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Most-read articles are from the articles published in 2022 during the last three month.

Reviews
Qualitative Research in Healthcare: Data Analysis
Dasom Im, Jeehye Pyo, Haneul Lee, Hyeran Jung, Minsu Ock
J Prev Med Public Health. 2023;56(2):100-110.   Published online February 15, 2023
DOI: https://doi.org/10.3961/jpmph.22.471
  • 5,790 View
  • 356 Download
  • 2 Web of Science
  • 8 Crossref
AbstractAbstract AbstractSummary PDF
Qualitative research methodology has been applied with increasing frequency in various fields, including in healthcare research, where quantitative research methodology has traditionally dominated, with an empirically driven approach involving statistical analysis. Drawing upon artifacts and verbal data collected from in-depth interviews or participatory observations, qualitative research examines the comprehensive experiences of research participants who have experienced salient yet unappreciated phenomena. In this study, we review 6 representative qualitative research methodologies in terms of their characteristics and analysis methods: consensual qualitative research, phenomenological research, qualitative case study, grounded theory, photovoice, and content analysis. We mainly focus on specific aspects of data analysis and the description of results, while also providing a brief overview of each methodology’s philosophical background. Furthermore, since quantitative researchers have criticized qualitative research methodology for its perceived lack of validity, we examine various validation methods of qualitative research. This review article intends to assist researchers in employing an ideal qualitative research methodology and in reviewing and evaluating qualitative research with proper standards and criteria.
Summary
Korean summary
질적연구 방법론은 보건의료 연구에서 연구 참여자가 경험하는 주요 현상을 잘 포착할 수 있도록 해 준다. 이 논문에서는 합의적 질적연구, 현상학적 연구, 질적 사례 연구, 근거이론, 포토보이스, 내용 분석 등 6가지의 대표적인 질적 연구 방법론에 대한 간략한 철학적 배경과 구체적인 데이터 분석 및 해석 방법을 소개한다.

Citations

Citations to this article as recorded by  
  • Surgical De-escalation in Breast Cancer: Qualitative Research Introduces Hope for Patients and Illuminates a Blind Spot Within Blinded Studies
    Jose G. Bazan, Benjamin W. Corn
    International Journal of Radiation Oncology*Biology*Physics.2024; 118(2): 455.     CrossRef
  • Consumer Perceptions of Home-Based Percussive Massage Therapy for Musculoskeletal Concerns: Inductive Thematic Qualitative Analysis
    Saloni Butala, Pearl Valentine Galido, Benjamin K P Woo
    JMIR Rehabilitation and Assistive Technologies.2024; 11: e52328.     CrossRef
  • Analyzing the prohibition of interfaith marriage in Indonesia: legal, religious, and human rights perspectives
    M. Thahir Maloko, Sippah Chotban, Muhammad Ikram Nur Fuady, Hasdiwanti
    Cogent Social Sciences.2024;[Epub]     CrossRef
  • Author Response: Students’ Positive Coping Strategies From Disaster: A Narrative Analysis
    Minsu Ock
    Journal of Preventive Medicine and Public Health.2023; 56(4): 390.     CrossRef
  • Letter to the Editor: Students’ Positive Coping Strategies From Disaster: A Narrative Analysis
    Allan M. Abiera, Jan Gresil Kahambing
    Journal of Preventive Medicine and Public Health.2023; 56(4): 388.     CrossRef
  • Knowledge, Attitude, and Practice of Qualitative Research Among Health Sciences Faculty
    Mohamud Mohamud, Alwaleed A Albarkani, Emad Masuadi, Abdullaziz A Alsahly, Abdulaziz I Alkudairy, Yazeed F Shalabi, Abdulrahman Faqih, Khaled A Alaukili, Saad J Alsahli
    Cureus.2023;[Epub]     CrossRef
  • Patients’ Reasons to Consider and Their Attitudes toward Complementary and Alternative Medicine
    Katharina Matjuschenko, Christian Keinki, Jutta Huebner, Pranshu Sahgal
    European Journal of Cancer Care.2023; 2023: 1.     CrossRef
  • The human role to guarantee an ethical AI in healthcare: a five-facts approach
    Raquel Iniesta
    AI and Ethics.2023;[Epub]     CrossRef
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
  • 6,167 View
  • 384 Download
  • 9 Web of Science
  • 12 Crossref
AbstractAbstract AbstractSummary 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.

