Japanese are afflicted by dementia in similar proportion to members of other developed countries. Yet while many at risk outside of Japan proactively seek medical advice and treatment, few Japanese undergo early screening for the disease. Eisai Co. and Pfizer Inc. approached PR Consulting Dentsu to discover the reasons for this reticence and identify solutions. We launched a five-year study and educational campaign that not only raised overall awareness of dementia among Japanese, but was instrumental in persuading the Ministry of Health, Labour and Welfare to alter its official term for the disease and spurred Japan’s first large-scale dementia research project.
Dementia is a debilitating disease prevalent among but not confined to the elderly. By 2050, one in three Japanese will be 65 or over, compared with one in five today. Among those over 65 today, already an estimated 7.2% suffer from dementia and as Japan’s population ages that number will grow.
Onset can be significantly slowed with treatment if detected early. Evidence from the late 1990s shows that ignorance about the disease at all levels of Japanese society has dissuaded people from seeking screening. Consequently, for the future health of the nation, the Japanese public, caregivers, and healthcare and medical communities must be able to identify dementia’s symptoms early, advocate screening and encourage treatment.
Pharmaceutical firms Eisai and Pfizer recognized the importance of discovering why Japanese were reluctant to submit to screening and why the medical community seemed unaware or unconcerned about the problem.
The two companies, together with the Tokyo Metropolitan Institute for Gerontology assigned PR Consulting Dentsu four tasks:
– Determine reasons for lack of screening and proper diagnosis
– Suggest ways to simplify screening and diagnosis
– Educate the public about dementia
– Improve doctors’ recognition of disease symptoms
An educational seminar being conducted
From the project launch, we recognized that to educate the medical community and public about dementia, adopting traditional public relations tools such as promotional kits and special events was unlikely to be successful.
The quantity and quality of information then available regarding the way caregivers and the health and medical communities were addressing the issue was so limited that we decided the research itself should be the campaign. Only by presenting Japan’s highly influential yet conservative medical community with concrete results gleaned from exhaustive research might doctors be persuaded to change the way dementia and those afflicted with it are viewed in Japan.Multilevel research was undertaken using a variety of methods quantitative and qualitative surveys, video interviews, group interviews and case studies.
- Phase 1:
- Discussions were held with specialists from organizations including the Japan Dementia Care Society and the Tokyo Metropolitan Institute for Gerontology to identify research targets and set survey criteria.
- During this year, two nationwide surveys and four group interview sessions were conducted.
- Phase 2:
- The survey results were assessed. The group interviews, conducted in Tokyo, central, western and northern Japan targeting caregivers and the healthcare community, were videotaped and analyzed.
- A key finding here was that many Japanese considered the discussion of dementia in public, or even private, to be taboo. The cultural stigma seemed so deeply ingrained that sufferers opted to endure in silence and families pretended it did not exist. This finding suggested that critical measures were needed to help remove the stigma.
- Phase 3:
- As all research to date had been aimed at determining Japan’s approach to the disease, DPR reasoned that an international comparison would be instructive. Between November 2003 and July 2004 the Tokyo Metropolitan Institute for Gerontology and the University of Barcelona conducted a joint study on public attitudes to the disease. Some results were so significant that they necessitated a major shift in the project focus.
Achieving the project objectives meant changing the attitudes of two different target audiences:
– Caregivers (families with elderly parents) and local medical community personnel such as health officials must be able to recognize early symptoms and be instructed on how to persuade those in their care to seek proper diagnosis and treatment- Medical professionals must be better educated about symptoms and treatment to respond positively when caregivers and others seek diagnosis and treatment.
– Produced a series brochures featuring actor Yuzo Kayama aimed at encouraging the public to seek early screening.
– Produced series of TV commercials with Yuzo Kayama encouraging early screening. Commercials had heavy rotation during prime time.
– Published research papers in leading medical journals including the Japanese Journal of Dementia Care, the Japanese Journal of Geriatric Society and the Japanese Journal of Gerontology.
– Convened series of nine conferences throughout Japan for doctors and medical professionals. (The research showed that in an alarming 21% of cases, family doctors told afflicted patients dementia was not a disease but a mere natural part of aging.) PR Consulting Dentsu provided individual and group interview video footage for instructional purposes at these conferences.
– Helped create a dementia education website (www.e-65.net) containing a wealth of information, from counseling to diagnosis.
– Produced a 20-page “self-diagnosis” brochure for doctors to distribute. (75% of those Japanese surveyed who never underwent screening gave their reason as “Dementia can happen to anyone once you get older,” indicating a critical need for education and self-diagnosis.) This “forgetfulness checklist” enables easy and private self-diagnosis.
Japanese Journal of Dementia Care and
the Japanese Journal of Gerontology
One of the initial goals was to raise awareness of the disease among primary caregivers and indicate how they could better approach dementia in the household. Research results indicated that many families had already given up hope for those loved ones stricken.
The University of Barcelona joint study found that 86.8% in Spain, and only 44.7% in Japan, said they would consult a doctor if they suspected dementia, even if it had no influence on daily activities.
We concluded that the campaign must shift focus to individuals and change the Japanese public’s perception of dementia.
– The project helped start a public discussion of dementia.
– It also spawned several major initiatives to increase understanding of dementia.
– Ministry of Health, Labour and Welfare opened a new section specifically dedicated to further research and support services for dementia. However, one of the most important results of the campaign was the decision of the Ministry to alter the official term for “dementia”, from chihosho, which has derogatory connotations in Japanese, to ninchisho (literally, “recognition disease”), thus significantly lessening the stigma associated with the name.
– The project also led Musashino City (west of Tokyo) to the decision to launch Japan’s and possibly the world’s most thorough research project to examine the incidence and effects of dementia. This 2005-2009 study will monitor 100,000 Musashino residents aged 70 to 79.
– The completion of the five-year Dementia Debunked campaign eventually led to PR Consulting Dentsu winning the Grand Prix Award for excellence in public relations from the International Public Relations Association (IPRA). Our campaign bested 239 entries from 39 different around the world.
- 7th Public Relations Society of Japan Awards
- IPRA Grand Prix Award
2005Category: Health Organizations