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Introduction: With health promotion initiatives in small companies lagging behind those in larger corporations, strengthening health and productivity management in small companies through innovative strategies is an urgent priority. We hypothesized that an outreach strategy involving a public-private partnership would be beneficial for this purpose. The present study examines the implementation of a public-private partnership strategy in Yokohama City, Japan, assessing its impact on health and productivity management in small enterprises, focusing on implementation outcomes., Methods: As part of the Yokohama Linkworker Project (Y-Link Project), this study describes and examines a public-private partnership program in Yokohama City, Japan, involving the city's government and a private life insurance company. Trained insurance sales representatives served as "Linkworkers" for the program, reaching out to small enterprises in the city. These Linkworkers provided tailored support to these companies, assisting them with obtaining the "Yokohama Health and Productivity Management Certification" issued by the City of Yokohama authorities and collaborating with external entities to offer health promotion programs for employees. Program interventions took place from August to September 2020. The RE-AIM framework was utilized to evaluate the Project. Data were extracted from Linkworkers' activity records, certification records, the Linkworker survey, and follow-up surveys with participating companies at 6- and 18- months post-interventions., Results: Within 2 months, 71 Linkworkers visited 500 companies (50% were small firms, <50 employees). Among them, 224 (45%) enterprises received certifications, contributing to an increased regional certification rate. Linkworker-assisted companies tended to be significantly smaller in size. The odds ratios of implementing workplace health promotion programs in certified firms, compared to non-certified firms, were 4.09 (95% CI: 1.79-9.35) at 6 months and 2.31 (95% CI: 1.04-5.11) at 18 months. For small firms, the odds ratios were 6.87 (95% CI: 1.74-27.06) at 6 months and 3.42 (95% CI: 1.17-10.03) at 18 months. The certification retention rate at 24 months was 60%, irrespective of company size. Linkworkers perceived the outreach strategy as having a positive impact on their primary operations., Conclusion: The Y-Link Project's outreach strategy enhanced health and productivity management in small enterprises in Yokohama City, enabling long-term health promotion programs addressing program availability disparities related to company size., Competing Interests: The Meiji Yasuda Life Foundation of Health and Welfare, where YK, YF, KY, YM-N, TN, and TA work, receives donations from Company M. However, this organization is a public interest incorporated foundation under the jurisdiction of the Cabinet Office of the Japanese government and is obligated to conduct research activities for the public interest. The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2024 Kai, Fujii, Takashi, Yoshiba, Muramatsu-Noguchi, Noda, Jindo, Kidokoro, Yajima, Kasuga and Arao.)

Introduction: COVID-19 caused major disruptions across the super-aged nation of Japan, yet few studies explored temporal changes among middle-aged and older cohorts from baseline to the height of community transmission. Changes in physical activity and sedentary behavior during global pandemics may alter patterns of morbidity and mortality among susceptible aging populations., Objectives: This study investigated patterns of physical activity, sitting behavior, and health among representative samples of middle-aged and older adults in Tokyo before and during the pandemic., Methods: Repeated online surveys were conducted with quota samples of 800 Tokyo residents in 2019 and 2021 using validated Japanese-language measures, including the short form-International Physical Activity Questionnaire and the Basic Ecological Health Scale-6. Statistical analyses included comparative evaluations of activity parameters by age cohort, gender, and selected covariates. Statistical tests included the Kruskal-Wallis test, Mann-Whitney U test, chi-square test for Independence and Hierarchical Regression., Results: Over 34% of respondents were inactive at each data collection point, and 72% reported negative impacts of COVID-19 on their physical activities. Older adults showed no significant changes in their activity and sitting behavior and reported better health compared with those in middle age across the pandemic. Middle-aged males reported a significant decline in total activity of 33% across the pandemic period (U = 16,958, z = -2.64, p = .008, r = .13). Middle-aged females reported the lowest levels of physical activity, and health, and showed a 29% increase in sitting behavior across the pandemic (U = 16,925, z = -2.68, p = .007, r = .13). Subjective health status was consistently associated with higher overall activity and walking before and during the pandemic., Conclusion: Differential outcomes were identified between age and gender regarding health, physical activity, walking, and sitting across the pandemic with significantly worse impacts reported among middle-aged samples., Implications: These results have implications for healthy transitions to later life and the design of postpandemic interventions to address activity opportunities in Japan.

