Annual Report 2023
Division of Behavioral Sciences
Yosuke Uchitomi, Taichi Shimazu, Maiko Fujimori, Junko Saito, Aki Otsuki, Miyuki Odawara, Yuki Kaji, Haruhiko Imamura, Rina Miyawaki, Akiko Yaguchi-Saito, Keiichi Yuwaki, Mari Ikeda, Rumi Izumi, Ayaka Kiyono, Yoko Shiraishi, Hikari Nagao
Introduction
In April 2020, a research division dealing with behavioral sciences was established for the first time at the National Cancer Center. There has been a remarkable development in technological innovation and drug development in cancer treatment. However, despite the fact that human behavior is deeply involved in all healthcare activities, including cancer prevention, early detection, diagnosis, treatment, and survivorship care, there had been no department that deals with the underlying behavior. Behavioral science and behavioral medicine have just begun to be included in the core curriculum of medical education at universities nationwide.
The Team and What We Do
The goal of the Division of Behavioral Sciences is to develop individualized behavioral interventions and to generate new evidence. Through a dialogue, we intend to develop effective behavioral interventions that are tailored to the diversity of individuals. We also use implementation science methods to develop strategies to steadily and rapidly scale up evidence-based, precise behavioral interventions nationwide.
Research Activities
1) National Center Consortium in Implementation Science for Health Equity, N-EQUITY
N-EQUITY is a collaboration of six national centers working together to implement and support implementation research projects in the areas of public health, clinical care, and international health (Figure 1). A Scientific Advisory Committee consisting of external experts was established to review protocols for implementation research. In FY2023, three new N-EQUITY research proposals were approved (No. 2301, 2401, and 2402) and the results were published for two (No. 2104 and 2106) (Table 1).
Figure 1. Organization of N-EQUITYsince December 2019
Table 1. N-EQUITY Approved Studies (2019-2024.3)
2) Implementation Research of Tobacco Control Measures in Workplaces
We have continued to conduct a cluster randomized controlled trial (eSMART-TC [N-EQUITY2101/J-SUPPORT2102]) aiming to examine whether interactive six-month interventions for employers and health managers through online sessions using behavioral change techniques to promote the implementation of tobacco control measures increase successful smoking cessation of employees compared with the absence of such interventions. We have completed data analysis for the primary endpoint. In addition, by having public health nurses from the Japan Health Insurance Association, who had been trained by researchers, conduct some of the post-intervention for the control group, we were able to identify issues that needed to be addressed to implement the program.
3) INFORM Study
A mail questionnaire survey of 10,000 randomly selected people aged 20 and older was conducted to identify methods to deliver useful information on cancer prevention and medical care (INFORM Study 2020). We have published 5 papers on our results. We also developed a questionnaire and conducted a survey on living with cancer in 2023 using the same study design (INFORM Study 2023) and obtained 3,452 valid responses.
Clinical Trials
Interactive assistance via eHealth for small and medium-sized enterprises' employer and health care manager teams on tobacco control (N-EQUITY2101/J-SUPPORT2102) (UMIN000044526)
Education
We supervised the research of four doctoral students and one master's student.
We held ten "Implementation Science Seminars."
Future Prospects
This division will promote behavioral science research related to public health and clinical practices, including cancer prevention, early detection, diagnosis, treatment, and survivorship care. We will also contribute to the development of evidence for implementation science. This will lead to the implementation of behavioral interventions for those who have difficulty accessing health care and for communities with limited medical resources.
