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Systematic Review
Adjusting for Confounders in Outcome Studies Using the Korea National Health Insurance Claim Database: A Review of Methods and Applications
Seung Jin Han, Kyoung Hoon Kim
J Prev Med Public Health. 2024;57(1):1-7.   Published online November 16, 2023
DOI: https://doi.org/10.3961/jpmph.23.250
  • 1,526 View
  • 191 Download
  • 2 Crossref
AbstractAbstract AbstractSummary PDF
Objectives
Adjusting for potential confounders is crucial for producing valuable evidence in outcome studies. Although numerous studies have been published using the Korea National Health Insurance Claim Database, no study has critically reviewed the methods used to adjust for confounders. This study aimed to review these studies and suggest methods and applications to adjust for confounders.
Methods
We conducted a literature search of electronic databases, including PubMed and Embase, from January 1, 2021 to December 31, 2022. In total, 278 studies were retrieved. Eligibility criteria were published in English and outcome studies. A literature search and article screening were independently performed by 2 authors and finally, 173 of 278 studies were included.
Results
Thirty-nine studies used matching at the study design stage, and 171 adjusted for confounders using regression analysis or propensity scores at the analysis stage. Of these, 125 conducted regression analyses based on the study questions. Propensity score matching was the most common method involving propensity scores. A total of 171 studies included age and/or sex as confounders. Comorbidities and healthcare utilization, including medications and procedures, were used as confounders in 146 and 82 studies, respectively.
Conclusions
This is the first review to address the methods and applications used to adjust for confounders in recently published studies. Our results indicate that all studies adjusted for confounders with appropriate study designs and statistical methodologies; however, a thorough understanding and careful application of confounding variables are required to avoid erroneous results.
Summary
Korean summary
건강보험청구자료를 사용한 성과연구에서는 교란요인 통제가 중요하다. 최근 발표된 연구들은 연구설계와 통계 분석 과정에 적절하게 교란요인을 통제하였다. 연구의 질을 높이기 위해서는 건강보험청구자료에서 수집 가능한 교란 요인에 대한 이해와 방법론적 가이드라인이 요구된다.
Key Message
All recently published studies using Health Insurance Claims Database adjusted for confounders with appropriate study designs and statistical methodologies. The review suggests the need for careful application of confounding variables and the methodological guidance to improve the quality of outcome studies.

Citations

Citations to this article as recorded by  
  • Worsening of health disparities across COVID-19 pandemic stages in Korea
    Hyejin Lee, Hyunwoo Nam, Jae-ryun Lee, Hyemin Jung, Jin Yong Lee
    Epidemiology and Health.2024; : e2024038.     CrossRef
  • Trends in Regional Disparities in Cardiovascular Surgery and Mortality in Korea: A National Cross-sectional Study
    Dal-Lae Jin, Kyoung-Hoon Kim, Euy Suk Chung, Seok-Jun Yoon
    Journal of Preventive Medicine and Public Health.2024; 57(3): 260.     CrossRef
Perspective
A Lifestyle Communication Tool: Association of E-cigarette Use and Pre-diabetes
Nilanga Aki Bandara, Tanisha Vallani, Xuan Randy Zhou, Senara Hansini Palihawadane, Rochelle Gamage, Miles Mannas, Jay Herath
J Prev Med Public Health. 2023;56(4):384-387.   Published online July 31, 2023
DOI: https://doi.org/10.3961/jpmph.23.086
  • 1,475 View
  • 92 Download
AbstractAbstract PDF
The aim of this study was to present a framework for clinicians to use when discussing electronic cigarette (e-cigarette) use and its association with pre-diabetes. A communication tool was designed using evidence-based strategies from the academic literature. A four-step framework is presented, which includes: step (1) helping patients to understand the association between e-cigarette use and pre-diabetes; step (2) the synergistic health impacts of e-cigarette use and pre-diabetes; step (3) management of diabetes-related lifestyle factors; and step (4) stages of change assessment related to e-cigarette reduction. This communication tool provides support for clinicians to discuss the risk of pre-diabetes associated with e-cigarette use. Moving forward, implementation and evaluation of this model are needed.
