkability are associated with the physical function of elderly men in the context of Asia. Walking-friendly neighborhoods can not only promote older adults' active behaviors but can also support their physical function.

BACKGROUND: Many desk-based workers can spend more than half of their working hours sitting, with low levels of physical activity. Workplace neighbourhood built environment may influence workers' physical activities and sedentary behaviours on workdays. We reviewed and synthesised evidence from observational studies on associations of workplace neighbourhood attributes with domain-specific physical activity and sedentary behaviour and suggested research priorities for improving the quality of future relevant studies. METHODS: Published studies were obtained from nine databases (PubMed, Web of Science, PsycINFO, Scopus, Transport Research International Documentation, MEDLINE, Cochrane, Embase, and CINAHL) and crosschecked by Google Scholar. Observational studies with quantitative analyses estimating associations between workplace neighbourhood built environment attributes and workers' physical activity or sedentary behaviour were included. Studies were restricted to those published in English language peer-reviewed journals from 2000 to 2019. RESULTS: A total of 55 studies and 455 instances of estimated associations were included. Most instances of potential associations of workplace neighbourhood built environment attributes with total or domain-specific (occupational, transport, and recreational) physical activity were non-significant. However, destination-related attributes (i.e., longer distances from workplace to home and access to car parking) were positively associated with transport-related sedentary behaviour (i.e., car driving). CONCLUSIONS: The findings reinforce the case for urban design policies on designing mixed-use neighbourhoods where there are opportunities to live closer to workplaces and have access to a higher density of shops, services, and recreational facilities. Studies strengthening correspondence between the neighbourhood built environment attributes and behaviours are needed to identify and clarify potential relationships. PROTOCOL REGISTRATION: The protocol of this systematic review was registered on the International Prospective Register of Systematic Reviews (PROSPERO) on 2 December 2019 (registration number: CRD42019137341 ).

Few studies examine associations between objectively-calculated neighbourhood built environment attributes and objectively-assessed sedentary behaviour in different geographical locations, especially in highly-populated environments. Additionally, no study, to our knowledge, has investigated associations between objective measures of neighbourhood built environment attributes and objectively-assessed sedentary behaviours in middle-aged adults, despite the fact that this is a critical stage of life when age-related functional decline begins. We examined the associations between neighbourhood built environment attributes with the total, and patterns of, objectively-assessed sedentary behaviours in a densely-populated area in Asia. Data from 866 adults (ages 40 to 64) living in Japan were included. Four classifications of sedentary behaviours, including daily total sedentary time, duration and number of long (≥30 min) sedentary bouts and breaks per sedentary hour, were estimated using hip-worn accelerometers. Individual (population density, availability of destinations, number of intersections, and distance to the nearest park) and composite (walkability and Walk Score®) neighbourhood built environment indices were calculated using geographic information systems. Covariate-adjusted multilevel linear mixed effects models were used to estimate the associations between the neighbourhood built environment attributes and sedentary behaviours. Population density and availability of destinations were positively associated with sedentary behaviours; however, the number of intersections was negatively associated with sedentary behaviours. No associations were observed between the distance to the nearest park and sedentary behaviours. There were positive associations between walkability and total sedentary time, and duration and the number of long sedentary bouts. Walk Score® was positively associated with total sedentary time and the number of long sedentary bouts. These findings suggest that urban design attributes supportive of walking (except for the number of intersections) may encourage sedentary behaviour among middle-aged adults living in densely-populated environments.

Evidence suggests a positive effect of dog ownership on physical activity. However, most previous studies used self-reported physical activity measures. Additionally, it is unknown whether owning a dog is associated with adults' sedentary behaviour, an emerging health risk factor. In this study, physical activity and sedentary behaviour were objectively collected between 2013 and 2015 from 693 residents (aged 40-64 years) living in Japan using accelerometer devices. Multivariable linear regression models were used, adjusted for several covariates. The means of total sedentary time and the number of long (≥ 30 min) sedentary bouts were 26.29 min/day (95% CI - 47.85, - 4.72) and 0.41 times/day (95% CI - 0.72, - 0.10) lower for those who owned a dog compared to those not owning a dog, respectively. Compared with non-owners, dog-owners had significantly higher means of the number of sedentary breaks (95% CI 0.14, 1.22), and light-intensity physical activity (95% CI 1.31, 37.51). No significant differences in duration of long (≥ 30 min) sedentary bouts, moderate, vigorous, and moderate-to-vigorous-intensity physical activity were observed between dog-owners and non-owners. A novel finding of this study is that owning a dog was associated with several types of adults' sedentary behaviours but not medium-to-high-intensity physical activities. These findings provide new insights for dog-based behavioural health interventions on the benefits of dog ownership for reducing sedentary behaviour.

本研究では、我が国の著名人の乳がん罹患公表が女性の乳がんに対する意識、知識、行動へ与える影響を検討することを目的とした。Web調査による横断調査へ回答が得られた20〜69歳の成人女性2,933名を分析対象とし、著名人のがん罹患情報取得者の特徴および情報取得と乳がんに対する意識・知識との関連をロジスティック回帰分析にて検討した。その結果、情報取得者の割合は77.4%で、その主な特徴は、子どもを持つ者(AOR、95%CI:1.50、1.12-1.83)、友人・同僚の乳がん罹患歴(1.82、1.46-2.27)であった。また、情報取得は、乳がんをこわいと思う意識(1.90、1.52-2.38)、乳がん検診知識(年齢:1.73、1.31-2.27、間隔:2.29、1.64-3.20)と関連し、情報取得後30.4%の者に行動変化が確認されたことから、我が国でも著名人のがん罹患公表が国民の意識、知識および行動に影響を与える可能性が示唆された。今後は、より国民のがんに対する理解を深め、がん対策を推進するためにも、著名人のがん罹患公表時に意図的なコミュニケーションや情報伝達ができるような体制・戦略の構築が必要である。(著者抄録)

AIM: To re-evaluate the suitability of calf circumference as a surrogate marker of low muscle mass measured by both bioelectrical impedance analysis (BIA) and dual-energy X-ray absorptiometry (DXA). We also examined the effects of obesity and age on low muscle mass screening using calf circumference. METHODS: In total, 1239 adults participated in this cross-sectional study. We measured the maximum calf circumference in a standing position and appendicular skeletal muscle mass (ASM) using BIA and DXA. We defined low muscle mass based on the Asian Working Group for Sarcopenia 2019 consensus. RESULTS: Calf circumference was positively correlated with BIA-measured ASM/height2 (men: r = 0.81, women: r = 0.73) and DXA-measured ASM/height2 (men: r = 0.78, women: r = 0.76). In the subgroup analyses by obesity and age, calf circumference was also positively correlated with ASM/height2 . The optimal calf circumference cut-offs for low muscle mass screening measured by BIA and DXA were 35 cm (sensitivity 91%, specificity 84%) and 36 cm (sensitivity 82%, specificity 80%) for men, and 33 cm (sensitivity 82%, specificity 84%) and 34 cm (sensitivity 85%, specificity 72%) for women, respectively. CONCLUSIONS: Calf circumference is positively correlated with BIA- and DXA-measured muscle mass regardless of obesity and age and is a simple and accurate surrogate marker of muscle mass for diagnosing sarcopenia. Geriatr Gerontol Int 2020; 20: 943-950.

通所型デイサービスを利用する要介護者17名を対象に、座りすぎ軽減を目的とした介入プログラムを3ヵ月間実施し(プログラム提供群)、その効果を、対照群(15名、通常サービス利用群)との総座位時間の比較から検討した。プログラムは、反復訓練と社会的認知理論に基づく行動変容支援を組み合わせたもので、具体的には以下の内容となっている。1)施設でのプログラム実施に加え、自宅でのホームワークを見据えた「座ったままでできる血行促進体操」。2)施設利用日以外に自宅で本プログラムの実施を促すため、体操の実施方法を記載した自宅掲示用ポスターを作成・配布するとともに、セルフ・モニタリング手帳を作成し、自宅で午前・午後・夕方の都合の良い時に各1セット(計3セット/日)プログラムを実施するよう促した。その結果、プログラム提供群(-88.8分)では通常サービス群(-22.9分)と比べ、総座位時間の有意な短縮がみられた。

Background

There are spatial disparities in cardiovascular disease (CVD) mortality related to area‐level socioeconomic status (SES) disadvantage, but little is known about the spatial distribution of CVD mortality according to built environment factors. We examined joint associations of neighborhood walkability attributes and SES with CVD mortality rates through linkage of Japanese national data sets.
Methods and Results

National data were used from the 1824 municipalities (of the 1880 potentially eligible municipalities) across Japan. The outcome was mortality from CVD for a 5‐year period (2008–2012) for each municipality. A national index of neighborhood deprivation was used as an indicator of municipality‐level SES. A national walkability index (based on population density, road density, and access to commercial areas) was calculated. Compared with higher SES municipalities, relative rates for CVD mortality were significantly higher in medium SES municipalities (relative rate, 1.05; 95% CI, 1.02–1.07) and in lower SES municipalities (relative rate, 1.09; 95% CI, 1.07–1.12). There were walkability‐related gradients in CVD mortality within the high and medium SES areas, in which lower walkability was associated with higher rates of mortality; however, walkability‐related CVD mortality gradients were not apparent in lower SES municipalities.
Conclusions

CVD mortality rates varied not only by area‐level SES but also by walkability. Those living in areas of lower walkability were at higher risk of CVD mortality, even if the areas have a higher SES. Our findings provide a novel element of the evidence base needed to inform better allocation of services and resources for CVD prevention.

Increased sedentary behavior (SB) can adversely affect health. Understanding time-dependent patterns of SB and its correlates can inform targeted approaches for prevention. This study examined diurnal patterns of SB and its sociodemographic associations among Japanese workers. The proportion of sedentary time (% of wear time) and the number of breaks in SB (times/sedentary hour) of 405 workers (aged 40–64 years) were assessed using an accelerometer. SB patterns and sociodemographic associations between each time period (morning, afternoon, evening) on workdays and nonworkdays were examined in a series of multivariate regression analyses, adjusting for other sociodemographic associations. On both workdays and nonworkdays, the proportion of sedentary time was lowest in the morning and increased towards evening (b = 12.95, 95% CI: 11.28 to 14.62; b = 14.31, 95% CI: 12.73 to 15.88), with opposite trend for breaks. Being male was consistently correlated with SB. Other sociodemographic correlates differed depending on time-of-day and day-of-the-week. For instance, desk-based workstyles and urban residential area were associated with SB during workday mornings and afternoons, being single was related to mornings and evenings, workdays and nonworkdays. Initiatives to address SB should focus not only on work-related but time-of-day contexts, especially for at-risk subgroups during each period.

<bold>Background</bold>: The present study examined the cluster of domain-specific sedentary behaviors (SBs) and their associations with physical function among community-dwelling older adults to identify the target groups that require intervention for SBs. <bold>Methods</bold>: A total of 314 older adults who participated in a population-based cross-sectional survey and an on-site functional assessment in Matsudo City in Chiba participated in this study. Participants were asked to report the daily average of 6 domain-specific SBs. To identify the cluster of domain-specific SBs, hierarchical cluster analysis was performed using the Ward method. Analysis of covariance adjusted for sociodemographic factors, exercise habit, chronic disease, and total SB time was performed to examine the associations between each cluster and physical functional status. <bold>Results</bold>: The average age of the participants was 74.5 (5.2) years. The 4 clusters identified were leisure cluster, low cluster, work and personal computer use cluster, and television viewing cluster. The analysis of covariance adjusted for covariates showed that grip strength (<italic>P</italic> = .01), maximum walking speed (<italic>P</italic> = .03), and 1-leg standing time (<italic>P</italic> = .03) were significantly poorer in the television viewing cluster than other clusters. <bold>Conclusions</bold>: It has been concluded that the television viewing group identified as a high-risk group of physical functional decline; therefore, interventions targeting this group are needed to prevent physical functional decline.

Examining the associations of eHealth literacy (eHL) with obtaining health knowledge from websites would help to clarify the causal pathway between eHL and health knowledge. This study aimed to compare the results obtained from Internet users with high or low eHL in accessing a reputable cancer website to obtain colorectal cancer (CRC) knowledge. A total of 105 participants with high eHL and 103 participants with low eHL accessed a reputable CRC website managed by the National Cancer Center and responded to Internet-based surveys before and after accessing a website in 2012. Twelve responses to knowledge statements regarding CRC were selected based on item response theory, and the differences in correct responses of pre- and post-surveys by each eHL group were compared. Two statements showed a significant increase in correct responses in the high eHL group only: "Red meat intake is a risk factor" (p = 0.002), and "Obesity is a risk factor" (p = 0.029), whereas only one response did so in the low eHL group: "Bloody stools are a symptom" (p = 0.004). Low eHL Internet users appeared less capable of obtaining knowledge of CRC by accessing information from a reputable cancer website than high eHL Internet users.

Recent research has suggested that the breadth and evenness of activity and activity diversity contribute to health outcomes among older adults. However, few established assessment tools for activity diversity have been developed. This study developed an Activity Diversity Questionnaire (ADQ) for older adults through expert consultation and a preliminary survey among 18 community-dwelling older adults. The diversity score was calculated according to Shannon's entropy. In study 1, the intraclass correlation coefficients (ICC) of the diversity scores were determined for community-dwelling older adults (n = 30). In study 2, concurrent validity was tested with participants receiving comprehensive health checkups at the Itabashi ward in Japan in 2018 (n = 766). The correlation coefficients of the diversity scores were then calculated in reference to the Tokyo Metropolitan Institute of Gerontology Index of Competence and Japan Science and Technology Agency Index of Competence. The final version of the ADQ consisted of 20 total items with excellent test-retest reliability (ICC = 0.84) and moderate correlations with both the Tokyo Metropolitan Institute of Gerontology Index of Competence and Japan Science and Technology Agency Index of Competence (r = 0.48 and 0.60, respectively). The ADQ was developed through scientific procedures and revealed sufficient reliability and validity. As such, it is a scientifically validated tool for assessing activity diversity among older adults.

The relationships between cardiorespiratory fitness (CRF) measurements not confounded by adiposity and the prevalence of pre-diabetes mellitus (pre-DM) and diabetes mellitus (DM) are not well known. Thus, we aimed to investigate the associations of visceral fat (VF) and CRF with the prevalence of pre-DM/DM among Japanese adults. The study included 970 individuals (327 women and 643 men) who were 40-87 years old and had complete health examinations, abdominal fat area, and fitness data from WASEDA'S Health Study during 2015-2018. The VF area was measured using magnetic resonance imaging. CRF was measured using a cycle ergometer and was defined as VO2peak divided by fat free mass. The pre-DM/DM was identified based on the questionnaire and fasting blood tests. The odds ratios (ORs) and 95% confidence intervals (CIs) for prevalence of pre-DM/DM were calculated. Seventy-three participants had pre-DM and 48 participants had DM. Compared to the low VF group, the high VF group had a higher prevalence of pre-DM/DM (OR: 1.87, 95% CI: 1.18-2.96), although no significant relationship was observed between CRF and pre-DM/DM prevalence (P for trend = 0.239). The sub-group analyses also revealed no significant relationship between CRF and pre-DM/DM prevalence in the low VF group (P for trend = 0.979), although CRF values were inversely related to the prevalence of pre-DM/DM in the high VF group (P for trend = 0.024). Although CRF was not independently related to the prevalence of pre-DM/DM after adjusting for adiposity, higher VF values were related to a higher prevalence of pre-DM/DM. In addition, CRF levels were inversely associated with the prevalence of pre-DM/DM only among high VF individuals.

[Purpose] The aim of this study was to investigate the relationship between leg muscle strength, measured by a very simple one-leg stand-up test, and the prevalence of diabetes among Japanese males to raise awareness of diabetes prevention. [Participants and Methods] This cross-sectional analysis was conducted in 1,800 Japanese males (median [interquartile range] age, 61 [56-67] years) who completed health examinations and a one-leg stand-up test. The prevalence of diabetes was defined if any of the following conditions applied: 1) fasting blood glucose level more than 126 mg/dl, 2) two-hour blood glucose level more than 200 mg/dl (75-g oral glucose tolerance test), 3) HbA1c more than 6.5%, 4) diagnosed with diabetes by a physician, and/or 5) treated for diabetes. [Results] There were 490 participants with diabetes, and 517 participants were unable to complete the sit-to-stand task. When males, who could stand up, were used as a reference, the odds ratio for the prevalence of diabetes was significantly higher among those who were unable to stand up on neither leg than those who successfully stood up on both right and left legs after adjustment for covariates. [Conclusion] Low leg muscle strength, as measured by the one-leg stand-up test, was associated with a higher prevalence of diabetes among Japanese males. Because of its simplicity, this test could be useful detecting individuals who are at increased risk of developing diabetes.

Lack of sufficient physical activity in youth is a worldwide concern. School-based extracurricular sports activities (SBECSA) are considered a central opportunity to increase youth physical activity. However, the factors that influence students' participation in SBECSA are not well established. Therefore, the purpose of the present study was to clarify the factors perceived to influence the motivation of Japanese students to participate in SBECSA. Semi-structured interviews were conducted with 23 junior high and high school students who participated in SBECSA. The KJ method was used to qualitatively analyse the transcribed interview data. Internal/intrapersonal factors included: attraction of sports; sense of responsibility and continuity; spirit of challenge; sense of advancement and physical condition. External factors included: team climate; encouragement and support; attributes of peers; policy and content of coaching; content of practice; events in school life and weather.

There is a dearth of evidence about how high-density living may influence dog-walking behaviour. We examined associations between neighbourhood built environment attributes and dog-ownership and dog-walking behaviour in Japan. Data from 1058 participants were used. The dog-ownership was 18.8%. All neighbourhood built attributes (excluding availability of parks) were negatively associated with dog-ownership. Among dog-owners, these same attributes were positively associated with any dog-walking in a usual week and with achieving 150-min per week of physical activity through dog-walking alone. These findings provided evidence on the importance of neighbourhood built environment attributes on dog-ownership and dog-walking behaviour in dense and compact areas. The urban design and public health implication of these findings is that the built environment attributes in high-density living areas may have different impacts on dog-ownership and dog-walking: while living in a walkable neighbourhood may not be conducive to dog-ownership, it may support dog-walking in such areas. Programs targeting dog-owners in high-density areas might be needed to encourage them to walk their dogs more. If successful, these programs could contribute to higher physical activity levels among dog-owners.

This study examined the relationship between a healthy Japanese dietary pattern and micronutrient intake adequacy based on the Dietary Reference Intakes for Japanese 2015 (DRIs-J 2015) in men and women. A cross-sectional study was conducted in 1418 men and 795 women aged 40-87 years, who participated in the Waseda Alumni's Sports, Exercise, Daily Activity, Sedentariness, and Health Study. Dietary patterns were derived from principal component analysis of the consumption of 52 food and beverage items, which were assessed by a validated brief-type self-administered diet history questionnaire. Micronutrient intakes were quantified using the dietary reference intakes score (DRIs-score) for 21 micronutrients (based on DRIs-J 2015). The healthy dietary pattern score was significantly and positively correlated with the intakes of all 21 micronutrients used for constructing the DRIs-score in men and in women (each, p < 0.001). In both sexes, the healthy dietary pattern scores were strongly and positively associated with DRIs-scores (in men: ρ = 0.806, p < 0.001; in women: ρ = 0.868, p < 0.001), and the DRIs-scores reached a plateau around the highest tertile of the healthy dietary pattern score. These results indicate that a healthy Japanese dietary pattern is associated with adequate micronutrient intakes based on the DRIs-J 2015 in both men and women.

