Search

Objective 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. Methods 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. Results 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. Conclusion 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.

The aim of this study was to examine the relationships between work engagement, productivity, and self-reported work-related sedentary behavior in Japanese adults.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.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).Reducing work-related sedentary behavior may improve workers' engagement and productivity.

Background Inconsistent associations of neighbourhood walkability with adults’ body weight have been reported. Most studies examining the relationships of walkability and adiposity are cross-sectional in design. We examined the longitudinal relationships of two walkability indices – conventional walkability and space syntax walkability, and their individual components, with weight change among adults over four years. Methods Data were from the Physical Activity in Localities and Community study in Adelaide, Australia. In 2003–2004, 2650 adults living in 154 Census Collection Districts (CCDs) returned baseline questionnaires; in 2007–2008, the follow-up survey was completed by 1098. Participants reported their weight at baseline and at follow-up. Neighbourhood walkability indices were calculated using geographic information systems and space syntax software. Linear marginal models using generalized estimating equations with robust standard errors were fitted to examine associations of the two walkability indices and their individual components with the weight at follow-up, adjusting for baseline weight, socio-demographic variables, and spatial clustering at the level of CCD. Results The overall mean weight gain over four years was 1.5 kg. The two walkability indices were closely correlated (r = 0.76, p

Objectives The present study investigated articles on cancer prevention published in Japanese newspapers in 2011.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.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.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.

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.

Objective: Leisure-time sedentary behaviors (LTSBs) have been associated adversely with health outcomes. However, limited research has focused on different categories of LTSB. We aimed at identifying categories of LTSBs and examining their separate associations with indices of health among Japanese older adults. Conclusions: Two types of sedentary time-passive and mentally-active-may play different roles in older adults' well-being. Methods: A postal survey collected data on self-reported health, psychological distress, body mass index, moderate-to-vigorous physical activity (MVPA), LTSBs (five behaviors) and socio-demographic characteristics from 1,580 Japanese older adults (67% response rate; 65-74 years) in 2010. Exploratory factor analysis was used to classify LTSBs. Odds ratios (ORs) were calculated for associations of LTSB categories with self-reported health, psychological distress, overweight, and lower MVPA. Data were analyzed in 2013. Results: Two categories of LTSB: passive sedentary time (consisting of TV time, listening or talking while sitting, and sitting around) and mentally-active sedentary time (consisting of computer-use and reading books or newspapers) were identified. Higher passive sedentary time was associated with a higher odds of being overweight (OR: 1.39, [95% CI: 1.08-1.80]), and lower MVPA (1.26, [1.02-1.54]). Higher mentally-active sedentary time was associated with lower odds of lower MVPA (0.70, [0.57-0.86]). Refereed/Peer-reviewed

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.

Little is known about the differences in the geriatric nutritional risk index (GNRI) status in older patients and their relationship to accelerometer-derived measures of physical activity (PA) levels. We determined both differences in daily measured PA based on the GNRI and related cut-off values for PA in elderly cardiac inpatients. We divided 235 consecutive elderly cardiac inpatients (mean age 73.6 years, men 70.6 %) into four groups by age and GNRI: older-high group, 65–74 years with high GNRI (≥92 points) (n = 111); older-low group, low GNRI (

Aim Nutrition is the focus of a new treatment target in older hospitalized cardiac patients. However, little is known about the differences in nutritional status in relation to physical performance in these inpatients. We determined the differences in physical performance based on the Geriatric Nutritional Risk Index (GNRI) and physical performance cut-off values according to the GNRI in older male cardiac inpatients. Methods We enrolled 251 Japanese male inpatients aged ≥65 years (mean age 74.7 years) with cardiac disease in the present cross-sectional study. We divided the patients into two groups according to GNRI: high-GNRI group (≥92 points; n = 178) and low-GNRI group (

