DEVELOPMENT OF SCHOOL HEALTH EDUCATION PROGRAM FOR HEALTHFUL LIFESTYLE

包括癌症、心脏病和中风在内的慢性病占日本所有死亡人数的近70%。高胆固醇、高血压、吸烟、缺乏运动和肥胖等危险因素可以预测这些慢性疾病的发展。这些风险因素通常是不良健康习惯的结果，如食用高脂肪、高胆固醇、高盐和高精制糖的饮食，缺乏体育活动和吸烟。如果能教导儿童更健康的生活方式，包括避免这些冒险行为，慢性病的发展就可以减少。传统的健康教育项目只是向学生提供有关健康风险的信息。然而，研究清楚地表明，获得的知识并不总能带来行为上的改变。另一方面，美国健康基金会制定了一项全面的学校健康促进计划“了解你的身体”，旨在使儿童掌握做出健康决定所需的知识、态度和技能。许多对照科学研究表明，该计划在学生的健康相关知识、态度和行为方面产生了重大变化。本研究（JKYB）的目标是开发日本版的KYB。第一阶段是需求评估和数据收集调查，于1989年进行。下一步，我们在1990年和1991年期间将KYB学生资料和教师手册翻译成日文。我们现在正在为日本小学4-6年级的孩子开发一个项目。该计划的重点是预防吸烟，其内容多种多样，包括有关吸烟的短期生理影响的信息、有关吸烟行为的社会影响的信息以及拒绝技巧的培训。过程评价证明了对吸烟态度和知识的短期有效性。目前正在进行影响评价。

Chronic diseases, including cancer heart disease and stroke account for nearly 70% of all deaths in Japan. Risk factors such as high blood cholesterol level, high blood pressure, cigarette smoking, physical inactivity and obesity can predict the development of these chronic diseases.These risk factors are usually the result of poor health habits such as the consumption of diets high in fat, cholesterol, salt and refined sugar, lack of physical activity and cigarette smoking. The development of chronic diseases can be reduced if children can be taught more healthful lifestyles that include avoidance of these risk-taking behavior.Traditional health education programs simply provided information on health risks to students. However, research clearly shows that knowledge gained does not always produce a behavioral change. On the other hand, a comprehensive school health promotion program "Know Your Body" developed by American Health Foundation aims to empower children with knowledge, attitudes and skills needed to make healthy decisions. A number of controlled scientific studies show that the program produces significant changes in students' health-related knowledge, attitudes and behavior.The goal of this study (JKYB) is to develop a Japanese version of KYB. The first phase was a needs assessment and data collection survey and it was administered during 1989. In the next step, we translated KYB student materials and teacher manuals into Japanese during 1990 and 1991. We are now developing a program for Japanese elementary school children in grades 4-6. The program that focuses on cigarette smoking prevention is based on a variety of content including information about the short-term physiological effects of smoking, information about social influences on smoking behavior, and training in refusal skills. The process evaluation has demonstrated the short-term effectiveness on attitudes and knowledge about smoking. The impact evaluation is now under way.