Journal of Preventive Medicine and Public Health

Original Articles

Empowering Rural Housewives in Iran: Utilizing the Transtheoretical Model to Increase Physical Activity: Mahboobe Borhani, Zakieh Sadat Hosseini, Najme Shahabodin, Ali Mehri, Mohadese Kiani, Marzieh Abedi; J Prev Med Public Health. 2024;57(2):167-175. Published online January 31, 2024; DOI: https://doi.org/10.3961/jpmph.23.457

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Abstract Summary PDF: Objectives
Rural housewives are integral to household management and family care, yet their sedentary lifestyles present significant health risks. This study used the transtheoretical model (TTM) to investigate strategies that encourage and maintain regular exercise habits among rural housewives.
Methods
A semi-experimental study was conducted in 2021 with 114 housewives aged 30 to 59 who attended rural health centers in Gorgan, Iran. Participants were randomly assigned to 1 of 2 groups. Data collection involved a validated questionnaire that gathered demographic information and constructs of the TTM. The intervention group participated in a comprehensive educational program, which included four 60-minute sessions. Data were collected again 6 months post-intervention and analyzed using descriptive and inferential statistics in SPSS version 21.
Results
The study encompassed women with an average age of 39.75±6.05 years, the majority of whom had educational levels below a diploma, and over 90% were married. We observed strong correlations between the processes of change, self-efficacy, and decisional balance. At the outset, there were no significant differences in demographics or model structures between the 2 groups. However, 6 months post-intervention, the intervention group exhibited statistically significant differences in the mean scores of model structures, stages of change, and body mass index (<>p<0.05).
Conclusions
This study highlights the importance of physical activity training for rural housewives. The findings suggest that the educational intervention, which utilized the TTM, significantly impacted the participants’ model structures and their stages of change.; Summary

Key Message
The study aimed to investigate strategies for promoting and sustaining regular exercise habits among rural housewives using the transtheoretical model (TTM). A semi-experimental study was conducted with 114 housewives aged 30 to 59 in Iran. The intervention group received a comprehensive educational program, and after 6 months, they exhibited significant differences in model structures, stages of change, and body mass index compared to the control group. These findings underscore the importance of physical activity training for rural housewives and suggest that the educational intervention utilizing the TTM substantially impacted the participants' model structures and stages of change.

Protection Motivation Theory and Rabies Protective Behaviors Among School Students in Chonburi Province, Thailand: Mayurin Laorujisawat, Aimutcha Wattanaburanon, Pajaree Abdullakasim, Nipa Maharachpong; J Prev Med Public Health. 2021;54(6):431-440. Published online November 16, 2021; DOI: https://doi.org/10.3961/jpmph.21.457

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Objectives
The aim of this study was to predict rabies protective behaviors (RPB) based on protection motivation theory (PMT) among fourth-grade students at schools in Chonburi Province, Thailand.
Methods
This cross-sectional study was conducted from December 2020 to February 2021. A multistage sampling technique was used for sample selection. The questionnaire was divided into socio-demographic data and questions related to PMT and RPB. Descriptive statistical analysis was conducted using the EpiData program and inferential statistics, and the results were tested using the partial least squares model with a significance level of less than 5%.
Results
In total, 287 subjects were included, of whom 62.4% were girls and 40.4% reported that YouTube was their favorite media platform. Most participants had good perceived vulnerability, response efficacy, and self efficacy levels related to rabies (43.9, 68.6, and 73.2%, respectively). However, 54.5% had only fair perceived severity levels related to rabies. Significant positive correlations were found between RPB and the PMT constructs related to rabies (β, 0.298; p<0.001), and the school variable (S4) was also a predictor of RPB (β, -0.228; p<0.001). Among the PMT constructs, self efficacy was the strongest predictor of RPB (β, 0.741; p<0.001).
Conclusions
PMT is a useful framework for predicting RPB. Future RPB or prevention/protection intervention studies based on PMT should focus on improving self efficacy and response efficacy, with a particular focus on teaching students not to intervene with fighting animals. The most influential PMT constructs can be used for designing tools and implementing and evaluating future educational interventions to prevent rabies in children.

Summary

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Screening Intention Prediction of Colorectal Cancer among Urban Chinese Based on the Protection Motivation Theory
Wenshuang Wei, Miao Zhang, Dan Zuo, Qinmei Li, Min Zhang, Xinguang Chen, Bin Yu, Qing Liu
International Journal of Environmental Research and Public Health.2022; 19(7): 4203. CrossRef
Career resilience of the tourism and hospitality workforce in the COVID-19: The protection motivation theory perspective
Diep Ngoc Su, Thi Minh Truong, Tuan Trong Luu, Hanh My Thi Huynh, Barry O'Mahony
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English Abstracts

