Effectiveness of distributing pocket cards in improving the behavior, attitude, and knowledge regarding proper medication use among junior high school students in Japan.

Objective: This study aimed to explore the effectiveness of distributing pocket cards with summaries of key information on appropriate medication usage after the implementation of a structured school-based medication education program for junior high school students in Japan. Methods: A total of 227 3rd-grade high school students participated in the intervention. Students who received the program without the provision of pocket cards in 2022 were included in the comparison group, and students who took the program with the provision of pocket cards in 2023 were included in the intervention group. After propensity score matching, the final sample of N = 116 comprised n = 58 comparison group participants and n = 58 intervention group participants. Questionnaires were administered at baseline, end-of-class, and 3-month follow-up to assess the changes in behavior, attitude, and knowledge scores. Results: The matched intervention group showed significantly lower scores at the 3-month follow-up than the matched comparison group. The results of the multiple linear regression analysis showed that for both groups, only the attitude scores were significantly correlated with the behavior scores. In addition, regardless of the baseline scores, the matched intervention group demonstrated smaller or negative changes in scores at the 3-month follow-up. Conclusion: Overall, the results of this study did not support the effectiveness of distributing pocket cards after in-class intervention. However, the usefulness of medication education intervention was confirmed. These results emphasize the need to explore other supplemental teaching tools to further enhance the impact of structured medication education programs.

Factors Influencing Medicine Use Behavior in Adolescents in Japan Using a Bayesian Network Analysis.

Background: Medicine education in Japan was introduced to junior high schools in 2012. However, the effectiveness of existing education programs is limited. In order to develop more effective programs for high school students, the present study investigated the variables that directly influence medicine use behavior and the magnitude of their influence, using a Bayesian network analysis. Methods: A national cross-sectional survey was conducted in 2017. Eighty-three public high schools across Japan were randomly selected, and questionnaires were administered to 15-16 years old 10th grade students. The number of valid responses was 17,437 (effective response rate was 98.46%). Responses were analyzed to measure students' behavior toward, attitudes regarding, and knowledge of medicines, and awareness of their prior medicine education. Results: Students' "attitude score" and "awareness of a class" directly influenced their "behavior score." The "score on attitude," which had a large influence on "score on behavior," was directly influenced by "score on knowledge of proper use" and "awareness of class." Conclusion: The present study argues that acquiring knowledge of appropriate medicine use leads to the acquisition of favorable attitudes, which may result in behavioral change. Therefore, for medicine education, it is expected that incorporating content related to knowledge acquisition for changing attitudes will be important for promoting behavioral change.

Common aspects of the lifestyles of high school students in Japan and their associations with drug abuse: Findings from an aggregate sample of the Japanese School Survey Project on Alcohol and Other Drugs in 2004, 2006, and 2009.

This study sought (1) to determine the significant associations between measures of drug abuse and lifestyle variables in high school students in Japan, and (2) to ascertain common lifestyle variables in relation to associations between lifestyle and eight measures of drug abuse. Four measures were use of an inhalant, marijuana, an amphetamine-type stimulant (ATS), or MDMA (ecstasy) over the past year, and four measures were use of those drugs over one's lifetime. Data were from a combined sample (aggregate sample) from the Japanese School Survey Project on Alcohol and Other Drugs (JSPAD). The aggregate sample consisted of 75, 726 1st-, 2nd-, and 3rd-year students (37,697 males and 38,029 females) at high schools nationwide who were selected by stratified, single-stage cluster sampling during surveys in 2004, 2006, and 2009. Eight measures of drug abuse were predicted with logistic regression analysis based on lifestyle variables. Six lifestyle variables jointly predicted those measures: "get- ting up at the same time every day," "eating breakfast," "enjoying school,'' "hours worked at a part-time job," "having close friends to hang out with", and "talking with one's parents about one's problems". The six lifestyle variables were associated with the measures of drug abuse in similar ways, regardless of which drug was abused. Those associations indicated that students whose parents were not at home had a markedly higher level of drug abuse. Students who lacked close friends to hang out with, students who did.not enjoy school, students who rarely ate breakfast, and students who did not get up at the same time every day had a higher level of drug abuse. Several indicators of associations yielded findings, and these findings could presumably help to determine if "individuals who abuse drugs display characteristics as a group" and if "individuals who abuse drugs tend to abuse multiple drugs".

Reasons for alcohol consumption among Japanese high school students overall and by sex and year in school: An exploratory study.