List of papers published in 2023
Journal
1. Miyawaki R, Oka K, Otsuki A, Saito J, Yaguchi-Saito A, Kuchiba A, Fujimori M, Kreps GL, Shimazu T. Trust in Mass Media as Sources of Cancer Information: Findings from a Nationally Representative Cross-Sectional Survey in Japan. Journal of health communication, 29:143-154, 2024
2. Momosaka T, Saito J, Otsuki A, Yaguchi-Saito A, Fujimori M, Kuchiba A, Katanoda K, Takaku R, Shimazu T. Associations of individual characteristics and socioeconomic status with heated tobacco product harmfulness perceptions in Japan: A nationwide cross-sectional study (INFORM Study 2020). Journal of epidemiology, 2024
3. Okamura M, Fujimori M, Otsuki A, Saito J, Yaguchi-Saito A, Kuchiba A, Uchitomi Y, Shimazu T. Patients' perceptions of patient-centered communication with healthcare providers and associated factors in Japan - The INFORM Study 2020. Patient education and counseling, 122:108170, 2024
4. Fujiwara M, Yamada Y, Etoh T, Shimazu T, Kodama M, Yamada N, Asada T, Horii S, Kobayashi T, Hayashi T, Ehara Y, Fukuda K, Harada K, Fujimori M, Odawara M, Takahashi H, Hinotsu S, Nakaya N, Uchitomi Y, Inagaki M. A feasibility study of provider-level implementation strategies to improve access to colorectal cancer screening for patients with schizophrenia: ACCESS2 (N-EQUITY 2104) trial. Implementation science communications, 5:2, 2024
5. Ueno T, Saito J, Murayama H, Saito M, Haseda M, Kondo K, Kondo N. Social participation and functional disability trajectories in the last three years of life: The Japan Gerontological Evaluation Study. Archives of gerontology and geriatrics, 121:105361, 2024
6. Ishikawa H, Ogawa R, Otsuki A, Saito J, Yaguchi-Saito A, Kuchiba A, Fujimori M, Fukuda Y, Shimazu T. Effect modification by geographic area on the association between health literacy and self-rated health: a nationwide cross-sectional study in Japan. BMC public health, 23:952, 2023
7. Saito J, Odawara M, Fujimori M, Kuchiba A, Oyamada S, Swe KT, Saito E, Fukai K, Tatemichi M, Nakamura M, Uchitomi Y, Shimazu T. Interactive assistance via eHealth for small- and medium-sized enterprises' employer and health care manager teams on tobacco control (eSMART-TC): protocol for a cluster randomized hybrid type II trial (N-EQUITY2101/J-SUPPORT2102). Implementation science communications, 4:61, 2023
8. Terada M, Shimazu T, Saito J, Odawara M, Otsuki A, Yaguchi-Saito A, Miyawaki R, Kuchiba A, Ishikawa H, Fujimori M, Kreps GL. Age, gender and socioeconomic disparities in human papillomavirus (HPV) awareness and knowledge among Japanese adults after a 7-year suspension of proactive recommendation for the HPV vaccine: A nationally representative cross-sectional survey. Vaccine, 41:7147-7158, 2023
9. Shimazu A, Fujiwara T, Iwata N, Kato Y, Kawakami N, Maegawa N, Nakao M, Nomiyama T, Takahashi M, Tayama J, Watai I, Arima M, Hasegawa T, Matsudaira K, Matsuyama Y, Miyazawa Y, Shimada K, Takahashi M, Watanabe M, Yamaguchi A, Adachi M, Tomida M, Chen D, Doi S, Hirano S, Isokawa S, Kamijo T, Kobayashi T, Matsuzaki K, Moridaira N, Nitto Y, Ogawa S, Sakurai M, Sasaki N, Tobayama M, Yamauchi K, Obikane E, Odawara M, Sakka M, Takeuchi K, Tokita M. Effects of work-family life support program on the work-family interface and mental health among Japanese dual-earner couples with a preschool child: A randomized controlled trial. Journal of occupational health, 65:e12397, 2023
10. Akiyama M, Ishida N, Takahashi H, Takahashi M, Otsuki A, Sato Y, Saito J, Yaguchi-Saito A, Fujimori M, Kaji Y, Shimazu T. Screening practices of cancer survivors and individuals whose family or friends had a cancer diagnoses-a nationally representative cross-sectional survey in Japan (INFORM Study 2020). Journal of cancer survivorship, 17:663-676, 2023