Factors Associated with Cancer Screening Intention in Eligible Persons for National Cancer Screening Program.: Rock Bum Kim, Ki Soo Park, Dae Yong Hong, Cheol Heon Lee, Jang Rak Kim; J Prev Med Public Health. 2010;43(1):62-72.; DOI: https://doi.org/10.3961/jpmph.2010.43.1.62

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Abstract PDF

OBJECTIVES
To identify factors associated with cancer screening intention using the Theory of Planned Behavior (TPB). METHODS: Among 55,920 eligible persons for National Cancer Screening Program (NCSP) in J city, 1,100 individuals were contacted. Of these, 797 were interviewed using a structured questionnaire. Thirty-six responses were excluded due to incomplete data. The remaining 761 completed questionnaires were analyzed to find factors associated with cancer screening intention. RESULTS: Cancer screening intention was significantly associated with behavioral attitude (p<0.01) and subjective norm (p<0.01), but not with perceived behavioral control (p=0.29) in the TPB model. These three constructs explained 29.7% of cancer screening intention in multiple linear regression analysis. External factors such as socio-demographic status, health and health behavior variables explained 8.9% of screening intention. Among them, household monthly income, past cancer screening experience, exercise and daily eating habit were significantly associated with screening intention. CONCLUSIONS: Cancer screening intention may be influenced by focusing attitude, subjective norm in TPB model and other external factors. However, further studies are warranted to identify factors influencing cancer screening intention and behavior.

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Sujeong Shin, Yun-Mi Song, Hyeonyoung Ko, Yoon-Ho Choi, Woo Yong Lee, Son Mi Chung, Sunyoung Park, Insub Kim, Jinyoung Shin
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Hyeongtaek Woo, Jeeyoo Lee, Jeonghee Lee, Ji Won Park, Sungchan Park, Jeongseon Kim, Jae Hwan Oh, Aesun Shin
Journal of Preventive Medicine and Public Health.2015; 49(1): 45. CrossRef
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The Korean Journal of Rehabilitation Nursing.2015; 18(2): 118. CrossRef
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Trends in Sex Ratio at Birth according to Parental Social Positions: Results from Vital Statistics Birth, 1981-2004 in Korea.: Heeran Chun, Il Ho Kim, Young Ho Khang; J Prev Med Public Health. 2009;42(2):143-150.; DOI: https://doi.org/10.3961/jpmph.2009.42.2.143

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Abstract PDF

OBJECTIVES
South Korea has experienced unprecedented ups and downs in the sex ratio at birth (SRB), which has been a unique phenomenon in the last two decades. However, little is known about socioeconomic factors that influence the SRB. Employing the diffusion theory by Rogers, this study was undertaken to examine the trends in social variations in the SRB from 1981 to 2004 in Korea. METHODS: The data was taken from Vital Birth Statistics for the period from 1981-2004. We computed the annual male proportion of live births according to the parental education (university, middle/high school, primary) and occupation (non-manual, manual, others). Logistic regression analysis was employed to estimate the odds ratios of male birth according to social position for the equidistant three time periods (1981-1984, 1991-1994, and 2001-2004). RESULTS: An increased SRB was detected among parents with higher social position before the mid 1980s. Since then, however, a greater SRB was found for the less educated and manual jobholders. The inverse social gradient for the SRB was most prominent in early 1990s, but the gap has narrowed since the late 1990s. The mother's socioeconomic position could be a sensitive indicator of the social variations in the sex ratio at birth. CONCLUSIONS: Changes in the relationship of parental social position with the SRB were detected during the 1980-2004 in Korea. This Korean experience may well be explained by diffusion theory, suggesting there have been socioeconomic differences in the adoption and spread of sex-detection technology.

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Asian Population Studies.2022; 18(2): 169. CrossRef
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Journal of Preventive Medicine and Public Health.2020; 53(5): 371. CrossRef
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PLOS ONE.2015; 10(11): e0143054. CrossRef
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The Factors Associated with Changes in the Stage of Breast Cancer Screening Behavior among the Woman who are Eligible for the Korean National Cancer Screening Program.: Hyo Kyung Son, Sin Kam, Ki Soo Park, Jang Rak Kim, Rock Bum Kim, Sun Kyun Park; J Prev Med Public Health. 2009;42(2):109-116.; DOI: https://doi.org/10.3961/jpmph.2009.42.2.109

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OBJECTIVES
This study was performed to evaluate the relationships between psychosocial characteristics and changes in the stage of breast cancer screening behavior. METHODS: The 474 study subjects were randomly sampled from 21,459 women (age range, 40-70 years) who were eligible for the Korean National Cancer Screening Program in 2006 in Jinju, Gyeongsangnam-do. The information, including behaviors and sociodemographic characteristics, attitudes, subjective norms and self-efficacy, was collected by trained interviewers via home visits. The breast cancer screening stages were grouped as precontemplation, contemplation, action, maintenance and relapse, according to Rakowski. RESULTS: Of the 474 women, 18.8% were in the precontemplation stage, 23.3% were in the contemplation stage, 13.1% were in the action stage, 36.6% were in the maintenance stage, and 8.2% were in the relapse stage. The distribution of stages was associated with attitude, subjective norms and self-efficacy (p for trend<0.01). To investigate the overall relationship between the variables, we conducted a linear structural equation model analysis based on the theory of planned behavior. The subjective norms and self-efficacy influenced the stage of the women's screening behavior. CONCLUSIONS: We should target on self-efficacy about the screening behavior of women by performing timely, thoughtful interventions. The support from family members, friends and other people is crucial for women to undergo breast cancer screening and to improve the breast cancer screening rate.