Summary
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
  • 4,724 View
  • 234 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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  • Health-related factors and dysregulation of epigenetic related genes in metabolic syndrome trigger finger patients and smoker trigger finger patients: preliminary analysis of patient-derived sample
    Abdulaziz M. F. Shayea, Amna A. Alshatti, Danah H. Alfadhli, Almutairi Fatimah Ibrahim, Mariam Kh. Almutairi, Mohammed Sh. Nadar
    Journal of Orthopaedic Surgery and Research.2023;[Epub]     CrossRef
  • Adjustment disorders, hypertension and type 2 diabetes: a cardiologist’s view (literature review)
    D.K. Miloslavsky, S.M. Koval
    INTERNATIONAL JOURNAL OF ENDOCRINOLOGY (Ukraine).2023; 19(5): 383.     CrossRef
  • Letter to the Editor: Insights on Health, Religion/Spirituality, and Vulnerable Populations
    Fides A. del Castillo
    Journal of Preventive Medicine and Public Health.2023; 56(1): 97.     CrossRef
  • Moderating effect of mindfulness on the relationship between anxiety and somatization symptoms in middle‐aged and elderly female patients with hypertension
    Haifei Shen, Ri Zhang, XiuJie Zhang, Ying Zhang, Yan Liu, Wei Song, Yunpeng Cheng, Minghui Yang, Yinong Jiang, Yan Lu
    The Journal of Clinical Hypertension.2023; 25(7): 647.     CrossRef
  • Exploring the health of child protection workers: A call to action
    Javier F. Boyas, Debra Moore, Maritza Y. Duran, Jacqueline Fuentes, Jana Woodiwiss, Leah McCoy, Antonella Cirino
    Health Promotion Perspectives.2022; 12(4): 381.     CrossRef
Original Article
Effects of Marital Status and Income on Hypertension: The Korean Genome and Epidemiology Study (KoGES)
Mia Son, Yeon Jeong Heo, Hye-Jin Hyun, Ho Jong Kwak
J Prev Med Public Health. 2022;55(6):506-519.   Published online October 7, 2022
DOI: https://doi.org/10.3961/jpmph.22.264
  • 5,967 View
  • 214 Download
  • 2 Web of Science
  • 2 Crossref
AbstractAbstract AbstractSummary PDF
Objectives
This study aimed to analyze the associations of income, marital status, and health behaviors with hypertension in male and female over 40 years of age in the Korea.
Methods
The data were derived from the Korean Genome and Epidemiology Study (KoGES; 4851-302) which included 211 576 participants. To analyze the relationships of income, marital status, and health behaviors with hypertension in male and female over 40 years of age, multiple logistic regression was conducted with adjustments for these variables.
Results
The prevalence of hypertension increased linearly as income decreased. The odds ratio for developing hypertension in people with an income of <0.5 million Korean won (KRW) compared to ≥6.0 million KRW was 1.55 (95% confidence interval [CI], 1.25 to 1.93) in the total population, 1.58 (95% CI, 1.27 to 1.98) in male, and 1.07 (95% CI, 0.35 to 3.28) in female. The combined effect of income level and marital status on hypertension was significant. According to income level and marital status, in male, low income and divorce were most associated with hypertension (1.76 times; 95% CI, 1.01 to 3.08). However, in female, the low-income, married group was most associated with hypertension (1.83 times; 95% CI, 1.71 to 1.97).
Conclusions
The results of this study show that it is necessary to approach male and female marital status separately according to income in health policies to address inequalities in the prevalence of hypertension.
Summary
Korean summary
이 연구는 한국의 40세 이상 성인 남녀를 대상으로 소득수준, 결혼, 건강행태요인이 고혈압에 미치는 영향을 분석하였다. 이 연구는 한국인유전체역학조사사업조사(KoGES; 4851-302, 2001-2011)에서 구축한 211576명을 대상으로 다중 로지스틱회귀모델을 이용하여 분석했다. 소득이 고혈압에 미치는 영향은 역의 선형으로 소득이 적을수록 고혈압이 증가하는 경향이 뚜렷하게 나타났다. 소득수준과 혼인상태, 고혈압과의 연관성은 여성보다 남성이 더 강하게 나타났다. 소득수준과 혼인상태가 상호작용하여 고혈압에 미치는 영향에서, 저소득층에서 별거 상태가 고혈압에 미치는 전반적인 영향이 가장 강하게 나타났으며, 남성의 경우 이혼 상태, 여성의 경우 결혼을 유지하고 있는 상태가 고혈압과 가장 강하게 연관되어, 남녀사이에 차이가 존재함을 보여주었다. 이 연구는 소득, 결혼이 고혈압에 중요하게 영향을 미치는 것으로 나타나, 고혈압예방대책에 저소득과 별거 이혼등의 결혼상태를 고려하는것이 필요하다는 것을 제안한다.