BACKGROUND: Although the main targets for reducing workplace sedentary behavior have been clarified, only a few studies have examined the association between social-ecological factors and workplace sedentary behavior for effective intervention. The present study aimed to examine the social-ecological factors of workplace sedentary behavior among Japanese sedentary workers. METHODS: Participants were recruited via a cross-sectional mail survey targeting randomly sampled 6000 middle-aged people dwelling in Matsuyama-city and Koto-ku in Japan. Participants answered a questionnaire on social-ecological factors, recorded their work time in a diary, and wore a triaxial accelerometer during waking time for 7 consecutive days. Workplace sedentary behavior was measured using accelerometer and was referred to as the work time in the recorded diary. Full-time workers who had mainly sitting work and valid accelerometer data were included in the analysis. Workplace sedentary variables were sedentary breaks per sedentary hour, sedentary time, and ≥ 30 min bouts of sedentary time. The associations between each sedentary variable and social-ecological factors were explored by conducting three multiple linear regression analyses adjusting for sociodemographic and health-related factors. RESULTS: A total of 227 participants (133 men, mean age 49.9 ± 6.9 years) were included in the analysis. In the overall sample, "typically seeing work colleagues take sedentary breaks" was significantly associated with more sedentary breaks (B [95% confidence interval {CI}=1.40 [0.07 to 2.73]) and shorter ≥30-min bouts of sedentary time (B [95% CI] = -7.08 [-13.75 to -0.40]). "I am motivated to take sedentary breaks" had an unfavorable association with less sedentary breaks (B [95% CI] = -1.36 [-2.61 to -0.12]) and longer sedentary time (B [95% CI] = 4.15 [0.29 to 8.00]). In male workers, "Too stressed to take sedentary breaks" was significantly associated with less sedentary breaks (B [95% CI] = -5.6 [-9.17 to -2.02]). CONCLUSIONS: Seeing work colleagues take sedentary breaks may be important for reducing workplace sedentary behavior. Those who are more sedentary are motivated to take sedentary breaks. Male workers who feel the need to take sedentary breaks at work are more sedentary.

BACKGROUND: Prolonged periods of sitting time can be adversely associated with older adults' well-being and functional capacities. Understanding patterns and contexts of sedentary behaviors (SB) can inform approaches to prevention. This study examined Japanese older adults' objectively-assessed patterns and reported domains of SB and their interrelationships. METHODS: Participants (n = 297; aged 65-84 years) of this cross-sectional study wore an accelerometer for 7 days and completed a survey. Five measures related to SB patterns were identified from the accelerometer data. SB from six domains, socio-demographics, and chronic conditions were identified from the survey data. Relative contributions of six domains to objectively-measured prolonged sedentary time (≥30 minutes) and the number of breaks were examined in a series of multivariate linear regressions. Covariates were socio-demographics, chronic conditions, and accelerometer wear time. RESULTS: On average, participants spent 8.8 hours a day sedentary (58% of accelerometer wear time), with 7.6 breaks per sedentary hour, and 3.7 hours a day through prolonged sedentary bouts (4.4 time/day). The proportions of time in the SB domains were 9.4% for car, 4.0% for public transport, 6.1% for work, 45.5% for television (TV) viewing, 9.8% for computer use, and 25.1% for other leisure. Domains of SB that contributed significantly to longer sedentary time through prolonged bouts were TV viewing and computer use. TV viewing was also associated with a lesser number of breaks. CONCLUSIONS: For Japanese older adults, initiatives to address SB could focus on breaking-up prolonged periods of SB by encouraging more frequent breaks, especially during TV viewing.

OBJECTIVES: The aims of this study were to examine (a) associations of two metric and space syntax measures of street layout with the cognitive function of Japanese older adults and (b) the extent to which objectively assessed physical activity mediated such associations. METHODS: Cross-sectional data from 277 older adults who lived in Japan were used. Street layout attributes were objectively calculated for each participant's geocoded home location. The Mini-Mental State Examination was used to evaluate cognitive function. Physical activity was objectively assessed with accelerometers. RESULTS: There was a statistically significant negative association between street integration and the odds of having cognitive impairment. Objectively assessed physical activity did not attenuate this relationship. CONCLUSIONS: Our findings provide unique evidence regarding the importance of the topological aspects of street layouts in (re)designing neighborhoods to support mental illness.

Different models of accelerometer have the potential to provide a different estimate of the same physical activity or sedentary behavior. Our study compared the outputs of the Active Style Pro (ASP) and ActiGraph (AG) devices in assessing predicted metabolic equivalents (METs) for specific activities under laboratory conditions. Thirty healthy young adults wore two hip accelerometers (ASP and AG), simultaneously while performing twenty-two activities (eight sedentary, eight household, and six ambulatory activities) in a controlled laboratory setting. For the AG, predicted METs for each activity was calculated using four equations based on vertical-axis and vector magnitude data. Separate paired t-tests and Bland-Altman analysis examined the difference and agreement in METs between AG using four commonly used equations and ASP measurements for each activity. AG devices using different equations calculated significantly different outcomes for most activities compared with ASP devices. The smallest differences in predicted METs estimates between ASP and AG were observed for ambulatory activities. Ambulatory activities demonstrated the best agreement between ASP and AG regardless of which AG equation was used. Our findings can be used to assist researchers in their selection of accelerometer and output estimation equations for measuring physical activity and sedentary behavior in adults.

Various accelerometers have been used in research measuring physical activity (PA) and sedentary behavior (SB). This study compared two triaxial accelerometers-Active style Pro (ASP) and ActiGraph (AG)-in measuring PA and SB during work and nonwork days in free-living conditions. A total of 50 working participants simultaneously wore these two accelerometers on one work day and one nonwork day. The difference and agreement between the ASP and AG were analyzed using paired t-tests, Bland-Altman plots, and intraclass coefficients, respectively. Correction factors were provided by linear regression analysis. The agreement in intraclass coefficients was high among all PA intensities between ASP and AG. SB in the AG vertical axis was approximately 103 min greater than ASP. Regarding moderate-to-vigorous-intensity PA (MVPA), ASP had the greatest amount, followed by AG. There were significant differences in all variables among these devices across all day classifications, except for SB between ASP and AG vector magnitude. The correction factors decreased the differences of SB and MVPA. PA time differed significantly between ASP and AG. However, SB and MVPA differences between these two devices can be decreased using correction factors, which are useful methods for public health researchers.

PURPOSE: The purposes of this study were to examine associations between objectively measured walkable urban design attributes with Japanese older adults' body mass index (BMI) and to test whether objectively assessed physical activity and sedentary behavior mediated such associations. DESIGN: Cross-sectional. SETTING: Matsudo City, Chiba Prefecture, Japan. PARTICIPANTS: Participants were 297 older residents (aged 65-84 years) randomly selected from the registry of residential addresses. MEASURES: Walkable urban design attributes, including population density, availability of physical activity facilities, intersection density, and access to public transportation stations, were calculated using geographic information systems. Physical activity, sedentary behavior, and BMI were measured objectively. ANALYSIS: The relationships of walkable urban design attributes, Walk Score®, and BMI were examined by multiple linear regression with adjustment for covariates in all models. Mediation effects of the physical activity and sedentary behavior variables in these relationships were tested using a product-of-coefficients test. RESULTS: Higher population density and Walk Score® were associated with lower BMI. Light and moderate-to-vigorous physical activities partially mediated the relationships between these walkable urban design attributes and BMI. CONCLUSIONS: Developing active-friendly environmental policies to (re)design neighborhoods may not only promote active transport behaviors but also help in improving residents' health status in non-Western contexts.

Background. Comparability of accelerometers in epidemiological studies is important for public health researchers. This study aimed to compare physical activity (light, LPA; moderate, MPA; and moderate-to-vigorous, MVPA) and sedentary behavior (SB) data collected using two Omron triaxial accelerometer generations (Active style Pro, ASP) among a sample of Japanese workers in a free-living environment. Methods. Thirty active and sedentary workers (24-62 years) wore two types of ASP accelerometers, the HJA-350IT (350IT) and the HJA-750C (750C), simultaneously for seven consecutive days to represent a typical week. The accelerometers estimated daily average step counts and time spent per day in LPA, MPA, and MVPA. If a participant had data for ≥4 days (>10 h/day) it was considered valid. The difference and agreement between the two ASPs were analyzed using a paired t-test, intra-class correlation coefficients (ICC), and a Bland-Altman analysis in total and for each type of worker. Results. Among all workers, the 750C measured significantly (p < 0.05) less SB, MPA, MVPA, and more LPA compared with the 350IT. The agreements in ICC were high (ICC ≥ 0.94). Conclusions. Compared with the 350IT, the newer generation 750C ASP accelerometer may not provide equivalent estimates of activity time, regardless of the type of physical activity.

抑うつと時間帯別の座位行動および身体活動時間との関連について検討した。日本の2都市(江東区・松山市)の住民基本台帳より無作為に抽出した40〜64歳の成人6000名を対象とした。加速度計を7日間腰部に装着して1分ごとの加速度を収集し、metabolic equivalents(METs)より、座位行動(1.5METs以下)および中高強度身体活動(3.0METs以上)時間を評価した。記述疫学的にみた座位行動の平均時間は、平日・休日ともに朝で最も短く、昼にかけて増加し、夜になると減少していた。中高強度身体活動時間は、平日では朝で最も長く、夜にかけて減少していたが、休日では朝から昼にかけて少し増加した後、夜で減少していた。ロジスティック回帰分析の結果、抑うつ得点と覚醒時間中の座位行動および中高強度身体活動の総実施時間には有意な関連は認められなかった。時間帯別の座位行動および中高強度身体活動の実施時間についても、すべての時間帯で有意な関連は認められなかった。

Despite associations found between physical activity and depression, and the built environment and physical activity, there appears to be inconclusive evidence regarding the role of built environment attributes with preventing depression among the elderly. This is mainly because few studies exist on this topic. In addition, the majority of existing studies have been conducted in Western countries; and there is a dearth of studies in other regions, where the built, social, and cultural environment is different than Western countries. Using data from Japanese older adults, this study examined the associations between objectively-assessed built environment attributes and depressive symptoms. We examined these associations stratified by gender, since research has well-documented gender differences in depression. Data were from 328 older adults living in Japan. Built environment attributes were objectively calculated and Walk Score ratings were obtained from the website. Depressive symptoms were assessed using the GDS-15. Gender-stratified regression models were used to estimate the associations. We found that a walkable environment characterized by a high population density and proximate local destinations to be supportive for a better mental health among older adults, in particular for women. These findings suggest that walkable built environment attributes may influence depression among older women in an Asian urban context. This study contributed to the literature by examining how walkable urban design may influence elderly's depression in a setting with extreme level of environmental attributes. Investing in urban design to promote walkability may help in reducing the observed gender gap in depression in the Japanese population.

目的:座位行動や身体活動の日内パターンの解明を主目的とした研究についてシステマティックレビューを行い、これまでの知見を整理し、今後の課題を明らかにすることを目的とした。方法:5つの文献データベースで検索した論文について、採択基準(成人、時間帯別の座位行動または身体活動に関する内容を含むなど)を基に該当論文を選定し、1)座位行動および身体活動の日内パターンの分布・傾向、2)座位行動および身体活動の日内パターンに関連する要因、3)座位行動および身体活動の日内パターンと健康アウトカムの関連という3つの観点から整理した。結果:採択論文27編のうち、2015年以降欧米や豪州の高齢者層を中心に、加速度計法で評価した座位行動や身体活動を1時間ごと、あるいは1日を3つに区分して検討した研究が主流であった。分布・傾向を検討した12編の主な傾向として、日内の遅い時間帯で座位行動レベルの上昇と身体活動レベルの低下がみられた。また、関連要因を検討した21編の多くで、性別や年齢、肥満度と座位行動や身体活動パターンに関連がみられた。健康アウトカムとの関連を検討した研究は1編のみであった。結論:座位行動や身体活動の日内パターンを検討した論文は少なく、対象者の居住地域や年齢、扱われた関連要因や健康アウトカムに偏りがあった。セグメント化した介入のため、今後は対象者の特性別、特に我が国の壮年・中年層を含めた研究成果の蓄積が必要である。(著者抄録)

OBJECTIVES: To examine patterns of sedentary behaviour and physical activity, among Japanese workers with differing occupational activity types. DESIGN: A cross-sectional observational study in 2013-2015. SETTING: Two local communities in Japan. PARTICIPANTS: Full-time workers aged 40-64 years (n=345; 55% men) and who lived in two cities. MAIN OUTCOME MEASURES: From accelerometer data for 7 days, mean overall sedentary time, prolonged bouts of sedentary time and light-and moderate-to vigorous-intensity of physical activity (LPA and MVPA) as a proportion of accelerometer wear time and number of breaks per sedentary hour were identified for four time periods: working hours, workdays, non-work hours and non-workdays. These sedentary behaviour and physical activity measures in the four time periods were examined among workers with four self-attributed occupational activity types (mainly sitting, standing, walking, and physical labour), adjusting for sociodemographic attributes. Diurnal patterns of sedentary behaviour, LPA, and MVPA were examined. RESULTS: In working hours, those with a sitting job had significantly more total and prolonged sedentary time (total: p<0.001; prolonged: p<0.01) along with less LPA (p<0.001) and MVPA (p<0.001) and less frequent breaks (p<0.01), compared with those with the three more active job type. Similar differences by job type were found for the whole working day, but not for prolonged sedentary time and breaks. On non-working hours and days, differences in sedentary and physically active patterns by job type were not apparent. CONCLUSIONS: Occupational activity type is related to overall sedentary time and patterns on working days, but not to leisure-time sitting and activity patterns, which were similar across the sitting, standing, walking, and physical labour occupational activity types.

OBJECTIVE: The aim of this study was to investigate the associations between dietary patterns and abdominal obesity among middle-aged and elderly Japanese people, using both waist circumference (WC) and visceral fat (VF) as indices. METHODS: A cross-sectional study was conducted with 829 adults (534 men and 295 women), 40 to 79 y of age, who participated in the Waseda Alumni's Sports, Exercise, Daily Activity, Sedentariness and Health Study (WASEDA'S Health Study). Dietary patterns were derived from principal component analysis. VF was measured using magnetic resonance imaging. To examine the associations of each dietary pattern with WC and VF, we calculated multivariate-adjusted means and 95% confidence intervals (CIs) of WC and VF for the tertile of each dietary pattern score. RESULTS: Two main dietary patterns were identified: "healthy Japanese" and "seafood and alcohol." The healthy Japanese dietary pattern score was inversely associated with WC and VF in men only. WC measurements were 84.9 cm (95% CI, 83.7-86.1), 83.9 cm (95% CI, 82.7-85.1), and 82.4 cm (95% CI, 81.2-83.6); Ptrend = 0.006, and VF measurements were 94.0 cm2 (95% CI, 85.6-102.4), 89.4 cm2 (95% CI, 81.1-97.7), and 80.4 cm2 (95% CI, 72.5-88.4); Ptrend = 0.027 for the lowest through the highest tertile of healthy Japanese dietary pattern scores in men. The seafood and alcohol dietary pattern was not associated with WC and VF. CONCLUSION: The healthy Japanese dietary pattern was negatively associated with WC and VF in middle-aged and elderly Japanese men.

[Purpose] The purpose of this study was to identify which physical attribute could influence each outcome in the Stand-up test and the Two-step test and the degree of their involvement. [Participants and Methods] The participants were 2,476 people (1,674 males and 802 females), who underwent a two-day health checkup and were requested to take the Locomotive Syndrome Risk Test (Locomo Test). Participants were divided into groups under the Locomo level based on the result of Locomo Test by gender. Furthermore, the relationship between each physical attributes (quartile) based on the result of Locomo Test and the Locomo level was evaluated. [Results] According to the relationship between each physical attributes and Locomo level 1 in the Stand-up test, height showed a positive relationship and the multivariable adjusted odds ratio significantly increased with taller height in both genders. Body weight and BMI showed a negative relationship, although rather weak positive relationship, it was identified in waist circumference. On the other hand, there was no clear correlation between each physical attribute and Locomo level 1 in the Two-step test. [Conclusion] The findings indicate The Stand-up test would overestimate the decline of locomotor function in taller people and would underestimate it in shorter individuals.

OBJECTIVES: Social isolation is a particular problem among older people and social participation may reduce future isolation. However, it is unclear which types of activities and which level of participation are effective. This study examines the relationship between social participation and isolation among Japanese older people by employing a 3-year longitudinal study. METHODS: A mail survey was sent to 3,518 community-dwelling older people in an urban area in 2014 (baseline: BL). We then conducted follow-up mail survey on respondents who were non-isolated at BL in 2017 (follow-up: FL), with isolation being defined as being in contact with others less than once a week. An analysis was carried out on 1,070 subjects (398 men and 672 women). Social participation is defined by participation in group activities (community, senior club, hobbies, sports, volunteering, politics, industry, and religion). A logistic regression analysis was conducted to determine the association between the types of social participation and the number of organization types at BL, and isolation at FL. RESULTS: At FL, 75 men (18.8%) and 59 women (8.8%) were considered to be isolated. Among the men, participation in a hobby group and sports group both significantly reduced the degree of isolation. Moreover, participation in two organizations and three or more organizations significantly lowered the risk of isolation when compared to non-participants. Among women, there were no significant associations among particular types of social activities and isolation. On the other hand, participation in one organization and three or more organizations significantly reduced their isolation when compared to non-participants. There was a significant linear trend between the number of types of organizations and isolation, regardless of gender. CONCLUSIONS: Participation in social activities reduces future isolation in older people. Encouraging participation in social activities could help reduce negative health outcomes associated with social isolation later in life.

© 2018 The Author(s). Background: The isotemporal substitution (IS) approach can be used to assess the effect of replacing one activity with the equal duration of another activity on relevant outcomes. This study examined the associations of objectively assessed sedentary behavior (SB) and physical activity (PA) with health-related quality of life (HRQOL) in older Japanese adults, using the IS approach. Methods: Participants were 287 older Japanese adults (aged 65-84 years) who wore accelerometers for at least 7 days. We calculated the average daily time spent in SB (≤1.5 METs); light-intensity PA (LPA: > 1.5 to < 3.0 METs); and moderate- to vigorous-intensity PA (MVPA: ≥3.0 METs) per day. HRQOL was assessed using the Medical Outcomes Survey Short Form-8 questionnaire. Results: The IS models showed replacing SB or LPA with MVPA to be significantly associated with better physical component summary scores. Replacing SB with MVPA was marginally associated with better mental component summary scores. Conclusion: These findings indicate that replacing SB with the same amount of MVPA may contribute to better physical HRQOL in older adults.

Although greater sedentary time has been found to be associated with negative health impacts, little is known whether the specific pattern of sedentary behavior (i.e. sedentary bouts, breaks and durations) are associated with physical function among older adults. The present study examined the associations between objectively measured sedentary behavior and physical function among older Japanese adults. A total of 174 male and 107 female community-dwelling older Japanese adults aged 65-84 years (mean age: 74.5 ± 5.2 years) were recruited. Sedentary behavior and physical activity were assessed using a triaxial accelerometer. Physical function was measured through hand grip strength, eye-open one leg standing, 5-m walking, and timed up and go tests. Forced-entry multiple linear regression models adjusted for potential confounders were performed. After adjustment, total daily sedentary time and duration of prolonged sedentary bouts (both ≥ 30 min) were positively associated with time spent on the 5-m walking stage and timed up and go tests in older women; however, no significant associations were observed in older men or the whole sample. This paper highlights the importance of developing sedentary behavior change strategies for interventions aiming to improve mobility in in older women. Further evidence from a prospective study is required to establish directions of causality between sedentary behavior and mobility.

