Health Education & Preventive Medicine: Driving Community-based Health Management

- Profile -

Norie KAWAHARA is Project Associate Professor, Graduate School of Arts and Sciences, The University of Tokyo. She concurrently serves as Representative Director of the Asia Cancer Forum, through which she is involved in public–private collaborations on policy recommendation initiatives that seek to raise cancer on the global health agenda, and also serves as Representative Director of the Asia Future Research Organization, a research organization focusing on future studies in Asia, including health initiatives. Research interests include interdisciplinary cancer research and global health, with a focus on Universal Health Coverage (UHC) in cancer care across Asia, cancer prevention and early detection strategies, and the socio-cultural dimensions of cancer in Asian communities. Dr. Kawahara’s work bridges medicine, public health policy, and social science to improve cancer outcomes and ensure that “no one is left behind” in access to cancer care in Asia. She received her doctoral degree from Juntendo University for her research and surveys of the quality of life of prostate cancer patients. Her work on the JCIA Grassroots Technical Cooperation Project (2014-2017) in Harbin, China resulted in valuable research outcomes that have subsequently been applied to other countries.

(1) Health Education & Preventive Medicine: Driving Community-based Health Management

Dr. Kawahara noted that from the very first lecture of the series, students had used the hardship of cancer as a powerful lens to rethink well-being across Asia. By layering medical facts with policy, economics, and culture, it can be possible to turn personal suffering into a clearly visible social challenge and search for workable solutions to the challenge of cancer. 

Dr. Kawahara noted that in the previous lecture students had heard about Yakult, a company that tackles the issue of well-being through a unique, community-based approach. 

Today, the students would sharpen their focus on community action, with a lecture titled “Health Education & Preventive Medicine: Driving Community-based Health Management.”

The goal of the lecture today is therefore to expand on the theme of community action and examine how community-based health education actually shifts human behavior, by revisiting the Malaysian BEAUTY (Bringing Education And Understanding to You) program, first mentioned in the lecture provided by Astellas Pharma on 27 May 2025—and use it as a main case study, looking at both its design and its early outcomes. 

In Malaysia, over 60 percent of cancers are found only after they have reached an advanced stage, so early screening and prevention are urgent. However, low awareness, limited clinic access, and cultural hesitation keep screening rates stubbornly low—meaning there is a need for new and creative approaches. In healthcare it has long been assumed that more knowledge automatically changes behavior. Reality tells a different story; people do not act on reason alone., when rethinking well-being in Asia, it is important to deepen one’s sense of why locally rooted approaches matter—and how they can turn insight into real-world impact.

(2) Overview to the Asia Cancer Forum (ACF)

Founded in 2004, Asia Cancer Forum (ACF) links researchers across Asia into a single cancer-information network. From the outset the organization has treated cancer as a shared social challenge, so our work cuts across medicine, policy, economics, and culture.

Anchored in clinical and epidemiological data, ACF still casts a wide net and shares what we have learned at high-level forums that end with concrete policy recommendations.

Since 2011, under the banner ‘Cancer is a Mirror,’ ACF has run the interdisciplinary lecture course “Surviving Cancer in Asia” here at the University of Tokyo. As a member of the Union for International Cancer Control (UICC), ACF also explores how universal health coverage (UHC) for cancer can be developed to fit with Asian realities.

  ACF takes a transformative approach to health promotion in Asia, one example being the Bringing Education and Understanding To You (BEAUTY) Project in Malaysia. This project has been hailed as being “truly unique,” but the reality is that this uniqueness did not appear overnight. 

It rests on years of groundwork by the ACF, which has spent more than a decade in northeast China’s rural villages wrestling with one tough question: How do we spark real behavior change through community-based health education? 

The BEAUTY project in Malaysia works from the lessons, the missteps, and the breakthroughs that emerged from that long Chinese experience and amplifies them with digital tools, structured training, and policy alignment, turning a village-scale idea into a national program.