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Factor structure and internal reliability of cultural belief scales about colorectal cancer screening among Koreans in the Republic of Korea
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Journal of Digital Convergence.2016; 14(7): 439. CrossRef
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Review

Why Do Health Inequalities Matter?.: Young Jeon Shin, Myoung Hee Kim; J Prev Med Public Health. 2007;40(6):419-421.; DOI: https://doi.org/10.3961/jpmph.2007.40.6.419

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OBJECTIVES
The aim of this study was to introduce the concept of health inequalities, and to discuss the underlying assumptions and ethical backgrounds associated with the issue, as well as the theoretical and practical implications of health inequalities. METHODS: Based on a review of the literature, we summarize the concepts of health inequalities and inequities and discuss the underlying assumptions and ethical backgrounds associated with these issues from the view of social justice theory. We then discuss the theoretical and practical implications of health inequalities. RESULTS: Health inequality involves ethical considerations, such as judgments on fairness, and it could provide a sensitive barometer to reflect the fairness of social arrangements. Discussion on health inequalities could deepen our understanding of the social etiology of health and provide a basis for the development of comprehensive and integrative social policies. CONCLUSIONS: Health equity is not a social goal in and of itself, but should be considered as a part of a broader effort to seek social justice.

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Original Articles

The Relationship between Treatment Intention and Compliance in Newly Detected Hypertensive Patients.: Sok Goo Lee, Sang Soo Bae; Korean J Prev Med. 2001;34(4):417-426.

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Abstract PDF: OBJECTIVES
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.; Summary

Patient Compliance and Associated Factors in the Community-based Hypertension Control Program.: Sangsoo Bae, Jee Kim, Kyungbok Min, Soonho Kwon, Dalsun Han; Korean J Prev Med. 1999;32(2):215-227.

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Abstract PDF: OBJECTIVES
To investigate compliance of hypertension patients using modified Theory of Reasoned Action(TRA). METHODS: The data were collected for 7-12 April 1997, by interviewing 190 hypertension patients in Hwachon, Kangwon-do. The analytical techniques employed include contingency table analysis and logit analysis. RESULTS: 15.1% of patients were unaware of the fact that he/she has hypertension and 11.2% did not know that he/she should take drug. 26.8% of patients took drug continuously, 20.1% had drug intermittently, and 53.1% had never have treatment. In the contingency table analysis, several variables were found to be significantly related to patient compliance. They included variables for attitude towards the consequences of taking drugs, normative beliefs, systolic BP at the enrollment, knowledge of how to take hypertensive drugs, variables for general health behavior and experience with having health worker's home visit. The logit analysis was performed by two steps. First step uses experience with drug treatment of hypertension as the dependent variable, and second step uses continuity of treatment. Included in the predictors that are significantly related to the former analysis are subjected norms produced by combining normative beliefs and motivation to comply, knowledge of how to take hypertensive drugs, and opinion about natural recovery of diseases. The only significant determinant of continuous treatment was knowledge of how to take hypertensive drugs. CONCLUSIONS: The results of analysis suggest the usefulness of TRA as a framework for the study of compliance of hypertensive patients. The findings have some practical implication as well. One is that efforts for enhancing compliance should be directed not only patients but also to other persons influencing patient's attitude and behavior. It also suggest that correct understanding of hypertension treatment is essential to perform the appropriate patient role.; Summary

Factors Related to the Health Behavior of Urban Residents on the Basis of Theory of Reasoned Action.: Sunhee Lee, Heuisug Jo; Korean J Prev Med. 1999;32(2):183-190.

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Abstract PDF: OBJECTIVES
The purpose of this study is to analyse factors related to the health promotion behavior on the basis of theory of reasoned action(TRA). METHODS: 509 residents in the city of Kyunggi-do were selected through multistage random sampling. A structured questionnaire was developed on the basis of Triandis model and collected by interviewing. RESULTS: Expectation toward act and social normative influence and age showed significant relationship to health promotion behavior. Also, facilitating factors, affective attitude, education level are indirectly related to health promotion behavior. CONCLUSIONS: The result suggest that TRA is useful in understanding the mechanism of health promotion behavior.; Summary

Health-Related Behaviors: Theoretical Models And Research Findings.: Sang Soo Bae; Korean J Prev Med. 1993;26(4):508-533.

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Abstract PDF: 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.; Summary

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