Annual Report 2024
Division of Behavioral Sciences
Taichi Shimazu, Maiko Fujimori, Junko Saito, Miyuki Odawara, Yuki Kaji, Mai Yamaguchi, Haruhiko Imamura, Eiko Saito, Natsu Sasaki, Khin Thet Swe, Rina Miyawaki, Akiko Yaguchi-Saito, Keiichi Yuwaki, Marina Terada, Tomomi Nagasawa, Mao Nakazawa, Mariko Nishihara, Tana Yang, Mari Ikeda, Ayaka Kiyono, Yoko Shiraishi, Hikari Nagao, Megumi Yamashita, Wakana Wakabayashi
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 promptly 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 FY2024, three new N-EQUITY research proposals were approved (No. 2403, 2404, and 2405) and the results were published for one (No. 2204) (Table 1).
Figure 1. Organization of N-EQUITY since December 2019
Table 1. N-EQUITY Approved Studies (2019-2025.3)
2) Implementation Research of Tobacco Control Measures in Workplaces
We conducted 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 presented the primary results as a poster at the 2024 ASCO Annual Meeting organized by the American Society of Clinical Oncology (ASCO).
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 (INFORM Study 2020). We have published two papers on our results. We also conducted a survey on living with cancer in 2023 using the same study design (INFORM Study 2023) and published one paper on our results.
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 six doctoral students and two master's students.
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 2024
Journal
1. Kako J, Kajiwara K, Kobayashi M, Kanno Y, Morikawa M, Nakano K, Matsuda Y, Shimizu Y, Niino M, Suzuki M, Shimazu T. Applicability of Nursing Support for Patients With Terminal Cancer and Their Families: A Delphi Study. The American journal of hospice & palliative care, 42:145-154, 2025
2. Nakano K, Kanno Y, Kajiwara K, Kobayashi M, Morikawa M, Matsuda Y, Shimizu Y, Shimazu T, Kako J. Nursing Support for Constipation in Patients with Cancer: A Scoping Review. Journal of palliative medicine, 28:115-122, 2025
3. Yamada Y, Fujiwara M, Nakaya N, Otsuki K, Shimazu T, Fujimori M, Hinotsu S, Nagoshi K, Uchitomi Y, Inagaki M. Trends in uptake of cancer screening among people with severe mental illness before and after the COVID-19 pandemic in Japan: A repeated cross-sectional study. PCN reports : psychiatry and clinical neurosciences, 4:e70062, 2025
4. Kuroda Y, Fujita K, Sugimoto T, Uchida K, Yokoyama Y, Shimazu T, Saito J, Arai H, Sakurai T. Evaluating the feasibility of a community-adapted multi-domain intervention for dementia prevention in older adults. Journal of Alzheimer's disease : JAD, 104:269-282, 2025
5. 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, 41:1184-1194, 2024
6. 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, 34:411-418, 2024
7. 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
8. 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
9. Sasaki N, Shimazu T, Takeno H, Ogawa S, Sawada U, Tsutsumi A, Imamura K. Implementation of an internet-based stress management program in micro- and small-sized enterprises: a study protocol for a pre-post feasibility study of the effectiveness-implementation hybrid type 2 trial. Pilot and feasibility studies, 10:56, 2024
10. Obama K, Fujimori M, Boku N, Matsuoka A, Mori K, Okizaki A, Miyaji T, Okamura M, Majima Y, Goto S, Shimazu T, Uchitomi Y. Shared decision-making support program for older patients with advanced cancer using a question prompt list and geriatric assessment: A pilot randomized controlled trial. Journal of geriatric oncology, 15:101778, 2024
11. Uneno Y, Fukuyama K, Nishimura A, Eguchi K, Kojima H, Umino T, Miyazaki K, Negora E, Minashi K, Sugiyama O, Shimazu T, Muto M, Matsumoto S. Barriers and Facilitators to the Implementation of an Electronic Patient-Reported Outcome System at Cancer Hospitals in Japan. Cureus, 16:e58611, 2024
12. Sasaki N, Ogawa S, Sawada U, Shimazu T, Powell BJ, Takeno H, Tsutsumi A, Imamura K. Effectiveness of an online text-based stress management program for employees who work in micro- and small-sized enterprises: A randomized controlled trial. Internet interventions, 37:100754, 2024
13. Uneno Y, Mori M, Saito J, Otsuki A, Kuchiba A, Sakurai N, Nakaya N, Fujimori M, Shimazu T. Awareness, information sources, and beliefs regarding palliative care in the general population in Japan: a nationwide cross-sectional survey (INFORM study 2023). Japanese journal of clinical oncology, 54:1171-1179, 2024
14. Ueno K, Nishioka D, Saito J, Kino S, Kondo N. Understanding the daily life needs of older public assistance recipient subgroups in Japan: A qualitative study. Global health & medicine, 6:259-263, 2024
15. Kato D, Kawachi I, Saito J, Kondo N. Complex Multimorbidity and Trajectories of Functional Disabilities in the Last Three Years of Life: A Prospective Cohort Study of Older Adults in Japan. Journal of applied gerontology, 7334648241303256, 2024