Citations

Citations to this article as recorded by  
  • A qualitative pilot study exploring clients’ and health-care professionals’ experiences with aquatic therapy post-stroke in Ontario, Canada
    Andresa R. Marinho-Buzelli, Abirami Vijayakumar, Elizabeth Linkewich, Catherine Gareau, Hasnain Mawji, Zoe Li, Sander L. Hitzig
    Topics in Stroke Rehabilitation.2024; 31(1): 86.     CrossRef
  • The Mindfulness-Based Social Work and Self-Care Programme: A Focus Group Study
    Alan Maddock, Karen McGuigan, Pearse McCusker, Jane Kellock
    Clinical Social Work Journal.2024; 52(1): 48.     CrossRef
  • Kazakhstani elite athletes’ perspectives on the Tokyo 2020 olympic and paralympic games postponement and their preparation during the COVID-19 pandemic: A qualitative study
    Venera Abdulla, Natalya Glushkova, Kulman Nyssanbayeva, Maira Bakasheva, Dominic Sagoe
    Performance Enhancement & Health.2024; 12(1): 100270.     CrossRef
  • Surgical De-escalation in Breast Cancer: Qualitative Research Introduces Hope for Patients and Illuminates a Blind Spot Within Blinded Studies
    Jose G. Bazan, Benjamin W. Corn
    International Journal of Radiation Oncology*Biology*Physics.2024; 118(2): 455.     CrossRef
  • Conducting and Writing Quantitative and Qualitative Research
    Edward Barroga, Glafera Janet Matanguihan, Atsuko Furuta, Makiko Arima, Shizuma Tsuchiya, Chikako Kawahara, Yusuke Takamiya, Miki Izumi
    Journal of Korean Medical Science.2023;[Epub]     CrossRef
  • “The chameleon among diseases” - an explorative view of sarcoidosis and identification of the consequences for affected patients and relatives using qualitative interviews
    Charlotte Hilker, Johanna Weis, Stefanie Ziehfreund, Elizabeth V. Arkema, Tilo Biedermann, Alexander Zink
    Orphanet Journal of Rare Diseases.2023;[Epub]     CrossRef
  • Qualitative Research in Healthcare: Data Analysis
    Dasom Im, Jeehye Pyo, Haneul Lee, Hyeran Jung, Minsu Ock
    Journal of Preventive Medicine and Public Health.2023; 56(2): 100.     CrossRef
  • ‘How is our job affecting us?’ Neonatal Intensive Care Unit healthcare providers and their pregnancy: A descriptive qualitative study
    Gaia Dussi, Stefano Bembich, Roberta Crevatin, Sara Buchini, Silvana Schreiber, Livia Bicego, Andrea Cassone, Raffaella Dobrina
    Journal of Advanced Nursing.2023; 79(10): 3776.     CrossRef
  • Investigating Functional Impairment in Chronic Low Back Pain: A Qualitative Study from the Patients and Specialists’ Perspectives
    Arturo Cuomo, Franco Marinangeli, Alberto Magni, Emiliano Petrucci, Alessandro Vittori, Marco Cascella
    Journal of Personalized Medicine.2023; 13(6): 1012.     CrossRef
  • Author Response: Students’ Positive Coping Strategies From Disaster: A Narrative Analysis
    Minsu Ock
    Journal of Preventive Medicine and Public Health.2023; 56(4): 390.     CrossRef
  • Knowledge, Attitude, and Practice of Qualitative Research Among Health Sciences Faculty
    Mohamud Mohamud, Alwaleed A Albarkani, Emad Masuadi, Abdullaziz A Alsahly, Abdulaziz I Alkudairy, Yazeed F Shalabi, Abdulrahman Faqih, Khaled A Alaukili, Saad J Alsahli
    Cureus.2023;[Epub]     CrossRef
  • A qualitative study on hope in iranian end stage renal disease patients undergoing hemodialysis
    Masoume Rambod, Nilofar Pasyar, Ali Mohammad Parviniannasab
    BMC Nephrology.2023;[Epub]     CrossRef
Systematic Reviews
Pre-exposure Prophylaxis Adherence Among Men Who Have Sex With Men: A Systematic Review and Meta-analysis
Suchitra Hudrudchai, Charin Suwanwong, Pitchada Prasittichok, Kanu Priya Mohan, Nopphadol Janeaim
J Prev Med Public Health. 2024;57(1):8-17.   Published online December 12, 2023
DOI: https://doi.org/10.3961/jpmph.23.345
  • 1,016 View
  • 127 Download
AbstractAbstract AbstractSummary PDFSupplementary Material
Objectives
The effectiveness and efficiency of pre-exposure prophylaxis (PrEP) in reducing the transmission of human immunodeficiency virus (HIV) among men who have sex with men (MSM) relies on how widely it is adopted and adhered to, particularly among high-risk groups of MSM. The meta-analysis aimed to collect and analyze existing evidence on various factors related to PrEP adherence in MSM, including demographic characteristics, sexual behaviors, substance use, and psychosocial factors.
Methods
The meta-analysis followed the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. The search included articles published between January 2018 and December 2022, obtained from the PubMed, ScienceDirect, and Scopus databases. The studies that were included in the analysis reported the proportion of MSM who demonstrated adherence to PrEP and underwent quality appraisal using the Newcastle-Ottawa Scale.
Results
Of the 268 studies initially identified, only 12 met the inclusion criteria and were included in the final meta-analysis. The findings indicated that education (odds ratio [OR], 1.64; 95% confidence interval [CI], 1.12 to 2.40), number of sexual partners (OR, 1.16; 95% CI, 1.02 to 1.31), engaging in sexual activities with an human immunodeficiency virus-positive partner (OR, 1.59; 95% CI, 1.16 to 2.26), substance use (OR, 0.83; 95% CI, 0.70 to 0.99), and lower levels of depression (OR, 0.55; 95% CI, 0.37 to 0.82) were associated with higher rates of PrEP adherence among MSM.
Conclusions
Despite these findings, further research is necessary to investigate PrEP adherence more comprehensively. The findings of this meta-analysis can be utilized to inform interventions aimed at improving PrEP adherence among MSM and provide directions for future research in this area.
Summary
Key Message
This systematic review and meta-analysis confirmed that factors such as education, number of sexual partners, engagement in sexual activities with an HIV-positive partner, substance use, and lower levels of depression were associated with higher rates of PrEP adherence among MSM. Healthcare providers and interventions should take these aspects into consideration when developing strategies to promote optimal PrEP adherence and reduce the risk of HIV transmission.
