The Journal of the Japanese Association of Health Communication
Vol. 12, No.1


Three Ways in which Health Communication Contributes toward Equitable Health Promotion

Naoki Kondo

Kyoto University

There are two types of population strategy in preventive medicine. One aims to promote public awareness for healthy behavior while the other is directed towards changing the social environment. The former may widen health inequity given that socially vulnerable people are less likely to have sufficient resources to follow behavioral recommendations. Thus, the latter approach is more important for achieving health equity. Given this, as a social epidemiologist, when it comes to obtaining equitable outcomes, I expect the active commitment of health communication researchers in relation to the following three activities. First, promoting advocacy and eliminating the perspective of individual responsibility from health services. Second, applying the latest scientific theories of behavior, including “nudge” theory, in health communication, so that daily lives can be structured in a way that allows people to undertake healthy actions without incurring a heavy cognitive burden. Third, developing organizational communication models to promote community organizing for equitable social actions at the global, national, and local levels. Community organizing is essential for being able to undertake actions that have a synergic impact on both population health and other social values, e.g., as seen with the UN Sustainable Development Goals. Health is “a major resource for social, economic and personal development,” “but not the objective of living” (WHO Ottawa Charter, 1986). We need good partnerships with other sectors. For this reason, health communication sciences are likely to become increasingly important.

Health Communication for Empowerment and Social Inclusion

Miki Akiyama1), Tatsuya Imamura2), Yusuke Kakei3), Masayo Nagai4), Yoshiharu Fukuda5)

1) Keio University,2) Sasaeai-Yorozu Clinic,3) Issue Plus Design,4) APCO Worldwide,5) Teikyo University

This paper is a summary report of Symposium I at the 12th Meeting of the Japanese Health Communication Association, titled "Health Communication for Nurturing and Moving Patients, Residents, and Communities". At this symposium, three practitioners working on empowerment and social inclusion of vulnerable parties having difficulties in their lives. First, a psychiatrist Dr. Imamura introduced “Tojisya-Kenkyu” by clients with mental disorder, which is a collaborative process of studying oneself through communication with others who share similar experiences. Next, Mr. Kakei as a designer introduced their project, "How to walk in the world of dementia", which conveys the world experienced by people with dementia so that people without dementia can understand it. Then, Ms. Nagai specializing in public affairs reported on a case study of macro-level advocacy, which enabled policy changes for women’s health promotion. After the presentations, Dr. Fukuda of Teikyo University wrapped up the symposium. He presented a new aspect of health communication, which is "Communication FOR Health” and concluded that health communication will be more interesting, involve more researchers and practitioners, and improve people's health.

Diversity Sensitive Communication in Healthcare

Hirono Ishikawa1), Yuko Takeda2), Wakako Osaka3), Sawako Okamoto4), Kazuhiko Fujisaki5),

1) Teikyo University Graduate School of Public Health, 2) Juntendo University Graduate School of Medicine, 3) Faculty of Nursing and Medical Care, Keio University, 4) Nara Medical University, 5) Medical Education Development Center, Gifu University

Over the past several decades, patient and public involvement and collaboration with healthcare providers have been increasingly emphasized in health care. Various studies have indicated that patients’ active participation in their care and healthcare decision making could lead to improved health outcomes and quality of healthcare. However, barriers to active participation and the characteristics of those who are likely to suffer from these barriers have also been suggested. Healthcare providers and institutions are increasingly expected to become sensitive to the diversity of their patients in communicating with them. Such communication could facilitate patient activation and participation, and decrease social inequality in health by supporting those vulnerable populations. The current article reports the discussion in the symposium of diversity sensitive communication in healthcare, focusing on the current status and future agenda of collaboration between healthcare provider/professional and patient/public in Japan.