(3) Overview of ACF activities in northeastern China

ACF activities in northeastern China began as a JICA supported grass-roots project in Harbin, China, bringing health lessons into primary schools. The Asia Cancer Forum has always aimed to help people ‘survive together’ across Asia’s many cultural borders. Our journey into health education in China began in 2005, deep in the villages the northeastern region. There, smoking rates were high, public cancer screening existed on paper, yet few villagers ever went. Too many cancers were caught at a late stage, pushing families into financial ruin.

Dr. Kawahara noted that her bond with that region of China is personal: before the Second World War her father’s company was based there, so working in those villages felt like honoring her own family history while fighting a new battle—preventing cancer. That hard-won field experience—learning how to change habits in places where awareness was low and trust was precious—became the foundation for newer projects like BEAUTY in Malaysia. 

While it was the BEAUTY & Health in Malaysia, implemented with Malaysia’s National Cancer Society turning salons and barbershops into screening hubs that won the Asia Business Conclave award for a “Transformative Approach to Health Prevention in Asia,” the origins of that award can be traced back to the rural Chinese villages where ACF first learned what true community-based health education means. 

From the outset of the project in Harbin, ACF worked with local public-health researchers, visiting the villages a few times each year. ACF ran health seminars, handed out leaflets, and followed China’s rural health-care improvement plan. Notwithstanding these efforts, nothing changed. People remained distant and unwelcoming. All this changed when an approach was made to the village hairdresser, and it was through the medium of hair and beauty, specifically in this case, Shiseido hand cream, that a relationship started to develop. People would come to a “hand-cream workshop” and also discuss health-related matters. It was through the salon’s trusted network that ACF was able to get a foothold in this rural village in China. 

  Based on that experience, it was decided to ask local hairdressers to take on the role of awareness-raising, after providing them with technical assistance in awareness-raising education. This is because beauty salons are places where local people go regularly, and hairdressers have communication skills customized to each person. Through the hair salons ACF distributed information on both beauty and medical check-ups. We also organized a beauty course in the village, using cosmetics from Shiseido with hairdressers playing a central role.

At the time of the project China’s economy was booming. Cash was flowing into the villages, and people were spending it on cigarettes, alcohol, and greasy takeaway dishes. Local public-health experts put out endless leaflets about the dangers of these high-risk habits—but no one read them. So ACF tried approaching the issue from a different angle. ACF partnered with the village’s favorite cook from the county-hospital cafeteria, together running workshops on how to make delicious and healthy food.

Adults rarely break old habits, but the birth of a baby can reset a household. So, at every newborn check-up, ACF launched a mothers’ class, encouraging the entire family to change their lifestyle for the better and avoid illness-related expenses, so that they could save for their children’s education. Each point of the program was framed as a step toward happiness – focusing on positive perspectives, rather than constantly telling people what they should not do. 

Listening to real talk in the beauty salon network showed clearly why cancer terrifies people. It was generally believed that “If you get cancer, you die—there’s nothing you can do.” Many people would keep a cancer diagnosis secret, and there was very little knowledge that early-stage diagnosis can be treated easily and at low cost.

Therefore, when a breast cancer patient who had been diagnosed early and had completed treatment shared her experience in front of the villagers, there was an uproar in the hall. Using the hairdresser‘s salon as an information network, she was asked to convey to others the information that cancer is not necessarily a death sentence, but is connected to everyday life.

Thanks to this salon-led campaign, 100 villagers turned up for the next screening day. We found early-stage cervical cancer in two women in their forties. Because their cancer was caught early, their hospital stays were short, their costs were minimal, and today they are back to their daily lives.

  In this region of China most messages from public-health experts never reached ordinary people. ACF research shows that behavior changes only when the message comes through someone people actually know, in words they can picture and discuss. 

Many health-education tools assume that humans decide things rationally, but when raw theories and data are simply dropped on the public, they rarely take it personally. Here in this region we have learned a simple truth: lasting change flows through relationships inside the community. 