Citations

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  • The impact of retirement on blood pressure: evidence from a nationwide survey in China
    Jiarun Mi, Xueyan Han, Man Cao, Hanchao Cheng, Zhaoyang Pan, Jian Guo, Wei Sun, Yuanli Liu, Congyi Zheng, Xin Wang, Xue Cao, Zhen Hu, Yixin Tian, Zengwu Wang, Tianjia Guan
    BMC Public Health.2024;[Epub]     CrossRef
  • Shapely additive values can effectively visualize pertinent covariates in machine learning when predicting hypertension
    Alexander A. Huang, Samuel Y. Huang
    The Journal of Clinical Hypertension.2023; 25(12): 1135.     CrossRef
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
  • 4,809 View
  • 192 Download
  • 6 Web of Science
  • 9 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

Citations to this article as recorded by  
  • Effects of vitamin D on the incidence and severity of COVID-19
    V. V. Krivosheev, L. Yu. Nikitina, I. V. Kozlovskiy, A. V. Fedorov
    Sanitarnyj vrač (Sanitary Doctor).2024; (1): 27.     CrossRef
  • Ukrainian Consensus on Diagnosis and Management of Vitamin D Deficiency in Adults
    Nataliia Grygorieva, Mykola Tronko, Volodymir Kovalenko, Serhiy Komisarenko, Tetiana Tatarchuk, Ninel Dedukh, Mykola Veliky, Serhiy Strafun, Yulia Komisarenko, Andrii Kalashnikov, Valeria Orlenko, Volodymyr Pankiv, Oleg Shvets, Inna Gogunska, Svitlana Reg
    Nutrients.2024; 16(2): 270.     CrossRef
  • Effect of Vitamin D3 Supplementation on Severe COVID-19: A Meta-Analysis of Randomized Clinical Trials
    Marharyta Sobczak, Rafał Pawliczak
    Nutrients.2024; 16(10): 1402.     CrossRef
  • Methodological issues in designing and reporting of systematic reviews in assessing association between vitamin D supplementation and COVID-19 severity
    R Bajpai
    QJM: An International Journal of Medicine.2023; 116(5): 406.     CrossRef
  • Mechanistic Insight into the role of Vitamin D and Zinc in Modulating Immunity Against COVID-19: A View from an Immunological Standpoint
    Nuzhat Ahsan, Mohammad Imran, Yousuf Mohammed, Fatme Al Anouti, Mohammad Idreesh Khan, Tanushree Banerjee, Mohd Adnan, Fauzia Ashfaq, Marek Kieliszek, Syed Amir Ashraf, Afrozul Haq
    Biological Trace Element Research.2023; 201(12): 5546.     CrossRef
  • The Role of Diet and Specific Nutrients during the COVID-19 Pandemic: What Have We Learned over the Last Three Years?
    Petra Rust, Cem Ekmekcioglu
    International Journal of Environmental Research and Public Health.2023; 20(7): 5400.     CrossRef
  • Self-Reported Pre-Pandemic Physical Activity and Likelihood of COVID-19 Infection: Data from the First Wave of the CoCo-Fakt Survey
    Nikola Schmidt, Andreas Gehlhar, Barbara Grüne, Annelene Kossow, Thomas Kraus, Johannes Nießen, Stefanie Wessely, Christine Joisten
    Sports Medicine - Open.2023;[Epub]     CrossRef
  • Diagnosis, prevention and treatment of vitamin D deficiency in adults: Ukrainian experts consensus statement
    N.V. Grygorieva, M.D. Tronko, V.M. Kovalenko, S.V. Komisarenko, T.F. Tatarchuk, N.V. Dedukh, M.M. Veliky, S.S. Strafun, Y.I. Komisarenko, A.V. Kalashnikov, V.L. Orlenko, V.I. Pankiv, O.V. Shvets, I.V. Gogunska, S.I. Regeda
    PAIN, JOINTS, SPINE.2023; 13(2): 60.     CrossRef
  • Vitamin D Deficiency and COVID-19: A Biological Database Study on Pathways and Gene-Disease Associations
    Ángela Alcalá-Santiago, Miguel Rodríguez-Barranco, Marta Rava, María Ángeles Jiménez-Sousa, Ángel Gil, María José Sánchez, Esther Molina-Montes
    International Journal of Molecular Sciences.2022; 23(22): 14256.     CrossRef
Original Articles
Decomposition of Socioeconomic Inequality in Cardiovascular Disease Prevalence in the Adult Population: A Cohort-based Cross-sectional Study in Northwest Iran
Farhad Pourfarzi, Telma Zahirian Moghadam, Hamed Zandian
J Prev Med Public Health. 2022;55(3):297-306.   Published online May 3, 2022
DOI: https://doi.org/10.3961/jpmph.22.051
  • 3,314 View
  • 99 Download
AbstractAbstract PDFSupplementary Material
Objectives
The incidence of cardiovascular disease (CVD) mortality is increasing in developing countries. This study aimed to decompose the socioeconomic inequality of CVD in Iran.
Methods
This cross-sectional population-based study was conducted on 20 519 adults who enrolled in the Ardabil Non-Communicable Disease cohort study. Principal component analysis and multivariable logistic regression were used, respectively, to estimate socioeconomic status and to describe the relationships between CVD prevalence and the explanatory variables. The relative concentration index, concentration curve, and Blinder-Oaxaca decomposition model were used to measure and decompose the socioeconomic inequality.
Results
The overall age-adjusted prevalence of CVD was 8.4% in northwest Iran. Multivariable logistic regression showed that older adults, overweight or obese adults, and people with hypertension and diabetes were more likely to have CVD. Moreover, people with low economic status were 38% more likely to have CVD than people with high economic status. The prevalence of CVD was mainly concentrated among the poor (concentration index, -0.077: 95% confidence interval, -0.103 to -0.060), and 78.66% of the gap between the poorest and richest groups was attributed to differences in the distribution of the explanatory variables included in the model.
Conclusions
The most important factors affecting inequality in CVD were old age, chronic illness (hypertension and diabetes), marital status, and socioeconomic status. This study documented stark inequality in the prevalence of CVD, wherein the poor were more affected than the rich. Therefore, it is necessary to implement policies to monitor, screen, and control CVD in poor people living in northwest Iran.
Summary
Association Between Sleep Quality and Anxiety in Korean Adolescents
Hyunkyu Kim, Seung Hoon Kim, Sung-In Jang, Eun-Cheol Park
J Prev Med Public Health. 2022;55(2):173-181.   Published online February 10, 2022
DOI: https://doi.org/10.3961/jpmph.21.498
  • 4,800 View
  • 244 Download
  • 9 Web of Science
  • 13 Crossref
AbstractAbstract AbstractSummary PDF
Objectives
Anxiety disorder is among the most prevalent mental illnesses among adolescents. Early detection and proper treatment are important for preventing sequelae such as suicide and substance use disorder. Studies have suggested that sleep duration is associated with anxiety disorder in adolescents. In the present study, we investigated the association between sleep quality and anxiety in a nationally representative sample of Korean adolescents.
Methods
This cross-sectional study was conducted using data from the 2020 Korea Youth Risk Behavior Web-based Survey. The Generalized Anxiety Disorder-7 questionnaire was used to evaluate anxiety. The chi-square test was used to investigate and compare the general characteristics of the study population, and multiple logistic regression analysis was used to analyze the relationship between sleep quality and anxiety.
Results
In both sexes, anxiety was highly prevalent in participants with poor sleep quality (adjusted odds ratio [aOR], 1.56; 95% confidence interval [CI], 1.43 to 1.71 in boys; aOR, 1.30; 95% CI, 1.19 to 1.42 in girls). Regardless of sleep duration, participants with poor sleep quality showed a high aOR for anxiety.
Conclusions
This study identified a consistent relationship between sleep quality and anxiety in Korean adolescents regardless of sleep duration.
Summary
Korean summary
청소년건강행태조사를 이용하여 청소년들의 수면의 질과 불안과의 연관성을 분석하였다. 좋지 않은 수면의 질은 불안감과 연관성이 있었으며 이 연관성은 대상자들의 수면시간과 상관없이 나타났다.