Handgrip strength (HS) and knee extensor muscle strength (KEMS) showed a negative correlation with the Disabilities of the Arm, Shoulder, and Hand (DASH) score at one month following cardiac surgery. We performed a longitudinal study to examine changes in HS/KEMS and DASH score during phase II cardiac rehabilitation (CR) in patients after cardiac surgery. We measured and assessed HS, KEMS, and DASH score in 41 consecutive patients at one and three months following cardiac surgery and examined the relation between these factors at three months following cardiac surgery. Wilcoxon signed-rank test and Spearman correlation coefficients were used to analyze the results. Finally, 26 patients (63.2 years, 73.1% male) were analyzed. There were significant differences from one month to three months following cardiac surgery in HS (26.78 &plusmn, 8.26 to 31.35 &plusmn, 9.41 kgf, p &lt, 0.001), KEMS (1.53 &plusmn, 0.42 to 1.72 &plusmn, 0.46 Nm/kg, p = 0.001), and DASH score (14.76 &plusmn, 12.58 to 7.62 &plusmn, 9.29, p &lt, 0.001). DASH score correlated negatively with HS (r = &minus, 0.41, p = 0.01) but not with KEMS (r = &minus, 0.32, p = 0.09) after three months of phase II CR. Although HS, KEMS, and DASH scores changed significantly from one to three months following cardiac surgery during phase II CR, only HS correlated negatively with DASH score at three months following cardiac surgery.

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™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.

Street layout is consistently associated with adults' travel behaviors, however factors influencing this association are unclear. We examined associations of street layout with travel behaviors: walking for transport (WT) and car use; and, the extent to which these relationships may be accounted for by availability of local destinations. A 24-h travel diary was completed in 2009 by 16,345 adult participants of the South-East Queensland Household Travel Survey, Australia. Three travel-behavior outcomes were derived: any home-based WT; over 30 min of home-based WT; and, over 60 min of car use. For street layout, a space syntax measure of street integration was calculated for each Statistical Area 1 (SA1, the smallest geographic unit in Australia). An objective measure of availability of destinations – Walk Score – was also derived for each SA1. Logistic regression examined associ-ations of street layout with travel behaviors. Mediation analyses examined to what extent availability of destina-tions explained the associations. Street integration was significantly associated with travel behaviors. Each one-decile increment in street integra-tion was associated with an 18% (95%CI: 1.15, 1.21) higher odds of any home-based WT; a 10% (95%CI: 1.06, 1.15) higher odds of over 30 min of home-based WT; and a 5% (95%CI: 0.94, 0.96) lower odds of using a car over 60 min. Local destinations partially mediated the effects of street layout on travel behaviors. Well-connected street layout contributes to active travel partially through availability of more local destinations. Urban design strategies need to address street layout and destinations to promote active travel among residents.

Introduction The most effective type of social participation against psychological distress in older adults is not well documented. The aim of this study was to examine whether different types of social participation are associated with changes in psychological distress level in older men and women in Japan. Methods Two thousand seven hundred community-dwelling older adults (aged 65–74 years, 50% women) were randomly selected from the resident registry of three cities. Of these, participants who reported social participation and psychological distress level in the baseline survey in 2010 were followed up. Psychological distress was evaluated based on K6 scales at baseline and follow-up (in 2015). Social participation level was examined using question items from the National Health and Nutrition Survey in Japan. Exploratory factor analysis was used to derive the underlying factor structure. Multiple linear regression analysis was used to examine the association between social participation and changes in psychological distress level after adjusting for covariates stratified by both gender and age group or living arrangement. Results Data from 825 community-dwelling older adults (45.3% women) were analyzed. Social participation was categorized into two types using factor analysis: community involvement (volunteer activities, community events, clubs for the elderly) and individual relationship (friendship, communication with family and friends, hobbies). During the 5-year follow-up, 29.5% of participants reported a deterioration in psychological distress. Higher community involvement was independently associated with lower risk of psychological distress for older women (β = 0.099, p = 0.047), whereas there were no associations with individual relationship for either gender. Furthermore, in older women living with others, higher community involvement was also associated with lower risk of psychological distress (β = 0.110, p = 0.048). Conclusion Community involvement provides older women with mental health benefits regardless of individual relationship level. Promoting community involvement may be an effective strategy for healthy mental aging.

