The Walter H. Shorenstein Asia-Pacific Research Center (APARC) is pleased to invite applications for a host of fellowships in contemporary Asia studies to begin in Autumn quarter 2025.

The Center offers postdoctoral fellowships that promote multidisciplinary research on Asia-focused health policy, contemporary Japan, and contemporary Asia broadly defined, postdoctoral fellowships and visiting scholar positions with the Stanford Next Asia Policy Lab, and a fellowship for experts on Southeast Asia. Learn more about each opportunity and its eligibility and specific application requirements:

Asia Health Policy Program Postdoctoral Fellowship

Hosted by the Asia Health Policy Program at APARC, the fellowship is awarded to one recent PhD undertaking original research on contemporary health or healthcare policy of high relevance to countries in the Asia-Pacific region, especially developing countries. Appointments are for one year beginning in Autumn quarter 2025. The application deadline is December 1, 2024.

Japan Program Postdoctoral Fellowship

Hosted by the Japan Program at APARC, the fellowship supports research on contemporary Japan in a broad range of disciplines including political science, economics, sociology, law, policy studies, and international relations. Appointments are for one year beginning in Autumn quarter 2025. The application deadline is December 1, 2024.  

Shorenstein Postdoctoral Fellowship on Contemporary Asia

APARC offers two postdoctoral fellowship positions to junior scholars for research and writing on contemporary Asia. The primary research areas focus on political, economic, or social change in the Asia-Pacific region (including Northeast, Southeast, and South Asia), or international relations and international political economy in the region. Appointments are for one year beginning in Autumn quarter 2025. The application deadline is December 1, 2024. 
 

On October 18, as part of its autumn 2023 seminar series on APEC in advance of the organization's meeting in San Francisco in November, Shorenstein APARC and its Asia Health Policy Program (AHPP) presented the series' second event, Asia-Pacific Digital Health Innovation: Technology, Trust, and the Role of APEC. The featured panelists were Kiran Gopal Vaska, Director of the National Health Authority of India, and CK Cheruvettolil, the Senior Strategy Officer, Digital Health and Artificial Intelligence, at the Bill & Melinda Gates Foundation. Siyan Yi, the Director of the Integrated Research Program at the National University of Singapore and a former AHPP fellow, moderated the conversation.

While India is not an APEC member, Indian initiatives are examples of leveraging technology to better the health of the most vulnerable citizens in low- and middle-income countries (LMICs). Kiran Gopal Vaska gave an overview of the Ayushman Bharat Digital Mission (ABDM), India's latest health initiative that focuses on the interoperability of health records, services, and health claims. He stressed that ABDM was built on previous digital infrastructure, like Aadhaar, the national digital identity system, and Digilocker, a digital storage scheme for citizens' health and other records.

The approach India has taken is for the government to build the rails—the infrastructure of the system—and create a space where the private sector can develop applications integrated with that space through application programming interfaces (APIs), avoiding the siloing that can hamper the interoperability of data.

Regarding health data, privacy is a crucial concern at the patient level. ABDM addresses this concern through the use of a consent artifact. Individuals decide whether hospitals or other medical service providers have access to their data, and this access has levels of granularity: you can share specific portions of 7 different data types, like immunizations or prescriptions. You can limit that sharing to a particular period, like one day.

Also participating on the panel was CK Cheruvettolil, who discussed strategies by the Bill & Melinda Gates Foundation in leveraging the power of mobile phones to augment the work of Accredited Social Health Activists (ASHAs), the more than one million female frontline health workers in India. ASHAs can use mobile phone cameras, sensors, and streaming data to better care for low-birth-weight babies and other patients. 

He explained the critical role of taking local context into account when developing software by using the example of pregnant Indian women in their third trimesters. The custom for Indian mothers, especially in rural areas, is for the child to be born in the maternal grandparents' home. If software were to store only the mother's address, healthcare workers in the grandparents' jurisdiction would not know that a pregnant woman in the critical third trimester would soon be giving birth at a local address.

Kiran Gopal Vaska noted that India had solved the technological issues, and now the task was to push for adoption. He emphasized that the technologies underlying India's digital health stack were created as public goods for the world, and for LMICs to support each other in advancing digital health technologies, the key was interoperability, "using standards that are accessible and acceptable worldwide."

Telemedicine has faced an uphill battle in South Korea and in fact, under the nation’s Medical Services Act, it is currently prohibited, a result of opposition from the medical community and other stakeholders. However, during the height of the COVID-19 pandemic, the South Korean government temporarily allowed for prescriptions and counseling by phone, which gave investigators the opportunity to examine patient preferences toward the service. 

It has been demonstrated that for consultations on chronic diseases—diabetes, hypertension, and heart disease—telemedicine is effectively equal to in-person visits, and moreover is convenient. Previous studies have looked at patient attitudes toward telemedicine but not many have used the COVID-19 pandemic as a backdrop. 

A new study, published in the Asia Pacific Journal of Public Health, helps to address this knowledge gap. The researchers focused on patients with the chronic diseases of diabetes and hypertension in South Korea and asked them about their preferences for telemedicine versus in-person care, including under different levels of recommended social distancing.

