- Factors Associated with Gastric Cancer Screening of Koreans Based on a Socio-ecological Model.
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Sang Soo Bae, Heui Sug Jo, Dong Hyun Kim, Yong Jun Choi, Hun Jae Lee, Tae Jin Lee, Hye Jean Lee
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J Prev Med Public Health. 2008;41(2):100-106.
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DOI: https://doi.org/10.3961/jpmph.2008.41.2.100
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Abstract
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- OBJECTIVES
We measured behavioral factors associated with Koreans receiving gastric cancer screening based on a socio-ecological model, in part to develop strategies to improve cancer screening rates. METHODS: A telephone survey was conducted with 2,576 people chosen through stratified random sampling from April 1- May 31, 2004. Collected information included gastric cancer screening, socio-demographic factors, and socio-ecological factors at intrapersonal, interpersonal, community, and public policy levels. RESULTS: Among 985 survey respondents (380 men and 605 women), 402 had received gastric cancer screening. Logistic analysis was performed to compare those screened and unscreened. 'Age' was the only demographic factor that showed a statistically significant association with getting screening. People in their fifties (OR=1.731, 95% CI=1.190-2.520) and sixties (OR=2.098, 95% CI=1.301-3.385) showed a higher likelihood of getting screened, compared to those in the forties. 'Accessibility to a medical institution' was a significant factor related to having gastric cancer screening at the intrapersonal level. At the interpersonal level, recommendations by family members to be screened and a family practice of routine cancer screening were significantly related. People with frequent education about cancer screening or with stronger social feelings that cancer screening is necessary also demonstrated significantly higher tendencies to be screened. CONCLUSIONS: In conclusion, a socio-ecological model seems appropriate for explaining gastric cancer screening behavior and associated factors. Health planners should develop integrated strategies to improve cancer screening rates based on socio-ecological factors, especially at the interpersonal and community levels.
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- Evaluation of Field Epidemiology Specialist Training Program Based on the Satisfaction and the Changes of Educational Needs.
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No Rai Park, Ihn Sook Jeong, Jong Gu Lee, Young Taek Kim, Jin Ho Chun, Ki Soon Kim, Sang Soo Bae, Jong Myon Bae, Gyung Jae Oh, Hee Chul Ohrr, Kun Sei Lee, Byung Kook Lee, Hun Jae Lee, Hyun Sul Lim, Young Hwangbo
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J Prev Med Public Health. 2004;37(1):80-87.
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To evaluate the learning achievement and satisfaction levels for the Field Epidemiology Specialist Training Program (FESTP), on infectious disease control between March 19 and October 31, 2002. METHODS: The FESTP was designed as a set of 84 hours curricula including lectures, discussions, self-studies, and field practicals, and organized both centrally and locally by the Division of Communicable Disease Control of the National Institute of Health and 11 universities. Before and after the program, a questionnaire survey on the educational need (49 items) and satisfaction (15 items) was conducted on 484 trainees, who were responsible for communicable disease control and immunization at 242 regional health centers. The data were analyzed with paired t-tests for comparison of the educational needs between the pre and post scores. RESULTS: The average score for satisfaction was 3.06 out of 5.0; with relatively higher scores for sincerity (4.10) and professionalism (4.01) of the tutors, adequacy (3.54) and clearness (3.51) of the evaluation criteria, usefulness (3.54) and fitness (3.52) of the contents, but with relatively lower satisfaction for schedule (2.96) and self-studies (2.91). The average for requirement for education improved, as shown by the decrease from 2.72 to 2.22 (p< .0001) with the biggest decrease in the outbreak investigation from 2.60 to 2.08. CONCLUSION: The FESTP was evaluated as being effective, the trainees showed moderate satisfaction and decrease educational needs. However, the actual schedules and self-studies should be rearranged to improve the satisfaction level.
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Summary
- The Relationship between Treatment Intention and Compliance in Newly Detected Hypertensive Patients.
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Sok Goo Lee, Sang Soo Bae
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Korean J Prev Med. 2001;34(4):417-426.
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To analyse the psychosocial factors associated with hypertension management(drug treatment and life style modification) of newly detected cases and to understand and assess their behavioral intention or behaviors. METHODS: The survey area was a combined urban and rural area in Chungnam province, Korea, and the sampling method was cluster sampling. Study subjects included 541 newly detected cases of hypertension rated above stage 2 by JNC-VI from a community survey. The first survey was applied to 383 of these patients in order to discern their psychosocial characteristics. A follow-up survey was given to 345 persons with an 11-month interval following monthly telephone counseling concerning medication and life style modification by trained nurses. The final study subjects for analysis comprised 271 persons after excluding cases of incomplete data and change of address. RESULTS: Among the 85(33.2%) new patients who had intended to undergo drug treatment, 30(35.3%) persons were treated with antihypertensive agent after 11- month interval, while among the patients with no intention to receive treatment, only 36(21.1%) persons were treated. Hypertensive patients with a high intention score revealed a high score in life style modification compliance as well. Seventy three percent of the variance of behavioral intention to undergo hypertension management was explained by the patients attitude toward performing the behavior and subjective norm associated with behaviors related to the theory of reasoned action in structural modeling. Actual behaviors related positively with behavioral intention. The coefficient of determination was 0.255. CONCLUSION: Improving the compliance level of hypertensive patients in respect to drug treatment or life style modification requires a build up of positive behavioral intention, and caregivers must pay more attention to eventually converting behavioral intention to actual behaviors.