This ecological study aimed to use nationally representative physical fitness (PF) data to investigate the geographical disparities in cardiorespiratory fitness (CRF) among Japanese children across prefectures before and during the coronavirus 2019 (COVID-19) pandemic. The publicly available descriptive PF data of children from Grade 5 (10-11 years; n = 1,946,437) and adolescents from Grade 8 (13-14 years; n = 1,243,103) at the prefecture level (47 prefectures) were obtained from the annual census PF survey in 2019 (before the pandemic) and 2021 (during the pandemic). The 20 m shuttle run performance was used as a measure of CRF. Geographical disparity was evaluated using the coefficient of variation (CV) for CRF across prefectures. There were significant negative relationships between the magnitude of infections (evaluated as the number of confirmed cases) and changes in CRF at the prefecture level (r ≤ -0.293, p < 0.05). This study also found a substantial increase in CVs of CRF across prefectures for Grade 8 students, suggesting that COVID-19-related restrictions had widened the geographical disparity in CRF among Japanese adolescents. Adolescents' CRF is an important marker for current and future health; hence, the findings of widening geographical disparities in CRF are suggestive of widening geographical disparities in health among the Japanese population.

Background and Objectives: Health-related expectations regarding aging is a gerontological construct that is potentially predictive of morbidity and mortality in later life. The Expectations Regarding Ageing scale (ERA-12) is a widely used measure of health-related expectations, although it has not previously been administered in Japanese. The present research aimed to elucidate the psychometric properties of the first Japanese translation of the ERA-12 and evaluate health-related expectations among middle-aged and older Japanese., Research Design and Methods: Repeated online surveys were conducted with representative quota samples of middle-aged and older adults in Tokyo during 2021 ( N = 1600). Primary outcome measures included total and subscale scores on a Japanese translation of the ERA-12 (ERA-12-J) addressing perceptions of physical, mental, and cognitive health. Standard measures were also used to gather information regarding respondent demographic details, general health, and health-related behavior., Results: The ERA-12-J and associated subscales showed acceptable test-retest reliability ( t (1598) = 0.60, p = 0.63), internal consistency (α > 0.80), inter-item correlation ( r = 0.21-0.78) and item-total correlation ( r = 0.53-0.73). Confirmatory Factor Analysis verified the hypothesized three-factor structure and construct validity on four common indices of fit (GFI = 0.968; CFI = 0.978; AGFI = 0.950; RMSEA = 0.059). ERA-12-J scores among Japanese respondents revealed prevailing negative sentiments concerning physical and cognitive health, with less negative sentiment regarding mental health. Significant and independent differences emerged concerning gender and age cohort, with middle-aged adults and females holding more negative expectations about their future health., Discussion and Implications: The ERA-12-J provides a sound basis for the elucidation of health-related expectations about aging in Japan and a useful tool for international comparative studies. Education and workplace intervention may be required in Japan to address age and gender disparities in health-related expectations.

While limited evidence is available, preliminary studies highlight the potential health benefits of risky play. However, most of the studies have used subjective methods (i.e., questionnaires) to evaluate children's risky play, which limits their validity and reliability. The purpose of the present study was to examine the relationship between the frequency of risky play and social behavior among Japanese preschoolers by using a valid and reliable method such as direct observation. A total of 32 Japanese preschoolers (71.4 ± 3.5 months old) participated in the study, and their social behaviors were measured by the Strength and Difficulties Questionnaire (SDQ). Data regarding the frequency of risky play was collected through direct observation. Results stated that, in a non-adjusted model, there was no significant association between children's risky play and prosocial behavior. However, the association became significant after adjusting for covariates such as gender, parental employment status, and physical activity. In contrast, there was no significant association between children's risky play and problem behavior (hyperactivity and aggression) after adjusting for covariates. In conclusion, covariates such as parental employment should be considered when examining the benefits of risky play.

