title: Assessing the validity of health impact assessment predictions regarding a Japanese city's transition to core city status: a monitoring review.
abstract: BACKGROUND
  The validity of health impact assessment (HIA) predictions has not been accurately assessed to date. In recent years, legislative attempts to promote decentralization have been progressing in Japan, and Kurume was designated as a core city in April 2008. An HIA into the transition of Kurume to a core city was conducted before the event, but the recommendations were not accepted by city officials.
  
  
  OBJECTIVE
  The aim of this study was to examine the validity of predictions made in the HIA on Kurume by conducting a monitoring review into the accuracy of the predictions.
  
  
  METHODS
  Before Kurume was designated as a core city, the residents completed an online questionnaire and city officials were interviewed. The findings and recommendations were presented to the city administration. One year after the transition, a monitoring review was performed to clarify the accuracy of the HIA predictions by evaluating the correlation between the predictions and reality.
  
  
  RESULTS
  Many of the HIA predictions were found to conflict with reality in Kurume. Prediction validity was evaluated for two groups: residents of Kurume and city officials. For the residents, 17% (2/12 items) of the predictions were found to be compatible, 58% (7/12) were incompatible and 25% (3/12) were difficult to evaluate. For city officials, the analysis was divided into those whose department was directly involved in tasks transferred to them (transfer tasks) and those whose department was not. For the city officials in departments responsible for conducting core city transfer tasks, 33% (3/9 items) of the predictions were found to be compatible, 33% (3/9) were incompatible and 33% (3/9) were difficult to evaluate. However, for the city officials whose responsibilities were unrelated to core city transfer tasks, 11% (1/9) of predictions were found to be compatible, 78% (7/9) were incompatible and 11% (1/9) were difficult to evaluate.
  
  
  CONCLUSIONS
  Although it was possible to validate some of the HIA predictions, the results of this monitoring review found substantial discrepancies between the predictions and reality 1 year after the transition of Kurume to a core city. This suggests that the accuracy of HIA predictions may be called into question. However, it should be noted that the review was conducted very soon after the transition and the steering group was very small, which may explain why the HIA predictions were inaccurate. Further, long-term studies may be needed to assess the accuracy of HIA predictions in similar contexts.
authors.affiliation: Kurume University School of Medicine, 67 Asahi-machi, Kurume 830-0011, Japan. hmichi@med.kurume-u.ac.jp
authors.forename: M
authors.initials: M
authors.lastname: Hoshiko
authors.forename: K
authors.initials: K
authors.lastname: Hara
authors.forename: T
authors.initials: T
authors.lastname: Ishitake
mesh_terms: D000328:Adult; D002947:Cities / Q000145:classification*; D005260:Female; D005544:Forecasting; D006291:Health Policy; D006304:Health Status; D006801:Humans; D007564:Japan; D008297:Male; D011050:Policy Making; D014507:Urbanization