Objective<br />
<br />
We examined (1) cross-sectional and prospective associations of perceived and objectively-measured neighborhood attributes with purpose-specific walking; (2) the differences between cross-sectional and prospective associations in the sample of Japanese middle-to-older-aged adults.<br />
Methods<br />
<br />
We conducted a prospective cohort study to collect data from 544 adults aged 40 to 69 years living in two cities in Japan in 2011 and again in 2013. Generalized linear modelling was employed to examine associations of perceived and GIS-measured built environment attributes (population density, access to destinations, access to public transportation, sidewalk, and street connectivity) with four types of self-reported purpose-specific walking, namely walking for commuting (to and from work), walking during work, walking for errands (shopping, to the bank or post office), and walking for exercise.<br />
Results<br />
<br />
After adjusting for potential confounders, GIS-measured higher population density and better street connectivity were associated with increased time spent walking for commuting and exercise. Furthermore, GIS-measured better access to public transportation was related to increased time spent walking for commuting, and perceived better access to destinations was also associated with increased time spent walking for commuting and daily errands. Unexpectedly, GIS-measured better access to destinations, and perceived sidewalk presence were related to decreased time spent in work-related walking.<br />
Conclusion<br />
<br />
Living in high-density neighborhoods with well-connected streets and convenient public transportation systems, and having a higher awareness of destinations are supportive of the long-term engagement in walking for various purposes. Further studies using a prospective design with longer follow-up period to confirm these results are warranted.

OBJECTIVES: Reducing sedentary behaviour (SB) and increasing physical activity (PA) have been shown to be associated with decreased depression. However, there are yet few studies examining the potential benefits on older adults' depression, when SB is replaced with PA. This study aimed to examine the associations of objectively assessed SB, light-intensity PA (LPA) and moderate-to-vigorous PA (MVPA) with depression among a sample of Japanese older adults, and to explore impacts of substituting SB with PA on older adults' depression. DESIGN: Cross-sectional analysis. SETTING: General community. PARTICIPANTS: A total of 276 older adults aged 65-85 years living in Japan. MAIN OUTCOME MEASURES: Three behaviours including the average daily time spent in SB (≤1.5 METs); LPA (>1.5 to <3.0 METs) and MVPA (≥3.0 METs) per day were calculated by accelerometers. Depression was assessed using the Japanese version of the 15-item Geriatric Depression Scale (GDS-15). RESULTS: Less SB (β=0.129, 95% CI 0.015 to 0.243) and more LPA (β=-0.138, 95% CI -0.265 to -0.011) were found to be significantly and negatively associated with the GDS-15 score in the single-activity model. The isotemporal substitution model found that replacing only 30 min per day of SB with the same amount of LPA to be significantly and negatively associated with the GDS-15 score (β=-0.131, 95% CI -0.260 to -0.002). CONCLUSIONS: These findings indicated that substituting even small amounts of SB with LPA may contribute to less depression in older adults. Potential favourable effects can be observed for replacing only 30 min per day of SB with LPA.

OBJECTIVE: The aim of this study was to examine the relationships between work engagement, productivity, and self-reported work-related sedentary behavior in Japanese adults. METHODS: The present study recruited 2572 Japanese individuals (20-59 years old) via an internet survey and assessed their demographic characteristics, work-related characteristics, and sedentary behavior. Data were analyzed with logistic regression. RESULTS: The mean proportion of work days involving work-related sedentary behavior was approximately 70% and the mean number of weekly working hours was approximately 43 hours. Among those aged 40 to 59 years, work-related sedentary behavior was associated with low work vigor (odds ratio: 1.43), dedication (1.61), absorption (1.39), and total score of work engagement (1.49). Among those aged 20 to 39 years, work-related sedentary behavior was associated with low efficiency (1.38). CONCLUSION: Reducing work-related sedentary behavior may improve workers' engagement and productivity.

Evidence about the impacts of the physical activity environment on adults' weight in the context of Asian countries is scarce. Likewise, no study exists in Asia examining whether Walk Score
®
-a free online walkability tool-is related to obesity. This study aimed to examine associations between multiple physical activity environment measures and Walk Score
®
ratings with Japanese adults' body mass index (BMI). Data from 1073 adults in the Healthy Built Environment in Japan study were used. In 2011, participants reported their height and weight. Environmental attributes, including population density, intersection density, density of physical activity facilities, access to public transportation, and availability of sidewalks, were calculated using Geographic Information Systems. Walk Scores
®
ratings were obtained from the website. Multiple linear regression analysis was conducted to examine the association between each environmental attribute and BMI. Adjusting for covariates, all physical activity environmental attributes were negatively associated with BMI. Similarly, an increase of one standard deviation of Walk Score
®
was associated with a 0.29 (95% confidence interval (CI) of -0.49--0.09) decrease in BMI. An activity-friendly built environment was associated with lower adults' BMI in Japan. Investing in healthy community design may positively impact weight status in non-Western contexts.

BACKGROUND: Good quality measures of Japanese adults' sedentary behaviors are needed to accurately assess correlates of specific sedentary behaviors. The present study assessed criterion validity of total sedentary behavior and test-retest reliability of six domain-specific sedentary behaviors. METHODS: We administered a questionnaire, based on previous studies, that measured domain-specific sedentary behaviors. To examine validity, agreement between self-reported time spent in sedentary behaviors from the questionnaire and objectively-measured sedentary time using accelerometers was compared among 392 adults (aged 40-64 years) in two Japanese cities. For reliability, a 2-week interval test-retest was administered to a convenience sample of 34 participants. RESULTS: The correlation between total self-reported and objectively measured sedentary time was significant (all P < 0.001) and fair-to-good for workdays (ρ = 0.57) and whole week (ρ = 0.49), but was low for non-workdays (ρ = 0.23). The difference between the two measures was significant for whole week (z = -2.25, P = 0.03) and non-workdays (z = -5.50, P < 0.001), but was not significant for workdays (z = -0.60, P = 0.55). There was a significant positive association between the difference in the two measures and the average of these two measures (workdays: r = 0.53; non-workdays: r = 0.45; and whole week: r = 0.54, all P < 0.001). There was fair-to-good test-retest reliability of total sedentary time for each domain (workdays: interclass correlation coefficient [ICC] = 0.77, non-workdays: ICC = 0.53, and whole week: ICC = 0.7; all P < 0.01). CONCLUSIONS: The scale of domain-specific sedentary behaviors is reliable for estimating where and for what purpose Japanese adults spend their sedentary time, and total sedentary time is valid for workdays and the whole week.

OBJECTIVES: This study examined cross-sectional and 2-year prospective associations of perceived and objectively measured environmental attributes with screen time among middle-aged Japanese adults. DESIGN: Prospective cohort study. SETTING: Nerima and Kanuma cities of Japan. PARTICIPANTS: Data were collected from adults aged 40-69 years living in two cities of Japan in 2011 (baseline: n=1011; 55.3±8.4 years) and again in 2013 (follow-up: n=533; 52.7% of baseline sample). MEASURES: The exposure variables were five geographic information system-based and perceived attributes of neighbourhood environments (residential density, access to shops and public transport, footpaths, street connectivity), respectively. The outcome variables were baseline screen time (television viewing time and leisure-time internet use) and its change over 2 years. Multilevel generalised linear modelling was used. RESULTS: On average, participants' screen time was not statistically different over 2 years (2.3 hours/day at baseline and 2.2 hours/day at follow-up; P=0.24). There were cross-sectional associations of objective (exp(β): 1.11; 95% CI 1.01 to 1.22) and perceived (1.12; 1.02 to 1.23) good access to public transport, perceived good access to shop (1.18; 1.04 to 1.36) and perceived good street connectivity (1.11; 1.01 to 1.23) with higher time spent in screen time at baseline. No objective and perceived environmental attributes were significantly associated with change in screen time. CONCLUSIONS: Activity-supportive neighbourhood environmental attributes appear to be related to higher levels of screen time cross-sectionally. Pattern of screen time might be maintained rather than changed over time under the same neighbourhood environments. Environmental interventions that promote physical activity may need to consider the potential negative health impact of screen time in Japan.

Objective measures of environmental attributes have been used to understand how neighborhood environments relate to physical activity. However, this method relies on detailed spatial data, which are often not easily available. Walk Score® is a free, publicly available web-based tool that shows how walkable a given location is based on objectively-derived proximity to several types of local destinations and street connectivity. To date, several studies have tested the concurrent validity of Walk Score as a measure of neighborhood walkability in the USA and Canada. However, it is unknown whether Walk Score is a valid measure in other regions. The current study examined how Walk Score is correlated with objectively-derived attributes of neighborhood walkability, for residential addresses in Japan. Walk Scores were obtained for 1072 residential addresses in urban and rural areas in Japan. Five environmental attributes (residential density, intersection density, number of local destinations, sidewalk availability, and access to public transportation) were calculated using geographic information systems for each address. Pearson's correlation coefficients between Walk Score and these environmental attributes were calculated (conducted in May 2017). Significant positive correlations were observed between Walk Score and environmental attributes relevant to walking. Walk Score was most closely associated with intersection density (r = 0.82) and with the number of local destinations (r = 0.77). Walk Score appears to be a valid measure of neighborhood walkability in Japan. Walk Score will allow urban designers and public health practitioners to identify walkability of local areas without relying on detailed geographic data.

BACKGROUNDS: The purpose of this study was to examine, in a sample of Japanese older adults, the associations of objectively-assessed sedentary behavior (SB) and physical activity (PA) with performance-based physical function. The isotemporal substitution (IS) approach was used to model simultaneously the effects of the specific activity being performed and the activity being displaced, in an equal time-exchange manner. METHODS: Among 287 older adults (65-84 years), we used accelerometers to identify the daily average time spent on SB (≤1.5 METs); light-intensity PA (LIPA) (>1.5 to <3.0 METs); and moderate- to vigorous-intensity PA (MVPA) (≥3.0 METs). Physical function was assessed using five performance-based measures: hand grip strength, usual and maximum gait speeds, timed up and go, and one-legged stance with eyes open. We employed three linear regression models - a single-activity model, a partition model, and an IS model - to assess the associations of SB, LIPA, and MVPA with each of the five measures of physical function. RESULTS: There were significant positive associations in the single-activity and partition models between MVPA and the measures of physical function (with the exception of hand grip strength). The IS models found that replacing SB or LIPA with MVPA was significantly and favorably associated with physical function measures. CONCLUSIONS: These findings indicate that replacing small amounts of SB and LIPA with MVPA (such as 10 min) may contribute to improvements in older adults' physical function.

Several studies have examined how the associations of built environment attributes with walking behaviors may be moderated by socioeconomic status (SES). Such understanding is important to address socioeconomic inequalities in health through urban design initiatives. However, to date, there is no study examining the moderation effects of SES in the relationships of environmental attributes and walking in non-Western countries. The current study aims to examine associations of environmental attributes with walking behaviors among Japanese adults, and to test whether these associations were moderated by area-level SES. Data on walking were collected from Japanese adults using a nationwide Internet survey (N = 4605). Built environment measures including population density, street density, distance to the nearest public open space, and distance to the nearest commercial destination were calculated using geographic information systems software. An index of neighborhood deprivation was used as an area-level indicator of SES. Logistic regression models adjusted for clustering and sociodemographic variables were used. It was found that more residents in high SES areas walked for commuting, for errands, and for exercise compared with those who lived in low SES areas. When the whole sample was examined, all environmental attributes were associated with walking behaviors (except for street density not being associated with walking for exercise). Associations of environmental attributes with walking behaviors were moderated by area-level SES only in walking for exercise. Walking for exercise was associated with higher population density, higher street density (marginally significant), and shorter distance to the nearest commercial destination only in high SES areas. Our findings showed that the associations of these environmental attributes and walking behaviors were largely consistent across different SES levels. Therefore, urban design interventions focusing on low SES areas may help to reduce socioeconomic disparities in walking.

This study aims to compare the outputs of the waist-worn Active style Pro HJA-350IT (ASP; used in studies with Asian populations), the waist-worn ActiGragh (TM) GT3X(+) using the normal filter (GT3X(+)) and the thigh-worn activPAL3 (AP) in assessing adults' sedentary behaviour (total sedentary time, number of breaks) under free-living conditions. Fifty healthy workers wore the three monitors simultaneously during their waking hours on two days, including a work day and a non-work day. Valid data were at least 10 hours of wearing time, and the differences between monitors on the sedentary outputs using the AP as criterion measurement were analyzed by ANOVA. The number of participants who had complete valid data for work day and non-work day was 47 and 44, respectively. Total sedentary time and breaks estimated by the AP were respectively 466.5 +/- 146.8 min and 64.3 +/- 24.9 times on the work day and 497.7 +/- 138.3 min and 44.6 +/- 15.4 times on the non-work day. In total sedentary time, the ASP estimated 29.7 min (95% CI = 7.9 to 51.5) significantly shorter than the AP on the work day but showed no significant difference against the AP on the non-work day. The GT3X(+) estimated 80.1 min (54.6 to 105.6) and 52.3 (26.4 to 78.2) significantly longer than the AP on the work day and the non-work day, respectively. For the number of breaks from sedentary time, on both days, the ASP and the GT3X+ estimated significantly more than the AP: 14.1 to 15.8 times (6.3 to 22.5) for the ASP and 27.7 to 28.8 times (21.8 to 34.8) for the GT3X(+). Compared to the AP as the criterion, the ASP can underestimate total sedentary time and the GT3X(+) can overestimate it, and more so at the lower levels of sedentary time. For breaks from sedentary time, compared to the AP, both the GT3X(+) the ASP can overestimate.

Background
Physical activity and physical performance relate to quality of life, mortality, and morbidity in elderly people. However, little is known about differences in physical performance related to low-intensity light physical activity (LLPA), high-intensity light physical activity (HLPA), and moderate-intensity physical activity (MPA) and how they are separated by sex in elderly populations.
Aims
This study aimed to determine differences in LLPA, HLPA, MPA, and physical performance, and associations between these measures in community-dwelling elderly men and women.
Methods
Physical activity and physical performance such as timed-up-and-go test, one-leg standing time, and maximum gait speed were measured in 181 community-dwelling elderly men (mean age, 75.1 +/- 5.3 years) and 109 women (mean age, 73.4 +/- 4.8 years) in 2013. Physical activity was classified as LLPA (1.6 +/- 1.9 METs of physical activity), HLPA (2.0 similar to 2.9 METs of physical activity), and MPA (over 3 METs of physical activity). The association between the values of these three intensities of physical activity in the participants was assessed by Pearson's correlation coefficients. Multiple linear regression analyses were used to assess the association of physical performance values with the three groups defined by accelerometer- measured physical activity intensity adjusted for sociographic, behavioral, and multiple diseases in the participants.
Results
MPA was beneficially associated with all physical performance indicators in the men (all P &lt; 0.05) and women (all P &lt; 0.05). Only HLPA showed significant associations with the timed-up-and-go test (P = 0.001) and maximum gait speed (P = 0.006) in women. Discussion These results may support the notion that not only HLPA in women but MPA in both sexes appears to improve physical performance in elderly populations. Conclusion The present study findings provide novel epidemiological evidence for the potential benefits of HLPA in women and also reinforce the potential benefits of MPA in both sexes, which is the mainstay of public health recommendations.

We examined whether street layout a key urban design element is associated with walking and sedentary behaviors in the context of a non-Western country; and, whether such associations differ between an urban and a rural area. In 2011, 1076 middle-to-older aged adults living in an urban and a rural area of Japan reported their walking and sedentary (sitting) behaviors. Two objective measures of street layout (intersection density and street integration) were calculated. Participants exposed to more-connected street layouts were more likely to walk for commuting and for errands, to meet physical activity recommendations through walking for commuting, and less likely to drive. These relationships differed between the urban and the rural area. This shows that previous findings from Western countries on associations of street connectivity with travel behaviors may also be applicable to Japan.

Background: It is vital to reduce the proportion of sedentary behavior in children. Understanding the duration and behavioral context is needed. The present study examined school-grade and sex differences in domain-specific sedentary times and concurrence with screen-time guidelines among Japanese elementary school children.
Methods: A total of 625 children (330 boys) were surveyed in 2010 and 2014. Using a questionnaire, data regarding participants' grade (first through third grades: lower grades; fourth through six grades: higher grades), sex, weight, and height were collected in addition to the time spent per day engaging in each specific sedentary behavior separately: (1) reading or listening to music, (2) TV or video viewing, (3) TV game use, (4) internet use excluding class, (5) homework, and (6) car travel. Two-way analysis of covariance and logistic regression analyses, adjusted for BMI and moderate to vigorous physical activity, were used to examine school-grade and sex differences in sedentary behaviors and the independent risk of exceeding recommended total daily screen time (&lt; 2 h).
Results: On 625 children, mean minutes (SD) of sedentary behavior per week in (1) - (6) were 90.3 (123.4), 535.0 (356.6), 167.3 (222.1), 23.9 (70.9), 264.9 (185.3), and 33.4 (61.2) in weekdays and 42.1 (70.0), 323.9 (232.0), 123.0 (96.4), 15.8 (49.9), 74.4 (96.4), and 71.3 (84.9) in weekends, respectively. There were differences in the minutes of sedentary behavior between participants of 2010 and 2014; e.g., TV game use and homework in weekdays and weekdays and car travel in weekends. Boys spent more time in TV game use, and girls spent more time reading, listening to music, doing homework, and car travel. Higher-grade students spent more time reading or listening to music, using a computer, and doing homework. Higher-grade students were 2.09 times (95% CI: 1.32 - 3.30) in whole week, 2.08 times (95% CI: 1.45 - 3.00) in weekday, and 1.88 times (95% CI: 1.29 - 2.74) in weekend more likely to spend &gt;= 2 h per day in domains (2) - (4) (screen-time) than lower-grade students.
Conclusions: Time spent engaging in each domain-specific sedentary behavior differed according to sex and school grade. Higher-grade students were less likely to meet screen-time guidelines. These findings highlight the need for domain-focused strategies to decrease sedentary behavior in Japanese school-age children.

Newspapers could provide effective and comprehensive information about cancer to the public. The present study conducted a content analysis of cancer-related articles in Japanese newspapers published in 2011. In total, 5,314 articles were identified and subsequently coded. Coding variables included cancer type, the cancer continuum, and topic of articles mentioning cancer. Approximately half mentioned at least one specific type of cancer, with the focus mostly on lung, leukemia, and breast. Stomach and colon cancers, which have the highest morbidity, were relatively underreported. The continuum received little attention, and was mentioned in only 11% of articles. Treatment was the most frequently mentioned part of the continuum, with prevention and screening mentioned only rarely. The most frequently mentioned topic was social issues. The findings suggest that cancer-related articles were found regularly throughout the year, meaning that they might be one of the most important sources of cancer information. However, they are affected by social issues and there were some imbalances in both cancer type and continuum. Considering the influence of newspapers, it would be helpful for providing more effective and accurate information to the public if Japanese newspapers increased mentions of specific types of common cancers and the cancer continuum, especially prevention.