Background: The 6-minute walking distance (6MWD) is an excellent measure of both functional endurance and health. The primary aim of this study was to estimate temporal trends in 6MWD for older Japanese adults between 1998 and 2017; the secondary aim was to estimate concurrent trends in body size (i.e., height and mass) and self-reported participation in exercise/sport., Methods: Adults aged 65-79 years were included. Annual nationally representative 6MWD data (n = 103,505) for the entire period were obtained from the Japanese Ministry of Education, Culture, Sports, Science and Technology. Temporal trends in means (and relative frequencies) were estimated at the gender-age level by best-fitting sample-weighted linear/polynomial regression models, with national trends estimated by a post-stratified population-weighting procedure. Temporal trends in distributional variability were estimated as the ratio of coefficients of variation., Results: Between 1998 and 2017 there was a steady, moderate improvement in mean 6MWD (absolute = 45 m (95% confidence interval (95%CI): 43-47); percent = 8.0% (95%CI: 7.6%-8.4%); effect size = 0.51 (95%CI: 0.48-0.54)). Gender- and age-related temporal differences in means were negligible. Variability in 6MWD declined substantially (ratio of coefficients of variation = 0.89, 95%CI: 0.87-0.92), with declines larger for women compared to men, and for 75-79-year-olds compared to 65-74-year-olds. Correspondingly, there were moderate and negligible increases in mean height and mass, respectively, and negligible increases in the percentage who participated in exercise/sport at least 3 days per week and at least 30 min per session., Conclusion: There has been a steady, moderate improvement in mean 6MWD for older Japanese adults since 1998, which is suggestive of corresponding improvements in both functional endurance and health. The substantial decline in variability indicates that the temporal improvement in mean 6MWD was not uniform across the distribution. Trends in 6MWD are probably influenced by corresponding trends in body size and/or participation in exercise/sport., (Copyright © 2021. Production and hosting by Elsevier B.V.)

This research examines physical activity (PA) parameters among urban-living middle-aged and older Japanese during the Tokyo Olympic build-up period. Population sampling was employed, and an online survey was administered with 4,000 adults across Japan's five largest cities. The International Physical Activity Questionnaire-Short Form constituted the main outcome variable, with auxiliary measures of Olympic interest and engagement, readiness for PA behavior change, perceived environmental barriers, and demographic information. Despite interest in the Olympics (>60% moderate-high interest), planned engagement with the event was low (>70% planned passive engagement). Higher levels of interest and planned engagement were both significantly correlated with greater self-reported PA participation (p < .001). Across the sample, the PA levels were in the low-moderate range (990 metabolic equivalent of task-min/week), with significant variations observed by the age-cohort and geographic area (p < .001). Age-cohort and geographic variations were also identified with regard to readiness for PA behavior change and perceived environmental barriers to activity (p < .001). Older age (65 years and above) and host city (Tokyo) residence emerged as correlates of higher levels of PA, greater readiness for behavior change, and fewer reported barriers to participation. These findings have implications for Olympic legacy management and successful transitions from middle age to later life in Japan.