The co-authors of the study are Karen Eggleston, director of the Asia Health Policy Program at Shorenstein APARC; Annie Chang, ’21, MS ’22, currently an MD candidate at Icahn School of Medicine at Mount Sinai in New York City, who started the project as a Stanford student; Richard Liang, MD/PhD candidate at Stanford, and Daejung Kim of the Korea Institute for Health and Social Affairs.

The data was collected from a larger study on the impacts of the pandemic on the management of chronic disease in a number of Asian countries.

Chang notes that her research with Eggleston began after taking her course Health and Healthcare Systems in East Asia: “As a Korean American, I was naturally interested in learning more about South Korea and its healthcare system. I had the opportunity to work with Dr. Eggleston during the COVID-19 pandemic, when telemedicine usage surged globally.”

The study findings indicate that respondents did not have a strong preference for telemedicine services during the COVID-19 pandemic. This could be attributed to the prohibition of such services outside of the pandemic, to unfamiliarity with the technology, or to other factors.

However, the results show that attitudes toward telemedicine differed among demographic segments: younger patients, who tend to be more familiar with new technologies, had a higher preference for telemedicine, as did males (who are more likely to be employed, restricting their time for in-person visits), and those whose access to healthcare was more restricted.

This research carries significant policy implications concerning the advancement of telemedicine in South Korea and elsewhere. To make better use of telemedicine, policymakers should raise awareness of and familiarity with the services, especially among older populations who are less comfortable with new technologies. There is also a need to develop basic guidelines for telemedicine practices like reimbursement and data security to encourage the adoption of telemedicine as a viable alternative to in-person consultations. 

This announcement was updated on October 6, 2023, to reflect the addition of two new fellowship offerings focused on contemporary Taiwan.

The Walter H. Shorenstein Asia-Pacific Research Center (APARC) is pleased to invite applications for a suite of fellowships in contemporary Asia studies to begin fall quarter 2024.

The Center offers postdoctoral fellowships that promote multidisciplinary research on Asia-focused health policy; contemporary Japan; contemporary Asia broadly defined; postdoctoral fellowships and visiting scholar positions as part of the new Stanford Next Asia Policy Lab; and a fellowship for experts on Southeast Asia. Learn more about each opportunity and its eligibility and specific application requirements:

Asia Health Policy Postdoctoral Fellowship

Hosted by the Asia Health Policy Program at APARC, the fellowship is awarded annually to one recent PhD undertaking original research on contemporary health or healthcare policy of high relevance to countries in the Asia-Pacific region, especially developing countries. Appointments are for one year beginning in fall quarter 2024. The application deadline is December 1, 2023.

Postdoctoral Fellowship on Contemporary Japan

Hosted by the Japan Program at APARC, the fellowship supports research on contemporary Japan in a broad range of disciplines including political science, economics, sociology, law, policy studies, and international relations. Appointments are for one year beginning in fall quarter 2024. The application deadline is December 1, 2023.  
 

The rise of antibiotic resistance is a global public health issue that poses a severe threat to the effectiveness of modern medicine. Antibiotic resistance can lead to prolonged hospital stays, increased mortality rates, and higher medical costs. The World Health Organization warns that there are not enough new antibacterial treatments in development to keep up with the growing resistance. The need to regulate the use of antibiotics is, therefore, critical. But Patients' lack of information intensifies the problem: misconceptions about antibiotics are prevalent and exacerbate unnecessary drug use.

In response to this challenge, a team of researchers, including Dr. Jianan Yang, a 2022-23 Asia Health Policy Postdoctoral Fellow at APARC, conducted a study to test the efficacy of informing patients directly of the risks of antibiotics overuse. In partnership with a community healthcare center in China, which is among the countries with the highest per capita usage of antibiotics, the researchers designed a randomized controlled trial to evaluate whether the provision of information on the impacts of antibiotic resistance via text messages could induce behavioral changes and reduce the unnecessary use of antibiotics. The results of the study, published in the Journal of Development Economics, suggest that social-health messaging could be a powerful tool in addressing antibiotics overuse as well as a variety of public health challenges with externalities.

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The researchers’ findings show that patients who received text messages highlighting the threat of antibiotic resistance to society reduced their antibiotics purchases by 17% relative to the control group. The reduction did not come at the cost of a decline in other observed dimensions of healthcare utilization, including the number of visits, examination and service spending, and the purchase of other medicines.

The study also reveals that messages with information on the social impacts of antibiotic resistance had a more pronounced effect than those with information on the harmful consequences for individual patients: text messages that emphasized the threats of antibiotics overuse to recipients’ own health showed negligible effects on antibiotics purchases.

The results provide evidence that prosocial messaging can have a substantial impact on health-related behavior and identify a cost-effective, low-touch intervention means of addressing concerns over antibiotics misuse and overuse. The rapid increase in mobile phone penetration makes text messaging easily scalable, highly inclusive, and inexpensive to implement public health interventions. While the study focused on antibiotic use in China, the findings may have broader implications for public health interventions across different countries and cultures.

The study results also suggest that social-health messaging could be an effective tool to address public health challenges with externalities beyond antibiotic resistance, such as low vaccination rates. For example, many governments have been attempting to increase COVID-19 vaccination rates among their populations. People might be more willing to act if they receive relevant information on the social impacts of their behavior from an institution that they trust.

Future studies that evaluate the effectiveness of this approach in different institutional contexts and their welfare implications with richer clinical data would be valuable.