日足P&Fの状況：（09月29日）～（10月04日）

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.

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.

Objective This study aimed to estimate the prevalence of walking behavior and investigate demographic correlates of recommended physical activity levels with five domains (exercise, commuting, working, shopping, and other movement) of walking behavior among Japanese adults aged 30-49.
Methods The sample was 5,009 Japanese adults collected from the registrants of a Japanese social research company. The study design was a cross-sectional study using an Internet questionnaire. The dependent variable was meeting physical activity recommendation levels (more than 150 min/1week) . Independent variables were demographic variables (e.g., gender, age, educational level, household income level, hour per day with TV watching, and hour per day with internet usage) . Logistic regression analysis was utilized.
Results Of all participants, 45.5% of men and 44.8% of women met physical activity recommendations. Regardless of meeting recommended physical activity levels, they walked for exercise less than 20%. The characteristics of those who met the recommendation levels were higher education, long Internet use and having a small number of children for men, and higher education, higher income and having a small number of children for women. As compared with those who did not meet physical activity recommendations, in lifestyle time men walked for shopping and other movement and women walked for shopping.
Conclusion Commuting and shopping for men and shopping for women were identified as a key factor for increasing walking behavior. It would be necessary for women to develop an intervention program which considers demographic factors such as marital status, employment status and household children.

BACKGROUND: As people age, they spend more time in and around their domestic environments, within which opportunities for health-enhancing physical activity (PA) may be limited. We examined the associations of frequency of excursions from home with accelerometer-determined PA and the total and prolonged sedentary behavior (SB, sitting for ≥30 min) among community-dwelling older adults. METHODS: Overall, 434 older adults (men, 57.1 %; age, 70-79 years) wore an accelerometer (HJA-350IT, Omron Healthcare) for 7 days. Time spent in SB, light-intensity PA (LPA), moderate-to-vigorous PA (MVPA), and prolonged SB bout (≥30 min) were calculated. Frequencies of excursions from home were categorized as 0-3, 4-5, and 6-7 days/week. Associations of excursions with PA and SB were tested by analysis of covariance adjusted for sociodemographic characteristics. RESULTS: Frequencies were 14.3 %, 31.1 %, and 54.6 % for excursions 0-3, 4-5, and 6-7 days/week, respectively. For men, less frequent excursions from home were significantly associated with less MVPA and more total and prolonged SB times (estimated means [minutes/day]: MVPA, 32, 42, and 48; total SB, 589, 549, and 539; prolonged SB, 344, 288, and 265; respectively; p < 0.05). LPA was not statistically significant (p = 0.09). For women, less frequent excursions were significantly associated with all PA outcomes (SB: 536, 497, and 467; prolonged SB: 260, 213, and 204; LPA: 328, 363, and 379; MVPA: 36, 39, and 54, respectively). CONCLUSIONS: Among community-dwelling Japanese older adults, more frequent excursions from home were associated with more PA, less SB, and more-favorable SB patterns, suggesting a potential strategy for preventive-health initiatives.

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.

A rapidly growing body of literature has explored associations between urban design attributes, which are conducive to walking, and social capital. The current study aimed to build on the limitations of previous research. Specifically, this study estimated the associations between traditional and novel walkable built environment metrics and social capital among a sample of adults in Japan. Data (n = 1010) from a randomly selected cross-section of residents (40–69 years old) from two areas in Japan were included. Social capital was assessed by questionnaires. Several objective and perceived walkable built environment attributes were calculated. Covariate-adjusted multivariable linear regression models were used to estimate associations between neighborhood built attributes and the three social capital scores. Street connectivity was negatively associated with activities with neighbors (b = -0.21, 95% CI -0.31, -0.11). Perceived population density was negatively associated with all three social capital scores, including social cohesion, activities with neighbors, and social participation (b = -0.21, 95% CI -0.30, -0.11, b = -0.15, 95% CI -0.24, -0.06, and b = -0.16, 95% CI -0.29, -0.02, respectively). Traditional walkability and Walk Score® were negatively associated with activities with neighbors (b = -0.04, 95% CI -0.07, -0.00 and b = -0.09, 95% CI -0.15, -0.04, respectively). No significant associations were observed between perceived walkability and social capital scores. Space syntax walkability was negatively associated with social cohesion and activities with neighbors (b = -0.12, 95% CI -0.23, -0.01 and b = -0.11, 95% CI -0.21, -0.01, respectively). This study provided unique findings demonstrating that walkable built environments may not necessarily support social capital in ultrahigh-density Asian cities.