Citations

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  • Analysis of the underlying mechanism of Ziziphi Spinosae Semen for treating anxiety disorder in a zebrafish sleep deprivation model
    Jian Zhang, Junli Feng, Chenyu Feng
    Pharmaceutical Science Advances.2024; 2: 100019.     CrossRef
  • Factors Influencing Adolescent Generalized Anxiety Disorder: A Zero-Inflated Negative Binomial Regression Model
    Kyung Im Kang, Chan Mi Kang
    Journal of Psychosocial Nursing and Mental Health Services.2024; 62(6): 46.     CrossRef
  • Insomnia and Migraine: A Missed Call?
    Angelo Torrente, Lavinia Vassallo, Paolo Alonge, Laura Pilati, Andrea Gagliardo, Davide Ventimiglia, Antonino Lupica, Vincenzo Di Stefano, Cecilia Camarda, Filippo Brighina
    Clocks & Sleep.2024; 6(1): 72.     CrossRef
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    Ji Ann Cho, Soyeon Kim, Haein Shin, Hyunkyu Kim, Eun-Cheol Park
    Nutrients.2024; 16(6): 794.     CrossRef
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    Danping Qiao, Shihai Wu, Linghui Xiang, Nan Zhang
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  • Adölesan Döneminde Sık Görülen Sağlık Riskleri ve Sorunları
    Betül UNCU, Elif DOĞAN, Rukiye DUMAN
    Sakarya Üniversitesi Holistik Sağlık Dergisi.2023; 6(2): 338.     CrossRef
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    Eunok Park
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    Chien‐Chia Huang, Pei‐Wen Wu, Yun‐Shien Lee, Chi‐Che Huang, Po‐Hung Chang, Chia‐Hsiang Fu, Ta‐Jen Lee
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Factors Related to Regional Variation in the High-risk Drinking Rate in Korea: Using Quantile Regression
Eun Su Kim, Hae-Sung Nam
J Prev Med Public Health. 2021;54(2):145-152.   Published online March 16, 2021
DOI: https://doi.org/10.3961/jpmph.20.507
  • 3,595 View
  • 123 Download
  • 3 Web of Science
  • 3 Crossref
AbstractAbstract AbstractSummary PDFSupplementary Material
Objectives
This study aimed to identify regional differences in the high-risk drinking rate among yearly alcohol users in Korea and to identify relevant regional factors for each quintile using quantile regression.
Methods
Data from 227 counties surveyed by the 2017 Korean Community Health Survey (KCHS) were analyzed. The analysis dataset included secondary data extracted from the Korean Statistical Information Service and data from the KCHS. To identify regional factors related to the high-risk drinking rate among yearly alcohol users, quantile regression was conducted by dividing the data into 10%, 30%, 50%, 70%, and 90% quantiles, and multiple linear regression was also performed.
Results
The current smoking rate, perceived stress rate, crude divorce rate, and financial independence rate, as well as one’s social network, were related to the high-risk drinking rate among yearly alcohol users. The quantile regression revealed that the perceived stress rate was related to all quantiles except for the 90% quantile, and the financial independence rate was related to the 50% to 90% quantiles. The crude divorce rate was related to the high-risk drinking rate among yearly alcohol users in all quantiles.
Conclusions
The findings of this study suggest that local health programs for high-risk drinking are needed in areas with high local stress and high crude divorce rates.
Summary
Korean summary
본 연구는 quantile regression을 이용하여 high risk drinking 의 지역간 변이 요인을 파악하였습니다. 연구결과, high risk drinking rate 의 지역간 변이가 크고, quanile별로 관련요인을 다르다는 것을 파악하였습니다. 본 연구의 결과는 높은 지역의 스트레스와 조이혼율의 관리와 함께 지역 고위험음주율의 건강프로그램이 필요하다는 것을 암시한다.