11. Yamada Y, Fujiwara M, Etoh T, Wada R, Inoue S, Mimaki Y, Kodama M, Yoshimura Y, Horii S, Matsushita T, Fujimori M, Shimazu T, Nakaya N, Hinotsu S, Tabata M, Tamura K, Uchitomi Y, Yamada N, Nagoshi K, Inagaki M. Perceptions toward issues in cancer care for people with mental illness among psychiatric care providers: A questionnaire study. Psycho-oncology, 32:1022-1029, 2023
12. Fujiwara M, Yamada Y, Shimazu T, Nakaya N, Hinotsu S, Fujimori M, Uchitomi Y, Inagaki M. Increasing disparities in cancer screening among people with severe mental illness during the COVID-19 pandemic. Schizophrenia research, 258:18-20, 2023
13. Ueno K, Nishioka D, Saito J, Kino S, Kondo N. Identifying meaningful subpopulation segments among older public assistance recipients: a mixed methods study to develop tailor-made health and welfare interventions. International journal for equity in health, 22:146, 2023
14. Itani Y, Obama K, Fujimori M, Saito J, Uchitomi Y. Cancer treatment-related financial toxicity in Japan: a scoping review. Frontiers in psychology, 14:1205016, 2023
15. Hasegawa N, Yasuda Y, Yasui-Furukori N, Yamada H, Hori H, Ichihashi K, Takaesu Y, Iida H, Muraoka H, Kodaka F, Iga JI, Hashimoto N, Ogasawara K, Ohi K, Fukumoto K, Numata S, Tsuboi T, Usami M, Hishimoto A, Furihata R, Kishimoto T, Nakamura T, Katsumoto E, Ochi S, Nagasawa T, Atake K, Kubota C, Komatsu H, Yamagata H, Ide K, Takeshima M, Kido M, Kikuchi S, Okada T, Matsumoto J, Miura K, Shimazu T, Inada K, Watanabe K, Hashimoto R. Effect of education regarding treatment guidelines for schizophrenia and depression on the treatment behavior of psychiatrists: A multicenter study. Psychiatry and clinical neurosciences, 77:559-568, 2023
16. Matsuoka A, Mizutani T, Kaji Y, Yaguchi-Saito A, Odawara M, Saito J, Fujimori M, Uchitomi Y, Shimazu T. Barriers and facilitators to implementing geriatric assessment in daily oncology practice in Japan: A qualitative study using an implementation framework. Journal of geriatric oncology, 14:101625, 2023
17. Nishioka D, Saito J, Ueno K, Kondo N. Sociodemographic inequities in unscheduled asthma care visits among public assistance recipients in Japan: additional risk by household composition among workers. BMC health services research, 23:1084, 2023
18. Kako J, Morikawa M, Kobayashi M, Kanno Y, Kajiwara K, Nakano K, Matsuda Y, Shimizu Y, Hori M, Niino M, Suzuki M, Shimazu T. Nursing support for breathlessness in patients with cancer: a scoping review. BMJ open, 13:e075024, 2023
19. Kuroda Y, Fujita K, Sugimoto T, Uchida K, Shimazu T, Saito J, Arai H, Sakurai T. Feasibility of a community-adapted multi-domain intervention for dementia prevention among older adults: a research protocol. Archives of public health = Archives belges de sante publique, 81:191, 2023
20. Honyashiki M, Decoster J, Lo WTL, Shimazu T, Usuda K, Nishi D. Mental Health Reform Processes and Service Delivery Shift From the Hospital to the Community in Belgium and Hong Kong. Health services insights, 16:11786329231211777, 2023
21. Kajiwara K, Kobayashi M, Morikawa M, Kanno Y, Nakano K, Matsuda Y, Shimizu Y, Shimazu T, Kako J. Nursing Support for Caregiver Burden in Family Caregivers of Patients With Cancer: A Scoping Review. The American journal of hospice & palliative care, 10499091231215808, 2023
22. Nagasawa T, Saito J, Odawara M, Kaji Y, Yuwaki K, Imamura H, Nogi K, Nakamura M, Shimazu T. Smoking cessation interventions and implementations across multiple settings in Japan: a scoping review and supplemental survey. Implementation science communications, 4:146, 2023
23. Kobayashi M, Kajiwara K, Morikawa M, Kanno Y, Nakano K, Matsuda Y, Shimizu Y, Shimazu T, Kako J. Nursing Support for Nausea and Vomiting in Patients With Cancer: A Scoping Review. Cureus, 15:e48212, 2023
24. Morikawa M, Kajiwara K, Kobayashi M, Yusuke K, Nakano K, Matsuda Y, Shimizu Y, Shimazu T, Kako J. Nursing Support for Pain in Patients With Cancer: A Scoping Review. Cureus, 15:e49692, 2023