IntroductionThe 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.MethodsTwo 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.ResultsData 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 (beta = 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 (beta = 0.110, p = 0.048).ConclusionCommunity 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.

BackgroundThere 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 ResultsNational 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.ConclusionsCVD 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.

Background: Although the benefits of the recommended level of physical activity on reducing chronic diseases are well-established, most of the Japanese population is not sufficiently active. Thus, examining correlates is an important prerequisite for designing relevant polices and effective programs. The present study investigated psychological, social, and environmental factors associated with meeting physical activity recommendations among Japanese adults.Methods: Data were analyzed for 1,932 men and women (43.6 +/- 13.0 years), who responded to an Internet-based cross-sectional survey. Self-reported measure of physical activity, psychological (self-efficacy, pros, and cons), social ( social support, health professional advice), environmental ( home fitness equipment, access to facilities, neighborhood safety, enjoyable scenery, frequently observing others exercising, residential area), and demographic ( gender, age, marital status, educational level, household income level, employment status) variables were obtained. Based on the current national guidelines for exercise in Japan ( 23 METs.hour per week), respondents were divided into two categories-recommended and not recommended ( insufficient and inactive)-according to their estimated weekly physical activity level. An adjusted logistic regression model was utilized.Results: When adjusting for all other variables, self-efficacy ( men: OR = 2.13; 95% CI: 1.55-2.94, women: OR = 2.72; 95% CI: 1.82-4.08) and possessing home fitness equipment ( men: OR = 1.55; 95% CI: 1.14-2.10, women: OR = 1.41; 95% CI: 1.01-1.99) for both genders, social support ( OR = 1.44; 95% CI: 1.06-1.97) for men, and enjoyable scenery ( OR = 1.60; 95% CI: 1.09-2.36) for women were positively associated with attaining the recommended level of physical activity. In women, cons ( OR = 0.47; 95% CI: 0.33-0.67) and living in rural areas ( OR = 0.50; 95% CI: 0.25-0.97) were negatively associated with meeting the physical activity recommendations.Conclusion: In the psychological, social, and environmental domains, significant correlates of attaining the recommended level of physical activity were observed. Men and women had different patterns of psychological, social, and environmental correlates. These findings suggest that an intervention design that accounts for those correlates may more effectively promote physical activity among Japanese adults.

Objective: The purpose of this study was to determine exercise maintenance rate, leisure-time objective physical activity level, and health-related quality of life in relation to exercise maintenance over the 6-mo period after a supervised 5-mo recovery-phase cardiac rehabilitation program in acute myocardial infarction patients. The study also investigated whether exercise maintenance resulted in reproducible health-related quality-of-life outcomes comparable with those of the Japanese normal population.Design: This observational study comprised 109 acute myocardial infarction patients (89 men, 20 women; mean age, 63.5 +/- 10.1 yrs). Physiologic outcomes (peak oxygen uptake, handgrip, and knee-extension strength) measured at 1 and 6 mos after acute myocardial infarction onset were compared. Completed exercise maintenance and health-related quality-of-life questionnaires and results of electronic pedometer recordings to evaluate leisure-time objective physical activity level were assessed 6 mos after cardiac rehabilitation.Results: The mean period from acute myocardial infarction to evaluation of outcomes was 18.8 +/- 3.4 mos. Ninety of 109 patients (82.6%) continued exercise for 6 mos after cardiac rehabilitation (exercise group); 19 patients (17.4%) quit exercise after cardiac rehabilitation (nonexercise group). Improvement in physiologic outcomes was noted at 6 mos vs. those at 1 mo, but outcomes were not significantly different between groups. The exercise group performed significantly better than the nonexercise group for leisure-time objective physical activity level and scored significantly higher than the nonexercise group for seven of eight health-related quality of life measures, attaining scores similar to those of the Japanese normal population.Conclusions: At 18 mos after acute myocardial infarction, the exercise maintenance rate in our patients remains high, and exercise maintenance may be one of the factors contributing to improvement of health-related quality of life and leisure-time objective physical activity level.