Citations

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  • Prevalence and Related Factors of Depression Before and During the COVID-19 Pandemic: Findings From the Korea National Health and Nutrition Examination Survey
    Eung-Joon Lee, Seung Jae Kim
    Journal of Korean Medical Science.2023;[Epub]     CrossRef
  • Data resource profile: the Korean Community Health Status Indicators (K-CHSI) database
    Hye-Eun Lee, Yeon-gyeong Kim, Jin-Young Jeong, Dong-Hyun Kim
    Epidemiology and Health.2023; 45: e2023016.     CrossRef
  • Prevalence, awareness, and treatment of depression among community-dwelling stroke survivors in Korea
    Eung-Joon Lee, Oh Deog Kwon, Seung Jae Kim
    Scientific Reports.2022;[Epub]     CrossRef
Modeling Survival in Patients With Brain Stroke in the Presence of Competing Risks
Solmaz Norouzi, Mohammad Asghari Jafarabadi, Seyed Morteza Shamshirgaran, Farshid Farzipoor, Ramazan Fallah
J Prev Med Public Health. 2021;54(1):55-62.   Published online December 7, 2020
DOI: https://doi.org/10.3961/jpmph.20.463
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AbstractAbstract PDF
Objectives
After heart disease, brain stroke (BS) is the second most common cause of death worldwide, underscoring the importance of understanding preventable and treatable risk factors for the outcomes of BS. This study aimed to model the survival of patients with BS in the presence of competing risks.
Methods
This longitudinal study was conducted on 332 patients with a definitive diagnosis of BS. Demographic characteristics and risk factors were collected by a validated checklist. Patients’ mortality status was investigated by telephone follow-up to identify deaths that may be have been caused by stroke or other factors (heart disease, diabetes, high cholesterol, etc.). Data were analyzed by the Lunn-McNeil approach at alpha=0.1.
Results
Older age at diagnosis (59-68 years: adjusted hazard ratio [aHR], 2.19; 90% confidence interval [CI], 1.38 to 3.48; 69-75 years: aHR, 5.04; 90% CI, 3.25 to 7.80; ≥76 years: aHR, 5.30; 90% CI, 3.40 to 8.44), having heart disease (aHR, 1.65; 90% CI, 1.23 to 2.23), oral contraceptive pill use (women only) (aHR, 0.44; 90% CI, 0.24 to 0.78) and ischemic stroke (aHR, 0.52; 90% CI, 0.36 to 0.74) were directly related to death from BS. Older age at diagnosis (59-68 years: aHR, 21.42; 90% CI, 3.52 to 130.39; 75-69 years: aHR, 16.48; 90% CI, 2.75 to 98.69; ≥76 years: aHR, 26.03; 90% CI, 4.06 to 166.93) and rural residence (aHR, 2.30; 90% CI, 1.15 to 4.60) were directly related to death from other causes. Significant risk factors were found for both causes of death.
Conclusions
BS-specific and non-BS-specific mortality had different risk factors. These findings could be utilized to prescribe optimal and specific treatment.
Summary
Association Between Parental Marital Status and Types of Suicidal Behavior Among Korean Adolescents: A Cross-sectional Study
Yoon Sik Park, Eun-Cheol Park
J Prev Med Public Health. 2020;53(6):419-428.   Published online September 21, 2020
DOI: https://doi.org/10.3961/jpmph.20.004
  • 4,009 View
  • 183 Download
  • 3 Crossref
AbstractAbstract PDF
Objectives
Adolescent suicide is a global problem. This study aimed to identify associations between parental marital status and suicidal behavior.
Methods
This study analyzed 118 715 middle and high school students from the 13th and 14th Korea Youth Risk Behavior Web-based Survey. The odds ratios (ORs) of suicidal ideation, planning, and attempts were calculated based on parental marital status, living situation, and socioeconomic factors. The data were analyzed using multiple logistic regression.
Results
When compared to those living with 2 married biological parents, the ORs of suicidal ideation among adolescents living with either remarried or no parents were 1.34 (95% confidence interval [CI], 1.17 to 1.53) and 1.36 (95% CI, 1.11 to 1.66), respectively. For suicidal planning, the OR of those living with 1 remarried biological parent was 1.24 (95% CI, 1.01 to 1.52), and that of those living without parents was 1.28 (95% CI, 0.95 to 1.73), when compared to adolescents living with 2 married biological parents. For suicide attempts, when compared to adolescents with 2 married biological parents, the OR of those living with 1 remarried biological parent was 1.48 (95% CI, 1.17 to 1.87) and that of those living without parents was 2.02 (95% CI, 1.44 to 2.83). For adolescents living with 1 remarried biological parent, suicidal behavior was strongly associated with having no siblings and were weakly associated with not living with grandparents.
Conclusions
Suicidal behavior among adolescents was associated with the remarriage and loss of parents. Therefore, special attention and interventions are needed for adolescents in those situations.
Summary

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  • Family Functioning and Suicide Attempts in Mexican Adolescents
    Francisco Alejandro Ortiz-Sánchez, Aniel Jessica Leticia Brambila-Tapia, Luis Shigeo Cárdenas-Fujita, Christian Gabriel Toledo-Lozano, María Alejandra Samudio-Cruz, Benjamín Gómez-Díaz, Silvia García, Martha Eunice Rodríguez-Arellano, Edgar Oswaldo Zamora
    Behavioral Sciences.2023; 13(2): 120.     CrossRef
  • Childhood adversities and mental health problems: A systematic review
    Titik Juwariah, Fendy Suhariadi, Oedojo Soedirham, Agus Priyanto, Erni Setiyorini, Auliasari Siskaningrum, Heni Adhianata, Angelina da Costa Fernandes
    Journal of Public Health Research.2022; 11(3): 227990362211066.     CrossRef
  • Experiences and needs of parents whose child has attempted suicide
    Kayla Raney, Kim Popa, Cara Gallegos
    Nursing.2022; 52(11): 57.     CrossRef
Educational Intervention Based on the Health Belief Model to Modify Risk Factors of Cardiovascular Disease in Police Officers in Iran: A Quasi-experimental Study
Mohsen Saffari, Hormoz Sanaeinasab, Hassan Jafarzadeh, Mojtaba Sepandi, Keisha-Gaye N. O'Garo, Harold G. Koenig, Amir H. Pakpour
J Prev Med Public Health. 2020;53(4):275-284.   Published online June 18, 2020
DOI: https://doi.org/10.3961/jpmph.20.095
  • 7,593 View
  • 364 Download
  • 6 Crossref
AbstractAbstract PDFSupplementary Material
Objectives
Police officers may be at a greater risk for cardiovascular disease (CVD) than the general population due to their highstress occupation. This study evaluated how an educational program based on the health belief model (HBM) may protect police officers from developing CVD.
Methods
In this single-group experimental study, 58 police officers in Iran participated in a 5-week intervention based on HBM principles. Outcomes included changes in scores on an HBM scale, time spent on moderate to vigorous physical activity (International Physical Activity Questionnaire), body mass index (BMI), blood lipid profile, blood glucose, and blood pressure. The intervention consisted of 5 HBM-based educational sessions. Follow-up was conducted at 3 months post-intervention. The paired t-test was used to examine differences between baseline and follow-up scores.
Results
All aspects of the HBM scale improved between baseline and follow-up (p<0.05), except the cues to action subscale. Self-efficacy and preventive behaviors improved the most. BMI decreased from 26.7±2.9 kg/m2 at baseline to 25.8±2.4 kg/m2 at follow-up. All components of the lipid profile, including triglycerides, cholesterol, high-density lipoprotein, and low-density lipoprotein, showed significant improvements post-intervention. Blood glucose and blood pressure also decreased, but not significantly. Nearly 25% of participants who were not physically active at baseline increased their physical activity above or beyond the healthy threshold.
Conclusions
A relatively brief educational intervention based on HBM principles led to a significant improvement in CVD risk factors among police officers. Further research is needed to corroborate the effectiveness of this intervention.
Summary