  Dr. Kawahara noted that her work in rural northern China taught her that positive reinforcement and optimism can shift everyday habits. Harnessing the power of beauty—literally, the beauty industry—can make that shift sustainable. 

The key is timing, namely, giving people the right message, at the right moment, in the right way. That means staying in steady, frequent contact, so we truly grasp both their obstacles and their hopes for self-realization. 

In any community, few places offer that kind of regular touchpoint better than barbershops and beauty salons. They are trusted, visited often, and naturally built for conversation—exactly the environment we need for lasting change.

(4) BEAUTY and Health Project in Malaysia

“The BEAUTY (Bringing Education And Understanding To You) & Health project began in 2022 as a joint initiative of the National Cancer Society Malaysia and the Asia Cancer Forum, with support from Astellas Pharma.

Its goal is simple: use neighborhood salons and barbershops—places everyone visits—to spread clear, digital health messages, raise cancer literacy, and nudge people toward screening and prevention. In short, the salon or barber shop becomes a health-communication hub for both women and men.

  In the first year the aim was to establish what it was that people really needed. Through focus groups and in-depth interviews, it became clear that people lacked screening materials that were easy to use and available in their own languages. That gap, in turn, helped explain low screening and prevention rates.

  Activities then turned to creating a full education library—44 short videos and 48 booklets—covering breast, cervical, colorectal, lung, nasopharyngeal, childhood and blood cancers, plus prostate cancer, smoking cessation, obesity, and general risk reduction (Fig. 1)

All content is offered in four languages—English, Malay, Tamil, and Mandarin—and stored on beauty.cancer.org.my.

Efforts were also made to build a training module so barbers and stylists could share these messages naturally with their clients. Because the materials reflect each viewer’s cultural background, users say they feel “familiar and approachable,” and they engage with the information by choice, not by force.”

In the second year activities moved to building the National Cancer Screening Registry. This is best described as a one-stop online portal that works both as a data bank and as a self-assessment tool. An individual can create a personal account, enter a few details, and immediately see a risk profile; a clinic or hospital can open an institutional account and manage every screening result it generates.

Right now the registry covers six cancers—breast, cervical, prostate, colorectal, lung, and liver. Each module begins with a short symptom-and-risk quiz and then guides the user to the right clinical test, whether that is a mammogram, a PSA score, or a FIT stool test. Along the way it also records health literacy, family history, and basic cancer knowledge. 

Work began by forming a working group of IT engineers, cancer-control specialists, and web-designers, who then held focus-group discussions with oncologists, public-health doctors, patient advocates, and technologists. After every round of user-acceptance testing the interface, the navigation flow, and the wording were revised until every stakeholder—from village nurse to hospital administrator—could use the system without instructions. 

The result is a simple, bilingual portal that lets people know their risk in minutes and gives providers a clean, central record for truly data-driven screening across

The third year of the project saw it move from planning to full intervention in five Malaysian states—Kuala Lumpur, Selangor, Perak, Negeri Sembilan, and Melaka—by bringing the program directly into barbershops and beauty salons. Every registered barber and stylist attended hands-on training sessions built around the modules that were created in Year 1, so they could talk comfortably about cancer specifics and general risk-reduction strategies while serving their clients.

Throughout the rollout the team visited each shop regularly to reinforce what had been taught, drop off fresh leaflets, and supply ready-made conversation scripts for both male and female customers. Posters and flyers carried a QR code that invited clients to complete a short baseline survey on cancer knowledge, attitudes, and practices, then join a dedicated WhatsApp community. In those groups videos and infographics were shared every week, questions answered in real time, and prize draws offered as an added incentive.

Every two months the neighborhoods hosting these salons held local screening events. Participants received free vouchers for blood tests, AI-read chest X-rays, mammography, and prostate checks—making it easy to act on the advice they had just heard in the chair. By embedding education, peer support, and concrete screening opportunities in one familiar setting, Year 3 turned awareness into measurable action across the five pilot states.” 