Challenges to Achieving Universal Health Coverage Throughout the World: A Systematic Review
Alireza Darrudi, Mohammad Hossein Ketabchi Khoonsari, Maryam Tajvar
J Prev Med Public Health. 2022;55(2):125-133.   Published online March 8, 2022
DOI: https://doi.org/10.3961/jpmph.21.542
  • 5,629 View
  • 245 Download
  • 9 Web of Science
  • 13 Crossref
AbstractAbstract PDFSupplementary Material
Objectives
No systematic review has explored the challenges related to worldwide universal health coverage (UHC). This study reviewed challenges on the road to UHC.
Methods
A systematic electronic search of all studies that identified the challenges of worldwide UHC was conducted, without any restrictions related to the publication date or language. A hand search and a bibliographic search were also conducted to identify which texts to include in this study. These sources and citations yielded a total of 2500 articles, only 26 of which met the inclusion criteria. Relevant data from these papers were extracted, summarized, grouped, and reported in tables.
Results
Of the 26 included studies, 7 (27%) were reviews, 6 (23%) were reports, and 13 (50%) had another type of study design. The publication dates of the included studies ranged from 2011 to 2020. Nine studies (35%) were published in 2019. Using the World Health Organization conceptual model, data on all of the challenges related to UHC in terms of the 4 functions of health systems (stewardship, creating resource, financing, and delivering services) were extracted from the included studies and reported.
Conclusions
This study provides a straightforward summary of previous studies that explored the challenges related to UHC and conducted an in-depth analysis of viable solutions.
Summary

Citations

Citations to this article as recorded by  
  • Impact of the COVID-19 pandemic on the services provided by the Peruvian health system: an analysis of people with chronic diseases
    David Villarreal-Zegarra, Luciana Bellido-Boza, Alfonso Erazo, Max Pariona-Cárdenas, Paul Valdivia-Miranda
    Scientific Reports.2024;[Epub]     CrossRef
  • Do national health insurance schemes guarantee financial risk protection in the drive towards Universal Health Coverage in West Africa? A systematic review of observational studies
    Sydney N. N. T. Odonkor, Ferdinand Koranteng, Martin Appiah-Danquah, Lorena Dini, Ama Pokuaa Fenny
    PLOS Global Public Health.2023; 3(8): e0001286.     CrossRef
  • Universal health coverage evolution, ongoing trend, and future challenge: A conceptual and historical policy review
    Chhabi Lal Ranabhat, Shambhu Prasad Acharya, Chiranjivi Adhikari, Chun-Bae Kim
    Frontiers in Public Health.2023;[Epub]     CrossRef
  • Networks of care to strengthen primary healthcare in resource constrained settings
    Enoch Oti Agyekum, Katherine Kalaris, Blerta Maliqi, Allisyn C Moran, Andrews Ayim, Sanam Roder-DeWan
    BMJ.2023; : e071833.     CrossRef
  • Cardiovascular Health Priorities in Sub-Saharan Africa
    Nchafatso G. Obonyo, Anthony O. Etyang
    SN Comprehensive Clinical Medicine.2023;[Epub]     CrossRef
  • Indicadores de desempeño de la Atención Primaria del Programa Previne Brasil
    Tatiele Estefâni Schönholzer, Fabiana Costa Machado Zacharias, Gabriela Gonçalves Amaral, Luciana Aparecida Fabriz, Brener Santos Silva, Ione Carvalho Pinto
    Revista Latino-Americana de Enfermagem.2023;[Epub]     CrossRef
  • Indicadores de desempenho da Atenção Primária do Programa Previne Brasil
    Tatiele Estefâni Schönholzer, Fabiana Costa Machado Zacharias, Gabriela Gonçalves Amaral, Luciana Aparecida Fabriz, Brener Santos Silva, Ione Carvalho Pinto
    Revista Latino-Americana de Enfermagem.2023;[Epub]     CrossRef
  • Performance indicators of Primary Care of the Previne Brasil Program
    Tatiele Estefâni Schönholzer, Fabiana Costa Machado Zacharias, Gabriela Gonçalves Amaral, Luciana Aparecida Fabriz, Brener Santos Silva, Ione Carvalho Pinto
    Revista Latino-Americana de Enfermagem.2023;[Epub]     CrossRef
  • How should we prioritise global surgery? A capabilities approach argument for the place of surgery within every health system
    Rashi Jhunjhunwala, Sridhar Venkatapuram
    BMJ Global Health.2023; 8(11): e013100.     CrossRef
  • The leading global health challenges in the artificial intelligence era
    Amal Mousa Zaidan
    Frontiers in Public Health.2023;[Epub]     CrossRef
  • Role of family factors in provision and perception of social support for older people in Iran: a cross-sectional survey
    Maryam Tajvar, Emily Grundy, Astrid Fletcher, Elizabeth Allen, Badriyeh Karami
    BMC Primary Care.2023;[Epub]     CrossRef
  • An Evaluation of the Philippine Healthcare System: Preparing for a Robust Public Health in the Future
    Dalmacito A. Cordero
    Journal of Preventive Medicine and Public Health.2022; 55(3): 310.     CrossRef
  • The impacts of donor transitions on health systems in middle-income countries: a scoping review
    Hanna E Huffstetler, Shashika Bandara, Ipchita Bharali, Kaci Kennedy Mcdade, Wenhui Mao, Felicia Guo, Jiaqi Zhang, Judy Riviere, Liza Becker, Mina Mohamadi, Rebecca L Rice, Zoe King, Zoha Waqar Farooqi, Xinqi Zhang, Gavin Yamey, Osondu Ogbuoji
    Health Policy and Planning.2022; 37(9): 1188.     CrossRef
Special Article
An Introduction to Causal Mediation Analysis With a Comparison of 2 R Packages
Sangmin Byeon, Woojoo Lee
J Prev Med Public Health. 2023;56(4):303-311.   Published online July 31, 2023
DOI: https://doi.org/10.3961/jpmph.23.189
  • 3,304 View
  • 220 Download
AbstractAbstract AbstractSummary PDFSupplementary Material
Traditional mediation analysis, which relies on linear regression models, has faced criticism due to its limited suitability for cases involving different types of variables and complex covariates, such as interactions. This can result in unclear definitions of direct and indirect effects. As an alternative, causal mediation analysis using the counterfactual framework has been introduced to provide clearer definitions of direct and indirect effects while allowing for more flexible modeling methods. However, the conceptual understanding of this approach based on the counterfactual framework remains challenging for applied researchers. To address this issue, the present article was written to highlight and illustrate the definitions of causal estimands, including controlled direct effect, natural direct effect, and natural indirect effect, based on the key concept of nested counterfactuals. Furthermore, we recommend using 2 R packages, ‘medflex’ and ‘mediation’, to perform causal mediation analysis and provide public health examples. The article also offers caveats and guidelines for accurate interpretation of the results.
