Journal of Preventive Medicine and Public Health

Volume 56(1); January 2023

Special Article

Cohort Study Protocol: A Cohort of Korean Atomic Bomb Survivors and Their Offspring: Seong-geun Moon, Ansun Jeong, Yunji Han, Jin-Wu Nam, Mi Kyung Kim, Inah Kim, Yu-Mi Kim, Boyoung Park; J Prev Med Public Health. 2023;56(1):1-11. Published online January 31, 2023; DOI: https://doi.org/10.3961/jpmph.22.469

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Abstract Summary PDF Supplementary Material

In 1945, atomic bombs were dropped on Hiroshima and Nagasaki. Approximately 70 000 Koreans are estimated to have been exposed to radiation from atomic bombs at that time. After Korea’s Liberation Day, approximately 23 000 of these people returned to Korea. To investigate the long-term health and hereditary effects of atomic bomb exposure on the offspring, cohort studies have been conducted on atomic bomb survivors in Japan. This study is an ongoing cohort study to determine the health status of Korean atomic bomb survivors and investigate whether any health effects were inherited by their offspring. Atomic bomb survivors are defined by the Special Act On the Support for Korean Atomic Bomb Victims, and their offspring are identified by participating atomic bomb survivors. As of 2024, we plan to recruit 1500 atomic bomb survivors and their offspring, including 200 trios with more than 300 people. Questionnaires regarding socio-demographic factors, health behaviors, past medical history, laboratory tests, and pedigree information comprise the data collected to minimize survival bias. For the 200 trios, whole-genome analysis is planned to identify de novo mutations in atomic bomb survivors and to compare the prevalence of de novo mutations with trios in the general population. Active follow-up based on telephone surveys and passive follow-up with linkage to the Korean Red Cross, National Health Insurance Service, death registry, and Korea Central Cancer Registry data are ongoing. By combining pedigree information with the findings of trio-based whole-genome analysis, the results will elucidate the hereditary health effects of atomic bomb exposure.

Summary

Korean summary
해당 연구는 한국인 원폭피해 생존자 및 그 후손에서 피폭이 건강에 미치는 영향과 그것의 유전적 영향 유무를 밝히고자 계획된 연구이다. 이 연구는 연구대상자들에 대한 건강 설문 조사, 신체계측, 가계도 조사, 유전체 조사 뿐 아니라 2차 자료 연계를 통해 폭넓고 정확한 건강 정보를 수집하고 있다. 이 연구를 통해 연구대상자들의 건강 상태 파악 및 개선에 도움이 되고자 한다.

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Intergenerational effects of ionizing radiation: review of recent studies from human data (2018–2021)
A. Amrenova, C. Baudin, E. Ostroumova, J. Stephens, R. Anderson, D. Laurier
International Journal of Radiation Biology.2024; : 1. CrossRef

Review

Qualitative Research in Healthcare: Necessity and Characteristics: Jeehee Pyo, Won Lee, Eun Young Choi, Seung Gyeong Jang, Minsu Ock; J Prev Med Public Health. 2023;56(1):12-20. Published online January 10, 2023; DOI: https://doi.org/10.3961/jpmph.22.451

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Abstract Summary PDF

Quantitative and qualitative research explore various social phenomena using different methods. However, there has been a tendency to treat quantitative studies using complicated statistical techniques as more scientific and superior, whereas relatively few qualitative studies have been conducted in the medical and healthcare fields. This review aimed to provide a proper understanding of qualitative research. This review examined the characteristics of quantitative and qualitative research to help researchers select the appropriate qualitative research methodology. Qualitative research is applicable in following cases: (1) when an exploratory approach is required on a topic that is not well known, (2) when something cannot be explained fully with quantitative research, (3) when it is necessary to newly present a specific view on a research topic that is difficult to explain with existing views, (4) when it is inappropriate to present the rationale or theoretical proposition for designing hypotheses, as in quantitative research, and (5) when conducting research that requires detailed descriptive writing with literary expressions. Qualitative research is conducted in the following order: (1) selection of a research topic and question, (2) selection of a theoretical framework and methods, (3) literature analysis, (4) selection of the research participants and data collection methods, (5) data analysis and description of findings, and (6) research validation. This review can contribute to the more active use of qualitative research in healthcare, and the findings are expected to instill a proper understanding of qualitative research in researchers who review qualitative research reports and papers.