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  • Cardiovascular Risk Factors and Metabolic Syndrome among Police Officers in Kozhikode Corporation
    Aparna Padmanabhan, Jayakrishnan Thayyil, G Alan, Siju Kumar
    Indian Journal of Occupational and Environmental Medicine.2024; 28(1): 45.     CrossRef
  • Effect of educational intervention on risk factors of cardiovascular diseases among school teachers: a quasi-experimental study in a suburb of Kolkata, West Bengal, India
    Anubrata Karmakar, Aritra Bhattacharyya, Bijit Biswas, Aparajita Dasgupta, Lina Bandyopadhyay, Bobby Paul
    BMC Public Health.2023;[Epub]     CrossRef
  • An Intervention Program Using the Health Belief Model to Modify Lifestyle in Coronary Heart Disease: Randomized Controlled Trial
    Mohsen Saffari, Hormoz Sanaeinasab, Hojat Rashidi-jahan, Fardin Aghazadeh, Mehdi Raei, Fatemeh Rahmati, Faten Al Zaben, Harold G. Koenig
    International Journal of Behavioral Medicine.2023;[Epub]     CrossRef
  • The effect of educational intervention in the prevention of cardiovascular diseases in patients with hypertension with application of health belief model: A quasi-experimental study
    Fatemeh Mohammadkhah, Abbas Shamsalinia, Fatemeh Rajabi, Pooyan Afzali Hasirini, Ali Khani Jeihooni
    JRSM Cardiovascular Disease.2023;[Epub]     CrossRef
  • Assessment of Compliance with Healthy Lifestyle Standards by the Instructional Staff of Higher Educational Institutions
    Ivan М. Okhrimenko, Viacheslav V. Zasenko, Olena V. Chebotaryova, Alla L. Dushka, Andrii V. Lapin, Nataliia O. Kvitka, Iryna A. Holovanovа
    Acta Balneologica.2022; 64(5): 463.     CrossRef
  • Educational interventions in relation to the level of physical activities for police officers: a systematic literature review
    Cleise Cristine Ribeiro Borges Oliveira, Carla Tatiane Oliveira Silva, Carolina de Souza-Machado, Fernanda Carneiro Mussi, Ana Carla Carvalho Coelho, Cláudia Geovana Da Silva Pires
    International Journal for Innovation Education and Research.2022; 10(12): 301.     CrossRef
Measuring Out-of-pocket Payment, Catastrophic Health Expenditure and the Related Socioeconomic Inequality in Peru: A Comparison Between 2008 and 2017
Akram Hernández-Vásquez, Carlos Rojas-Roque, Rodrigo Vargas-Fernández, Diego Rosselli
J Prev Med Public Health. 2020;53(4):266-274.   Published online June 10, 2020
DOI: https://doi.org/10.3961/jpmph.20.035
  • 4,629 View
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  • 9 Crossref
AbstractAbstract PDFSupplementary Material
Objectives
Describe out-of-pocket payment (OOP) and the proportion of Peruvian households with catastrophic health expenditure (CHE) and evaluate changes in socioeconomic inequalities in CHE between 2008 and 2017.
Methods
We used data from the 2008 and 2017 National Household Surveys on Living and Poverty Conditions (ENAHO in Spanish), which are based on probabilistic stratified, multistage and independent sampling of areas. OOP was converted into constant dollars of 2017. A household with CHE was assumed when the proportion between OOP and payment capacity was ≥0.40. OOP was described by median and interquartile range while CHE was described by weighted proportions and 95% confidence intervals (CIs). To estimate the socioeconomic inequality in CHE we computed the Erreygers concentration index.
Results
The median OOP reduced from 205.8 US dollars to 158.7 US dollars between 2008 and 2017. The proportion of CHE decreased from 4.9% (95% CI, 4.5 to 5.2) in 2008 to 3.7% (95% CI, 3.4 to 4.0) in 2017. Comparison of socioeconomic inequality of CHE showed no differences between 2008 and 2017, except for rural households in which CHE was less concentrated in richer households (p<0.05) and in households located on the rest of the coast, showing an increase in the concentration of CHE in richer households (p<0.05).
Conclusions
Although OOP and CHE reduced between 2008 and 2017, there is still socioeconomic inequality in the burden of CHE across different subpopulations. To reverse this situation, access to health resources and health services should be promoted and guaranteed to all populations.
Summary