Summary
Korean summary
전통적 매개분석은 여러 유형의 변수 혹은 복잡한 상호작용을 포함할 경우, 직접 및 간접효과의 정의가 불분명하다는 비판에 직면해왔다. 이에 대한 대안으로서 인과매개분석은 반사실적 개념에 기반하여 직접 및 간접효과를 명료하게 정의하며 유연한 모델링을 가능하게 한다. 다만 이 새로운 접근의 주요 개념을 응용 연구자들이 이해하는 데에는 다소 어려운 측면이 있다. 이러한 점에서 이 논문에서는 중첩된 반사실적 변수에 기반한 인과적 모수의 정의를 상술하고 인과매개분석을 위한 대표적인 R 패키지인 medflex 및 mediation을 활용하여 공공 보건 사례에 대한 분석 실례 및 유의사항을 제공하였다.
Original Article
Health Behaviors Before and After the Implementation of a Health Community Organization: Gangwon’s Health-Plus Community Program
Joon-Hyeong Kim, Nam-Jun Kim, Soo-Hyeong Kim, Woong-Sub Park
J Prev Med Public Health. 2023;56(6):487-494.   Published online August 17, 2023
DOI: https://doi.org/10.3961/jpmph.23.121
  • 1,072 View
  • 175 Download
AbstractAbstract AbstractSummary PDF
Objectives
Community organization is a resident-led movement aimed at creating fundamental social changes in the community by resolving its problems through the organized power of its residents. This study evaluated the effectiveness of health community organization (HCO), Gangwon’s Health-Plus community program, implemented from 2013 to 2019 on residents’ health behaviors.
Methods
This study had a before-and-after design using 2011-2019 Korea Community Health Survey data. To compare the 3-year periods before and after HCO implementation, the study targeted areas where the HCO had been implemented for 4 years or longer. Therefore, a total of 4512 individuals from 11 areas with HCO start years from 2013 to 2016 were included. Complex sample multi-logistic regression analysis adjusting for demographic characteristics (sex, age, residential area, income level, education level, and HCO start year) was conducted.
Results
HCO implementation was associated with decreased current smoking (adjusted odds ratio [aOR], 0.73; 95% confidence interval [CI], 0.57 to 0.95) and subjective stress recognition (aOR, 0.79; 95% CI, 0.64 to 0.97). Additionally, the HCO was associated with increased walking exercise practice (aOR, 1.39; 95% CI, 1.13 to 1.71), and attempts to control weight (aOR, 1.36; 95% CI, 1.12 to 1.64). No significant negative changes were observed in other health behavior variables.
Conclusions
The HCO seems to have contributed to improving community health indicators. In the future, a follow-up study that analyzes only the effectiveness of the HCO through structured quasi-experimental studies will be needed.
Summary
Korean summary
건강주민운동은 지역사회 건강지표 향상에 기여한 것으로 보여진다. 따라서 주민참여형 건강증진사업이 주민들의 건강을 향상하기 위해서는 주민이 주체가 되어 조직화된 힘으로 지역사회의 근본적인 변화를 만들어가는 주민운동의 관점으로 시행될 필요가 있다.
Key Message
The Health Community Organization (HCO) appears to contribute to the enhancement of community health indicators. Therefore, in order to improve the health of residents through community-based participatory health promotion programs, it is necessary to implement them from the perspective of the HCO in which residents organize themselves as a mobilized force to bring about fundamental changes in the community.