Summary

Korean summary
이 원고는 질적연구 방법론의 필요성 및 특징과 함께 보건의료 분야에서 질적연구 방법론이 활용된 선행 연구들을 정리하였다. 이는 보건의료 분야의 사회과학적 특성을 더 잘 드러내는 질적연구 방법론의 적용 및 확대에 도움이 될 것이다.

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Kazakhstani elite athletes’ perspectives on the Tokyo 2020 olympic and paralympic games postponement and their preparation during the COVID-19 pandemic: A qualitative study
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Surgical De-escalation in Breast Cancer: Qualitative Research Introduces Hope for Patients and Illuminates a Blind Spot Within Blinded Studies
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Edward Barroga, Glafera Janet Matanguihan, Atsuko Furuta, Makiko Arima, Shizuma Tsuchiya, Chikako Kawahara, Yusuke Takamiya, Miki Izumi
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Charlotte Hilker, Johanna Weis, Stefanie Ziehfreund, Elizabeth V. Arkema, Tilo Biedermann, Alexander Zink
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Dasom Im, Jeehye Pyo, Haneul Lee, Hyeran Jung, Minsu Ock
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Knowledge, Attitude, and Practice of Qualitative Research Among Health Sciences Faculty
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Original Articles

Predisposing, Enabling, and Reinforcing Factors of COVID-19 Prevention Behavior in Indonesia: A Mixed-methods Study: Putri Winda Lestari, Lina Agestika, Gusti Kumala Dewi; J Prev Med Public Health. 2023;56(1):21-30. Published online December 29, 2022; DOI: https://doi.org/10.3961/jpmph.22.340

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Abstract PDF: Objectives
To prevent the spread of coronavirus disease 2019 (COVID-19), behaviors such as mask-wearing, social distancing, decreasing mobility, and avoiding crowds have been suggested, especially in high-risk countries such as Indonesia. Unfortunately, the level of compliance with those practices has been low. This study was conducted to determine the predisposing, enabling, and reinforcing factors of COVID-19 prevention behavior in Indonesia.
Methods
This cross-sectional study used a mixed-methods approach. The participants were 264 adults from 21 provinces in Indonesia recruited through convenience sampling. Data were collected using a Google Form and in-depth interviews. Statistical analysis included univariate, bivariate, and multivariate logistic regression. Furthermore, qualitative data analysis was done through content analysis and qualitative data management using Atlas.ti software.
Results
Overall, 44.32% of respondents were non-compliant with recommended COVID-19 prevention behaviors. In multivariate logistic regression analysis, low-to-medium education level, poor attitude, insufficient involvement of leaders, and insufficient regulation were also associated with decreased community compliance. Based on in-depth interviews with informants, the negligence of the Indonesian government in the initial stages of the COVID-19 pandemic may have contributed to the unpreparedness of the community to face the pandemic, as people were not aware of the importance of preventive practices.
Conclusions
Education level is not the only factor influencing community compliance with recommended COVID-19 prevention behaviors. Changing attitudes through health promotion to increase public awareness and encouraging voluntary community participation through active risk communication are necessary. Regulations and role leaders are also required to improve COVID-19 prevention behavior.; Summary

The Effect of Cognitive Impairment on the Association Between Social Network Properties and Mortality Among Older Korean Adults: Eunji Kim, Kiho Sung, Chang Oh Kim, Yoosik Youm, Hyeon Chang Kim; J Prev Med Public Health. 2023;56(1):31-40. Published online November 22, 2022; DOI: https://doi.org/10.3961/jpmph.22.350