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- Prevalence of Dementia in the Elderly of an Urban Community in Korea .
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Dong Hyun Kim, Duk L Na, Byeon Gil Yeon, Yeonwook Kang, Kyung Bok Min, Soo Hyun Lee, Sang Suk Lee, Mi Ra Lee, Ok Jung Pyo, Chan Byung Park, Sunmean Kim, Sang Soo Bae
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Korean J Prev Med. 1999;32(3):306-316.
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In Korea, as in most countries, there will be a sharp increase in the number of dementia patients in the near future. However basic data on dementia prevalence, which is important in defining epidemiologic characteristics and in implementing preventive strategy, are limited. This study was conducted to estimate the prevalence rate of dementia in the urban elderly aged 65 or older in Kwangmyung, Korea. METHODS: A two phase design was used for case finding and case identification. In phase I, a representative sample aged 65 or older was selected and interviewed by door-to-door survey with a Korean version of the Mini-Mental State Examination (K-MMSE). In phase II, Of the 946 subjects interviewed in phase I, 356 elderly were randomly selected disproportionately according to K-MMSE score. Of these elderly, 223 (61.5%) underwent standardized clinical evaluations, including psychiatric interview, neurological examination, and neuropsychological assessment. Dementia was diagnosed by the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) criteria. The diagnosis of Alzheimer's disease (AD) was made by National Institute of Neurological and Communicative Disorders and Stroke-Alzheimer's Disease and Related Disorders Association(NINCDS-ADRDA) criteria and vascular dementia (VD) by DSM-IV. RESULTS: The overall weighted prevalence rate of all dementia among Kwangmyung residents aged 65 or older was 12.8%(age-adjusted rate: 13.0%, 95% Confidence Interval[CI]: 10.6-15.3%). Women had much higher prevalence rate than men even when age was controlled(15.9%[95% CI 12.6-19.2%] vs 7.5%[95% CI 4.6-10.4%]). The rates of dementia were 5.2%, 12.2%, 17.0%, and 34.3% for the age groups of 65-69, 70-74, 75-79 and 80 and over, respectively. The rate of AD appeared to be slightly higher than that of VD(5.2% vs 4.8%), though not statistically significant. Most of the cases(69%) were mild dementia according to CDR(<1) in these subjects. CONCLUSIONS: These results showed that the prevalence rate of dementia among urban elderly in Korea appears to be higher than those of other Asian countries.
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- Health-Related Behaviors: Theoretical Models And Research Findings.
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Sang Soo Bae
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Korean J Prev Med. 1993;26(4):508-533.
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- A wide range of health professionals have interest in changing the health behavior of individuals. To intervene effectively and to make informed judgements about how to measure the success of such interventions, health professionals must have an deep understanding of health behavior. This paper provides and overview of the thories of health-related behaviors and the strength and weakness of each, how the theories relate to others, and how they can be used in practice. The theories reviewed include Suchmann's stages of illness experience, Health belief model, Attribution theory, Fishbein's theory of reasoned action, Multiattribute utility models, Consumer information processing, and Andersen's models. Finally, this paper introduces the reader to interesting research findings in our country.
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- On Determinants of Physician Utilization: A causal analysis.
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Sang Soo Bae
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Korean J Prev Med. 1985;18(1):13-24.
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- This study seeks to provide a framework for understanding differential access to medical care. The framework is provided by Andersen Model, a model of health services utilization which suggests a sequence of predisposing, enabling, illness-morbidity characteristics that determine the number of times people will visit a physician. The framework in this study is composed of two models, one is for Adults and the other is for Non-Adults. Models are operationalized using stepwise multiple regression analysis and path analysis. The data come from a national health survey conducted in 1983. The findings of the analysis can be summarized as follows: First, the casual models used in this study are able to explain only a small amount of the variance in medical care utilization(Adjusted R2 is. 144 in the Model for Adults and .243 in that for Non-Adults). This finding suggests that we reconsider the utility of such existing model using the predisposing, enabling, and illness-morbidity characteristics in light of their poor correspondence with these data. Second, while small amount of the variance in medical care utilization is explained, most of the explained variance is due to the illness-morbidity characteristics. The path coefficients of study variables except illness-morbidity variables show these characteristics to be substantially unrelated to medical care utilization, and the indirect effects of the predisposing and enabling characteristics on medical care utilization are also negligible. This casts doubt on the importance of the predisposing and enabling characteristics in explaining medical care utilization. Third, among the predisposing and enabling characteristics, Medical Security variable is the only one having significant direct effect on medical care utilization in both models for Adults and for Non-Adults. Fourth, the amount of the variance explained in the Model for Non-Adults is more than in the Model for Adults. This suggests that medical care utilization of adults is more influenced by behavioral factors than that of children.
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