  To sum up the last three-year journey of the BEAUTY project, it can be said that it began with the Asia Cancer Forum shaping the ideas, but it was the National Cancer Society Malaysia that put every plan into action—quickly and decisively. What is remarkable is that the project successfully linked two very different Asian countries, Japan and Malaysia, while still moving as one team.

From the start, both the Malaysian Ministry of Health and the Embassy of Japan stood behind the project, making the path far easier. This demonstrates that community projects only last when someone inside government believes in them. Malaysia’s Ministry of Health and the Ministry of Human Resources—working through SOCSO and their Workplace Health Initiative—are actively promoting BEAUTY Library materials as part of the national cancer-control and health-promotion agenda. 

The private sector has picked up the baton, too. Companies across the board are weaving BEAUTY Library resources into their own wellness programs. This matters because patient-centered education and disease awareness give people a clear path to early screening and early detection. This amply demonstrates that when health literacy rises lives are saved. 

The power of public-private partnership lies in the fact that when government and business move in synchronization, corporate social responsibility efforts stop being one-off campaigns and start becoming a sustainable force for the future (Fig. 2) 

Tackling Cancer will require a significant shift in the way we live and work. This can only be achieved through an ‘all-society’ approach, systematically combining the power and reach of all sectors.

The Partnering Initiative (TPI), the Union for International Cancer Control (UICC) and Bupa have worked together to co-create a partnering guidebook designed particularly for non-profit organizations seeking to partner with companies against NCDs. The guidebook sets out how to bridge the divide between societal sectors, to engage with business and create effective partnerships to address the causes of NCDs.

(5) Conclusion

For many years people concentrated on building a perfect cancer-screening system. However, even the best system fails if people don’t feel like using it. It is therefore imperative to see health the way that everyday people see it. Real change needs personal, one-to-one messages, which can be spread far and fast by digital means. 

The biggest challenge is moving from “knowing” to “doing.” To cross that gap, three questions must be answered:

What message truly matters to people?

Who is the best person or group to say it?

Where should that conversation happen?

If the answers to those questions can be found, then simple information turns into healthier choices—everywhere and for everyone.

　ACF’s exploration of rural China’s community health efforts and Malaysia’s BEAUTY & Health project reveals two fundamental lessons about driving sustainable health change. These insights transcend geography and discipline, resonating with public health, social policy, design, and education alike:

Effective health interventions start with a deep understanding of local context. In rural China, initiatives succeeded by empowering trusted community members and embracing everyday realities. In short, field-level insight means seeing through the community’s eyes – understanding culture, trust networks, and daily routines – and using that knowledge to design interventions people truly embrace.

Lasting health improvements require more than isolated projects; they demand structural integration across policy, education, and service design. Community interventions flourish when backed by robust systems. 

Similarly, Malaysia’s BEAUTY & Health project has paired local engagement with digital and institutional design. The initiative isn’t just an app or a few salon events – it’s conceived as a comprehensive ecosystem of interlinked solutions that can scale up into a nationwide program. 

By fusing on-the-ground activities at salons with a digital health library and screening registry, and by involving the Health Ministry, NGOs, and corporate partners, the project works structurally at multiple levels. This systems thinking ensures that community efforts are reinforced by technology, policy support, and sustainable financing. 

The takeaway is clear: to build durable health interventions, we must connect the dots – linking grassroots innovation with top-down frameworks in policy, education, and service delivery.

It is important to remember that transformative health change happens when we marry the wisdom of the field with the power of structure. Whether you are in public health, design, technology, education, or policy, the challenge moving forward is the same: How will you combine ground-level insight with systemic vision to create solutions that truly last?

(6) Assignment to students

Dr. Kawahara gave students the following assignment: 

“If you launched the BEAUTY project in your own country, what chances for success and what barriers would you face?”