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.

Background: Identifying correlates of physical activity that can be targeted as potential mediators is important for developing interventions to promote physical activity in adolescent girls. However, the mediated effects of multilevel correlates of physical activity remain poorly understood. Therefore, the present study aimed to examine direct and mediated effects of personal, social and perceived school physical environmental factors on school-based physical activity of Japanese adolescent girls. Methods: In this cross-sectional survey of the Japanese adolescent lifestyles, 344 junior high school girls were invited to complete self-report measures of age, grade, weight, height, self-efficacy, social support (family, friends and teachers), perceived school physical environment (equipment, facilities and safety) and physical activity at school (min per week during lunch time and after- school hours). Structural equation modeling analysis controlling for age was performed to examine the effects of body mass index (BMI), self-efficacy, social support and school physical environmental variables on lunchtime and after-hours physical activity. Results: The final structural model demonstrated an acceptable fit for each context-specific physical activity. During lunch recess, perceived equipment and friend support exhibited direct effects on physical activity; perceived facilities, safety, and self-efficacy were indirectly associated with physical activity through friend support. During after-school hours, both family and friend support directly affected physical activity at school; perceived safety, facilities and self-efficacy exhibited indirect effects on physical activity through family or friend support. However, there were no significant associations between equipment and after-school-hours physical activity. Regardless of contexts, BMI had neither direct nor indirect effects on physical activity. Conclusion: Social support from family and friends was identified as factors mediating the effects of perceived environment and self-efficacy on school-based physical activity among Japanese adolescent girls. This finding encourages the future development of effective interventions to promote physical activity through family and friend support in the future.

School-based extracurricular sports activity (SBECSA) has developed as an opportunity that adolescents play sports in Japan. However, there are some issues to maintain active SBECSA such as lack of teacher who can coach SBECSA expertly, and large imposition of teachers to manage SBECSA. For resolving these issues, promoting engagement of external coach is favorable. Nevertheless, the number of external coach has not been enough. Therefore, the purpose of the present study was to explain facilitators and barriers related with teacher’s action for recruitment and handling with external coach, and expected qualification for external coach. Personal semi-structured interview was performed toward 22 teachers who worked in a public junior high school or a public high school. In the analysis of the present study, the KJ method―a type of qualitative analyses―was used. All transcribed data were divided into individual content and grouped together into small, middle and large categories. For facilitators, four large categories such as benefits to SBECSA, benefits to teachers, system and support were emerged. For barriers, four large categories such as negative influences on SBECSA, negative influences on teachers, system and support were grouped. For expected qualifications, five large categories such as humanity, ability, cooperativeness, attributions and trust were categorized. In conclusion, the present study identified various facilitators, barriers and expected qualifications. External coach would increase by enhancing facilitators, reducing barriers, and targeting human resource who meets expected qualifications.

School-based extracurricular sports activity (SBECSA) provides one of the main opportunities for adolescents to play sports in Japan. However, maintaining active SBECSA is difficult because of the large burden on teachers to manage SBECSA and a lack of SBECSA teachers who can coach expertly. To resolve these issues, the recruitment of external coaches has been promoted. However, the number of coaches and frequency of coaching are not sufficient for the current demand. Additionally, it is not clear how to promote the engagement of external coaches. Therefore, the purpose of the present study was to explore a variety of facilitators and barriers associated with the involvement of external coaches into SBECSA. Twenty-five external coaches were recruited from junior high and high schools across Japan. Data obtained through personal semi-structured interviews were analyzed using the KJ method (a qualitative type of analyses). As a result, seven facilitators (positive feelings, adequate system, positive social support, comfortable climate of SBECSA, environment, growth of external coach, network building), and six barriers (negative feelings, inadequate system, lack of support, uncomfortable climate of SBECSA, poor environment, burdens) were identified. In conclusion, SBECSA would become more attractive for external coaches by enhancing facilitators and reducing barriers.