そうなんです。今考えても思い切ったなと思いますが、あれが全ての始まりでした。 私は結婚を機に仕事を辞め、専業主婦になりました。 そして2009年に第一子を出産。もともと子供が苦手だったので子育てには不安がありました。案の定息子が2歳になる前後くらいから子育てに悩み始めたんです。 ある芸能人ママの子育てブログをずっと読んでいたのですが、なんと大阪にイベントで来るという情報が！息子を連れて、久々に化粧をして会場の百貨店に向かいました。あの時のドキドキは今でも覚えています。終了後もずっと興奮状態でした。月〜土まで息子と二人っきりの生活をしていた私にとっては、こうやって外に出かけるということ自体がもう一大イベント。しかもずっとブログを読んでいて大好きだった憧れの芸能人ママに会えるなんてもう、たまりませんでした。その時に実感したのは、「ママになっても、こうやってドキドキしたり、ワクワクしたりする瞬間は必要だ！」ということ。イベント参加後は自分がリフレッシュできたこともあり、気持ちに余裕を持って息子と接することができて、こんないい効果も生まれるんだなと実感しました。

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 < 0.01). No significant associations were found between the overall neighbourhood walkability indices and weight change. Among walkability components, there was a marginally significant negative association between space syntax measure of street integration and weight change: one standard deviation increment in street integration was associated with 0.31 kg less weight gain (p = 0.09). Conclusions: Using a prospective study design and a novel space-syntax based measure of walkability, we were not able to identify relationships between neighbourhood walkability with weight gain. This is consistent with other inconclusive findings on the built environment and obesity. Research on the built environment and adults' weight gain may need to consider not just local environments but also a larger scale environment within a city or workplace environment in order to capture multiple behaviours relevant to weight gain.

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.

© The Author(s) 2019. An increasing number of studies have examined neighbourhood built environment attributes associated with cycling. Some of them suggest non-linear relationships between built environment attributes and cycling. This study examined the strength and shape of associations of cycling for transport with objectively measured built environment attributes. Data were from 9146 Australian adults who took part in the 2009 South-East Queensland Travel Survey. Participants (aged 18–64 years) completed a 24-hour travel survey, in which they reported modes of travel. Residential density, Walk Score and a Space Syntax measure of street integration were calculated at a neighbourhood level using geographic information systems. Multilevel logistic regression analyses examined associations of bicycle use with each built environment attribute, which was modelled continuously and categorically. All continuous measures of the built environment attributes were associated with bicycle use. Each one-decile increment in residential density, Walk Score, and street integration was associated with 13%, 16%, and 10% higher odds of bicycle use, respectively. However, the associations appeared to be non-linear, with significant odds ratios observed only for the higher categories of each built environment attribute relative to the middle category. This study found that adults living in high-density neighbourhoods with more destinations nearby and well-connected streets were more likely to cycle for transport. However, medium-level density, access to destinations and street connectivity may not be enough to facilitate bicycle use. Further studies are needed to investigate urban design threshold values above which cycling can be promoted.

Objective: To investigate the effect of the self-monitoring of physical activity by hospitalized cardiac patients attending phase I cardiac rehabilitation (CR).Design: Randomized controlled trial.Setting: University hospital CR program.Participants: CR patients (N=126) with a mean age of 59.1 years.Interventions: Patients were randomly assigned to the selfmonitoring group (group A, n=63) or the control group (group B, n=63). Along with CR, group A patients performed selfmonitoring of their physical activity at the beginning of a phase I CR program (acute in-hospital phase for inpatients) and ending just before they began a phase 11 CR program (postdischarge recovery phase for outpatients).Main Outcome Measures: Physical activity (averages of daily number of steps taken and daily energy expenditure for lwk) as measured by accelerometer was assessed in both groups at baseline (t1) and before the beginning of phase II CR (t2).Results: Although there were no significant differences in physical activity values between groups A and B at t1, values of group A at t2 were significantly higher than those of group B (8609.6 vs 5512.9 steps, P.001; 242.6 vs 155.9kcal, P.001).Conclusions: Self-monitoring of patient physical activity from phase II CR might effectively increase the physical activity level in preparation for entering a phase IT CR program. Results of the present study could contribute to the development of new strategies for the promotion of physical activity in cardiac patients.