Background: Sedentary behaviors (SB) are associated with health indicators; however, there are currently very few studies that have examined these associations, especially in conjunction with psychological factors, in children. The current study examined the independent relationship between objectively assessed SB, and indicators of obesity and psychological, well-being, among Japanese children. Methods: A total of 967 elementary-school children completed a cross-sectional survey. SB was measured with accelerometers for 7 consecutive days. Psychological well-being data (eg, anxiety and behavior problems) were collected via a self-report questionnaire. To determine the relationship of SB with degree of obesity and psychological well-being, linear regression analyses were conducted to relate the indicators of obesity and psychological well-being on SB, adjusted by gender, grade, percentage of moderate-to-vigorous physical activity per day, duration spent wearing the accelerometer, and degree of obesity. Results: SB was significantly related to behavioral/emotional problems (beta = .280, P = .010, R-2 = .015). There was a statistically significant relationship between SB and anxiety (beta = .206, P = .059, R-2 = .007). No significant association with degree of obesity was found. Conclusions: Excess SB relates higher levels of behavioral/emotional problems and anxiety. These results can inspire the development of interventions that promote well-being and enhance psychological health, by focusing on SB in Japanese children.

<p>The present study is a systematic review of the effectiveness of acceptance and mindfulness based interventions for enhancing athletes' performance. Studies were initially identified by literature searches in multiple international and domestic databases. Search terms used included "acceptance-based", "acceptance and commitment therapy", "mindfulness", "sport", "athlete", and "performance". Studies were then assessed for inclusion by examination of their title, abstract, and full text. On this basis, 11 studies were selected for inclusion in the present review. No studies conducted in Japan met the criteria. The studies reviewed encompassed the Mindfulness-Acceptance-Commitment approach (n＝5), Mindful Sport Performance Enhancement (n＝2), and alternative interventions (n＝4). Most of the studies (n＝8) found positive effects on sport performance. In 2 other studies, enhancement of sport performance was observed during a follow-up period. These findings suggest that acceptance and mindfulness based interventions appear to be effective for enhancing sport performance. Because none of the studies reviewed was conducted in Japan, research is needed on the effects of acceptance and mindfulness based interventions on the performance of Japanese athletes.</p>

&nbsp;&nbsp;&nbsp;&nbsp;Considering the benefits of participating in school-based extracurricular sports activities (SBECSA), providing active SBECSA is important. However, heavy burden on teachers in coaching and management of SBECSA has been reported. Additionally, appropriate allowance and role allotment have not been discussed enough. It is necessary to understand the quality and quantity of task-related burdens in coaching and managing SBECSA to promote discussion. Therefore, the purpose of the study was to quantify the temporal, psychological, and economic burdens on teachers in coaching and management of SBECSA. The present study used a mixed-methods approach. Firstly, a semi-structured interview was conducted to clarify the contents of tasks about coaching and management of SBECSA. Participants were 12 teachers who work in junior high school or high school. All interview data was recorded and transcribed verbatim. Through the recording process, 26 contents of SBECSA tasks were grouped. Secondly, a self-completed questionnaire survey was conducted. 200 junior high schools and 200 high schools were recruited. Seventy-three schools agreed to cooperate in the study, and 361 SBECSA teachers answered the questionnaire. Question items were as follows: yearly hours taken for each of the 26 tasks, psychological burdens to do each of the 26 tasks, and yearly expenditure for coaching and management of SBECSA. As results, exact temporal burden for each of the 26 tasks was examined. On average, SBECSA teachers were spending approximately 1,400 hours a year for coaching and management. Regarding psychological burden, there were some tasks which were highly perceived although the temporal burdens were comparatively low. SBECSA teachers were payed approximately 136,000 yen a year to coach and manage SBECSA. In conclusion, SBECSA teachers assumed various tasks for management other than direct coaching. Contents of tasks would affect psychological burden as well as temporal length. Additionally, heavy individual payment for coaching and management of SBECSA was revealed. Increasing support for SBECSA coaching and management is necessary to decrease teachers&rsquo; burden and promote youth sports.

&nbsp;&nbsp;&nbsp;&nbsp;Recently, the carry-over of physical fitness or physical activity from childhood to adulthood has been actively discussed. However, the carry-over effect of participation in organized sports is not well understood, despite the fact that organized sports participation has a number of positive effects on physical, mental, and social aspects. Therefore, the purpose of the present study was to clarify the association of organized sports participation during school age with organized sports participation and sports volunteer participation in adulthood. The data was secondarily obtained from &ldquo;nationwide questionnaire research for promotion of sports activities according to the life stage&rdquo; conducted by the National Recreation Association of Japan. This research was conducted with 1,200 Japanese adults (612 males and 588 females) who were 20-39 years old. Path Analysis was conducted with respect to each sex. Regarding association of organized sports participation in school-age with organized sports participation in adulthood, participation in elementary school was related to that of junior high school, participation in junior high school was related to that of high school and adulthood, and participation in high school was related to that of adulthood in males. By contrast, in females, participation in elementary school was related to that of junior high and high school, participation in junior high school was related to that of high school and adulthood, and participation in high school was related to that of adulthood. With respect to association of organized sports participation in school-age with sports volunteer participation in adulthood, only organized sports participation in high school was affected in males, and only organized sports participation in junior high school was affected in females. There is a possibility that participation in organized youth sports has a carry-over effect for adult sports involvement. In order to promote organized sports participation and sports volunteer participation in adulthood, enhancing organized sports participation in school-age would be valuables.

<p>Objectives The present study investigated articles on cancer prevention published in Japanese newspapers in 2011.</p><p>Methods A content analysis of news coverage on cancer primary prevention and screening was conducted. Articles which mentioned cancer risk, prevention, and screening were extracted. For all articles on prevention, the newspaper's name, month of publication, and information source were checked. Coding variables for articles on primary prevention included causes of human cancer, risk and/or prevention, and recommended screening criteria. Cancer screening articles were classified according to four coding variables: cancer screening site, subjects for screening, examination interval, and whether to promote the screening.</p><p>Results A total of 272 articles were identified and subsequently coded as either articles on primary prevention or screening. The number of articles on primary prevention was 208. The focus of these articles was mostly on food/nutrition (n=56), cancer-causing infection (n=40), and smoking (n=32). Alcohol drinking (n=12), exercise/physical activity (n=11), and obesity (n=10), which are also major lifestyle factors for cancer, were rarely mentioned. Moreover, cancer risk was more frequently mentioned than prevention. The recommended criteria for major lifestyle factors were mentioned in 13 articles. Screening was mentioned in 92 articles. Breast cancer screening was the most frequently mentioned (n=31). The screening of colon (n=18), cervical (n=18)，stomach (n=15), and lung cancer (n=10), which are recommended by the cancer control act, were mentioned in less than 20 articles. Seven articles on screening indicated subjects and interval. Only 39 articles discussed cancer-screening behaviors.</p><p>Conclusions Articles on cancer prevention were found to be published in Japanese newspapers. However, the number of articles on both primary prevention and screening was not enough, and there were some disparities in the lifestyle factors and specific type of screening that were mentioned in these articles. Considering the influence of newspapers as a source of information on cancer prevention, it is necessary to encourage publishers to increase the number of published articles on cancer primary prevention and screening in Japanese newspapers.</p>

Background: This study examined associations of perceived and objectively measured neighborhood environmental attributes with leisure-time sitting for transport among middle-to-older aged Japanese adults. Method: Data were collected using a postal survey of 998 adults aged 40 to 69 years. Generalized linear modeling with a gamma distribution and a log link was used to examine associations of perceived (International Physical Activity Questionnaire-Environmental module) and Geographic Information Systems (GIS)-derived built environment attributes with self-reported leisure-time sitting for transport. Results: Mean leisure-time sitting time for transport was 20.4 min/day. After adjusting for potential confounders, perceived higher residential density, GIS-measured higher population density, better access to destinations, better access to public transport, longer sidewalk length, and higher street connectivity, were associated significantly with lower sitting time for transport. Conclusion: Residents living in neighborhoods with attributes previously found to be associated with more walking tended to spend less time sitting for transport during leisure-time. The health benefits of walkability-related attributes may accrue not only through increased physical activity, but also through less sedentary time.

Data on the effect of increased or decreased physical activity on children's psychological status are scarce, and effect sizes are small. This study conducted two-year longitudinal research to identify associations between physical activity, sedentary behavior, and psychological well-being in Japanese school children through a mail survey completed by 292 children aged 6-12 years. Data on sociodemographics, physical activity, sedentary behavior on weekdays and the weekend, and psychometrics (self-efficacy, anxiety, and behavioral/emotional problems) were collected using a self-reported questionnaire. A logistic regression analysis was performed, calculating odds ratios for physical activity, psychometrics, and baseline age and physical activity and sedentary behavior changes. For boys, a negative association was found between increased physical activity outside school and maintained or improved self-efficacy as opposed to a positive association in girls. Increased sedentary behavior on weekdays and long periods of sedentary behavior on weekends were associated with maintained or improved behavioral/emotional problems in girls only. This two-year longitudinal study is the first of its kind conducted in Japan. Although effect sizes were small, these results may nevertheless assist in intervention development to promote psychological well-being.

目的:地域在住高齢者における腰痛の強度別の有訴率,腰痛の強度と抑うつ症状の関連,運動習慣が腰痛と抑うつ症状の関連に与える影響を横断的に明らかにすること。方法:千葉県松戸市の住民基本台帳より無作為抽出した65歳から84歳の高齢者3,000名に対して郵送法による質問紙調査を実施し,1,051名より有効回答を得た。調査内容は,腰痛の強度,抑うつ症状,運動習慣,人口学的・社会経済的属性,生活習慣,現病歴だった。腰痛の強度と抑うつ症状の関連および腰痛と運動習慣の抑うつ症状への複合的な関連を検討するため,多重ロジスティック回帰分析を行った。結果:腰痛の有訴率は47.7%(軽度:35.2%,中程度:10.0%,強度:2.5%)だった。腰痛がない者を参照群とすると,軽度の腰痛を有する者(オッズ比(OR)=1.85,95%信頼区間(95%CI):1.23-2.79),中程度以上の腰痛を有する者(OR=2.03,95%CI:1.15-3.58)は,抑うつ症状の増加と有意に関連していた。腰痛の強度と運動習慣の複合的な関連を検討した結果,腰痛なし・運動習慣あり群を参照群とすると,軽度の腰痛あり・運動習慣なし群(OR=2.85,95%CI:1.63-4.98),中程度以上の腰痛あり・運動習慣なし群(OR=2.92,95%CI:1.42-6.00)は,抑うつ症状を有することと有意に関連していた。結論:地域在住高齢者の約半数は腰痛を抱えており,その4分の1は中程度以上の腰痛を有していた。また,腰痛の強度と抑うつ症状に有意な正の関連が認められた。更に,運動習慣がない群は,ある群よりも,腰痛の強度と抑うつ症状との関連が強くなる傾向があった。(著者抄録)

The present study reviewed the current trends of interventions focused on the physical activity environment for reducing sedentary behavior among children. Multiple international and domestic databases were searched to identify studies that involved changes to the physical activity environment, measured sedentary behavior, were specific to childhood populations, and published in a peer-reviewed journal. After studies were carefully assessed for inclusion by examining the title, abstract, and full text, the characteristics of the included studies (i.e., participants, study design, environmental intervention, measurement of sedentary behavior, and results) were summarized. A total of 31 studies (randomized controlled trial: n=25; quasi-experimental design: n=3; within-subject design: n=3) met the inclusion criteria. The majority of studies (n=23) were conducted using school-based interventions focused on the playground environment, involving either one or a combination of the following changes: improved markings, providing play equipment, or offering built facilities. Other studies included in the summary focused on behaviors at home and in the community like using electronic time managers while watching the television and providing low-cost or free entry to safe and easily accessible sports facilities. The measurement of sedentary behavior included an accelerometer, self-report, and direct observation. Twenty studies had a positive effect on reducing sedentary behavior among children. All but two of the studies were conducted in foreign nations. The present findings suggest that improving the physical activity environment to children can reduce sedentary behavior; therefore, further interventions focused on the physical activity environment for reducing sedentary behavior among Japanese children should be conducted.

Associations between levels of sedentary behavior and depressive symptoms independently and in combination with different levels of physical activity remain unclear.
This study aimed to examine independent and combined associations of physical activity (PA) and sedentary behavior (SB) with depressive symptoms among Japanese adults.
An Internet-based survey collected data on depression levels (Center for Epidemiologic Studies Depression Scale), self-reported time spent in PA and SB (Japanese short version of the International Physical Activity Questionnaire), and sociodemographic variables from 2,914 adults in 2009. Binary logistic regression analyses were conducted to examine the odds ratios (ORs) for being depressed (depression scores a parts per thousand yen16) according to independent PA levels (none, insufficient, sufficient), SB levels (low, moderate, high), and nine combinations of PA and SB categories.
After adjusting for potential confounders, sufficient PA level was found to be related to lower risk of depressive symptoms independently (OR = 0.61), whereas no significant associations were observed between SB levels and depression. In the combined associations, adults in the sufficient PA/high SB (OR = 0.44), sufficient PA/moderate SB (OR = 0.56), and sufficient PA/low SB (OR = 0.57) categories were significantly less likely to have depressive symptoms in comparison with the no PA/high SB category.
Meeting physical activity recommendations is associated with a lower risk of depressive symptoms, regardless of time spent in total sedentary behavior. These results suggest that promoting physical activity may be an effective strategy against depressive symptoms among Japanese adults.

Background: In the rapidly developing use of the Internet in society, eHealth literacy-having the skills to utilize health information on the Internet-has become an important prerequisite for promoting healthy behavior. However, little is known about whether eHealth literacy is associated with health behavior in a representative sample of adult Internet users.
Objective: The aim of this study was to examine the association between eHealth literacy and general health behavior (cigarette smoking, physical exercise, alcohol consumption, sleeping hours, eating breakfast, eating between meals, and balanced nutrition) among adult Internet users in Japan.
Methods: The participants were recruited among registrants of a Japanese Internet research service company and asked to answer a cross-sectional Internet-based survey in 2012. The potential respondents (N= 10,178) were randomly and blindly invited via email from the registrants in accordance with the set sample size and other attributes. eHealth literacy was assessed using the Japanese version of the eHealth Literacy Scale. The self-reported health behaviors investigated included never smoking cigarettes, physical exercise, alcohol consumption, sleeping hours, eating breakfast, not eating between meals, and balanced nutrition. We obtained details of sociodemographic attributes (sex, age, marital status, educational attainment, and household income level) and frequency of conducting Internet searches. To determine the association of each health behavior with eHealth literacy, we performed a logistic regression analysis; we adjusted for sociodemographic attributes and frequency of Internet searching as well as for other health behaviors that were statistically significant with respect to eHealth literacy in univariate analyses.
Results: We analyzed the data of 2115 adults (response rate: 24.04%, 2142/10,178; male: 49.74%, 1052/2115; age: mean 39.7, SD 10.9 years) who responded to the survey. Logistic regression analysis showed that individuals with high eHealth literacy were significantly more likely to exhibit the good health behaviors of physical exercise (adjusted odds ratio [AOR] 1.377, 95% CI 1.131-1.678) and eating a balanced diet (AOR 1.572, 95% CI 1.274-1.940) than individuals with low eHealth literacy.
Conclusions: We found that some health behaviors, including exercise and balanced nutrition, were independently associated with eHealth literacy among Japanese adult Internet users.

【はじめに，目的】地域在住高齢者における足部痛に関連する能力障害（Disabling Foot Pain；DFP）の発生を効果的に予防する方法を明らかにするため，地域在住高齢者が実施する足部自己管理行動とDFP発生状況を分析したので報告する。【方法】地域在住高齢者346名（男性215名，女性131名，第1次調査時平均年齢（S.D.）は74.03（5.21）歳）を対象とした。第1次調査は郵送自記式質問紙調査を行い，人口統計学的指標，生活習慣（飲酒・喫煙・運動習慣），足部痛・DFPの有無（日本語版Manchester Foot Pain and Disability Index；以下MFPDI-Jにより判定），足部自己管理行動に関する項目（「毎日足の状態を観察していますか」等7項目），履き物の選択行動に関する項目（「踵がしっかりとした靴を履いていますか」等靴の種類に関する9項目と「試着をして履き心地を確認していますか」等選択行動に関する4項目）について尋ねた。第1次調査の8か月後に第2次調査として対面自記式質問紙調査を実施し，足部痛・DFPの有無（MFPDI-J）を尋ねた。第1次調査と第2次調査の回答から，DFPなし群，DFP発生群，DFP改善群，DFP持続群の4群に分類し，各群の足部自己管理行動に関する項目の実施数，履き物選択行動に関する項目の実施数について一元配置分散分析を行った。さらに第1次調査時にDFPがなかった271名を抽出し第2次調査時のDFPの有無を従属変数，第1次調査時の足部自己管理行動に関する項目，履き物選択行動に関する項目，運動習慣の有無を独立変数として，多重ロジスティック回帰分析を行った。【結果】DFP発生状況は，DFPなし群244名（70.5%），発生群27名（7.8%），改善群46名（13.3%），持続群25名（13.3%）であった。一元配置分散分析では足部自己管理行動の実施数において有意な差を認め（F=5.86，p＜.01），多重比較の結果，DFP持続群はDFPなし群に比べて足部自己管理行動の実施数が有意に高かった（DFP持続群平均3.79に対しDFPなし群2.14，p＜.01）。多重ロジスティック回帰分析の結果は，履物選択行動に関する項目のうち「デザインや価格以外の要素を考慮して靴を選んでいる」（Odds ratio 2.94，95%CI 1.08-7.97）と「日常的な運動習慣がある」（Odds ratio 0.33，95%CI 0.14-0.80）が有意にDFPの発生に関連した（p＜.05）。【結語】第1次調査時にDFPがあり8か月後にも持続する者の足部自己管理行動の実施数がむしろ多く，足部自己管理行動の実施数はDFP発生・改善に単純には影響しないことがわかった。一方，第1次調査時にDFPがない対象者のみの分析では，足部自己管理行動の実施数や履物選択行動の実施数はDFPの発生に有意な関連はなく，履物の選択時に履物の外観や価格以外の要素を考慮することと日常的に運動習慣があることがDFPの発生を有意に抑制できる可能性が示唆された。履物選択時に考慮するべき内容や習慣化するべき運動内容の仔細は本研究では明らかとならないため，今後の調査・分析の課題とする。

Problem Statement: Many youths participate in school-based extracurricular sports activities (SBECSA). These SBECSAs contribute to positive youth development. However, SBECSAs sometimes require the outsourcing of human resources. The major reason is difficulty to manage SBECSAs by employing teachers as the primary coaching resources. Using external coaches is an effective solution for reducing the workload on teachers, and it can contribute to improving teachers’ and students’ knowledge and skills. Because teacher involvement also appears to provide benefits for students, cooperative coaching between external coaches and teachers is essential. However, the lack of evidence regarding the benefits that cooperative coaching offers students may result in inadequate cooperation. Approach: In all, 23 students who participated in SBECSAs were recruited from three junior high schools and three high schools that employed external coaches. An open-ended, semi-structured interview was conducted with each student. The KJ method was used for qualitative analysis of the responses. Purpose: The purpose of this study is to determine how external coaches and teachers impact students’ experiences in SBECSAs, and how external coaches and teachers differ and/or have similar impacts. Results: In terms of benefits from external coaches, six categories and 31 subcategories were identified. The major categories included the following: expert coaching; support for SBECSA teacher; general coaching; human network; improved SBECSA atmosphere; and equipment supply. Benefits from teachers comprised six categories and 22 subcategories. The major categories identified were as follows: general coaching; management and office work; participation in SBECSA; human network; connection with school life; and improved SBECSA atmosphere. Conclusions: Students perceived overlapping and specific benefits from both groups, which indicated that cooperative coaching would be more desirable to students than having only external coaches or teacher instruct their SBECSAs.