AIM The objective of the present study was to evaluate the long-term effectiveness of an exercise program in modifying the exercise behavior of the community-dwelling elderly subjects. METHODS This study was a single-blinded randomized controlled trial. The subjects included 52 males and 65 females 65 years of age or over who were randomly assigned to an exercise-intervention group or a health-education group. The stages of change in exercise behavior were evaluated before and one-year after the intervention period. The subjects' physical function (muscle strength, balance, walking speed) and self-efficacy in each domain of the physical function were measured during the intervention period. RESULTS There were no significant differences in the stages of change before the intervention between the two groups. Significant differences in the stages of change were observed in "relapse" of stages at two points in time between the two groups (p

Purpose: Background: Physical activity is a complex behavior which involves the interaction of multilevel factors at the individual, social and environmental level. However, previous studies have largely focused on psychological and/or social environmental factors and the direct impact of such factors on physical activity. There are few studies having examined how multilevel factors may interact to influence activity level. Therefore, the purpose of the present study was to examine both direct and indirect effects of multilevel factors on school-based physical activity in Japanese adolescent boys. Methods: In this cross-sectional survey of the Japanese adolescent lifestyles, 379 junior high school boys were invited to complete self-report measures of age, grade, weight, height, self-efficacy, social support (family, friends and teachers), school physical environment (equipment, facilities and safety) and average minutes per week of physical activity during lunch time and after-school hours occurring at school. Structural equation modeling analyses controlling for age were utilized to examine the effects of body mass index (BMI), self-efficacy, social support and school physical environmental variables on lunchtime and after-school physical activity. Results: During lunch time, self-efficacy exhibited direct positive effects on physical activity. BMI, facilities, and safety were indirectly associated with lunchtime physical activity through self-efficacy. However, there were no significant relationships of equipment and social support with lunchtime physical activity. During after-school hours, family support and facilities directly affected physical activity. Self-efficacy was indirectly related with physical activity through family support. BMI, equipment, and safety indirectly affected physical activity through self-efficacy and/or family support. Conclusion: Effects of multilevel factor on physical activity among adolescent boys differed according to context, which implies that interventions to promote physical activity should be context-specific. Findings encourage the development of future effective interventions to promote physical activity through self-efficacy during lunch time as well as family support during after-school hours.

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 (β = .280, P = .010, R2 = .015). There was a statistically significant relationship between SB and anxiety (β = .206, P = .059, R2 = .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.

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.

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

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. [J Med Internet Res 2016;18(7):e192]

Dog ownership is emerging as an important correlate of sufficient physical activity and therefore has the potential to positively affect a portion of the population. A growing body of literature indicates that dog-walking contributes to increased physical activity. However, most of the previous studies have been conducted in Australia or the U.S. and have sampled from the general adult population.This study examined the association between dog ownership, dog-walking, and physical activity in older Japanese adults.Participants were community-dwelling residents aged 65-74 years who responded to a population-based cross-sectional survey (N=1926). Physical activity, dog ownership, dog-walking, and sociodemographic attributes were self-reported (collected in 2010; analyzed in 2011). ANCOVAs and multivariate logistic regressions were used.Overall, 14.0% of older adults were dog owners, with 71% reporting that they walked their dog for an average of 308.5±300.7 minutes/week. Dog walkers reported more minutes/week of moderate-to-vigorous physical activity (M±SE: 241.7±27.0) and total physical activity (M±SE: 698.6±40.6) than both non-dog walkers (M±SE: 110.7±41.8; M±SE: 527.2±62.9) and non-dog owners (M±SE: 164.7±9.1; M±SE: 519.2±13.7), respectively (p0.05). Dog walkers also walked more minutes per week (M±SE: 508.0±33.4) than non-dog owners (M±SE: 384.5±11.3; p0.05). Dog walkers were more likely to be sufficiently active than both non-dog walkers and non-dog owners (p0.001).Use of dog-walking may be a potentially viable means of intervention for increasing walking and overall physical activity in older Japanese adults.

