• culturally sensitive care;
  • health counseling;
  • prevention of lifestyle-related diseases;
  • public health nursing


This study explored the methods that are used by public health nurses to provide culturally sensitive health counseling to elderly Japanese farmers in order to motivate them to adopt healthy behaviors. Fourteen elderly farmers (eight men and six women) from three rural communities underwent health counseling and then changed their habits to prevent lifestyle-related diseases. Qualitative and inductive analyses were conducted to determine the effects of the culturally sensitive counseling. Five methods for providing culturally sensitive counseling were identified: (i) showing an interest in, and respect for, the local culture; (ii) stimulating the participants' awareness of the health risks inherited in their local cultural practices through the use of familiar examples; (iii) accepting and understanding the participants' ambivalence about their local culture; (iv) connecting the reasons for the participants to change their lifestyle with their local culture; and (v) adjusting the health-promoting behaviors of the participants to fit their local culture. Public health nurses should consider the pride that elderly farmers have in their background and their resistance to change and use these factors to point out the discrepancies in their lifestyle and promote more quality-of-life-oriented and practical self-care behaviors.