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Abstract Summary PDF Supplementary Material: Objectives
This study investigated the effect of cognitive impairment on the association between social network properties and mortality among older Korean adults.
Methods
This study used data from the Korean Social Life, Health, and Aging Project. It obtained 814 older adults’ complete network maps across an entire village in 2011-2012. Participants’ deaths until December 31, 2020 were confirmed by cause-of-death statistics. A Cox proportional hazards model was used to assess the risks of poor social network properties (low degree centrality, perceived loneliness, social non-participation, group-level segregation, and lack of support) on mortality according to cognitive impairment.
Results
In total, 675 participants (5510.4 person-years) were analyzed, excluding those with missing data and those whose deaths could not be verified. Along with cognitive impairment, all social network properties except loneliness were independently associated with mortality. When stratified by cognitive function, some variables indicating poor social relations had higher risks among older adults with cognitive impairment, with adjusted hazard ratios (HRs) of 2.12 (95% confidence interval [CI], 1.34 to 3.35) for social nonparticipation, 1.58 (95% CI, 0.94 to 2.65) for group-level segregation, and 3.44 (95% CI, 1.55 to 7.60) for lack of support. On the contrary, these effects were not observed among those with normal cognition, with adjusted HRs of 0.73 (95% CI, 0.31 to 1.71), 0.96 (95% CI, 0.42 to 2.21), and 0.95 (95% CI, 0.23 to 3.96), respectively.
Conclusions
The effect of social network properties was more critical among the elderly with cognitive impairment. Older adults with poor cognitive function are particularly encouraged to participate in social activities to reduce the risk of mortality.; Summary

Korean summary
고령인구에서의 불충분한 사회연결망 특성은 높은 사망 위험과 연관이 있었으며, 이는 인지기능이 저하된 그룹에서 그렇지 않은 군에 비해 더 높게 관찰되었다. 특히, 인지기능이 저하된 노인에서 사회활동들에 참여하지 않는 것, 한정된 소집단에만 속하는 것, 주변으로부터 도움을 받지 못하는 것은 높은 사망 위험과 연관이 있기 때문에, 이들의 사회연결망을 강화하는 것이 사망 위험을 낮추는 데 도움이 될 수 있다.

Prediction of Stunting Among Under-5 Children in Rwanda Using Machine Learning Techniques: Similien Ndagijimana, Ignace Habimana Kabano, Emmanuel Masabo, Jean Marie Ntaganda; J Prev Med Public Health. 2023;56(1):41-49. Published online January 6, 2023; DOI: https://doi.org/10.3961/jpmph.22.388

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Abstract PDF

Objectives
Rwanda reported a stunting rate of 33% in 2020, decreasing from 38% in 2015; however, stunting remains an issue. Globally, child deaths from malnutrition stand at 45%. The best options for the early detection and treatment of stunting should be made a community policy priority, and health services remain an issue. Hence, this research aimed to develop a model for predicting stunting in Rwandan children.
Methods
The Rwanda Demographic and Health Survey 2019-2020 was used as secondary data. Stratified 10-fold cross-validation was used, and different machine learning classifiers were trained to predict stunting status. The prediction models were compared using different metrics, and the best model was chosen.
Results
The best model was developed with the gradient boosting classifier algorithm, with a training accuracy of 80.49% based on the performance indicators of several models. Based on a confusion matrix, the test accuracy, sensitivity, specificity, and F1 were calculated, yielding the model’s ability to classify stunting cases correctly at 79.33%, identify stunted children accurately at 72.51%, and categorize non-stunted children correctly at 94.49%, with an area under the curve of 0.89. The model found that the mother’s height, television, the child’s age, province, mother’s education, birth weight, and childbirth size were the most important predictors of stunting status.
Conclusions
Therefore, machine-learning techniques may be used in Rwanda to construct an accurate model that can detect the early stages of stunting and offer the best predictive attributes to help prevent and control stunting in under five Rwandan children.

Summary

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Predicting stunting in Rwanda using artificial neural networks: a demographic health survey 2020 analysis
Similien NDAGIJIMANA, Ignace KABANO, Emmanuel MASABO, Jean Marie NTAGANDA
F1000Research.2024; 13: 128. CrossRef
Child stunting prevalence determination at sector level in Rwanda using small area estimation
Innocent Ngaruye, Joseph Nzabanita, François Niragire, Theogene Rizinde, Joseph Nkurunziza, Jean Bosco Ndikubwimana, Charles Ruranga, Ignace Kabano, Dieudonne N. Muhoza, Jeanine Ahishakiye
BMC Nutrition.2023;[Epub] CrossRef