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.

PURPOSE: Exercise capacity of fewer than 5 metabolic equivalents (METs) has been associated with high risk of death and poor physical functioning in male patients with heart failure (HF). Therefore, we aimed to determine upper and lower extremity muscle strength levels required to attain an exercise capacity of 5 or more METs in male outpatients with HF. METHODS: We enrolled 148 male HF patients (age 60.1 +/- 1.0 years). Peak oxygen uptake (peak o2) was assessed by cardiopulmonary exercise testing (CPX). After CPX, we further divided the patients into groups according to exercise capacity: 5 or more METs (group A, n = 85) and fewer than 5 METs (group B, n = 63). Handgrip strength and knee extensor and flexor muscle strengths were assessed as indices of upper and lower extremity muscle strength, respectively. Receiver operating characteristic curves were used to select cutoff values for upper and lower extremity muscle strength resulting in an exercise capacity of 5 or more METs in these patients. RESULTS: Exercise capacity of 5 or more METs in male HF patients was equivalent to approximately 35.2 kgf of handgrip strength and 1.70 Nm/kg of knee extensor and 0.90 Nm/kg of knee flexor muscle strengths. CONCLUSIONS: These upper and lower extremity muscle strength values may be useful target goals for improvement of exercise capacity, risk management, and activities of daily living in male HF patients.

Background Although regular physical activity can facilitate healthy aging, improve functional capacity, and prevent chronic diseases in the elderly, many of the Japanese elderly are not sufficiently active. Thus, examining the determinants is an important prerequisite for designing effective programs. The present study investigated the demographic, behavioral, psychosocial, and environmental determinants of meeting the national pedometer-determined physical activity recommendations for the elderly Japanese. Method Data were analyzed for 137 community-dwelling elderly Japanese aged 70 to 89 years (47% male, mean age = 74.5 years), who completed a questionnaire and wore a pedometer. Demographic (gender, age, marital status), behavioral (BMI, smoking, alcohol consumption), psychosocial (self-efficacy, social support, health professional advice), and environmental (perceived neighborhood environment) variables were self-reported. Averaged daily steps were obtained using 1-year pedometer measurements. Based on the national physical activity recommendations in Japan (males: 6700 steps; females: 5900 steps), the participants were divided into two categories - sufficiently active and insufficiently active. An adjusted logistic regression model was utilized. Results Totally, 47.4% of the participants (males: 51.5%; females: 43.8%) met the national recommendations. When adjusting for all other variables, a higher self-efficacy for exercise (AOR = 1.16; 95% CI: 1.04-1.28) and positive perception of the neighborhood environment (AOR = 1.43; 95% CI: 1.03-1.98) significantly influenced the meeting of the national recommendations. Conclusions The findings clarified the need to identify effective intervention strategies to promote physical activity and suggest that an intervention design that accounts for these determinants may more effectively promote physical activity among the elderly Japanese.

Background:There are no previous data on factors at multiple levels associated with the stages of change for dog walking. The current study examined psychosocial and environmental correlates of the stages of change for dog walking among Japanese dog owners.Methods:Dog owners (N = 1940) completed a self-administered questionnaire that included items about demographics as well as psychosocial (dog attachment, dog obligation, normative belief, social norm, social support, self-efficacy) and environmental (access to areas, neighborhood safety, enjoyable scenery, frequently observing others dog walking, area where dogs are allowed to be off the lead) factors. MANOVA and discriminant functional analysis were used.Results:The distribution of the dog owners across the stages was as follows: precontemplation (14.7%), contemplation (7.6%), preparation (39.7%), action (2.8%), and maintenance (35.2%). Although differences among the stages were found for all factors in MANOVA, the pattern of distinction among stages differed depending on the factors. Dog obligation and self-efficacy were the best predictors of the stages of change for dog walking.Conclusions:Although psychosocial and environmental correlates differed with the stages, psychosocial factors such as the sense of obligation and self-efficacy in dog walking seem to make relatively stronger contributions to distinctions among the stages.