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  • Causes of death among international travellers in Peru, 2017 to 2021
    Kasim Allel, Miguel M Cabada, Collen Lau, Deborah Mills, Richard C Franklin, Yan Zhu, Luis Furuya-Kanamori
    Journal of Travel Medicine.2024;[Epub]     CrossRef
  • Informal payments in health facilities in Peru in 2018: Analysis of a cross-sectional survey
    Laura Espinoza-Pajuelo, Patricia Mallma, Hannah Hogan Leslie, Patricia Jannet García, Sarthak Gaurav
    PLOS Global Public Health.2024; 4(1): e0001837.     CrossRef
  • An Examination of Inter-State Variation in Utilization of Healthcare Services, Associated Financial Burden and Inequality: Evidence from Nationally Representative Survey in India
    Aashima, Rajesh Sharma
    International Journal of Social Determinants of Health and Health Services.2024; 54(3): 206.     CrossRef
  • Consumer Financial Protection Versus Catastrophic Healthcare Expenditure in Zambia
    MccPowell Fombang, Richard Wamalwa Wanzala
    Public Health Challenges.2024;[Epub]     CrossRef
  • High cost drugs in Latin America: access and barriers
    Diego Rosselli
    Expert Review of Pharmacoeconomics & Outcomes Research.2023; 23(6): 619.     CrossRef
  • 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.2023;[Epub]     CrossRef
  • Determinants of Eye Care Service Utilization among Peruvian Adults: Evidence from a Nationwide Household Survey
    Antonio Barrenechea-Pulache, Andres Portocarrero-Bonifaz, Akram Hernández-Vásquez, Carlos Portocarrero-Ramos, Jenny Moscoso-Carrasco
    Ophthalmic Epidemiology.2022; 29(3): 339.     CrossRef
  • Financial risk protection from out-of-pocket health spending in low- and middle-income countries: a scoping review of the literature
    Taslima Rahman, Dominic Gasbarro, Khurshid Alam
    Health Research Policy and Systems.2022;[Epub]     CrossRef
  • THE IGNORED PANDEMIC OF PUBLIC HEALTH CORRUPTION: A CALL FOR ACTION AMID AND BEYOND SARS-COV-2/COVID-19
    Jorge A. Sánchez-Duque, Zhaohui Su, Diego Rosselli, Maria Camila Chica-Ocampo, Maria Isabel Lotero-Puentes, Ana M. Bolaños-Portilla, Manish Dhawan, Alfonso J. Rodríguez-Morales, Kuldeep Dhama
    Journal of Experimental Biology and Agricultural Sciences.2021; 9(2): 108.     CrossRef
Risk and Protective Factors Associated With Intimate Partner Violence in a Nationally Representative Sample of Korean Men
Riccardo Ferraresso
J Prev Med Public Health. 2020;53(2):135-142.   Published online February 13, 2020
DOI: https://doi.org/10.3961/jpmph.19.292
  • 4,229 View
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  • 2 Crossref
AbstractAbstract PDF
Objectives
In recent years, multiple studies have investigated the issue of intimate partner violence (IPV) in Korea. However, most of those studies have focused on IPV against women, while overlooking the problem of men IPV victimization. Considering this, the current study identified risk and protective factors for IPV and examined their influence on IPV victimization among Korean men.
Methods
We used a nationally representative sample of 1668 Korean men from the 2013 Korea National Survey on Domestic Violence. The associations between potential IPV risk factors and different types of IPV were investigated using univariate and multivariate logistic regression. Specifically, separate analyses were conducted of 5 types of IPV (neglect, controlling behaviors, emotional violence, economic violence, and physical violence).
Results
The prevalence of IPV among Korean men and women showed only marginal gender differences. Controlling behaviors (men, 23.3%; women, 23.9%) and emotional violence (men, 16.5%; women, 18.8%) were the most common types of IPV reported, followed by neglect (men, 11.2%; women, 11.7%). Separate logistic regression analyses for the 5 subtypes of IPV revealed that mutual IPV was a strong predictor of IPV. Men who abused their wives were more likely to experience neglect (odds ratio [OR], 29.24; p<0.01), controlling behaviors (OR, 36.61; p<0.01), emotional violence (OR, 58.07; p<0.01), economic violence (OR, 18.78; p<0.01), and physical violence (OR, 38.09; p<0.01).
Conclusions
The findings of this study suggest that IPV intervention strategies should particularly focus on couples whose relationship is characterized by patterns of bidirectional violence.
Summary

Citations

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  • Factors Associated With Willingness To Report Intimate Partner Violence (IPV) to Police in South Korea
    Chunrye Kim, Riccardo Ferraresso
    Journal of Interpersonal Violence.2022; 37(13-14): NP10862.     CrossRef
  • Ugandan Men Exposed to Intimate Partner Violence: A Cross-Sectional Survey of Nationally Representative Data
    Jacinta Waila, Herman Lule, Michael Lowery Wilson, Till Bärnighausen, Anne Abio
    Journal of Prevention.2022; 43(4): 567.     CrossRef
Association Between Atrial Fibrillation and the Risk of Dementia in the Korean Elderly: A 10-Year Nationwide Cohort Study
Min-Ah Nah, Kyeong Soo Lee, Tae-Yoon Hwang
J Prev Med Public Health. 2020;53(1):56-63.   Published online January 3, 2020
DOI: https://doi.org/10.3961/jpmph.19.117
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AbstractAbstract AbstractSummary PDF
Objectives
The objective of this study was to determine the effect of atrial fibrillation (AF) on the risk of dementia in the Korean elderly.
Methods
A 10-year retrospective cohort study was conducted using the National Health Insurance Service-Senior Cohort database. We excluded those who were under 65 years of age as of January 2006 (n=46 113), those who were diagnosed with dementia between 2002 and 2005 (n=9086), and those with a history of stroke prior to AF diagnosis (n=8392). We used a Cox proportional hazards model with a time-varying covariate to determine whether AF is associated with the risk of dementia after adjusting for potential confounders.
Results
In univariable Cox regression, the hazard ratio (HR) of dementia according to AF status was 1.28 (95% confidence interval [CI], 1.23 to 1.33). After adjusting for potential confounders, AF was found to increase the risk of dementia (HR, 1.12; 95% CI, 1.07 to 1.17), Alzheimer dementia (HR, 1.12; 95% CI, 1.07 to 1.17), and vascular dementia (HR, 1.10; 95% CI, 1.03 to 1.18). In patients diagnosed with AF, the incidence of dementia was lower (HR, 0.50; 95% CI, 0.47 to 0.52) in patients who were treated with oral anticoagulants.
Conclusions
Investigating the potential risk factors of dementia in an aged society is important. We found a slightly higher risk of dementia in those with AF than in those without AF, and we therefore concluded that AF is a potential risk factor for dementia.
Summary
Korean summary
본 연구에서는 국민건강보험공단 노인표본코호트 자료를 사용하여 심방세동의 유무가 치매의 발생위험과 연관되어 있는지 분석하였다. 잠재적인 교란변수들을 통제하여 분석한 결과 심방세동은 치매(HR 1.12, 95% CI 1.07 to 1.17), 알츠하이머 치매(HR 1.12, 95% CI 1.07 to 1.17), 혈관성 치매(HR 1.10, 95% CI 1.03 to 1.18) 발생과 연관되어 있는 것으로 나타났다. 한 편, 심방세동 환자에서의 항응고제 복용은 치매 발생위험(HR 0.50, 95% CI 0.47 to 0.52)을 감소시키는 것으로 나타났다.