The present study reviewed the current trends of interventions focused on the physical activity environment for reducing sedentary behavior among children. Multiple international and domestic databases were searched to identify studies that involved changes to the physical activity environment, measured sedentary behavior, were specific to childhood populations, and published in a peer-reviewed journal. After studies were carefully assessed for inclusion by examining the title, abstract, and full text, the characteristics of the included studies (i.e., participants, study design, environmental intervention, measurement of sedentary behavior, and results) were summarized. A total of 31 studies (randomized controlled trial: n=25
quasi-experimental design: n=3
within-subject design: n=3) met the inclusion criteria. The majority of studies (n=23) were conducted using school-based interventions focused on the playground environment, involving either one or a combination of the following changes: improved markings, providing play equipment, or offering built facilities. Other studies included in the summary focused on behaviors at home and in the community like using electronic time managers while watching the television and providing low-cost or free entry to safe and easily accessible sports facilities. The measurement of sedentary behavior included an accelerometer, self-report, and direct observation. Twenty studies had a positive effect on reducing sedentary behavior among children. All but two of the studies were conducted in foreign nations. The present findings suggest that improving the physical activity environment to children can reduce sedentary behavior
therefore, further interventions focused on the physical activity environment for reducing sedentary behavior among Japanese children should be conducted.

Background: Physical activity levels in childhood have decreased, making the promotion of children's physical activity an important issue. The present study examined gender and grade differences in objectively measured sedentary behavior, physical activity, and physical activity guideline attainment among Japanese children and adolescents.
Methods: In total, 329 boys and 362 girls age 3-15 years completed the survey. School grade, gender, height, and weight were collected by questionnaires and physical activity objectively measured using an accelerometer (Lifecorder Suzuken Co.). Physical activity level (in MET) was classified as sedentary (&lt;1.5), light (&gt;= 1.5 to &lt;3), moderate (&gt;= 3 to &lt;6), or vigorous (&gt;= 6). Continuous zero accelerometer counts for &gt;= 20 min were censored and a valid accelerometry study required at least 3 days (2 weekdays and 1 weekend day) with &gt;600 min/day total wear time. Two-way analysis of covariance and logistic regression analyses, adjusted for weight status and accelerometer wear time, were used to examine gender and grade differences in physical activity variables and the likelihood of physical activity guideline attainment by gender and grade level.
Results: Participants were sedentary 441.4 (SD, 140.1) min/day or 53.7 % of the average daily accelerometer wear time of 811.2 (118.7) min, engaged in light physical activity 307.1 (70.0) min or 38.4 % of wear time, moderate physical activity 34.6 (14.8) min (4.3 %), vigorous physical activity 28.3 (19.1) min (3.6 %), and took 12462.6 (4452.5) steps/day. Boys were more physically active and took more steps/day than girls. Students in higher grades were less active than those in lower grades. Boys were significantly more likely to meet physical activity guidelines than girls (OR: 2.07, 95 % CI: 1.45-2.96). Preschoolers (6.66, 4.01-11.06), lower-grade elementary school students (17.11, 8.80-33.27), and higher-grade elementary school students (7.49, 4.71-11.92) were more likely to meet guidelines than junior high school students.
Conclusions: Boys and lower-grade students engaged in more physical activity and were more likely to attain guidelines than girls and higher-grade students. These findings highlight the need for effective and sustainable strategies to promote physical activity in Japanese school children.

Objective: The present study was conducted to examine the effects of providing equipment for use during school recess on elementary school children's physical activity.<br>Methods: In this cross-sectional study, 98 fifth-grade children (63 boys) from two elementary schools were assigned to an intervention group (n = 39) or a control group (n = 59). The intervention group received equipment such as volleyballs and oval balls. The children's physical activity was measured using accelerometry before and three months after receiving the equipment. Evaluated indicators were time spent engaging in sedentary, light, moderate, and vigorous physical activity during break, lunch recess, and the entire school day. Analysis of covariance—with sex, body mass index, and physical activity level prior to receipt of the equipment as covariates—was performed to examine the differences between two groups with respect to physical activity after receiving the equipment.<br>Results: During break, lunch recess, and the entire school day, data were collected from 23, 25, and 18 children in the intervention group. In the control group, it was done from 41, 42, and 37 children, respectively. During break and lunch recess, the intervention group was less likely to engage in sedentary behavior (p = 0.01, p < 0.01) and more likely to engage in light physical activity (p < 0.01, p < 0.01) than the control group. Regarding vigorous physical activity during break, the intervention group was less likely to engage in vigorous physical activity (p = 0.02). During the entire school day, the intervention group was more likely to engage in moderate physical activity (p = 0.03) than the control group.<br>Conclusion: The availability of equipment for use during recess was associated with high levels of physical activity.

Background: Providing information about cancer prevention might increase awareness of prevention and promote preventive behaviours. A better understanding about the prevalence and preferences of obtaining information about cancer might help to identify targeted individuals and design effective strategies for promoting cancer-preventive behaviours. Thus, the present study examined the prevalence and correlates of obtaining information about cancer among Japanese adults, and described preferences including source and content.
Methods: Data were analysed for 3,058 Japanese adults (mean age 45.0 +/- 13.4 years) who responded to an Internet-based cross-sectional survey. The data included whether information about cancer had been obtained, sources, preference for content, sociodemographic variables, health status, and cancer histories. Force-entry logistic regression analysis was used.
Results: Overall, 46.7% of respondents had obtained information about cancer. Gender, age, and education level were statistically significant correlates of doing so. Women were more likely to obtain information (OR = 1.97) as were older age groups (40-49: OR = 1.54, 50-59: OR = 2.27, 60-69: OR = 3.83), those with higher education (2 years college or equivalent degree: OR = 1.31, college graduate or higher: OR = 1.48) and those with having cancer histories (personal: OR = 3.52, family: OR = 1.57, friends/co-worker: OR = 2.09). The most prevalent source of information about cancer was mass media. Content of prevention is most needed among inconsistent contents with the frequently obtained contents.
Conclusions: Less than half of the respondents information about cancer. The finding suggests that better health communication strategies would be necessary to inform Japanese people about cancer. Understanding which subgroups were less likely to obtain information and preferences of information might be effective in promoting cancer prevention.

Knee pain is one of the common symptoms experienced by elderly people. Knee pain problem is a complex issue which contains physical and psychological aspects. For example, knee pain is associated with muscle weakness, mobility limitation, cognitive difficulties, behavioral abnormalities, and emotional upheavals. Recently, non-pharmacological treatment (e.g., exercise therapy, cognitive behavioral therapy) to improve physical and psychological outcomes has been used to cope with knee pain. The aim of this review is to introduce the key studies on non-pharmacological treatment for knee pain. Some studies showed that exercise therapy was effective for alleviating knee pain and improving physical function and that cognitive behavioral therapy improved psychological parameters. Moreover, combined exercise and cognitive behavioral therapy intervention may be more effective for pain management elderly people with knee pain than non-combined therapy. However there is a lack of evidence indicating the efficacy of such combined intervention, further research is needed.

The newspaper is a primary source of cancer information for the public, and newspaper articles could provide effective and comprehensible information about cancer prevention. Content analyses of cancer news coverage contribute to understanding the effect of newspaper coverage on public knowledge and behavior. The current study reviewed previous comprehensive content analyses. The news coverage was not balanced with regard to the population incidence and mortality of each cancer. Lack of balance may contribute to distortion in readers’ perceptions of cancer risk. In addition, newspaper articles rarely mentioned cancer prevention behaviors, although there was a positive association between news coverage and individuals knowledge of cancer prevention. The cancer stories in newspapers are affected by the social, existential, and religious characteristics of a country
the themes of cancer stories differ according to country. However, no study has used comprehensive content analysis to investigate cancer news coverage in Japan. Thus, comprehensive analysis of cancer story content in Japanese newspapers should be conducted to assess the value these stories have in delivering accurate information to the public.

School-based extracurricular sports activities are beneficial for positive youth development. However, there is a shortage of appropriate in-school coaches, and therefore recruitment of external coaches has been considered as one solution to this. A previous study has reported four model strategies of organizational promotion to recruit external coaches. These four models included "compensational support", "staff introduction", "delivery of collegiate students", and "cooperation with company". In order to promote the further development and popularization of these organizational trials, user-side evaluation is necessary. Therefore, the purpose of the present study was to clarify the strengths and problems related to these four organizational promotion strategy models when recruiting external coaches for school-based extracurricular sports activities from the viewpoint of teachers. The participants were 12 teachers who worked in public junior high or high schools. All of them had experience of coaching school-based extracurricular sports activities. Face-to-face semi-structured interviews were conducted with the individual participants, and all interview data were transcribed. Then, similar meaning units were grouped into themes with respect to the four models, strengths and problems. As a result, many specific themes for each model emerged. For instance, with regard to "compensational support", monetary support was regarded as a strength, although the early application period was a problem. With regard to "staff introduction", adequacy for beginners was a strength, but lack of mediation organization was a problem. With regard to "delivery of collegiate students", regular coaching was seen as a strength, but worry over not choosing a delivered external coach was a problem. With regard to "cooperation with company", high coaching skill was a strength, but an expensive coaching fee was a problem. Additionally, comprehensive opinions about all the models were reported, such as lack of information about the system and the need for educational coaching. These similarities and differences in the results indicated the importance of mediation system design considering the regionality and situation of the school-based extracurricular sports activity. Effective publicity and re-examination of financial manager is also needed. In addition, mediation organization and teachers should arrange previous meetings with external coaches to understand their human qualities and educational attitude. Furthermore, it would be valuable to develop the quality of external coaches through previous training or workshops. Finally, changes in the application period for each mediation system are suggested.<br>

Use of external coaches for school-based extracurricular sports activities has been promoted because of the lack of teachers who can coach expertly and the large burden placed on teachers when coaching and managing such activities. However, it has been reported that securing external coaches through human resources is difficult. To promote the use of external coaches, previous studies have suggested some possible strategies: 1) clarifying the role and status of external coaches, and promoting cooperative coaching with external coaches and teachers; 2) interactive collection and provision of information about external coaches and schools, and improving recognition of the mediation system; 3) improving the way external coaches are recruited, and setting a suitable trial period; 4) moderating institutional limitations for coaching frequency and number of coaches; and 5) holding workshops for external coaches. However, these suggestions were made from only an individual viewpoint (i.e. that of teachers, external coaches, and potential external coaches), and did not consider organizational perspectives. In Japan, there are some organizations that help recruitment of external coaches for school-based extracurricular sports activities. It is necessary to consider the opinions of these organizations to develop more realistic and concrete promotion strategies. Therefore, the present study explored in detail the trials, problems, challenges, and strategies of organizations in order to promote the recruitment of external coaches for school-based extracurricular sports activities. Face to face semi-structured interviews were conducted involving 15 individuals in 11 organizations (2 national and 4 prefectural organizations, 3 schools, 1 university, and 1 company) supporting the recruitment of external coaches for school-based extracurricular sports activities. The interviews contained questions asking details of the recruitment system, problems, challenges and management strategies. All interviews were audio-recorded with agreement from the participants. The transcript data were integrated into 7 trials and their details, problems, challenges, and strategies were described. The results indicated that in order to promote the engagement of external coaches, a number of factors were important, including building human relationships between external coaches and teachers led by teachers that could share information, interactive collection and provision of information through mediator and cooperation with other organizations, collecting information about external coaches and interviewing them before formal acceptance, keeping the coaching non-compensatory, holding workshops and creating feedback to promote communication and learning of external coaches, and considering the continuity of the trial. Knowledge of the various problems, challenges, and strategies from an organizational perspective would contribute to improvement of recruitment strategy. The results of the present study could also provide information that is beneficial for other organizations wishing to conduct similar trials.<br>

School-based extracurricular sports activities are beneficial for positive youth development. However, there is a shortage of appropriate in-school coaches, and therefore recruitment of external coaches has been considered as one solution to this. A previous study has reported four model strategies of organizational promotion to recruit external coaches. These four models included "compensational support", "staff introduction", "delivery of collegiate students", and "cooperation with company". In order to promote the further development and popularization of these organizational trials, user-side evaluation is necessary. Therefore, the purpose of the present study was to clarify the strengths and problems related to these four organizational promotion strategy models when recruiting external coaches for school-based extracurricular sports activities from the viewpoint of teachers. The participants were 12 teachers who worked in public junior high or high schools. All of them had experience of coaching school-based extracurricular sports activities. Face-to-face semi-structured interviews were conducted with the individual participants, and all interview data were transcribed. Then, similar meaning units were grouped into themes with respect to the four models, strengths and problems. As a result, many specific themes for each model emerged. For instance, with regard to "compensational support", monetary support was regarded as a strength, although the early application period was a problem. With regard to "staff introduction", adequacy for beginners was a strength, but lack of mediation organization was a problem. With regard to "delivery of collegiate students", regular coaching was seen as a strength, but worry over not choosing a delivered external coach was a problem. With regard to "cooperation with company", high coaching skill was a strength, but an expensive coaching fee was a problem. Additionally, comprehensive opinions about all the models were reported, such as lack of information about the system and the need for educational coaching. These similarities and differences in the results indicated the importance of mediation system design considering the regionality and situation of the school-based extracurricular sports activity. Effective publicity and re-examination of financial manager is also needed. In addition, mediation organization and teachers should arrange previous meetings with external coaches to understand their human qualities and educational attitude. Furthermore, it would be valuable to develop the quality of external coaches through previous training or workshops. Finally, changes in the application period for each mediation system are suggested.<br>

Objective: The present study examined the prevalence and correlates of awareness about the role physical activity plays in colon cancer prevention among Japanese adults.Methods: Data were analyzed for 1,964 Japanese adults (aged 44.7 years) who responded to an internet-based cross-sectional survey. The survey was used to assess awareness of the role of physical activity in colon cancer prevention, knowledge of colon cancer, exposure to information about physical activity and cancer, a self-reported physical activity and sociodemographic variables (gender, age, marital status, education level, employment status, household income, and colon cancer history). A multivariate logistic regression analysis was used.Results: Overall, 47.5% of respondents were aware of the preventive role of physical activity on colon cancer. Respondents aged 60-69 (AOR, 95%CI: 0.59, 0.45-0.79) were significantly less likely to be aware than respondents aged 20-29 years, while those with college graduates or higher (1.32, 1.05-1.66) were more likely to be aware than those who had graduate junior high or high school. Moreover, exposure to information about cancer and physical activity (2.07, 1.71-2.51), and meeting physical activity recommendations (1.43, 1.12-1.84) were positively associated with the awareness.Conclusions: Awareness of the role of physical activity in colon cancer prevention was not sufficient. The finding suggests that strategies are needed for promoting awareness of the effect of physical activity in colon cancer prevention among Japanese adults, especially in consideration of age and education level.

The promotion of strength training is a public health priority. Employing both self-reported and objective assessment of environmental factors is helpful for a better understanding of the environmental influences on strength-training behavior.
This study aims to investigate the associations of perceived and objectively measured access to strength-training facilities with strength-training behavior.
A cross-sectional questionnaire survey targeted 3,000 Japanese adults and 1,051 responded validly. Strength-training behavior, perceived access to facilities, and sociodemographic factors were assessed. Objective access to facilities was calculated using a geographic information system. Logistic regression analyses were conducted.
Perceived good access to the facilities was significantly associated with strength-training behavior, whereas objective access to the facilities was not, even when adjusted for sociodemographic factors and other measures of access to strength-training facilities.
Perceived access to the facilities may be a stronger predictor of strength-training behavior than objective access.

Differences in recess physical activity (PA) according to perceived school environment among elementary school children were examined. Participants were 103 children from two schools in Japan. PA was measured using accelerometry for seven consecutive days. Time spent in sedentary or PA (light, moderate, or vigorous) during their morning recess (25 min) and lunch recess (15 min) was determined. The School Physical Activity Environment Scale (three factors: equipment, facility, and safety) was used to investigate perceived school environment. Environmental factor scores were assigned to low or high groups for each factor by median. An analysis of covariance, with grade as the covariate, was conducted separately by gender to examine differences in PA between two groups. During lunch recess, boys in the high-equipment group spent significantly more time in moderate PA (high: 1.5; low: 0.8 min) whereas girls in this group spent less time in light PA (9.3, 11.0). Boys in the high-facility group spent significantly less time in sedentary (2.3, 3.9) and more time in vigorous PA (2.4, 1.4) during lunch recess, and girls spent more time in moderate (2.1, 1.2) and vigorous PA (1.9, 1.3) during morning recess. Differences were observed in recess PA according to school environment perceptions. The present study may be useful for further intervention studies for the promotion of PA during recess.

Background: Although considerable evidence has demonstrated that physical activity is associated with breast cancer prevention, few studies have assessed the level of awareness of this association. Awareness is a key first step to successful of behavior change. Increasing awareness may contribute to promote physical activity and prevent breast cancer at the population level. The present study examined the prevalence and correlates of awareness about the role of physical activity in breast cancer prevention among Japanese women.
Methods: 1,000 Japanese women aged 20-69 years (mean age: 44.3 +/- 13.4 years) who responded to an internet-based cross-sectional survey. Awareness of the role of physical activity in breast cancer prevention, knowledge of breast cancer (symptom, risk factor, screening), exposure to information about physical activity and cancer, a self-reported physical activity, and sociodemographic variables (age, marital status, having a child, education level, employment status, and household income) were obtained. Force-entry logistic regression analysis was used.
Results: The prevalence of awareness was 31.5% (95% CI: 28.6-34.4). Factors significantly associated with awareness included sociodemographic variables, exposure to information, and knowledge of breast cancer. Being married (AOR, 95% CI: 1.75, 1.05-2.92) was positively related to awareness, while having children (0.65, 0.36-0.86) was negatively related. College graduates or those with higher levels of education (1.50, 1.01-2.22) were significantly more likely to be aware than those who had not graduated high school. Moreover, exposure to information (2.11, 1.51-2.95), and high knowledge of symptoms (2.43, 1.75-3.36) were positively associated with awareness. Finally, low knowledge of risk factors (0.30, 0.22-0.40) was negatively associated with awareness.
Conclusions: Japanese women through internet-based study were poorly aware of the role of physical activity in breast cancer prevention. Awareness was especially low among individuals with children and higher knowledge of risk factors whereas high in married women, those with higher educational level, exposure to information, and greater knowledge of symptoms. The findings suggest that strategies to increase the awareness about the preventive role of physical activity are needed for breast cancer prevention in consideration of subgroups with low awareness.

Differences in recess physical activity (PA) according to perceived school environment among elementary school children were examined. Participants were 103 children from two schools in Japan. PA was measured using accelerometry for seven consecutive days. Time spent in sedentary or PA (light, moderate, or vigorous) during their morning recess (25 min) and lunch recess (15 min) was determined. The School Physical Activity Environment Scale (three factors: equipment, facility, and safety) was used to investigate perceived school environment. Environmental factor scores were assigned to low or high groups for each factor by median. An analysis of covariance, with grade as the covariate, was conducted separately by gender to examine differences in PA between two groups. During lunch recess, boys in the high-equipment group spent significantly more time in moderate PA (high: 1.5; low: 0.8 min) whereas girls in this group spent less time in light PA (9.3, 11.0). Boys in the high-facility group spent significantly less time in sedentary (2.3, 3.9) and more time in vigorous PA (2.4, 1.4) during lunch recess, and girls spent more time in moderate (2.1, 1.2) and vigorous PA (1.9, 1.3) during morning recess. Differences were observed in recess PA according to school environment perceptions. The present study may be useful for further intervention studies for the promotion of PA during recess.