Objective: to estimate temporal trends in handgrip strength (HGS) for older Japanese adults between 1998 and 2017., Design and Methods: adults aged 60-79 years were included. Annual nationally representative HGS data (n = 176,449) for the 19-year study period were obtained from the Japanese Ministry of Education, Culture, Sports, Science and Technology. Temporal trends in mean HGS were estimated by sample-weighted regression models relating the year of testing to mean HGS. National trends in absolute, percent and standardised HGS were estimated by a post-stratified population-weighting procedure. Temporal trends in variability were estimated as the ratio of coefficients of variation (CVs)., Results: collectively, there was a small improvement in mean HGS of 1.4 kg (95% confidence interval [CI]: 1.3-1.5), 4.5% (95%CI: 4.3-4.7) or 0.27 standard deviations (95%CI: 0.26-0.28) between 1998 and 2017. The rate of improvement progressively increased over time, with more recent values (post-2008) 1.5-fold larger than earlier values. Gender- and age-related temporal differences were negligible. Variability in HGS declined substantially over time (ratio of CVs [95%CI]: 0.88 [0.86-0.90]), with declines 1.9-fold larger in women compared to men and 1.7-fold larger in 70- to 79-year-olds compared to 60- to 69-year-olds., Conclusions: there has been a small, progressive improvement in mean HGS for older Japanese adults since 1998, which is suggestive of a corresponding improvement in strength capacity. The substantial decline in variability indicates that the improvement in mean HGS was not uniform across the population., (© The Author(s) 2020. Published by Oxford University Press on behalf of the British Geriatrics Society. All rights reserved. For permissions, please email: journals.permissions@oup.com.)

Health benefits of physical activity are well known, yet available physical activity data is limited from children living in African and Asian countries. The purpose of the cross-sectional study was to evaluate and compare physical activity and sedentary behavior patterns, particularly hourly variations, among children in Kenya and Japan. Participants included 298 primary school students (122 Kenyan, 176 Japanese) aged 9-12 years. Physical activity and sedentary behavior were measured with accelerometers. Domain-specific physical activity, screen time, and proportion of children using active transport to school were measured by questionnaire. A two-way ANOVA (countries × time) was used to examine the differences in the activity patterns between Kenyan and Japanese children. The results from the present study demonstrated that Kenyan children spent more time in moderate-to-vigorous physical activity compared to Japanese children ( p < 0.05) with the greatest differences found for weekday evenings (for boys and girls) and weekend afternoons (for girls). This suggests that these were 'critical periods' to differentiate the physical activity levels between Kenyan and Japanese children. However, a higher proportion of the children from Japan used active transport to school and spent less time in television viewing and computer gaming. The results suggest that both countries have successes and challenges that can aid in developing effective and country-specific intervention strategies for promoting physical activity., Competing Interests: The authors declare that they have no competing interests.

The purpose of the present study was to examine the effects of height-adjustable standing desks on time-series variation in sedentary behavior (SB) among primary school children. Thirty-eight children aged 11-12 years (22 boys and 16 girls) from two classes at a primary school in Nagano, Japan, participated in this study. One class was allocated as the intervention group and provided with individual standing desks for 6 months, and the other was allocated as the control group. Time spent in SB, light-intensity physical activity (LPA), and moderate-to-vigorous-intensity physical activity (MVPA) was measured using accelerometers (ActiGraph) at baseline and follow-up. Time spent in SB was significantly lower by 18.3 min/day on average in the intervention class at follow-up (interaction effects: F (1, 36) = 4.95, p = 0.035, η 2 = 0.082). This was accompanied by a significant increase in time spent in MVPA (+19.9 min/day on average). Our time-series analysis showed significant decreases in SB during school time, while no change in SB was found during non-school time. This result indicates that the use of standing desks promotes an overall reduction in SB with no compensatory increase during non-school time.