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.

To determine self-reported sleep quality-related differences in physical activity (PA) and health-related quality of life (HRQOL) and target values of PA for high-quality sleep in chronic heart failure (CHF) outpatients, 149 CHF outpatients (mean age 58 years) were divided into two groups by sleep-quality level determined via self-reported questionnaire: shallow sleep (SS) group (n = 77) and deep sleep (DS) group (n = 72). Steps were assessed by electronic pedometer, HRQOL was assessed with the Short Form 36 (SF-36) survey, and data were compared between groups. PA resulting in high-quality sleep was determined by receiver-operating characteristics curves. All SF-36 subscale scores except that of bodily pain were significantly decreased in the SS versus DS group. A cutoff value of 5723.6 steps/day and 156.4 Kcal/day for 1 week were determined as target values for PA. Sleep quality may affect PA and HRQOL, and attaining target values of PA may improve sleep quality and HRQOL of CHF outpatients. Patents relevant to heart failure are also discussed in this article.

〔目的〕重度糖尿病教育入院患者における入院前のウォーキング行動に関連した心理的要因および環境的要因を調査した．〔方法〕患者22人（年齢55.3歳）を対象とし，入院時に質問紙調査を実施した．項目は，ウォーキング行動のセルフ・エフィカシー（以下，歩行SE），糖尿病関連領域質問表（PAID），うつ・不安尺度（HADS），ウォーキング行動評価尺度，国際標準化身体活動質問紙環境尺度（IPAQ-E）とした．〔結果〕歩行時間は歩行SEと正の相関を認め，うつ得点と負の相関を認めた．また，歩行時間の下位尺度である「運動のために歩く時間」は環境尺度の「公園，体育館，施設などがある」項目と正の相関を認めた．〔結語〕歩行時間を増加するには歩行SEを高め，うつ状態を軽減させるアプローチが有用である可能性が考えられた．

The purpose of this study was to evaluate the effects of a group-based walking program on physical activity and mediators of activity in middle-aged and older adults. Fifty-six community residents (mean age = 60.3 years) participated in either a walking program (WP: n = 39) or health information program (IP: n = 17) for 2 months. The WP included: 1) instruction in walking technique; 2) participating in group walks; and 3) practicing behavioral skills. The IP consisted of: 1) information about the importance of diet and physical activity; 2) participating in easy exercise; and 3) practicing behavioral skills. After the programs, participants were provided a daily self monitoring and goal setting sheet to be completed over a 4-month period. Letters were sent to participants four times during the follow-up period. Physical activity and mediators of activity were assessed at baseline, 2 months, and 6 months. For the WP participants, daily step count and moderate and vigorous physical activity significantly increased during the 6-month period. There was a significant group-by-time interaction for physical activity, but no interaction for mediators of activity. These results suggest that the group-based walking program played an important role in increasing daily physical activity.

〔目的〕人工膝関節全置換術（TKA）による回復過程を検討するために，身体機能および健康関連QOL（HRQOL）を調査した．〔対象〕TKA術後リハを実施した変形性膝関節症患者40膝とした．〔方法〕身体機能評価にはTimed Up and Go test（TUG），膝伸展筋力，開眼片脚起立時間を測定し，HRQOL評価には準WOMACとSF-36を用いた．〔結果〕身体機能の全項目において術後3ヶ月で有意に改善した．準WOMACの痛みとSF-36の身体機能，体の痛み，全体的健康感，社会生活機能は術後1ヶ月で有意に改善し，さらに術後3ヶ月で準WOMACの機能も有意に改善した．開眼片脚起立時間を除く身体機能とHRQOLの全項目は，変化量と初期値との間に有意な負の相関を認めた．〔結語〕TKAによりHRQOLは術後1ヶ月で改善し，術後3ヶ月では身体機能が改善することが示唆された．