【はじめに，目的】地域在住高齢者における足部痛に関連する能力障害（Disabling Foot Pain；DFP）の発生を効果的に予防する方法を明らかにするため，地域在住高齢者が実施する足部自己管理行動とDFP発生状況を分析したので報告する。【方法】地域在住高齢者346名（男性215名，女性131名，第1次調査時平均年齢（S.D.）は74.03（5.21）歳）を対象とした。第1次調査は郵送自記式質問紙調査を行い，人口統計学的指標，生活習慣（飲酒・喫煙・運動習慣），足部痛・DFPの有無（日本語版Manchester Foot Pain and Disability Index；以下MFPDI-Jにより判定），足部自己管理行動に関する項目（「毎日足の状態を観察していますか」等7項目），履き物の選択行動に関する項目（「踵がしっかりとした靴を履いていますか」等靴の種類に関する9項目と「試着をして履き心地を確認していますか」等選択行動に関する4項目）について尋ねた。第1次調査の8か月後に第2次調査として対面自記式質問紙調査を実施し，足部痛・DFPの有無（MFPDI-J）を尋ねた。第1次調査と第2次調査の回答から，DFPなし群，DFP発生群，DFP改善群，DFP持続群の4群に分類し，各群の足部自己管理行動に関する項目の実施数，履き物選択行動に関する項目の実施数について一元配置分散分析を行った。さらに第1次調査時にDFPがなかった271名を抽出し第2次調査時のDFPの有無を従属変数，第1次調査時の足部自己管理行動に関する項目，履き物選択行動に関する項目，運動習慣の有無を独立変数として，多重ロジスティック回帰分析を行った。【結果】DFP発生状況は，DFPなし群244名（70.5%），発生群27名（7.8%），改善群46名（13.3%），持続群25名（13.3%）であった。一元配置分散分析では足部自己管理行動の実施数において有意な差を認め（F=5.86，p＜.01），多重比較の結果，DFP持続群はDFPなし群に比べて足部自己管理行動の実施数が有意に高かった（DFP持続群平均3.79に対しDFPなし群2.14，p＜.01）。多重ロジスティック回帰分析の結果は，履物選択行動に関する項目のうち「デザインや価格以外の要素を考慮して靴を選んでいる」（Odds ratio 2.94，95%CI 1.08-7.97）と「日常的な運動習慣がある」（Odds ratio 0.33，95%CI 0.14-0.80）が有意にDFPの発生に関連した（p＜.05）。【結語】第1次調査時にDFPがあり8か月後にも持続する者の足部自己管理行動の実施数がむしろ多く，足部自己管理行動の実施数はDFP発生・改善に単純には影響しないことがわかった。一方，第1次調査時にDFPがない対象者のみの分析では，足部自己管理行動の実施数や履物選択行動の実施数はDFPの発生に有意な関連はなく，履物の選択時に履物の外観や価格以外の要素を考慮することと日常的に運動習慣があることがDFPの発生を有意に抑制できる可能性が示唆された。履物選択時に考慮するべき内容や習慣化するべき運動内容の仔細は本研究では明らかとならないため，今後の調査・分析の課題とする。

地域から無作為抽出した成人を対象に、加速度計および調査票を用い、身体活動・座位行動を網羅的に評価し、それらの指標を抑鬱症状との関連について包括的に検討した。分析対象者は343名(平均47.9±12.1歳)で全体の32%が大学卒または大学院卒、40%が世帯収入500万円以上、80%が既婚者/フルタイム・パートタイム就業者であった。また、全体の16%が喫煙者、23%が週5日以上飲酒すると回答した。脳梗塞、心臓病、癌の現病歴を持つ者は各0.6%、2.9%、3.2%であった。BMIによる判定では19%が過体重・肥満に該当した。抑鬱傾向を有する者は17.5%であった。対象者の平均加速度計装着日は7.0±1.1日(平日5.1±1.0日、休日2.0±0.5日)であった。平均装着時間は934.1±94.6分であった。客観的評価による中等度の強度以上平均身体活動時間および座位行動時間は各67.3±38.7分/日、360.3±98.2分/日であった。身体活動と抑鬱症状の関連は、中等度の強度以上の身体活動時間高値群は低値群と比べ抑鬱傾向と有意な負の関連が認められた。座位行動と抑鬱症状の関連は、総座位時間と抑鬱傾向に有意な関連は認められなかった。

Sedentary behavior, defined as participation in activities such as sitting and reclining during waking hours that do not increase energy expenditure substantially, has been gaining increased focus in physical activity research. In the last decade, sedentary behavior has emerged as a new risk factor for physical and mental health, independent of moderate to vigorous intensity physical activity. Especially, older adults spend most of their waking time in sedentary activities. Despite this high exposure, a broader base of evidence on sedentary behavior research in older adults has not yet been well reviewed. To inform future directions on sedentary behavior research among older adults, the present study provides the overview of the evidence from recently-published studies. This review includes evidence on the prevalence of objectively-measured and self-reported sedentary behaviors; the relationships with sedentary behavior (too much sitting) with multiple health outcomes; the effectiveness of interventions to reduce sedentary time and an overview of public health recommendations on reducing and breaking up sedentary time. Additional studies with high methodological quality are still needed to develop informed guidelines for addressing sedentary behavior in older adults.

School-based extracurricular sports activity (SBECSA) is a beneficial activity for positive youth development. However, there are some problems regarding the management of SBECSA, such as the lack of SBECSA teachers who can coach expertly and the great burden for SBECSA teachers. Although the number of external coaches has not been sufficient, recruiting external coaches into SBECSA has been focused on to help resolve these issues. For further effective recruitment of external coaches, approaching the community residents who have motivation to be external coaches is important. Nevertheless, the sociodemographics associated with the motivation still have not been explored. Therefore, the purpose of the present study was to clarify the sociodemographics of community residents who have motivation to become involved in SBECSA as external coaches (potential external coaches) . An Internet-based cross-sectional survey was conducted by a social survey company with 19506 registrants aged 20-69 years. Stratified random sampling was continued till 100 potential external coaches were collected for both genders and every age group. Coaching motivation as an external coach and six sociodemographics (gender, age, occupational status, marital status, teaching credential, and coaching credential) were obtained. As a statistical analysis, logistic regression analysis was performed. Overall, 19239 participants were included in the analysis and 5.9% of them had coaching motivation. Potential external coaches were significantly less likely to be females (OR = 0.42) , people in their 30s (OR = 0.63) , 40s (OR = 0.40) , 50s (OR = 0.30) , 60s (OR = 0.24) than males and people in their 20s. In addition, workers (OR = 1.49) , students (OR = 1.52) , married people (OR = 1.32) , those who have teaching credentials (OR = 1.60) and coaching credentials (OR = 8.13) were more likely to be external coaches. In conclusion, the present study clarified the sociodemographics of potential external coaches. It is suggested in recruiting external coaches into SBECSA, providing promotion strategies which take these sociodemographic factors into account would be effective.

&nbsp;&nbsp;Use of external coaches for school-based extracurricular sports activities has been promoted because of the lack of teachers who can coach expertly and the large burden placed on teachers when coaching and managing such activities. However, it has been reported that securing external coaches through human resources is difficult. To promote the use of external coaches, previous studies have suggested some possible strategies: 1) clarifying the role and status of external coaches, and promoting cooperative coaching with external coaches and teachers; 2) interactive collection and provision of information about external coaches and schools, and improving recognition of the mediation system; 3) improving the way external coaches are recruited, and setting a suitable trial period; 4) moderating institutional limitations for coaching frequency and number of coaches; and 5) holding workshops for external coaches. However, these suggestions were made from only an individual viewpoint (i.e. that of teachers, external coaches, and potential external coaches), and did not consider organizational perspectives. In Japan, there are some organizations that help recruitment of external coaches for school-based extracurricular sports activities. It is necessary to consider the opinions of these organizations to develop more realistic and concrete promotion strategies. Therefore, the present study explored in detail the trials, problems, challenges, and strategies of organizations in order to promote the recruitment of external coaches for school-based extracurricular sports activities. Face to face semi-structured interviews were conducted involving 15 individuals in 11 organizations (2 national and 4 prefectural organizations, 3 schools, 1 university, and 1 company) supporting the recruitment of external coaches for school-based extracurricular sports activities. The interviews contained questions asking details of the recruitment system, problems, challenges and management strategies. All interviews were audio-recorded with agreement from the participants. The transcript data were integrated into 7 trials and their details, problems, challenges, and strategies were described. The results indicated that in order to promote the engagement of external coaches, a number of factors were important, including building human relationships between external coaches and teachers led by teachers that could share information, interactive collection and provision of information through mediator and cooperation with other organizations, collecting information about external coaches and interviewing them before formal acceptance, keeping the coaching non-compensatory, holding workshops and creating feedback to promote communication and learning of external coaches, and considering the continuity of the trial. Knowledge of the various problems, challenges, and strategies from an organizational perspective would contribute to improvement of recruitment strategy. The results of the present study could also provide information that is beneficial for other organizations wishing to conduct similar trials.<br>

School-based extracurricular sports activity (SBECSA) is a beneficial activity for positive youth development. However, there are some problems regarding the management of SBECSA, such as the lack of SBECSA teachers who can coach expertly and the great burden for SBECSA teachers. Although the number of external coaches has not been sufficient, recruiting external coaches into SBECSA has been focused on to help resolve these issues. For further effective recruitment of external coaches, approaching the community residents who have motivation to be external coaches is important. Nevertheless, the sociodemographics associated with the motivation still have not been explored. Therefore, the purpose of the present study was to clarify the sociodemographics of community residents who have motivation to become involved in SBECSA as external coaches (potential external coaches) . An Internet-based cross-sectional survey was conducted by a social survey company with 19506 registrants aged 20-69 years. Stratified random sampling was continued till 100 potential external coaches were collected for both genders and every age group. Coaching motivation as an external coach and six sociodemographics (gender, age, occupational status, marital status, teaching credential, and coaching credential) were obtained. As a statistical analysis, logistic regression analysis was performed. Overall, 19239 participants were included in the analysis and 5.9% of them had coaching motivation. Potential external coaches were significantly less likely to be females (OR = 0.42) , people in their 30s (OR = 0.63) , 40s (OR = 0.40) , 50s (OR = 0.30) , 60s (OR = 0.24) than males and people in their 20s. In addition, workers (OR = 1.49) , students (OR = 1.52) , married people (OR = 1.32) , those who have teaching credentials (OR = 1.60) and coaching credentials (OR = 8.13) were more likely to be external coaches. In conclusion, the present study clarified the sociodemographics of potential external coaches. It is suggested in recruiting external coaches into SBECSA, providing promotion strategies which take these sociodemographic factors into account would be effective.

There has been a growing interest in dog ownership and walking as a unique and potential resource to provide physical activity for many individuals in the community. The present study reviewed current trends regarding the studies on dog ownership, dog walking, and human health, and clarified the future direction of research on the topic. There is evidence to suggest that it is not dog ownership itself, but rather dog-walking that contributes to increased physical activity and the likelihood of meeting public health guidelines for physical activity. Also, a growing body of literature indicates that dogs appear to provide an important form of social support, motivation, and obligation that encourages dog owners to walk. Regarding the environmental and policy-related factors associated with dog walking, some literature showed that access to a dog-supportive park/area or living in a walkable neighborhood seems to positively affect dog owners walking with their dog. The evidence is still limited on interventions for promoting dog owners walking with their dog. With the high level of dog ownership in many industrialized countries, further evaluation of physical activity, including dog walking and use of an accelerometer, identification of factors related to dog owners' regular/irregular dog walking by means of a longitudinal study, and implementation of an intervention study related to the promotion of physical activity among dog owners with a focus on dog walking are needed.

Objectives: Although physical activity reduces the risk of diseases such as cancer, diabetes and cardiovascular disease, a large proportion of the population is not sufficiently physically active. Therefore, the present study examined the environmental, social, and psychological correlates for meeting the 2 recommended physical activity criteria: &gt;= 420 min per week of at least moderate-intensity activity (MPA criterion) and &gt;= 210 min per week of vigorous activity (VPA criterion) for colon cancer prevention among Japanese adults.
Design: Cross-sectional study.
Methods: The sample included 2000 Japanese adults aged 20-79 years. An Internet-based survey was used to assess seven sociodemographic variables (e.g., education level, employment status), environmental variables (home fitness equipment, access to facilities, neighborhood safety, aesthetic sensibilities, and frequency of observing others exercising, residential area), social variables (social support), psychological variables (self-efficacy, perceived positive (pros) and negative (cons) aspects of exercise), and physical activity. The adjusted odds of meeting each physical activity criterion by these variables were calculated.
Results: Overall, 22.3% of the study population met the criterion of MPA, and 73% met the criterion of VPA. Having high self-efficacy, fewer perceived cons, possessing home fitness equipment, reporting enjoyable scenery, and living in a rural area were significantly associated with meeting the recommended criteria.
Conclusions: Participants who met the 2 activity recommendations differed by self-efficacy, cons, possession of home fitness equipment, reporting of enjoyable scenery, and residential area. These findings imply that strategies to promote more intense physical activities specifically in terms of these variables may be necessary for colon cancer prevention. Crown Copyright (C) 2013 Published by Elsevier Ltd on behalf of Sports Medicine Australia. All rights reserved.

Background: Concern over the health risks of sedentary behavior has highlighted the need to examine factors associated with screen-based (television/computer) sedentary behavior. The present study examined the association of screen-based sedentary behavior with body weight and sociodemographic attributes among Japanese adults.
Methods: A population-based cross-sectional study enrolled 1034 Japanese adults aged 40 to 69 years who lived in 2 Japanese cities. Sociodemographic variables, height, weight, and time spent on screen-based sedentary behavior were collected by self-administered questionnaire. Differences in screen time in relation to body mass index and weight gain since age 20 years were assessed by the Mann-Whitney U test. Independent associations of each variable with screen time were examined by forced-entry logistic regression analyses.
Results: Mean (SD) age and median (interquartile range) duration of screen time per week were 55.6 (8.4) years and 832.0 (368.8-1263.1) minutes, respectively, for men, and 55.3 (8.4) years and 852.6 (426.0-1307.5) minutes, respectively, for women. Screen time among participants with weight gain was longer than among those with a weight gain of less than 10 kg (P = 0.08). Unmarried and unemployed participants had longer screen times. Participants aged 40 to 49 years were less likely than older age groups to spend time on screen-based sedentary behavior during leisure hours.
Conclusions: The present findings imply that strategies are necessary to discourage screen-based sedentary behavior among all demographic groups, especially among adults who are elderly, unmarried, or unemployed.

BACKGROUNDPhysical activity is beneficial for adolescent health. The physical activity patterns of Japanese adolescents are relatively unknown. Therefore, this study aimed to describe the current patterns of physical activity and to identify sex and grade differences among them.
METHODSThe participants comprised 714 Japanese adolescents aged 12 to 15years old (boys N=372, girls N=342) from a public junior high school in Okayama, Japan. Physical activity at school, outside of school after hours, and during lunch recess as well as the total leisure time in a usual week was assessed with a 5-item questionnaire. To assess the differences in the physical activity patterns by sex and grade, independent t tests and analysis of variance (ANOVA) were conducted, respectively.
RESULTSBoys spent significantly more time in physical activity both inside and outside of school settings than girls (p&lt;.05). Higher grade students were significantly less active than lower grade students (p&lt;.05). Furthermore, the physical activity patterns across the grades differed between settings (at school, outside of school during the after-school period, lunchtime recess, and at home).
CONCLUSIONTo increase physical activity levels among Japanese adolescents, implementation of after-school programs or environmental modifications developed within the school setting could be effective strategies.

Promoting engagement of external coaches in school-based extracurricular sports activities (SBECSA) is valuable for positive youth development. However, the number of external coaches is insufficient. When trying to enhance recruitment and engagement of external coaches, registrants of sports leader banks are a good potential source of external coaches. Sports leader bank is an organization that registers community residents who can coach sports and introduces them to sports organizations that need coaching. Therefore, the purpose of the present study was to identify facilitators and barriers associated with engagement in SBECSA among registrants of sports leader banks. Participants were 12 registrants of four sports leader banks who were not currently engaging in SBECSA as external coaches. Data were obtained through personal semi-structured interviews and analyzed using the KJ method that is one of qualitative analysis. As results, facilitators were categorized into four large (benefit, system, environment, and motivation), 15 middle, and 42 small categories and barriers were categorized into four large (burden, system, environment, and lack of motivation), 15 middle, and 44 small categories. Findings suggested some ways of improving the situation with external SBECSA coaches, such as developing the insurance system, promoting information about the characteristics of coaches, and encouraging schools to accept these coaches. Recruitment and engagement of external coaches can be promoted by enhancing these facilitators and reducing barriers.

Background : The purpose of the present study was to develop a school physical activity environment scale and to examine the relationship between school physical activity environment and school physical activity among Japanese elementary school children. Methods : Internet-based cross-sectional survey was conducted to 1,074 Japanese guardians who had elementary school children. Sociodemographic attributes,school physical activity environment scale and time of physical activity at school for a usual lunch time recess and after school were assessed. Results：Exploratory factor analyses identified 3 factors (equipment,facility, and safety). Confirmatory factor analyses to examine the factorial validity revealed acceptable fit indices and the reliability of the scale was acceptable. Those who perceived good these environments were significantly more likely to be physically active in school. Conclusion：The school physical activity environment scale was developed in the present study and demonstrated acceptable factorial validity,internal consistency and inter-rater reliability.

子どもの身体活動および座位活動がメンタルヘルスに及ぼす影響について検討した。幼稚園、小学校、中学校を対象としたコホート研究におけるデータの一部を解析した。2010年度初回調査と2012年度調査のデータを使用した。身体活動および座位活動の実施は、2年後のメンタルヘルスや身体活動および座位活動にも関連があることが示された。現在の身体活動および座位活動は、現在のメンタルヘルスのみならず2年後のメンタルヘルスと相関関係を認めた。男子においては、現在の身体活動時間が長いと現在および2年後のメンタルヘルスが良好であることが示された。女子では現在の身体活動時間が長いと現在および2年後の自己効力感は良好であるが、行動は良好ではないことが示された。また、現在の座位活動時間が長いことは女子の2年後の不安傾向および行動、また現在の行動が、男子においては、2年後の自己効力感が良好ではないことが示された。

Background: In contemporary society, prolonged sitting has become pervasive in our lives across many settings, including transportation, the workplace, and the home. There is a rapidly accumulating evidence that large volumes of daily sedentary time (typically in the contexts of television viewing, computer use, workplace sitting, and time spent in automobiles) are adversely associated with cardio-metabolic risk biomarkers, type 2 diabetes, some types of cancer, and premature mortality. Importantly, these detrimental associations remain even after accounting for time spent in physical activity. To inform future directions on sedentary behavior research among adults, the present paper reviews the evidence from recently-published studies, applying the behavioral epidemiology framework.Contents: This review includes evidence on the relationships with sedentary behavior (too much sitting) with health risk indicators; self-report and device-based measurement of sedentary behaviors; the prevalence and trends for key sedentary behaviors; an ecological model and the environmental correlates of sedentary behavior; the effectiveness of interventions to reduce sedentary time; and, an overview of public health recommendations on reducing and breaking up sedentary time.Conclusions: Future directions for sedentary behavior research are as follows: population-based prospective studies using device-based measures to better understand the impact of sedentary time on health outcomes, prospective studies to clarify the multiple levels of determinants of prolonged sitting time in different life settings, further intervention trials to reduce and break up sedentary behaviors in domestic, workplace, and transportation environments, translational research (such as mass media campaigns) to spread messages about reducing sitting time in daily life, and experimental studies to determine underlying mechanisms and dose-response relationships.