Risk Communication Regarding COVID-19 Outbreak in Japan

Kiyotaka Watanabe1)2), Kyoko Kitazawa2)3), Masae Sato2)4), Satoshi Kutsuna5), Kaori Muto6)

1) Division of Medical Oncology, Department of Medicine, Teikyo University School of Medicine, 2) Media Doctor Japan, 3) Kyoto Pharmaceutical University, 4) Chibaken Saiseikai Narashino Hospital, 5) Disease Control and Prevention Center, National Center for Global Health and Medicine Hospital, 6) Department of Public Policy, Human Genome Center, The Institute of Medical Science,The University of Tokyo

At the end of 2019, a novel coronavirus was identified as the cause of severe acute respiratory syndrome. The virus caused a pandemic throughout the world. Coronavirus disease 2019 (COVID-19) has been a global public health issue since early 2020. We held a special symposium at the 12th Annual Meeting of the Japanese Association of Health Communication under the theme of “risk communication regarding COVID-19” in September 2020. In this session, panelists debated about various aspects of COVID-19: 1) methods of gathering reliable information, literature searches, 2) updates on prevention, diagnosis, and treatment, and 3) social and public issues. Health and economic disparity, and legal and ethical aspects were also highlighted. Discussion with panelists and meeting participants was held online and useful information on COVID-19 was shared. Participants shared their views about the importance of effective risk communication and the need for health literacy of citizens, together with various health-related issues in medical news reporting that have been discussed in Media Doctor Research Japan (established in 2007 for better health news reporting and communication). During the pandemic threat, participants were able to share a wide range of information to cope with the new era of the pandemic.

Exploring Physicians’ Communication Approaches to Know their Patients’ Wishes and Will from the Patients’ Perspectives: A Qualitative Study Based on Interviews with Patients Diagnosed with Hematological Malignancies

Fumika Horinuki1), Naoko Mikoshiba1), Shunya Arai2), Nobuko Motojima3)

1) Division of Health Sciences and Nursing, Graduate School of Medicine, The University of Tokyo, 2) Department of Hematology and Oncology, The University of Tokyo Hospital, 3) Department of Nursing, The University of Tokyo Hospital

Introduction: This study aimed to describe the patients’ perspectives of physicians’ communication approaches to know and respect patients’ wishes and will.Method: We conducted semi-structured interviews with patients diagnosed with hematological malignancies. We asked about communication experiences with physicians, with a particular emphasis on whether they felt their wishes and will were known to, and respected by physicians. We also asked for patients’ ideas about physicians’ communication approaches. We made verbatim records and analyzed the data qualitatively using content analysis techniques.Results: We interviewed 11 patients. From the patients’ perspectives, the physicians’ communication approaches to know and respect patients’ wishes and will were classified into three categories: 1) Making a comfortable environment to talk, 2) Reaching out, and 3) Expressing understanding. Making a comfortable environment to talk included greetings, smiling, and daily conversations. Reaching out included asking the patients about their wishes and will with regards to the treatment of the diseases, and the way of life. Expressing understanding included showing recognition verbally to the patients’ wishes and will.Conclusion: The combination of the physicians’ active communication approaches would contribute to the development of the patients’ perception that their wishes and will are respected in daily healthcare.

Training in Medical Interview with Simulated Difficult Patients

ICHIKURA Kanako1), MORIYA Rika2), CHIBA Hiroki2), INOUE Akiomi3)4), SHIMAZU Akihito5), TSUTSUMI Akizumi3),

1) Department of Health Science, Kitasato University School of Allied Health Sciences, 2) Department of Medical Education, Kitasato University School of Medicine, 3) Department of Public Health, Kitasato University School of Medicine, 4) Institutional Research Center, University of Occupational and Environmental Health, Japan, 5) Faculty of Policy Management, Keio University

Purpose To clarify the status of health promotion interventions designed to change consumers’ awareness, attitudes, and behavior in Japan, we conducted a systematic review of Japanese studies. Method Relevant articles were identified from the database of the Japan Medical Abstracts Society. Of the 197 retrieved, we selected 41 articles that fit our predetermined inclusion and exclusion criteria. Results Few of the studies were randomized controlled trials. Most studies aimed to change participant behavior, but none focused on consumers with a relatively low interest in health matters. We extracted 77 ideas/themes related to intervention methods and classified them into eight categories. Conclusion To improve interventions, designs should be reconsidered and reworked using the “5Ws/H” (“what”, “who”, “where”, “when”, “why”, and “how”), and should consider how to include individuals with a low interest in health matters. The potential role of industry in health promotion should also be evaluated.

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