Review
DALY Estimation Approaches: Understanding and Using the Incidence-based Approach and the Prevalence-based Approach
Young-Eun Kim, Yoon-Sun Jung, Minsu Ock, Seok-Jun Yoon
J Prev Med Public Health. 2022;55(1):10-18.   Published online January 19, 2022
DOI: https://doi.org/10.3961/jpmph.21.597
  • 4,782 View
  • 255 Download
  • 12 Web of Science
  • 14 Crossref
AbstractAbstract AbstractSummary PDF
Disability-adjusted life-year (DALY) estimates may vary according to factors such as the standard life expectancy, age weighting, time preference and discount rate, calculation of disability weights, and selection of the estimation method. DALY estimation methods are divided into the following 3 approaches: the incidence-based approach, the pure prevalence-based approach, and the hybrid approach. These 3 DALY estimation approaches each reflect different perspectives on the burden of disease using unique characteristics, based on which the selection of a suitable approach may vary by the purpose of the study. The Global Burden of Disease studies, which previously estimated DALYs using the incidence-based approach, switched to using the hybrid approach in 2010, while the National Burden of Disease studies in Korea still mainly apply the incidence-based approach. In order to increase comparability with other international burden of disease studies, more DALY studies using the prevalence-based approach need to be conducted in Korea. However, with the limitations of the hybrid approach in mind, it is necessary to conduct more research using a disease classification system suitable for Korea. Furthermore, more detailed and valid data sources should be established before conducting studies using a broader variety of DALY estimation approaches. This review study will help researchers on burden of disease use an appropriate DALY estimation approach and will contribute to enhancing researchers’ ability to critically interpret burden of disease studies.
Summary
Korean summary
장애보정생존연수 산출 방법은 발생률 접근법, 순수 유병률 접근법 및 하이브리드 접근법으로 나뉜다. 이러한 3가지 장애보정생존연수 산출 접근법은 각각 고유한 특성을 가지고 질병부담에 대한 다양한 관점을 반영하기 때문에, 연구 목적에 따라 산출 접근법의 선택이 달라질 수 있다. 이번 연구의 결과는 연구자들이 장애보정생존연수 산출 방법의 타당성을 향상시키기 위하여 질병부담 연구에 사용할 산출 접근법을 결정하는 데 도움이 될 것이다.

Citations

Citations to this article as recorded by  
  • Trends in Healthy Life Expectancy (HALE) and Disparities by Income and Region in Korea (2008–2020): Analysis of a Nationwide Claims Database
    Yoon-Sun Jung, Young-Eun Kim, Minsu Ock, Seok-Jun Yoon
    Journal of Korean Medical Science.2024;[Epub]     CrossRef
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    Aji Kusumaning Asri, Chia-Hao Yeh, Hao-Ting Chang, Hsiao-Yun Lee, Shih-Chun Candice Lung, John D. Spengler, Chih-Da Wu
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    Peihong Wu, Qingtao Jiang, Lei Han, Xin Liu
    Frontiers in Medicine.2023;[Epub]     CrossRef
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Original Articles
Association Between Parental BMI and Offspring’s Blood Pressure by Mediation Analysis: A Study Using Data From the Korean National Health and Nutrition Examination Survey
Hyowon Choi, Hunju Lee, Yeon-Soon Ahn
J Prev Med Public Health. 2023;56(6):533-541.   Published online October 30, 2023
DOI: https://doi.org/10.3961/jpmph.23.289
  • 788 View
  • 54 Download
AbstractAbstract AbstractSummary PDFSupplementary Material
Objectives
This study analyzed the relationship between parental body mass index (BMI; BMI_p) and hypertension in their adolescent offspring (HTN_a), focusing on the mediating effect of adolescents’ BMI (BMI_a).
Methods
Utilizing data from the Korea National Health and Nutrition Examination Survey, including participants aged 12-18, we conducted a mediation analysis while controlling for confounding factors such as age, sex, physical activity, dietary habits, household income quartile, and parents’ alcohol and smoking habits.
Results
The study included a total of 5731 participants, of whom 3381 and 5455 participants had data on fathers’ and mothers’ BMI, respectively. For adolescent systolic blood pressure (SBP_a), the father’s BMI (BMI_f) had a significant total effect (β, 0.23; 95% confidence interval [CI], 0.12 to 0.34) and average controlled mediated effect (ACME) (β, 0.27; 95% CI, 0.23 to 0.32), but the average direct effect (ADE) was not significant. The mother’s BMI (BMI_m) had a significant total effect (β, 0.17; 95% CI, 0.09 to 0.25), ACME (β, 0.25; 95% CI, 0.22 to 0.28) and ADE (β, -0.08; 95% CI, -0.16 to 0.00). For adolescent diastolic blood pressure, both BMI_f and BMI_m had significant ACMEs (β, 0.10; 95% CI, 0.08 to 0.12 and β, 0.09; 95% CI, 0.07 to 0.12, respectively), BMI_m had a significant ADE (β, -0.09; 95% CI, -0.16 to -0.02) but BMI_f had an insignificant ADE and total effect.
Conclusions
The study found that parental BMI had a significant effect on SBP_a, mediated through BMI_a. Therefore, a high BMI in parents could be a risk factor, mediated through BMI_a, for systolic hypertension in adolescents, necessitating appropriate management.
Summary
Korean summary
본 연구를 통해 부모의 BMI가 청소년기의 BMI를 매개하여 청소년의 수축기 혈압에 영향을 미침을 확인할 수 있었습니다. 그러나 본 연구는 단면적인 데이터를 활용하였으며, 후향적 연구로 이에 대한 한계를 가지고 있으며, 이후 이에 대한 추가 연구가 필요합니다.
Key Message
This study was able to confirm that parents' BMI mediated their BMI during adolescence and affected systolic blood pressure in adolescents. However, this study utilized cross-sectional data, and has limitations on this as a retrospective study, so further studies are needed.