Background: In rapidly developing Internet-user societies, eHealth literacy has become important in promoting wellness. Although previous studies have observed that poor health literacy is associated with less knowledge and screening practice of colorectal cancer (CRC), little is known about whether eHealth literacy is associated with these variables.
Objective: The present study examined associations between eHealth literacy, knowledge of CRC, and CRC screening practices.
Methods: Data were analyzed for 2970 Japanese adults (men, 49.9%; mean age +/- SD, 39.7 +/- 10.9 years) who responded to an Internet-based cross-sectional survey. Knowledge of the definition of CRC, its risk factors and screening practice, previous experience of CRC screening, score on the Japanese version of the eHEALS (J-eHEALS), sociodemographic attributes (sex, age, marital status, educational attainment, and household income level), and frequency of Internet usage were obtained. Sociodemographic attributes and frequency of Internet usage were used as control variables in the multiple regression and logistic regression models.
Results: eHealth literacy was positively associated with CRC knowledge (beta = .116, &lt; .001), when the covariables of both eHealth literacy and CRC knowledge were used in the multiple regression model. Moreover, after controlling for sociodemographic factors, which were significantly associated with eHealth literacy and CRC screening practice, an increase of 1 point in the eHEALS score signified that participants were 1.03 times (95% CI = 1.01-1.05) more likely to undergo CRC screening.
Conclusions: Internet users with high eHealth literacy are more likely to have knowledge and previous screening practice related to CRC compared to those with low eHealth literacy. (J Med Internet Res 2012;14(6):e153) doi:10.2196/jmir.1927

Background: It is still not known whether overweight men have different patterns and socio-demographic correlates of self-reported physical activity (PA) compared with normal-weight men. Thus, this study examined the perceived PA patterns and associated socio-demographic factors among normal-weight and overweight Japanese men.
Methods: Data were analyzed for 1,420 men (aged 44.4 +/- 8.3 years) who responded to an Internet-based cross-sectional survey relating to socio-demographic variables, BMI status, and a short version of the International Physical Activity Questionnaire. Mann-Whitney, chi-square, and binary logistic regression analyses were employed.
Results: Normal-weight men were significantly more likely to attain 150 minutes per week of moderate-to-vigorous PA than overweight men (26.6 % vs. 21.3 %; p = 0.035), whereas there were no significant proportional differences in total PA and walking between the two BMI subgroups. With PA, a significant interaction was observed between BMI status and household income (p = 0.004 for total PA; p = 0.02 for walking). In the subgroup analyses, having a lower household income (odds ratio, 0.63; 95 % confidence interval, 0.41-0.96) was negatively associated with attaining 150 minutes of walking per week among normal-weight men. No significant associations between household income and attaining 150 minutes per week of total PA and walking were found among overweight men.
Conclusions: The results revealed that patterns and socio-demographic correlates of self-reported PA in overweight men are different from those in normal-weight men. This finding suggests the necessity of developing specific strategies for PA intervention among overweight men. Socio-demographic correlates of PA may be more important for normal-weight than overweight men.

Engaging in physical activity was proved to have positive effects on physical and mental health in children. Built environment is an important correlate of physical activity participation. School recess provides a daily opportunity for children to be active during school day. Therefore, the purpose of the present article was to review literatures regarding 1) physical activity during school recess, 2) the relationship between recess physical activity and school physical environment, 3) intervention for physical activity promotion during recess by changing school physical environment, and to explore trends of current researches and assignments of future research. A review was conducted and included studies published to May 31, 2011. Twenty-two studies were selected in 1) and showed boys often engaged in more physical activity than girls, but the results on differences in physical activity between ages were inconsistent. Six studies were selected in 2) and indicated recess physical activity was associated with playground environments such as equipments, marking, and surface situate. School environment intervention was observed to be a potential method for promoting physical activity in children by 8 studies in 3). Playground environment with marking, additional play equipments, and designated activity zones increased physical activity during recess. Most researches regarding recess physical activity was conducted in U.S., Australia, and Western countries, and confirmed the effectiveness of recess to promote physical activity. However, few studies on this topic were conducted in Japan. Further researches are needed to draw a conclusion about the possibility of recess to promote physical activity among Japanese children.

The dose-response association between physical activity (PA) and obesity is well-established; however, the correlates of PA among overweight and obese populations require clarification. Therefore, the purpose of this study was to review the correlates of PA among overweight and obese populations. Literature searches were conducted for English and Japanese-language published articles, between Jan 2000 and Dec 2010, using "PubMed", "Medline", "Psycinfo" and the "Japan Medical Abstract Society". A total of nine eligible articles were included in the analysis: five studies compared the PA correlates between normal-weight and overweight/obese populations; and four studies examined PA correlates in overweight/obese populations. Consistent correlates of PA among overweight and obese populations were age, self-efficacy, social support, perceived good access to facilities, and seeing people being active in the neighborhood. For obesity prevention, particularly in non-Western countries, further research is required with the purpose of developing effective PA interventions among overweight and obese populations. Future studies should examine both perceived and objectively-assessed environmental factors associated with specific PA behavior.

Objective: Environmental factors are related to physical activity among youth on a long-term. The purpose of the present study was to develop a neighborhood physical activity environment scale and to examine the relationship between neighborhood physical activity environment and out-side of school physical activity and school commuting among Japanese elementary students.Methods: Internet-based survey was administered to 1,074 Japanese guardians aged 20-59 years who had elementary school child. Sociodemographic attributes (gender and age of guardians, gender, age, hight and weight of children), neighborhood physical activity environment scale including 16 items and time of physical activity during out-side of school for leisure and walking to school commuting were assessed by the self-administered questionnaire.Results: Exploratory factor analyses identified 4 factors labeled "safety" with 5 items, "pleasing aesthetic" with 4 items, "crime safety" with 2 items and "uncomfortable aesthetic" with 2 items. Confirmatory factor analyses to examine the construct validity revealed acceptable fit indices (GFI = 0.969, AGFI = 0.949, RMSEA = 0.052, AIC = 288.360). The reliability of the subscale was found good internal consistency (r = 0.67-0.79) and moderately high inter-rater reliability (r = 0.55-0.68). Those who perceived good "safety", "pleasing aesthetic" and "uncomfortable aesthetic" environments were significantly more likely to spent of physical activity during out-side of school for leisure and school commuting.Conclusion: The valid and reliable neighborhood physical activity environment scale was developed and it is applicable to the assessment of neighborhood environmental perceptions relevant to physical activity in Japanese elementary school children.

Engaging in physical activity was proved to have positive effects on physical and mental health in children. Built environment is an important correlate of physical activity participation. School recess provides a daily opportunity for children to be active during school day. Therefore, the purpose of the present article was to review literatures regarding 1) physical activity during school recess, 2) the relationship between recess physical activity and school physical environment, 3) intervention for physical activity promotion during recess by changing school physical environment, and to explore trends of current researches and assignments of future research. A review was conducted and included studies published to May 31, 2011. Twenty-two studies were selected in 1) and showed boys often engaged in more physical activity than girls, but the results on differences in physical activity between ages were inconsistent. Six studies were selected in 2) and indicated recess physical activity was associated with playground environments such as equipments, marking, and surface situate. School environment intervention was observed to be a potential method for promoting physical activity in children by 8 studies in 3). Playground environment with marking, additional play equipments, and designated activity zones increased physical activity during recess. Most researches regarding recess physical activity was conducted in U.S., Australia, and Western countries, and confirmed the effectiveness of recess to promote physical activity. However, few studies on this topic were conducted in Japan. Further researches are needed to draw a conclusion about the possibility of recess to promote physical activity among Japanese children.

Background: Depression, a common mental illness, has a high global incidence. Regular physical activity at recommended levels is inversely associated with depression
however, this association has not yet been studied in the Japanese population. The present study examines the association between recommended physical activity criteria and depression, and depression score differences between physical activity groups and sociodemographic variables among Japanese adults. Methods: Sociodemographic data (gender, age, educational level, employment status, marital status, living conditions, and household income), the Japanese short version of the International Physical Activity Questionnaire (IPAQ), and the Center for Epidemiologic Studies Depression Scale were used to estimate the participants' physical activity and depression levels, respectively, via an Internet-based survey. A representative sample of 3000 Japanese adults answered the survey, stratified by gender and age. The present study followed current Japanese exercise guidelines to categorize respondents as "meeting" or "not meeting" the recommended criteria. Analysis of covariance, logistic regression, and two-way univariate analysis of covariance were performed. Results: Respondents not meeting the recommendations for physical activity had significantly higher depression scores than those meeting the recommendations. Individuals not meeting the recommended criteria had significantly higher depression scores than those meeting the criteria across the following variables: age, marital status, living conditions, and household income in men
and age, marital status, education level, employment status, and household income in women. Men who were unmarried and had low household income levels and women who were young, unmarried, and had lower household income levels had higher depression scores. Conclusion: The present study is one of the first studies to report on the cross-sectional associations among depression scores, physical activity levels, and various sociodemographic factors in the Japanese population. © 2011 Elsevier Ltd. All rights reserved.

Background: Although both insufficient physical activity (PA) and high screen time (ST) are independent risk factors for obesity, how the combination of sufficient/insufficient PA and high/low ST could increase obesity risk among the adult population of Japan is not known. This study examined joint associations of PA and ST with overweight among Japanese adults.
Methods: An Internet-based survey collected data on height, weight, self-reported time spent in PA and ST, and sociodemographic variables from 2832 adults. Respondents were categorized into sufficient PA/low ST, sufficient PA/high ST, insufficient PA/low ST, or insufficient PA/high ST categories as per public PA guidelines and the median of ST. Logistic regression analysis examined the odds ratios (OR) of being overweight (body mass index, &gt;= 25 kg/m(2)) according to the categories of PA and ST.
Results: In comparison with the sufficient PA/low ST category, participants in the insufficient PA/high ST category were significantly more likely overweight (OR, 1.48; 95% confidence interval [95%CI), 1.14, 1.93) after adjusting for sociodemographic variables. A significantly higher OR for overweight (including obesity) among insufficient PA/high ST category was also observed in men, but no significant association was found in women.
Conclusions: Both insufficient PA and prolonged ST contribute to overweight and obesity among Japanese adults. Public health initiatives addressing obesity in Japan need to consider both promoting PA and reducing ST, especially in men.

Background: Although physical activity is associated with a lower risk of colon cancer, few studies have described the physical activity required for colon cancer prevention in various sociodemographic subgroups. The current study examined the prevalence and sociodemographic correlates of attaining the 2 recommended physical activity criteria for colon cancer prevention among Japanese adults. Methods: The sample included 5322 Japanese adults aged 20 to 79 years. Seven sociodemographic attributes (eg, gender, age, education level, employment status) and the International Physical Activity Questionnaire were assessed via an Internet-based survey. The odds of meeting each physical activity criterion by sociodemographic variables were calculated. Results: Overall, 23.8% of the study population met the criterion of &gt;= 420 minutes of moderate-intensity activity, and 6.4% met the criterion of &gt;= 210 minutes of vigorous activity. Being male, highly educated, employed, living with another person, being married and having a higher household income were significantly correlated with the attainment of recommendations. Conclusions: Participants who met the 2 activity recommendations differed in gender, education level, employment status, marital status, living conditions, and household income. The findings of the current study imply that strategies to promote more intense physical activity in all demographic groups may be necessary.

Objective: The purpose of this study was to clarify the process of shaping partnerships for developing and implementing a system of walking groups as a health promotion effort.Methods: We conducted a semi-structured interview with two public health nurses who were responsible for the IC-Walk program implemented by the Department of Health Promotion in M City and also performed document analysis regarding the program. Qualitative analysis was used to capture perspectives related to partnership formation processes by extracting codes, subcategories, and categories from interview transcripts and the documents.Results: Eighteen identified codes for shaping partnerships were grouped into nine subcategories ("mayors," "parties," "conferences," "groups," budget from sections beyond health," "subsidy," "private sector," "intersectoral collaboration within the government," and "intersectoral collaboration without the government"). Four categories were then abstracted: "political decision," "programs," "organization," and "budget". Finally, a structured model showed the relationships among the categories, taking into consideration the process of shaping partnerships.Conclusions: This study presented a structured model of the process of shaping partnerships for a municipal health promotion program. The model indicated that administrators' awareness and behavior contributed to the shaping of partnerships.

The authors examined the relationship between strength-training behavior and perceived environment in older Japanese adults. An Internet-based survey was conducted of 293 adults age 68.2 +/- 2.8 yr. The dependent variable was regular strength-training behavior. The IPAQ environment module, access to facilities for strength training, and home equipment for strength training were environmental factors. Logistic-regression analysis was employed. After demographic variables (gender, age, educational background, household income, body-mass index, self-rated health status, smoking habit, and residential area) were adjusted for, home equipment for strength training (OR = 2.14, 95% CI = 1.50-3.06), access to facilities for strength training (OR = 2.53, 95% CI = 1.32-4.85), and observing active people (OR = 2.20, 95% CI = 1.06-4.58) were positively correlated with regular strength-training behavior. In conclusion, environmental factors associated with strength-training behavior were access to facilities for strength training, having home equipment for strength training, and observing active people.

OBJECTIVES: With the rapid developing an internet society, ehealth literacy, defined as the ability to seek, find, understand, and appraise and apply the knowledge gained to addressing or solving a health problem, becomes important to promote and aid health care at the individual level. However, the eHealth Literacy Scale (eHEALS) was only a scale developed to assess the ehealth literacy. Thus, the present study was conducted to evaluated the validity and reliability of a Japanese version of the eHEALS (J-eHEALS), and examine the association of ehealth literacy with demographic attributes and characteristics on health information searching among Japanese adults. METHODS: Data were analyzed for 3,000 Japanese adults (males: 50.0%,mean age: 39.6 + 10.9 years) who responded to an Internet-based cross-sectional survey. The J-eHEALS, 6 demographic attributes, resources for obtaining health information (health resources), and contents of health information obtained from internet (ehealth contents) were obtained with a questionnaire. Confirmatory factor analysis and correlation with the communicative and critical health literacy scale were utilized to assess construct validity and criterion validity. Cronbach alpha and correlation coefficients were computed for internal consistency and test-retest reliability. Also, differences in J-eHEALS scores with each demographic attribute were examined with ANOVA and the independent t-test. Finally, chi-square tests were used to determine differences in the proportions of ehealth literacy groups (high or low) classified with a median split within health resources and ehealth contents. RESULTS: Principal components analysis produced a single factor solution and confirmatory factor analysis for the 8-items model demonstrated high indices (GFI = .988, CFI = .993, RMSEA= .056). A significant positive correlation was found between the J-eHEALS and communicative and critical health literacy scores. Cronbach alpha was 0.93 (P < .01), and test-retest reliability was r = 0.63 (P < .01). The J-eHEALS scores were significantly higher in women, the 40-and 50-year age group, those with high income, and individuals with a high frequency of internet searching. Furthermore, the high ehealth literacy group used many health resources and obtained a greater variety of ehealth contents as compared with the low literacy group. The most frequent resource was the internet in the high group, and television/radio in the low group. However, these results could be subject to bias because of the non-representative nature of the Internet population. CONCLUSION: The results indicate the J-eHEALS to be a highly validated and reliable scale. The present study suggests that enhancement of ehealth literacy will be important to utilize the increasing amount of health information on the internet effectively and appropriately.

Although it is crucial to examine the environmental correlates of physical activity (PA) for developing more effective interventions for overweight populations, limited studies have investigated differences in the environmental correlates on body mass index (BMI). The purpose of the present study was to examine the perceived environmental correlates of PA among normal-weight and overweight Japanese men. Data were analyzed for 1,420 men (aged 44.4 +/- 8.3 years), who responded to an internet-based cross-sectional survey of answering the short version of the International Physical Activity Questionnaire and its Environment Module. Binary logistic regression analyses were utilized to examine the environmental factors associated with meeting the PA recommendation (150 minutes/week) between the normal-weight and overweight men. After adjusting for socio-demographic variables, common and different environmental correlates of PA were observed among normal-weight and overweight men. Furthermore, significant interactions regarding PA were observed between BMI status and two environmental correlates: access to public transportation (P = 0.03) and crime safety during the day (P = 0.01). The results indicated that BMI status is a potential moderator between perceived environmental factors and PA and suggested that different environmental intervention approaches should be developed for overweight populations.

Background Psychological, social, and environmental factors are important determinants for physical activity promotion. There are numerous studies of the direct effects of these factors on physical activity. However, only a few studies have been examined the direct and mediated effects of these factors on physical activity.
Purpose The purpose of the present study was to examine the direct and indirect influences of psychological, social, and environmental factors on physical activity among Japanese adults.
Methods An internet-based cross-sectional survey was conducted to 2,000 Japanese adults aged 20-79 years. Seven sociodemographic attributes (e. g., gender, age, and marital status), self-efficacy, pros and cons, social support for exercise and environmental variables (home fitness equipment, access to facilities, neighborhood safety, aesthetics, seeing others exercising) were assessed by a self-administered questionnaire. The physical activity was estimated from the Japanese version of the short form of the International Physical Activity Questionnaire. Data were analyzed using structural equation modeling by gender.
Results The respondents&apos; mean (SD) age was 43.6(13.0). Environmental factors had indirect effects on physical activity through self-efficacy, social support and pros and cons. On both gender, the strongest indirect effects was the path of environmental factors on physical activity through pros to self-efficacy. The total effects of environmental factors on physical activity were 0.06 of males and 0.04 of females.
Conclusion The results indicate that environmental factors had indirect effects on physical activity through psychological and social factors among Japanese adults. These results could contribute to the development of physical activity promotion strategies in Japan. (Jpn. J. Phys. Fitness Sports Med. 2011, 60 89 similar to 97)

Background: Psychological, social, and environmental factors are important determinants for physical activity promotion. There are numerous studies of the direct effects of these factors on physical activity. However, only a few studies have been examined the direct and mediated effects of these factors on physical activity. Purpose: The purpose of the present study was to examine the direct and indirect influences of psychological, social, and environmental factors on physical activity among Japanese adults. Methods: An internet-based cross-sectional survey was conducted to 2,000 Japanese adults aged 20-79 years. Seven sociodemographic attributes (e. g., gender, age, and marital status), self-efficacy, pros and cons, social support for exercise and environmental variables (home fitness equipment, access to facilities, neighborhood safety, aesthetics, seeing others exercising) were assessed by a self-administered questionnaire. The physical activity was estimated from the Japanese version of the short form of the International Physical Activity Questionnaire. Data were analyzed using structural equation modeling by gender. Results: The respondents' mean (SD) age was 43.6(13.0). Environmental factors had indirect effects on physical activity through self-efficacy, social support and pros and cons. On both gender, the strongest indirect effects was the path of environmental factors on physical activity through pros to self-efficacy. The total effects of environmental factors on physical activity were 0.06 of males and 0.04 of females. Conclusion: The results indicate that environmental factors had indirect effects on physical activity through psychological and social factors among Japanese adults. These results could contribute to the development of physical activity promotion strategies in Japan.