Background: As arterial stiffness increases in the absence of subjective symptoms, a personal indicator that reflects increased risk of cardiovascular disease is necessary. Penile erection is regulated by vascular function, and atherosclerosis affects the penile artery earlier than it affects the coronary and carotid arteries. Therefore, we hypothesized that deterioration of erectile function could be a marker of increased risk for cardiovascular disease. To test our hypothesis, we assessed erectile function and arterial stiffness in a cross-sectional study., Methods and Results: Carotid-femoral pulse wave velocity (PWV), brachial-ankle PWV, femoral-ankle PWV, and arterial stiffness gradient (PWV ratio: carotid-femoral PWV/femoral-ankle PWV) were measured as indexes of central, systemic, and peripheral arterial stiffness and peripheral organ damage, respectively, in 317 adult men. In addition, erectile function was assessed by using the questionnaire International Index of Erectile Function 5 (a descending score indicates worsening of erectile function). The scores of male sexual function were inversely correlated with carotid-femoral PWV ( r s =-0.41), brachial-ankle PWV ( r s =-0.35), femoral-ankle PWV ( r s =-0.19), and PWV ratio ( r s =-0.33). Furthermore, multivariate linear regression analyses revealed that International Index of Erectile Function 5 scores were significantly associated with carotid-femoral PWV (β=-0.22) and PWV ratio (β=-0.25), but not with brachial-ankle PWV and femoral-ankle PWV., Conclusions: Our results indicated that erectile function is independently associated with central arterial stiffness and peripheral organ damage. These findings suggest that male sexual function could be an easily identifiable and independent marker of increased central arterial stiffness and peripheral organ damage., (© 2018 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley.)

Background: The epidemiologic features of those who requested to undergo the human immunodeficiency virus (HIV) antibody test at public health centers in Japan are still ambiguous, although as a group, they are probably at a high risk to be infected., Methods: Between April 2001 and March 2002, 14,900 persons visited 131 public health centers that cooperated with this study in relation to the HIV antibody tests. A questionnaire was given to 8,972 persons who agreed to participate in the survey and 5,079 (56.6%) returned the form. Excluding those filled out by persons whose true intent in undergoing the test was the diagnosis of hepatitis C, 4,102 questionnaires were analyzed, individual characteristics examined, and first time visitors and repeaters were compared to assess their behavior and the reasons for of undergoing the test., Results: There were 2,515 (61.3%) males and 1,587 (38.7%) females. The largest age group was composed of 25 to 29 year-olds. Repeaters accounted for 27.2% of all the males and 21.3% of all the females. Their main reason for undergoing the test was anxiety about having contracted an HIV infection through sexual contact with a person of the opposite sex. The proportion of those having sexual contact with males was significantly higher among male repeaters (14.1%) than first timers (8.0%). Among females, the proportion of those who had experience of sexual contact with many and unspecified males was significantly higher for repeaters (39.6%) than first timers (27.3%)., Conclusion: It was evident from this study that repeaters exist among those who seek to be examined for possible contraction of HIV: they are characterized by risk-taking behavior in contracting an HIV infection through sexual contact.

Background: In recent years a decline in the number of new AIDS cases has been observed in several industrialized countries. It is important to know whether these recent trends observed in North America and Europe are also occurring in Japan., Methods: The number of people reported with HIV and AIDS by nationality, route of infection, and sex was calculated based on the HIV/AIDS surveillance data available in Japan through December 1997. The effect of reporting delay, which was defined as those HIV and AIDS cases reported in the calendar year following diagnosis, on the trends was examined. The coverage rate in reporting HIV cases was estimated as the ratio of the reported AIDS cases with prior report as an HIV-positive to the total number of reported AIDS cases., Results: The cumulative number of reported cases of HIV among Japanese and non-Japanese residents of Japan up to the end of 1997 were 1,300 and 1,190, respectively. The cumulative number of reported cases of AIDS among Japanese and non-Japanese up to the end of 1997 were 758 and 298, respectively. The number of reported cases of HIV among Japanese was found to be still increasing, with the major contribution from male cases. The increasing trend in the number of reported AIDS cases among Japanese began to slow in 1996 and 1997. The number of reported cases of HIV among non-Japanese residents of Japan peaked in 1992, and has decreased since then, and remained constant after 1994. In contrast, the number of reported AIDS cases among these non-Japanese tended to increase gradually. There was a slight reporting delay for people with HIV and AIDS. The estimated coverage rate in reporting HIV cases tended to decrease in 1996 and 1997 (1/7.2, 1/10.2, respectively). We point out several reasons for this recent decline and suggest the possibility of an ostensible decline in the estimates., Conclusions: We suggest that the number of people with HIV among Japanese has continued to increase, and that the increase in the number of AIDS cases among Japanese is now slowing.