This study sought to ascertain the association between alcohol consumption by Japanese high school students and their reasons for drinking. Monitoring the Future is a U.S. survey of substance abuse that features a core question that asks about reasons for drinking. This study translated that question into Japanese to survey 2,283 students (1,404 males and 879 females; 1,142 freshmen and 1,141 sophomores) at 3 Japanese high schools from November to December 2014. The original question had 15 possible answers, but 2 were eliminated and the answer "I don't drink" was added. Responses were analyzed overall and by sex and year. Results indicated that 9.4% of male students drank in the past 30 days, 28.4% drank in the past year, and 43.0% had drunk at some point in their lives. Similarly, 6.5% of female students drank in the past 30 days, 23.8% drank in the past year, and 36.7% had drunk at some point in their lives. Of the sample, 58.1% answered that they "don't drink. " Given reasons for drinking were "because it tastes good" (15.8%), "to-experiment-to see what it's like" (14.5%), "to have a good time with my friends" (14.1%), "to relax or relieve tension" (10.2%), "to feel good or get high" (7.9%), and "to fit in with a group I like" (5.2%). Respondents who drank in the past 30 days, in the past year, or at some point in their lives did so for different reasons. As alcohol consumption increased, respondents drank "because it tastes good" markedly more often. Reasons for drinking were ranked by frequency to compare Japanese high school students and U.S. 12th graders. Japanese students were more likely to drink "to fit in with a group I like" while U.S. students were more likely to drink "because of boredom, nothing else to do."

[The association between extracurricular activities and exercise and substance abuse among high school students in Japan: results for an aggregate sample from the Japanese School Survey Project on Alcohol and Other Drugs in 2004, 2006, and 2009].

The purpose of this study was to clarify the subgroup differences in the association between participation in school-based extracurricular activities and exercise and levels of cigarette, alcohol, or marijuana use during one's lifetime and in the past year. This study also sought to determine the optimal classification of subgroups based on four variables (participation in school-based extracurricular activities, exercise, gender, and school year). Data consisted of a combined sample (aggregate sample) from the Japanese School Survey Project on Alcohol and Other Drugs (JSPAD) conducted in 2004, 2006, and 2009. The aggregate sample consisted of 75,726 1st-, 2nd-, and 3rd-year students (37,697 males and 38,029 females) at full-time high schools nationwide that were selected by stratified, single-stage cluster sampling during each survey. The aggregate sample combined randomly selected samples of the same size from each year the survey was conducted. Results indicated that 63.4% of the entire sample participated in school-based extracurricular activities, 64.8% of males did so, and 61.9% of females did so. Results also indicated that 66.4% of the entire sample exercised outside of PE class, 79.2% of males did so, and 53.8% of females did so. In addition, the prevalence of cigarette, alcohol, or marijuana use was predicted from the four variables by multiple logistic regression analysis. Results yielded optimal subgroups for the prevalence of each drug's use. Results revealed (1) that participation in school-based extracurricular activities and gender were more predictive, whereas exercise was least predictive, (2) that the association between exercise and substance use measures varies subtly for each subgroup, suggesting the existence of a great variety of opportunities for high school students to exercise, and (3) that school year had a substantial and positive effect on drinking among students who actively participated in school-based extracurricular activities.

[Gender differences in the association between substance abuse and lifestyles among high school students in Japan: findings from the 2009 Japanese School Survey Project on Alcohol and Other Drugs].

The purpose of this paper is to clarify gender differences in the association between substance abuse measures and lifestyle variables among Japanese high school students. The data was obtained from the nationwide representative sample of the Japanese School Survey Project on Alcohol and Other Drugs (JSPAD) conducted in 2009. The sample consisted of 25,242 1st-, 2nd-, and 3rd-year students at full-time high schools, which were selected by stratified, single-step cluster sampling. The results indicated seven principal findings. (1) All levels of cigarette smoking, alcohol consumption, and any illicit drug use throughout one's lifetime and the past year among high school students in 2009 were lower than those of the 2004 JSPAD. (2) The levels of lifetime and annual alcohol consumption among high school females were significantly higher than those of high school males. (3) Gender differences in the association between the measures of smoking or use of any illicit drug and lifestyle variables were more effective than those between drinking measures and lifestyle variables. (4) More recent alcohol consumption was likely to be less effective for gender differences in the association between drinking measures and lifestyle variables. (5) The combination of gender and "hours worked in a paid job" was generally most predictive for substance abuse measures. (6) Gender differences of "participating in extracurricular activities" and "eating breakfast" were significantly effective in the association with all substance abuse measures. (7) The orders of lifestyle variables combined with gender by model-fitting were stable for each substance, especially cigarettes and illicit drugs. The findings suggest that females are more likely to be vulnerable to isolation and irregularity of life than males, whereas the association patterns of lifestyles with substance abuse are highly similar between males and females while in high school, except for the differences in user proportion for each respective substance.