Background Psychological, social, and environmental factors are important determinants for physical activity promotion. There are numerous studies of the direct effects of these factors on physical activity. However, only a few studies have been examined the direct and mediated effects of these factors on physical activity.
Purpose The purpose of the present study was to examine the direct and indirect influences of psychological, social, and environmental factors on physical activity among Japanese adults.
Methods An internet-based cross-sectional survey was conducted to 2,000 Japanese adults aged 20-79 years. Seven sociodemographic attributes (e. g., gender, age, and marital status), self-efficacy, pros and cons, social support for exercise and environmental variables (home fitness equipment, access to facilities, neighborhood safety, aesthetics, seeing others exercising) were assessed by a self-administered questionnaire. The physical activity was estimated from the Japanese version of the short form of the International Physical Activity Questionnaire. Data were analyzed using structural equation modeling by gender.
Results The respondents&apos; mean (SD) age was 43.6(13.0). Environmental factors had indirect effects on physical activity through self-efficacy, social support and pros and cons. On both gender, the strongest indirect effects was the path of environmental factors on physical activity through pros to self-efficacy. The total effects of environmental factors on physical activity were 0.06 of males and 0.04 of females.
Conclusion The results indicate that environmental factors had indirect effects on physical activity through psychological and social factors among Japanese adults. These results could contribute to the development of physical activity promotion strategies in Japan. (Jpn. J. Phys. Fitness Sports Med. 2011, 60 89 similar to 97)

OBJECTIVES:With the rapid developing an internet society, ehealth literacy, defined as the ability to seek, find, understand, and appraise and apply the knowledge gained to addressing or solving a health problem, becomes important to promote and aid health care at the individual level. However, the eHealth Literacy Scale (eHEALS) was only a scale developed to assess the ehealth literacy. Thus, the present study was conducted to evaluated the validity and reliability of a Japanese version of the eHEALS (J-eHEALS), and examine the association of ehealth literacy with demographic attributes and characteristics on health information searching among Japanese adults.;METHODS:Data were analyzed for 3,000 Japanese adults (males: 50.0%,mean age: 39.6 + 10.9 years) who responded to an Internet-based cross-sectional survey. The J-eHEALS, 6 demographic attributes, resources for obtaining health information (health resources), and contents of health information obtained from internet (ehealth contents) were obtained with a questionnaire. Confirmatory factor analysis and correlation with the communicative and critical health literacy scale were utilized to assess construct validity and criterion validity. Cronbach alpha and correlation coefficients were computed for internal consistency and test-retest reliability. Also, differences in J-eHEALS scores with each demographic attribute were examined with ANOVA and the independent t-test. Finally, chi-square tests were used to determine differences in the proportions of ehealth literacy groups (high or low) classified with a median split within health resources and ehealth contents.;RESULTS:Principal components analysis produced a single factor solution and confirmatory factor analysis for the 8-items model demonstrated high indices (GFI = .988, CFI = .993, RMSEA= .056). A significant positive correlation was found between the J-eHEALS and communicative and critical health literacy scores. Cronbach alpha was 0.93 (P < .01), and test-retest reliability was r = 0.63 (P < .01). The J-eHEALS scores were significantly higher in women, the 40-and 50-year age group, those with high income, and individuals with a high frequency of internet searching. Furthermore, the high ehealth literacy group used many health resources and obtained a greater variety of ehealth contents as compared with the low literacy group. The most frequent resource was the internet in the high group, and television/radio in the low group. However, these results could be subject to bias because of the non-representative nature of the Internet population.;CONCLUSION:The results indicate the J-eHEALS to be a highly validated and reliable scale. The present study suggests that enhancement of ehealth literacy will be important to utilize the increasing amount of health information on the internet effectively and appropriately.

Objective:The present study examined physical activity(PA)levels and differences in PA by gender and grades during school recess periods. Method:PA levels of two hundred and thirty children(55% boys, 42%younger)from two elementary schools in Japan were measured with accelerometry for seven consecutive days. Time spent in sedentary, light PA, moderate PA, vigorous PA during break(25 minutes)and lunch recess(15 minutes), and total recess(40 minutes)was determined. Two-way analysis of variance was used to examine differences in PA variables by gender and grades. Results:Data of one hundred and eighty four children(52% boys, 56% younger)was available. Time spent in sedentary, light PA, moderate PA, and vigorous PA was 8.5±4.9, 12.9±3.8, 1.6±1.2, and 2.9±2.8 minutes during break, and 3.5±2.5, 9.5±2.2, 1.4±0.9, and 1.6±1.4 minutes during lunch recess, respectively. There were no significant interactions between gender and grades. Significant main effects of PA variables were found for gender and grades. Boys had fewer sedentary time(p=0.017)and higher vigorous PA time(p<0.001)than girls during total recess. Younger engaged in more sedentary(p=0.045)and less light(p=0.023)and moderate PA(p=0.006)than older at break. On the other hand, at lunch recess, younger had significantly longer light(p=0.015)and vigorous PA(p<0.001)and shorter sedentary time(p<0.001)than older. Conclusion:Overall, boys were less sedentary and engaged in PA at higher intensity levels than girls during school recess. Different pattern in PA was shown between break and lunch recess by grades.

The present case study evaluated an environment-focused project for promoting walking, which included the development of walking courses (using public spaces, parks, roads) with stations for smart cards in the community and an interfaced internet-based self-monitoring system. The project was started in 2008 in Misato City of Saitama Prefecture. In this project, individuals can participate by paying a registration fee (500 yen) and obtaining their own cards. If registrants walk the course, holding their cards over a scanner at 3-4 stations, the smart card records their data (e.g. distance and time spent in walking) from one to the other station and transfers these to a self-monitoring system. As a result, registrants could check their data online. From June 2008 to November 2009, a total of 631 individuals (62% female) who obtained the information from newspaper, magazines, website, or some local events, registered for this project. From walking data collected automatically in the database through the self-monitoring system, it was found that 445 registrants (63% female) used this system at least once, and most of the registrants were 40 years old or more. This suggests that the project in this study might have been effective in promoting walking only among older people. Also, most of the registrants lived around the courses. In particular, the courses in the area surrounded by beautiful nature and residential areas were often used. To expand this idea to other age groups, new attempts, including a point supplying system based on the distance of walking are under development.

The present case study evaluated an environment-focused project for promoting walking, which included the development of walking courses (using public spaces, parks, roads) with stations for smart cards in the community and an interfaced internet-based self-monitoring system. The project was started in 2008 in Misato City of Saitama Prefecture. In this project, individuals can participate by paying a registration fee (500 yen) and obtaining their own cards. If registrants walk the course, holding their cards over a scanner at 3-4 stations, the smart card records their data (e.g. distance and time spent in walking) from one to the other station and transfers these to a self-monitoring system. As a result, registrants could check their data online. From June 2008 to November 2009, a total of 631 individuals (62% female) who obtained the information from newspaper, magazines, website, or some local events, registered for this project. From walking data collected automatically in the database through the self-monitoring system, it was found that 445 registrants (63% female) used this system at least once, and most of the registrants were 40 years old or more. This suggests that the project in this study might have been effective in promoting walking only among older people. Also, most of the registrants lived around the courses. In particular, the courses in the area surrounded by beautiful nature and residential areas were often used. To expand this idea to other age groups, new attempts, including a point supplying system based on the distance of walking are under development.

Background: An understanding of the contributing factors to be considered when examining how individuals engage in physical activity is important for promoting population-based physical activity. The environment influences long-term effects on population-based health behaviors. Personal variables, such as self-efficacy and social support, can act as mediators of the predictive relationship between the environment and physical activity. The present study examines the direct and indirect effects of environmental, psychological, and social factors on walking, moderate-intensity activity excluding walking, and vigorous-intensity activity among Japanese adults.
Methods: The participants included 1,928 Japanese adults aged 20-79 years. Seven sociodemographic attributes (e. g., gender, age, education level, employment status), psychological variables (self-efficacy, pros, and cons), social variables (social support), environmental variables (home fitness equipment, access to facilities, neighborhood safety, aesthetic sensibilities, and frequency of observing others exercising), and the International Physical Activity Questionnaire were assessed via an Internet-based survey. Structural equation modeling was conducted to determine associations between environmental, psychological, and social factors with physical activity.
Results: Environmental factors could be seen to have indirect effects on physical activity through their influence on psychological and social variables such as self-efficacy, pros and cons, and social support. The strongest indirect effects could be observed by examining the consequences of environmental factors on physical activity through cons to self-efficacy. The total effects of environmental factors on physical activity were 0.02 on walking, 0.02 on moderate-intensity activity excluding walking, and 0.05 on vigorous-intensity activity.
Conclusions: The present study indicates that environmental factors had indirect effects on walking, moderate-intensity activity excluding walking and vigorous-intensity activity among Japanese adults, especially through the effects on these factors of self-efficacy, social support, and pros and cons. The findings of the present study imply that intervention strategies to promote more engagement in physical activity for population-based health promotion may be necessary.

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.

Background: Understanding the long-term effects of environment on health behavior is important for the promotion of population-based physical activity.
Purpose: The purpose of this study was to examine the relationship between perceived environment and active commuting among Japanese adults.
Methods: Internet-based cross-sectional survey were conducted to 3,000 Japanese adults aged 30-59 years. Seven sociodemographic attributes (gender, age, marital status, employment status, living status, educational attainment and household income), type of commute and International Physical Activity Questionnaire Environment Module were assessed by self-administered questionnaire.
Results: Of all respondents to the survey, 2,032 (mean age: 43.8 +/- 9.2, male: 62.5%) were employed. Those who use an active commute were 1,401 (68.9%). In both genders, high residential density (male: OR=2.28, female: OR=3.08), good access to shops (OR=2.03, 3.06), public transportation (OR=1.65, 3.78), recreational facilities (OR=1.31, 1.44), presence of sidewalks (OR=1.42, 1.77), crossroads (OR=1.87, 1.76), having a destination (OR=1.84, 2.34), and not having household vehicles (OR=15.13, 41.24) were associated with an active commute. The results indicated some gender differences. Among male, the presence of a bicycle lane and good aesthetics was positively associated with the active commute, while traffic safety was negatively associated. On the-other hand, crime safety was associated with the active commute in female.
Conclusion: The results indicate that perceived environment was associated with the active commute among Japanese adults. (Jpn. J. Phys. Fitness Sports Med. 2010, 59: 215 similar to 224)

Background: Understanding the long-term effects of environment on health behavior is important for the promotion of population-based physical activity.
Purpose: The purpose of this study was to examine the relationship between perceived environment and active commuting among Japanese adults.
Methods: Internet-based cross-sectional survey were conducted to 3,000 Japanese adults aged 30-59 years. Seven sociodemographic attributes (gender, age, marital status, employment status, living status, educational attainment and household income), type of commute and International Physical Activity Questionnaire Environment Module were assessed by self-administered questionnaire.
Results: Of all respondents to the survey, 2,032 (mean age: 43.8 +/- 9.2, male: 62.5%) were employed. Those who use an active commute were 1,401 (68.9%). In both genders, high residential density (male: OR=2.28, female: OR=3.08), good access to shops (OR=2.03, 3.06), public transportation (OR=1.65, 3.78), recreational facilities (OR=1.31, 1.44), presence of sidewalks (OR=1.42, 1.77), crossroads (OR=1.87, 1.76), having a destination (OR=1.84, 2.34), and not having household vehicles (OR=15.13, 41.24) were associated with an active commute. The results indicated some gender differences. Among male, the presence of a bicycle lane and good aesthetics was positively associated with the active commute, while traffic safety was negatively associated. On the-other hand, crime safety was associated with the active commute in female.
Conclusion: The results indicate that perceived environment was associated with the active commute among Japanese adults. (Jpn. J. Phys. Fitness Sports Med. 2010, 59: 215 similar to 224)

Built environment is an important correlate of physical activity participation. Understanding the long-term effects of environment on health behavior is necessary for the promotion of population-based physical activity. However, most studies assessing the relationships between physical activity and environment have been conducted in the United States and Australia. The present study reviews Japanese researches on built environment and physical activity, and discusses the applicability of the built environment on promoting physical activity among Japanese adults. A review was conducted by searching the PubMed and Ichushi electronic database from inception to Sept 24, 2009. Eligible articles were identified as follows : 2 studies that developed the environment scale ; 10 studies that assessed the relationships with physical activity and built environment. There have been only a limited number of studies which were conducted with Japanese adults, thus more researches are needed to draw conclusions about the built environment associated with physical activity.

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.<BR>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.<BR>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.<BR>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.

Background: Understanding the long-term effects of environment on health behavior is important for the promotion of population-based physical activity. Purpose: The purpose of this study was to examine the relationship between perceived environment and active commuting among Japanese adults. Methods: Internet-based cross-sectional survey were conducted to 3,000 Japanese adults aged 30-59 years. Seven sociodemographic attributes (gender, age, marital status, employment status, living status, educational attainment and household income), type of commute and International Physical Activity Questionnaire Environment Module were assessed by self-administered questionnaire. Results: Of all respondents to the survey, 2,032 (mean age: 43.8±9.2, male: 62.5%) were employed. Those who use an active commute were 1,401 (68.9%). In both genders, high residential density (male: OR=2.28, female: OR=3.08), good access to shops (OR=2.03, 3.06), public transportation (OR=1.65, 3.78), recreational facilities (OR=1.31, 1.44), presence of sidewalks (OR=1.42, 1.77), crossroads (OR=1.87, 1.76), having a destination (OR=1.84, 2.34), and not having household vehicles (OR=15.13, 41.24) were associated with an active commute. The results indicated some gender differences. Among male, the presence of a bicycle lane and good aesthetics was positively associated with the active commute, while traffic safety was negatively associated. On the other hand, crime safety was associated with the active commute in female. Conclusion: The results indicate that perceived environment was associated with the active commute among Japanese adults.

Background: Perceived benefits and barriers to exercise are important correlates of exercise participation. Purpose: To develop a short version of the perceived benefits and barriers to exercise scale and to examine its validity and reliability. Methods: A population-based cross-sectional study of 865 participants (age: 20-69 years old, men: 46.5%) was conducted in four cities in Japan (Koganei, Tshukuba, Shizuoka, Kagoshima). Perceived benefits and barriers scale including five benefit subscales (physical benefit, psychological benefit, social benefit, weight management, self-improvement) with 10 items, five barrier subscales (discomfort, lack of motivation, lack of time, lack of social support, poor physical environment) with 10 items and stage of change for exercise behavior were assessed by self-administered questionnaire. Results: Confirmatory factor analyses to examine the construct validity revealed acceptable fit indices (benefit scale: GFI=.980, AGFI=.951, RMSEA=.058, AIC=151.669, barrier scale: GFI=.973, AGFI=.949, RMSEA=.060, AIC=166.084), Seven of ten subscales indicated significant linear associations with stage of change for exercise behavior, criterion-related validity was revealed. The reliability of the scale was found to be good as internal consistency and inter-rater reliability. Conclusion: The short version of the perceived benefits and barriers scale developed in this study demonstrated acceptable construct validity, criterion-related validity, internal consistency and inter-rater reliability. (Jpn. J. Phys. Fitness Sports Med. 2009, 58 : 507 similar to 516)

Background: Perceived benefits and barriers to exercise are important correlates of exercise participation. Purpose: To develop a short version of the perceived benefits and barriers to exercise scale and to examine its validity and reliability. Methods: A population-based cross-sectional study of 865 participants (age: 20-69 years old, men: 46.5%) was conducted in four cities in Japan (Koganei, Tshukuba, Shizuoka, Kagoshima). Perceived benefits and barriers scale including five benefit subscales (physical benefit, psychological benefit, social benefit, weight management, self-improvement) with 10 items, five barrier subscales (discomfort, lack of motivation, lack of time, lack of social support, poor physical environment) with 10 items and stage of change for exercise behavior were assessed by self-administered questionnaire. Results: Confirmatory factor analyses to examine the construct validity revealed acceptable fit indices (benefit scale: GFI=.980, AGFI=.951, RMSEA=.058, AIC=151.669, barrier scale: GFI=.973, AGFI=.949, RMSEA=.060, AIC=166.084). Seven of ten subscales indicated significant linear associations with stage of change for exercise behavior, criterion-related validity was revealed. The reliability of the scale was found to be good as internal consistency and inter-rater reliability. Conclusion: The short version of the perceived benefits and barriers scale developed in this study demonstrated acceptable construct validity, criterion-related validity, internal consistency and inter-rater reliability.

Objective : To translate the Abbreviated Neighborhood Environment Walkability Scale into Japanese (ANEWS-J) and to examine its reliability.
Methods : One hundred sixty three community residents (male: 38.7%, age: 21-69 years old) of 600 who were randomly selected from the registry of residential addresses of Taitoh Ward in Tokyo and Fujinomiya City in Shizuoka Prefecture, responded to mail survey including ANEWS-J. Seventy-seven of 163 answered same questionnaire twice with ten days interval to examine the test-retest reliability. The questionnaire was translated into Japanese and fixed through the processes of preliminary test, backtranslation into English and discussion with authors of original version. Intraclass correlation coefficients (ICCs) were calculated for the evaluation of reliability of ANEWS-J.
Results : ICCs of the eight subscales of A.NEWS-J were residential density; r = 0.95 (95% confidence interval; 0.93-0.97), land use mix - diversity; r = 0.96 (0.94-0.98), land use mix - access; r = 0.90 (0.84-0.94), street connectivity; r = 0.83 (0.74-0.90), sidewalk/bike lane; r = 0.82 (0.71.-0.89), aesthetics; r = 0.85 (0.76-0.91), traffic safety; r = 0.81 (0.70-0.89), crime safety; r = 0.76 (0.62-0.86). Stratified analyses by gender and residential district showed satisfactory reproducibility of the subscales (r = 0.63-0.97).
Conclusion : Acceptable reliabilities of all eight subscales of ANEWS-J were confirmed in this study. (Jpn. J. Phys. Fitness Sports Med. 2009, 58 : 453 similar to 462)

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.

Objective. Although environmental attributes related to physical activity is an emerging research topic, most studies have been reported from Western countries. This study aimed to examine the relationship between perceived environment and physical activity among Japanese adults.
Methods. The sample included 492 adults aged 20 to 74 years (61%: male) living in Tokyo and Himeji in Japan. Primary measures were the short version of International Physical Activity Questionnaire and its Environmental Module. Data were collected between October and December 2003. Odds ratio (OR) of meeting physical activity recommendations was examined in relation to neighborhood environmental characteristics, adjusted for age, sex, employment status and education.
Results. Three perceived environmental attributes were significantly related to walking 150 min/week or more: high residential density (OR = 1.82), good access to shops (OR = 1.65) and presence of sidewalks (OR = 1.65). Two environmental attributes, access to shops (OR = 2.32) and the presence of bike lanes (OR = 1.57), were related to high levels of moderate to vigorous physical activity (950 MET*min/week or more).
Conclusion. Associations of physical activity with four environmental attributes emerged in this Japanese sample. These results support the generalizability of findings on physical activity environments across Western countries and Japan. (C) 2009 Elsevier Inc. All rights reserved.