Measurement and Decomposition of Socioeconomic Inequality in Metabolic Syndrome: A Cross-sectional Analysis of the RaNCD Cohort Study in the West of Iran: Moslem Soofi, Farid Najafi, Shahin Soltani, Behzad Karamimatin; J Prev Med Public Health. 2023;56(1):50-58. Published online January 6, 2023; DOI: https://doi.org/10.3961/jpmph.22.373

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Abstract PDF

Objectives
Socioeconomic inequality in metabolic syndrome (MetS) remains poorly understood in Iran. The present study examined the extent of the socioeconomic inequalities in MetS and quantified the contribution of its determinants to explain the observed inequality, with a focus on middle-aged adults in Iran.
Methods
This cross-sectional study used data from the Ravansar Non-Communicable Disease cohort study. A sample of 9975 middle-aged adults aged 35-65 years was analyzed. MetS was assessed based on the International Diabetes Federation definition. Principal component analysis was used to construct socioeconomic status (SES). The Wagstaff normalized concentration index (CI_n) was employed to measure the magnitude of socioeconomic inequalities in MetS. Decomposition analysis was performed to identify and calculate the contribution of the MetS inequality determinants.
Results
The proportion of MetS in the sample was 41.1%. The CI_n of having MetS was 0.043 (95% confidence interval, 0.020 to 0.066), indicating that MetS was more concentrated among individuals with high SES. The main contributors to the observed inequality in MetS were SES (72.0%), residence (rural or urban, 46.9%), and physical activity (31.5%).
Conclusions
Our findings indicated a pro-poor inequality in MetS among Iranian middle-aged adults. These results highlight the importance of persuading middle-aged adults to be physically active, particularly those in an urban setting. In addition to targeting physically inactive individuals and those with low levels of education, policy interventions aimed at mitigating socioeconomic inequality in MetS should increase the focus on high-SES individuals and the urban population.

Summary

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Sleep Quality, Nutrient Intake, and Social Development Index Predict Metabolic Syndrome in the Tlalpan 2020 Cohort: A Machine Learning and Synthetic Data Study
Guadalupe Gutiérrez-Esparza, Mireya Martinez-Garcia, Tania Ramírez-delReal, Lucero Elizabeth Groves-Miralrio, Manlio F. Marquez, Tomás Pulido, Luis M. Amezcua-Guerra, Enrique Hernández-Lemus
Nutrients.2024; 16(5): 612. CrossRef
Socioeconomic inequalities in metabolic syndrome and its components in a sample of Iranian Kurdish adults
Pardis Mohammadzadeh, Farhad Moradpour, Bijan Nouri, Farideh Mostafavi, Farid Najafi, Ghobad Moradi
Epidemiology and Health.2023; 45: e2023083. CrossRef

Discrete-time Survival Analysis of Risk Factors for Early Menarche in Korean Schoolgirls: Yong Jin Gil, Jong Hyun Park, Joohon Sung; J Prev Med Public Health. 2023;56(1):59-66. Published online December 29, 2022; DOI: https://doi.org/10.3961/jpmph.22.428

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Abstract Summary PDF: Objectives
The aim of this study was to evaluate the effect of body weight status and sleep duration on the discrete-time hazard of menarche in Korean schoolgirls using multiple-point prospective panel data.
Methods
The study included 914 girls in the 2010 Korean Children and Youth Panel Study who were in the elementary first-grader panel from 2010 until 2016. We used a Gompertz regression model to estimate the effects of weight status based on age-specific and sex-specific body mass index (BMI) percentile and sleep duration on an early schoolchild’s conditional probability of menarche during a given time interval using general health condition and annual household income as covariates.
Results
Gompertz regression of time to menarche data collected from the Korean Children and Youth Panel Study 2010 suggested that being overweight or sleeping less than the recommended duration was related to an increased hazard of menarche compared to being average weight and sleeping 9 hours to 11 hours, by 1.63 times and 1.38 times, respectively, while other covariates were fixed. In contrast, being underweight was associated with a 66% lower discrete-time hazard of menarche.
Conclusions
Weight status based on BMI percentiles and sleep duration in the early school years affect the hazard of menarche.; Summary