An Important Strategy to Improve Adolescent Health Literacy: COVID-19 Modules in High School in Indonesia
Nurina Hasanatuludhhiyah, Visuddho Visuddho, Abdul Khairul Rizki Purba, Annette d’ Arqom, Ancah Caesarina Novi Marchianti
J Prev Med Public Health. 2023;56(6):523-532.   Published online November 1, 2023
DOI: https://doi.org/10.3961/jpmph.23.113
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  • 83 Download
AbstractAbstract AbstractSummary PDF
Objectives
During the second coronavirus disease 2019 (COVID-19) surge, cases increased sharply due to low awareness and compliance with measures to limit disease spread. Health literacy (HL) is an important component of public health initiatives, and schools are potential sources of health education to increase HL via the presentation of COVID-19 educational modules.
Methods
This cross-sectional study involved an online questionnaire administered to students from 5 high schools in Surabaya and Sidoarjo, Indonesia, 6-7 weeks after the start of government-issued directives restricting public gatherings. We collected data on each respondent’s age, gender, parental education, and socioeconomic variables. HL was determined by the Health Literacy Measure for Adolescents. We additionally measured their attitudes and behaviors related to preventing the spread of COVID-19. The students were asked if they watched the COVID-19 module at school, their feelings about vaccination, and preferred online sources of COVID-19-related information.
Results
Most of the 432 respondents had viewed COVID-19 modules at school. Module exposure was associated with significantly higher total and domain-specific HL and more positive attitudes toward government-issued COVID-19 restrictions on travel and public gatherings (p<0.05). However, behaviors to prevent COVID-19 spread and vaccine acceptance were not associated with module exposure. Most students chose social media as their source of COVID-19-related information.
Conclusions
Schools can provide information to increase adolescents’ HL and the public’s support for health initiatives to prevent or limit the spread of COVID-19.
Summary
Key Message
A cross-sectional study carried out on high school students during the second surge of COVID-19 in Indonesia revealed that they benefitted from the COVID-19 module. Students who viewed the module had higher scores on health literacy measures of adolescents (HELMA), had a more favorable attitude toward government-issued restrictive policies, and were more likely to have adequate health literacy, in regard to the ability to use health information. These imply schools as part of the public health response by providing education to increase adolescents’ health literacy and the public’s support for health initiatives to prevent and limit the spread of COVID-19.
Teachers’ Negative Attitudes and Limited Health Literacy Levels as Risks for Low Awareness of Epilepsy in Turkey
Gulay Yilmazel
J Prev Med Public Health. 2023;56(6):573-582.   Published online November 13, 2023
DOI: https://doi.org/10.3961/jpmph.23.330
  • 764 View
  • 50 Download
AbstractAbstract AbstractSummary PDFSupplementary Material
Objectives
For students with epilepsy, schools are a critical environment for managing the disease properly. This study examined awareness of epilepsy, attitudes toward epilepsy, and health literacy among school teachers in Turkey.
Methods
This study was conducted in a city in Turkey with 1408 public school teachers from June 2021 to September 2021.
Results
The median scores of the scales were 5, 29, and 32 for epilepsy awareness, epilepsy attitudes, and health literacy, respectively. Epilepsy awareness was higher in women, and epilepsy attitudes were more positive in women than men (p<0.05). While epilepsy awareness was higher in primary school teachers, epilepsy attitudes were more positive in secondary school teachers (p<0.05). Epilepsy awareness was lower in secondary school teachers (odds ratio [OR], 1.27; p<0.05), those who did not have an individual with epilepsy in their family/social environment (OR, 1.57; p<0.001), those who did not have a student with epilepsy in their class (OR, 1.45; p<0.05), and in those who had not witnessed an epilepsy seizure (OR,1.19; p<0.05). Compared to those with positive attitudes regarding epilepsy, epilepsy awareness was 1.36 times lower in those with negative attitudes (p<0.001). Epilepsy awareness was 1.92 times lower in those with limited health literacy than those with adequate health literacy (p<0.001).
Conclusions
In this study, low epilepsy awareness, negative epilepsy attitudes, and limited health literacy were common among teachers. The findings from this study suggest that panels, workshops, and health training on epilepsy should be organized for school teachers and included at regular intervals in certified first-aid practices.
Summary
Key Message
• This article examined school teachers' barriers to epilepsy awareness. • Awareness was low, negative attitudes were high, and health literacy level was limited. • Negative attitudes and limited health literacy were the most effective risks for poor awareness.
Special Article
Examining the Role of Psychosocial Stressors in Hypertension
Komal Marwaha
J Prev Med Public Health. 2022;55(6):499-505.   Published online November 30, 2022
DOI: https://doi.org/10.3961/jpmph.21.266
  • 3,335 View
  • 208 Download
  • 5 Crossref
AbstractAbstract PDF
Despite advances in medicine and preventive strategies, fewer than 1 in 5 people with hypertension have the problem under control. This could partly be due to gaps in fully elucidating the etiology of hypertension. Genetics and conventional lifestyle risk factors, such as the lack of exercise, unhealthy diet, excess salt intake, and alcohol consumption, do not fully explain the pathogenesis of hypertension. Thus, it is necessary to revisit other suggested risk factors that have not been paid due attention. One such factor is psychosocial stress. This paper explores the evidence for the association of psychosocial stressors with hypertension and shows that robust evidence supports the role of a chronic stressful environment at work or in marriage, low socioeconomic status, lack of social support, depression, anxiety, post-traumatic stress, childhood psychological trauma, and racial discrimination in the development or progression of hypertension. Furthermore, the potential pathophysiological mechanisms that link psychosocial stress to hypertension are explained to address the ambiguity in this area and set the stage for further research.
