Affective stimuli in behavioural interventions soliciting for health check-up services and the service users’ socioeconomic statuses: a study at Japanese pachinko parlours
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  • Published on:
    Concern about interactions and true effect of heroic stimuli
    • Hiraku Tsujimoto, Research associate Hospital Care Research Unit, Hyogo Prefectural Amagasaki General Medical Center
    • Other Contributors:
      • Yasushi Tsujimoto, Physician
      • Yuki Kataoka, Physician

    We read an article recently published online in Journal of Epidemiology and Community Health by Dr.Kondo and Dr.Ishikawa with great interest and appreciate the authors' efforts to seek effective interventions for socioeconomically vulnerable people to have a health check-up. They suggested "hedonic stimuli" promote socially vulnerable people to have health check-up services. The "heroic effect" in this research directed to one gender only (mostly). We consider they should have performed the analysis which compares the difference of the intervention effect between on male (sensitive to this heroic stimuli) and on female (insensitive to the stimuli) in order to consider interactions (e.g. simply wearing healthcare staff's costumes). We believe that the difference in effect size between genders is the true intervention effect arisen from the "hedonic stimuli". We suggest it should be investigated using the original data of Table 2.

    Conflict of Interest:
    None declared.
  • Published on:
    Criticism of Kondo and Ishikawa article

    I felt deeply offended after reading ‘Affective stimuli in behavioural interventions soliciting for health check-up services and the service users’ socioeconomic statuses: a study at Japanese pachinko parlours’ by Kondo and Ishikawa (Kondo N, Ishikawa Y. J Epidemiol Community Health 2018; 0:1–6. doi:10.1136/jech-2017-209943). As a Japanese woman and a registered nurse, I found phrases such as ‘young women wearing mildly erotic nurse costumes’ or ‘solicitation by young women wearing sexy nurse costumes’ to be derogatory and disrespectful. If the authors needed to clarify the point of their hypothesis on the possible relationship between sexual stimuli and health behaviours, which is already disturbing enough as a research topic, it would be enough to mention ‘a person wearing mildly erotic clothes’ or ‘invitation by persons wearing sexy costumes.’ When the authors add (and the editors retain) such words as ‘young women’ or ‘nurses’ to describe the distinctive features of the intervention, they tacitly accept and capitalize on stereotypes and prejudices against young women and nurses, and assume that readers will share such insulting views as well. I was very disappointed that the paper was developed by the authors, reviewed by peer reviewers, and accepted in its current form by the editor-in-chief of the Journal of Epidemiology and Community Health. I sincerely hope that the authors, reviewers, and editor-in-chief give some more thought to how social disparity could persist...

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    Conflict of Interest:
    None declared.
  • Published on:
    Concerns re: Kondo and Ishikawa - Editors' note
    • James R. Dunn, Co-Editor Journal of Epidemiology & Community Health
    • Other Contributors:
      • Martin Bobak, Co-Editor

    The paper by Kondo and Ishikawa uncritically investigates a public health program that contradicts the journal’s values. We are aware of the concerns raised and have already begun to address them, with more action to come. We are conducting an audit of our editorial processes to determine where errors were made and will be publishing e-letters that articulate the concerns about the paper. The Editors have attached the statement below to the paper as an ‘Editorial Note’. This represents an interim measure to assert our principles. In the coming days, we publish additional E-letters to provide more detail on the actions we will take to ensure that we are consistently upholding these principles going forward.

    The Editorial Note reads:

    “The study reported in this article examines a health intervention which uses gendered stereotypes of the nursing profession and suggestive uniforms that play on women’s sexuality to encourage people to engage in health checkups. The intervention was not under the control of the authors and the study was approved by an institutional research ethics board.”

    “The Journal of Epidemiology & Community Health condemns the use of sexism, gender and professional stereotypes and other forms of discriminatory or exploitive behaviour for any purpose, including health promotion programs. In light of concerns raised about this paper, we are conducting an audit of our review process and will put in place measures to ensure that the m...

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    Conflict of Interest:
    None declared.