Korean summary
초경연령의 조기화는 세계적인 현상이나 유독 우리나라에서는 그 단축속도가 매우 빠르나. 그 위험요인은 비만 이외에 확립되어 있지 못하다. 본 연구는 한국아동청소년패널의 2010-16년도까지 추적관찰된 914 명의 여아 자료를 Gompetz 회귀모형 (다중 분절형 생존분석모형)을 통해 분석하였며, 그 결과 과체중은 1년의 초경연령 단축을 유발할 위험도가 정상체중 여아에 비해 1.63배, 수면시간이 충분하지 못한 여아는 충분한 수면을 취하는 여아에 비해 1년의 초경연령 단축이 발생할 위험도가 1.38배 높은 것으로 나타났다.

The Impact of Public Transfer Income on Catastrophic Health Expenditures for Households With Disabilities in Korea: Eun Jee Chang, Sanggu Kang, Yeri Jeong, Sungchan Kang, Su Jin Kang; J Prev Med Public Health. 2023;56(1):67-76. Published online January 16, 2023; DOI: https://doi.org/10.3961/jpmph.22.183

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Abstract Summary PDF

Objectives
Previous studies have reported that people with disabilities are more likely to be impoverished and affected by excessive medical costs than people without disabilities. Public transfer income (PTI) reduces financial strain in low-income households. This study examined the impact of PTI on catastrophic health expenditures (CHE), focusing on low-income households and households with Medical Aid beneficiaries that contained people with disabilities.
Methods
We constructed a panel dataset by extracting data on registered households with disabilities from the Korea Welfare Panel Study 2012-2019. We then used a generalized estimating equation model to estimate the impacts of PTI on CHE. A subgroup analysis was carried out to assess the moderating effects of family income levels and health insurance types.
Results
As PTI increased, the odds ratio (OR) of CHE in households that contained people with disabilities decreased significantly (OR, 0.92; 95% confidence interval [CI], 0.89 to 0.94; p<0.001). In particular, PTI effectively reduced the likelihood of CHE for low-income households (OR, 0.85; 95% CI, 0.81 to 0.89; p<0.001) and those who received medical benefits (OR, 0.78; 95% CI, 0.68 to 0.89; p<0.001).
Conclusions
This study highlights the positive effect of PTI on decreasing CHE. Household income and the health insurance type were significant effect modifiers, but economic barriers seemed to persist among low-income households with non-Medical Aid beneficiaries. Federal policies or programs should consider increasing the total amount of PTI targeting low-income households with disabilities that are not covered by the Medical Aid program.

Summary

Korean summary
장애인은 비장애인에 비해 소득수준이 낮고 빈곤율이 높으며, 저소득 장애인 가구일수록 소득원천 비중에서 공적이전소득 의존성이 높다. 본 연구는 공적이전소득이 장애인 가구의 재난적 의료비 발생 확률(Odds ratio)을 효과적으로 낮춘다는 점을 밝혔으며, 특히 저소득층 및 의료급여 수급 가구에서 의료비 부담 완화 효과가 큰 것을 확인하였다. 향후 의료급여 적용대상에서 제외되어 건강보험에 가입해 있는 저소득 장애인 가구를 대상으로 추가적인 맞춤형 지원 정책이 필요하다.

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Prevalence and Determinants of Catastrophic Healthcare Expenditures in Iran From 2013 to 2019
Abdoreza mousavi, Farhad lotfi, Samira Alipour, Aliakbar Fazaeli, Mohsen Bayati
Journal of Preventive Medicine and Public Health.2024; 57(1): 65. CrossRef

Adapting the Community Readiness Model and Validating a Community Readiness Tool for Childhood Obesity Prevention Programs in Iran: Mahdieh Niknam, Nasrin Omidvar, Parisa Amiri, Hassan Eini-Zinab, Naser kalantari; J Prev Med Public Health. 2023;56(1):77-87. Published online January 10, 2023; DOI: https://doi.org/10.3961/jpmph.22.409

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Abstract PDF Supplementary Material