Summary

Citations

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Original Articles
Impact of Physical Activity on the Association Between Unhealthy Adolescent Behaviors and Anxiety Among Korean Adolescents: A Cross-sectional Study
Hyo-jung Lee, Jeong Pil Choi, Kunhee Oh, Jin-Young Min, Kyoung-Bok Min
J Prev Med Public Health. 2023;56(6):552-562.   Published online November 15, 2023
DOI: https://doi.org/10.3961/jpmph.23.313
  • 724 View
  • 67 Download
AbstractAbstract AbstractSummary PDF
Objectives
Adolescents who engage in unhealthy behaviors are particularly vulnerable to anxiety. We hypothesized that participation in physical activity could influence the relationship between anxiety and unhealthy behaviors in adolescents. These behaviors include smoking, alcohol consumption, and unsafe sexual activity.
Methods
This study included 50 301 students from the first year of middle school to the third year of high school, all from Korea. The unhealthy adolescent behaviors examined included current alcohol consumption, current smoking, and unsafe sexual behavior. Anxiety levels were assessed using the Generalized Anxiety Disorder-7 questionnaire (GAD-7).
Results
The participants had a mean age of 15.19 years and an average GAD-7 score of 4.23. No significant differences were observed in GAD-7 score among exercising participants when categorized by smoking status (p=0.835) or unsafe sexual behavior (p=0.489). In contrast, participants in the non-exercise group who engaged in these behaviors demonstrated significantly higher GAD-7 scores (p<0.001 and 0.016, respectively). The only significant interaction was found between unsafe sexual behavior and exercise (p=0.009). Based on logistic regression analysis, within the non-exercise group, significant positive associations were observed between current smoking and anxiety (odds ratio [OR], 1.36; 95% confidence interval [CI], 1.18 to 1.57), as well as between unsafe sexual behavior and anxiety (OR, 1.33; 95% CI, 1.02 to 1.73). However, within the exercise group, no significant association was found between anxiety and either smoking or unsafe sexual behavior. Furthermore, no significant interaction was observed between unhealthy behaviors and exercise.
Conclusions
These findings are insufficient to conclude that physical activity influences the relationship between unhealthy behaviors and anxiety.
Summary
Korean summary
이 연구는 신체활동이 한국 청소년들사이에서 불안과 불건강행태간의 관계에 어떠한 영향을 미치는지 조사하였다. 이 연구에서 신체활동을 하지 않는 청소년에서만 흡연 및 불안전한 성행위와 같은 불건강행태와 불안 간의 유의미한 연관성을 보였음에도 불구하고, 이러한 불건강행태와 운동 간에는 같은 방향의 유의미한 상호작용이 관찰되지 않았다. 따라서 이 연구는 신체 활동이 청소년들의 불건강행태와 불안간의 관계에 직접 미치는 영향에 대해 명확하게 결론을 내릴 수 없었다.
Key Message
Among Korean adolescents, this study found that significant associations between unhealthy behaviors such as smoking and unsafe sex, and anxiety were only observed in adolescents who did not engage in physical activity. Despite this, no significant interaction was observed between these unhealthy behaviors and exercise. Contrary to popular belief, this study concludes that the evidence is insufficient to definitively say that physical activity influences the relationship between adolescent unhealthy behaviors and anxiety.
Vaccination Status and In-hospital Mortality Among Adults With COVID-19 in Jakarta, Indonesia: A Retrospective Hospital-based Cohort Study
Hotma Martogi Lorensi Hutapea, Pandji Wibawa Dhewantara, Anton Suryatma, Raras Anasi, Harimat Hendarwan, Mondastri Korib Sudaryo, Dwi Gayatri
J Prev Med Public Health. 2023;56(6):542-551.   Published online October 30, 2023
DOI: https://doi.org/10.3961/jpmph.23.360
  • 730 View
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AbstractAbstract AbstractSummary PDFSupplementary Material
Objectives
Prospective studies on vaccination status and mortality related to coronavirus disease 2019 (COVID-19) in low-resource settings are still limited. We assessed the association between vaccination status (full, partial, or none) and in-hospital mortality among COVID-19 patients at most hospitals in Jakarta, Indonesia during the Delta predomination wave.
Methods
We conducted a retrospective cohort study among hospitalized COVID-19 patients who met the study criteria (>18 years old and admitted for inpatient treatment because of laboratory-confirmed severe acute respiratory syndrome coronavirus 2 infection). We linked individual-level data in the hospital admission database with vaccination records. Several socio-demographic and clinical characteristics were also analyzed. A Cox proportional hazards regression model was used to explore the association between vaccination status and in-hospital mortality in this patient group.
Results
In total, 40 827 patients were included in this study. Of these, 70% were unvaccinated (n=28 543) and 19.3% (n=7882) died during hospitalization. The mean age of the patients was 49 years (range, 35-59), 53.2% were female, 22.0% had hypertension, and 14.2% were treated in the intensive care unit, and the median hospital length of stay across the group was 9 days. Our study showed that the risk of in-hospital mortality among fully and partially vaccinated patients was lower than among unvaccinated adults (adjusted hazard ratio [aHR], 0.43; 95% confidence interval [CI], 0.40 to 0.47 and aHR, 0.70; 95% CI, 0.64 to 0.77, respectively).
Conclusions
Vaccinated patients had fewer severe outcomes among hospitalized adults during the Delta wave in Jakarta. These features should be carefully considered by healthcare professionals in treating adults within this patient group.