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  • Effects of risk factors on the development and mortality of early- and late-onset dementia: an 11-year longitudinal nationwide population-based cohort study in South Korea
    Min Young Chun, Wonjeong Chae, Sang Won Seo, Hyemin Jang, Jihwan Yun, Duk L. Na, Dongwoo Kang, Jungkuk Lee, Dustin B. Hammers, Liana G. Apostolova, Sung-In Jang, Hee Jin Kim
    Alzheimer's Research & Therapy.2024;[Epub]     CrossRef
  • The effect of oral anticoagulants on the incidence of dementia in patients with atrial fibrillation: A systematic review and meta-analysis
    Fakhar Latif, Muhammad Moiz Nasir, Komail K. Meer, Syed Husain Farhan, Huzaifa Ahmad Cheema, Adam Bilal Khan, Mohammad Umer, Wajeeh Ur Rehman, Adeel Ahmad, Muhammad Aslam Khan, Talal Almas, Sebastian Mactaggart, Abdulqadir J. Nashwan, Raheel Ahmed, Sourbh
    International Journal of Cardiology Cardiovascular Risk and Prevention.2024; 21: 200282.     CrossRef
  • Progressive Memory Decline in a Patient With Atrial Septal Defect: Case Report and Literature Review
    Yaw Amo Wiafe, Gordon Manu Amponsah, George Asafu Adjaye Frimpong, Isaac Kofi Owusu
    Clinical Medicine Insights: Case Reports.2023; 16: 117954762311767.     CrossRef
  • FIBRILAÇÃO ATRIAL E DEMÊNCIA VASCULAR: UMA REVISÃO INTEGRATIVA DA LITERATURA
    Caroline Melo de Sousa, Milena Nunes Alves Sousa, Fabrício Kleber de Lucena Carvalho
    Revista Contemporânea.2022; 2(3): 739.     CrossRef
  • A systematic review and meta‐analysis to determine the effect of oral anticoagulants on incidence of dementia in patients with atrial fibrillation
    Mingjie Lin, Wenqiang Han, Jingquan Zhong, Lin Wu
    International Journal of Clinical Practice.2021;[Epub]     CrossRef
  • Risk of dementia in patients with atrial fibrillation: Short versus long follow‐up. A systematic review and meta‐analysis
    Marco Zuin, Loris Roncon, Angelina Passaro, Cristina Bosi, Carlo Cervellati, Giovanni Zuliani
    International Journal of Geriatric Psychiatry.2021; 36(10): 1488.     CrossRef
  • Clinical Utility of the Pathogenesis-Related Proteins in Alzheimer’s Disease
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    International Journal of Molecular Sciences.2020; 21(22): 8661.     CrossRef
Interactions of Behavioral Changes in Smoking, High-risk Drinking, and Weight Gain in a Population of 7.2 Million in Korea
Yeon-Yong Kim, Hee-Jin Kang, Seongjun Ha, Jong Heon Park
J Prev Med Public Health. 2019;52(4):234-241.   Published online July 3, 2019
DOI: https://doi.org/10.3961/jpmph.18.290
  • 4,712 View
  • 164 Download
  • 1 Crossref
AbstractAbstract AbstractSummary PDF
Objectives
To identify simultaneous behavioral changes in alcohol consumption, smoking, and weight using a fixed-effect model and to characterize their associations with disease status.
Methods
This study included 7 000 529 individuals who participated in the national biennial health-screening program every 2 years from 2009 to 2016 and were aged 40 or more. We reconstructed the data into an individual-level panel dataset with 4 waves. We used a fixed-effect model for smoking, heavy alcohol drinking, and overweight. The independent variables were sex, age, lifestyle factors, insurance contribution, employment status, and disease status.
Results
Becoming a high-risk drinker and losing weight were associated with initiation or resumption of smoking. Initiation or resumption of smoking and weight gain were associated with non-high-risk drinkers becoming high-risk drinkers. Smoking cessation and becoming a high-risk drinker were associated with normal-weight participants becoming overweight. Participants with newly acquired diabetes mellitus, ischemic heart disease, stroke, and cancer tended to stop smoking, discontinue high-risk drinking, and return to a normal weight.
Conclusions
These results obtained using a large-scale population-based database documented interactions among lifestyle factors over time.
Summary
Korean summary
이 분석은 흡연, 음주, 체중의 동시적 변화에 대해 패널분석방법론인 고정효과 모형을 이용하여 분석하였으며, 2009년부터 2016년까지 2년 주기로 4차례 모두 건강검진을 수검받은 720만 명을 대상으로 하였다. 흡연, 음주, 체중의 동시적 변화에 대한 방향성을 탐색하여 생활습관 관련 행태가 독자적이 아닌 유기적으로 변화하는 양상을 확인하였다, 또한 당뇨병, 뇌졸중, 암이 신규로 진단되었을 때 행태 변화가 나타나는 것을 확인하였다.

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    Jieun Jang, Sangjun Lee, Kwang-Pil Ko, Sarah K. Abe, Md. Shafiur Rahman, Eiko Saito, Md. Rashedul Islam, Norie Sawada, Xiao-Ou Shu, Woon-Puay Koh, Atsuko Sadakane, Ichiro Tsuji, Jeongseon Kim, Isao Oze, Chisato Nagata, Shoichiro Tsugane, Hui Cai, Jian-Min
    Cancer Epidemiology, Biomarkers & Prevention.2022; 31(9): 1727.     CrossRef

JPMPH : Journal of Preventive Medicine and Public Health