Objectives
It is critical to assess community readiness (CR) when implementing childhood obesity prevention programs to ensure their eventual success and sustainability. Multiple tools have been developed based on various conceptions of readiness. One of the most widely used and flexible tools is based on the community readiness model (CRM). This study aimed to adapt the CRM and assess the validity of a community readiness tool (CRT) for childhood obesity prevention programs in Iran.
Methods
A Delphi study that included 26 individuals with expertise in 8 different subject areas was conducted to adapt the CRM into a theoretical framework for developing a CRT. After linguistic validation was conducted for a 35-question CR interview guide, the modified interview guide was evaluated for its content and face validity. The quantitative and qualitative analyses were performed using Stata version 13 and MAXQDA 2010, respectively.
Results
The Delphi panelists confirmed the necessity/appropriateness and adequacy of all 6 CRM dimensions. The Persian version of the interview guide was then modified based on the qualitative results of the Delphi study, and 2 more questions were added to the community climate dimension of the original CRT. All questions in the modified version had acceptable content and face validity. The final CR interview guide included 37 questions across 6 CRM dimensions.
Conclusions
By adapting the CRM and confirming linguistic, content, and face validity, the present study devised a CRT for childhood obesity prevention programs that can be used in relevant studies in Iran.

Summary

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Improving community readiness among Iranian local communities to prevent childhood obesity
Mahdieh Niknam, Nasrin Omidvar, Hassan Eini-Zinab, Naser Kalantari, Keyvan Olazadeh, Parisa Amiri
BMC Public Health.2023;[Epub] CrossRef

Factors Influencing Suicidal Ideation According to the Deprivation Indices of Different Regions in Korea: Yun-Young Kim, Hyung-Joo Park; J Prev Med Public Health. 2023;56(1):88-94. Published online January 31, 2023; DOI: https://doi.org/10.3961/jpmph.22.356

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Abstract Summary PDF

Objectives
This study examined how deprivation differed by region and the effect those differences had on suicidal ideation among the local population.
Methods
Data collected over 10 years (2012-2021) in the Korea Welfare Panel Study were organized into 3 categories: metropolitan, city, and rural. A panel analysis was conducted on the impact of deprivation indices, socio-demographic characteristics, and life satisfaction on suicidal ideation in each category.
Results
Income, divorce status, family relationship satisfaction, and medical deprivation had a significant impact on suicidal ideation in metropolitan areas, whereas these variables did not have significant effects in rural areas. In other words, income, family, and medical support were more impactful in city areas.
Conclusions
Although the deprivation index was higher in rural areas than in city areas due to an aging population and reduced income levels, the mental health of rural residents was found to be generally better than that of city residents. The possibility that this is related to the strength of relationships within the respective communities should be considered in light of recent discussions on relational welfare.

Summary

Korean summary
본 연구는 지역별 박탈수준을 살펴보고 각 지역에서 5개 박탈영역이 자살 생각에 미치는 영향을 조사하였다. 연구결과, 고령화와 소득수준 감소로 농촌지역이 도시지역보다 박탈지수가 높았지만 농촌지역 주민의 자살생각은 도시지역보다 낮은 것으로 나타났다. 이는 최근 관계적 복지에 관한 논의에 비추어 각 지역사회 내의 관계강화와 관련이 있을 가능성을 고려해야 한다.

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Factors of Capital on Depression in Older Adulthood: A Comparison of Urban and Rural Regions in Korea
MinYoung Bae, YunYoung Kim, Ijin Hong
Healthcare.2023; 11(21): 2850. CrossRef

Correspondences

Letter to the Editor: Addressing Children’s Mental Health Issues Related to Economic Changes Caused by the COVID-19 Pandemic: Dalmacito A. Cordero Jr.; J Prev Med Public Health. 2023;56(1):95-96. Published online January 31, 2023; DOI: https://doi.org/10.3961/jpmph.22.486

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Letter to the Editor: Insights on Health, Religion/Spirituality, and Vulnerable Populations: Fides A. del Castillo; J Prev Med Public Health. 2023;56(1):97-98. Published online January 31, 2023; DOI: https://doi.org/10.3961/jpmph.22.533

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68 Download
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Letter to the Editor: Strengthening the Disaster Response of the Philippines for a Better Healthcare System
Dalmacito A. Cordero
Journal of Preventive Medicine and Public Health.2023; 56(2): 200. CrossRef

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