Summary
Key Message
During the COVID-19 pandemic the Delta variant of SARS-CoV-2 was dominating and challenging. Vaccination is one of many approaches to control the pandemic. We assessed the association between vaccination status and in-hospitalized mortality in COVID-19 patients. We found that vaccination status was associated with lower mortality, and fully vaccinated patients experienced lower risk of in-hospitalized mortality compared to partially vaccinated ones.
Systematic Review
Vitamin D Deficiency and Comorbidities as Risk Factors of COVID-19 Infection: A Systematic Review and Meta-analysis
Pinki Mishra, Rizwana Parveen, Ram Bajpai, Nidhi Agarwal
J Prev Med Public Health. 2022;55(4):321-333.   Published online June 13, 2022
DOI: https://doi.org/10.3961/jpmph.21.640
  • 3,895 View
  • 184 Download
  • 8 Crossref
AbstractAbstract PDFSupplementary Material
Objectives
Extensive evidence links low vitamin D status and comorbidities with coronavirus disease 2019 (COVID-19) outcomes, but the results of published studies are contradictory. Therefore, we investigated the association of lower levels of vitamin D and comorbidities with the risk of COVID-19 infection.
Methods
We searched MEDLINE (via PubMed), Cochrane Central Register of Controlled Trials, and ClinicalTrials.gov for articles published until August 20, 2021. Sixteen eligible studies were identified (386 631 patients, of whom 181 114 were male). We included observational cohort and case-control studies that evaluated serum levels of vitamin D in COVID-19-positive and COVID-19-negative patients. Mean differences (MDs) with 95% confidence intervals (CIs) were calculated.
Results
Significantly lower vitamin D levels were found in COVID-19-positive patients (MD, -1.70; 95% CI, -2.74 to -0.66; p=0.001), but with variation by study design (case-control: -4.04; 95% CI, -5.98 to -2.10; p<0.001; cohort: -0.39; 95% CI, -1.62 to 0.84; p=0.538). This relationship was more prominent in female patients (MD, -2.18; 95% CI, -4.08 to -0.28; p=0.024) than in male patients (MD, -1.74; 95% CI, -3.79 to 0.31; p=0.096). Male patients showed higher odds of having low vitamin D levels (odds ratio [OR], 2.09; 95% CI, 1.38 to 3.17; p<0.001) than female patients (OR, 1.17; 95% CI, 0.74 to 1.86; p=0.477). Comorbidities showed inconsistent, but generally non-significant, associations with COVID-19 infection.
Conclusions
Low serum vitamin-D levels were significantly associated with the risk of COVID-19 infection. This relationship was stronger in female than in male COVID-19 patients. Limited evidence was found for the relationships between comorbidities and COVID-19 infection, warranting large population-based studies to clarify these associations.
Summary

Citations

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Original Article
Multilevel Analysis of the Relationship Between Prescribing Institutions and Medication Adherence Among Patients With Hypertension and Diabetes in Korea
Haryeom Ghang, Juhyang Lee
J Prev Med Public Health. 2023;56(6):504-514.   Published online October 5, 2023
DOI: https://doi.org/10.3961/jpmph.23.252
  • 696 View
  • 79 Download
AbstractAbstract AbstractSummary PDFSupplementary Material
Objectives
This study investigated the relationship between prescribing institutions and medication adherence among patients newly diagnosed with hypertension and diabetes.
Methods
This study investigated patients with new prescriptions for hypertension and diabetes in Korea in 2019 with using data collected from general health screenings. A multilevel logistic regression model was applied to explore the relationship between patients’ first prescribing institution and their medication adherence, defined as a medication possession ratio (MPR) over 80%.
Results
The overall adherence rates were 53.7% and 56.0% among patients with hypertension and diabetes, respectively. The intraclass correlation coefficients were 13.2% for hypertension and 13.8% for diabetes (p<0.001), implying that the first prescribing institution had a significant role in medication adherence. With clinics as the reference group, all other types of hospitals showed an odds ratio (OR) less than 1.00, with the lowest for tertiary hospitals (OR, 0.30 for hypertension; 0.45 for diabetes), and the next lowest in health screening specialized clinics (OR, 0.51 for hypertension; 0.46 for diabetes). Among individual-level variables, female sex, older age, higher insurance premium level, and residing in cities were positively associated with adherence in both the hypertension and diabetes samples.
Conclusions
This study showed that the prescribing institution had a significant relationship with medication adherence. When the first prescribing institution was a clinic, newly diagnosed patients were more likely to adhere to their medication. These results highlight the important role played by primary care institutions in managing mild chronic diseases.
Summary
Korean summary
2019년 일반건강검진을 통해 발견된 고혈압과 당뇨병의 신규 환자를 대상으로 복약순응도를 분석하였다. 그 결과 검진 후 첫번째 처방기관이 의원인 경우에 비해 다른 종별 의료기관인 경우 복약순응 오즈비가 모두 감소하였는데 상급종합병원이 가장 낮았고(고혈압 0.30, 당뇨병 0.45), 그 다음은 검진전문의원인 것으로 나타났다(고혈압 0.51, 당뇨병 0.46).
Key Message
This study investigated the relationship between prescribing institutions and medication adherence among patients newly diagnosed with hypertension and diabetes using general health screening data in Korea in 2019. The results showed that with clinics as the reference group, all other types of hospitals showed an odds ratio (OR) less than 1.00, with the lowest for tertiary hospitals (OR, 0.30 for hypertension; 0.45 for diabetes), and the next lowest in health screening specialized clinics (OR, 0.51 for hypertension; 0.46 for diabetes).

JPMPH : Journal of Preventive Medicine and Public Health