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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
  • 7,492 View
  • 133 Download
AbstractAbstract AbstractSummary 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.
Postpartum Depression in Young Mothers in Urban and Rural Indonesia
Alifa Syamantha Putri, Tri Wurisastuti, Indri Yunita Suryaputri, Rofingatul Mubasyiroh
J Prev Med Public Health. 2023;56(3):272-281.   Published online May 7, 2023
DOI: https://doi.org/10.3961/jpmph.22.534
  • 3,388 View
  • 210 Download
  • 1 Web of Science
  • 2 Crossref
AbstractAbstract PDF
Objectives
Young mothers are vulnerable to postpartum depression due to role transition-related stress. Understanding the causes underlying these stressors is essential for developing effective interventions.
Methods
This study analyzed the 2018 Indonesian Basic Health Research data. The Mini International Neuropsychiatric Interview was used to assess postpartum depression symptoms in mothers aged 15-24 years with infants aged 0-6 months. In 1285 subjects, the risk factors for postpartum depression were evaluated using multivariate logistic regression.
Results
The overall prevalence of depression in the 6 months postpartum was 4.0%, with a higher prevalence in urban areas (5.7%) than in rural areas (2.9%). Urban and rural young mothers showed distinct postpartum depression risk factors. In urban areas, living without a husband (odds ratio [OR], 3.82; 95% confidence interval [CI], 1.24 to 11.76), experiencing preterm birth (OR, 4.67; 95% CI, 1.50 to 14.50), having pregnancy complications (OR, 3.03; 95% CI, 1.20 to 7.66), and having postpartum complications (OR, 5.23; 95% CI, 1.98 to 13.80) were associated with a higher risk of postpartum depression. In rural areas, postpartum depression was significantly associated with a smaller household size (OR, 3.22; 95% CI, 1.00 to 10.38), unwanted pregnancy (OR, 4.40; 95% CI, 1.15 to 16.86), and pregnancy complications (OR, 3.41; 95% CI, 1.31 to 8.88).
Conclusions
In both urban and rural contexts, postpartum depression relates to the availability of others to accompany young mothers throughout the postpartum period and offer support with reproductive issues. Support from the family and the healthcare system is essential to young mothers’ mental health. The healthcare system needs to involve families to support young mothers’ mental health from pregnancy until the postpartum period.
Summary

Citations

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  • Common Mental Disorders and Associated Factors During Pregnancy and the Postpartum Period in Indonesia: An Analysis of Data From the 2018 Basic Health Research
    Arum Ariasih, Besral, Meiwita Budiharsana, Sudarto Ronoatmodjo
    Journal of Preventive Medicine and Public Health.2024; 57(4): 388.     CrossRef
  • Qualitative Study of Perinatal Mental Health Services: Experiences and Perspectives of Health Workers and Patients
    Evi Diliana Rospia, Dwi Kartika Cahyaningtyas, Siti Mardiyah WD, Cahaya Indah Lestari
    EMBRIO.2023; 15(2): 216.     CrossRef
Ethnic Variation and Its Association With Malaria Awareness: A Cross-sectional Study in East Nusa Tenggara Province, Indonesia
Robertus Dole Guntur, Jonathan Kingsley, Fakir M. Amirul Islam
J Prev Med Public Health. 2022;55(1):68-79.   Published online November 15, 2021
DOI: https://doi.org/10.3961/jpmph.21.367
  • 4,588 View
  • 129 Download
  • 2 Crossref
AbstractAbstract PDF
Objectives
This study investigated associations between ethnicity and malaria awareness in East Nusa Tenggara Province (ENTP), Indonesia.
Methods
A community-based cross-sectional study was conducted upon 1503 adults recruited by multi-stage cluster random sampling. A malaria awareness questionnaire was used to collect data, according to which participants were classified as aware or unaware of malaria. Logistic regression was applied to quantify the strength of associations of factors with malaria awareness.
Results
The participation rate in this study was high (99.5%). The participants were distributed relatively evenly among the Manggarai, Atoni, and Sumba ethnicities (33.0, 32.3, and 30.2%, respectively). Malaria awareness was significantly different amongst these groups; it was most common in the Manggarai ethnicity (65.1%; 95% confidence interval [CI], 59.9 to 70.3) and least common in the Sumba ethnicity (35.0%; 95% CI, 27.6 to 42.4). The most prominent factor influencing the malaria awareness in the Sumba and Manggarai ethnicities was education level, whilst it was socioeconomic status (SES) in the Atoni ethnicity. The likelihood of malaria awareness was significantly higher in adults with an education level of diploma or above (adjusted odds ratio [aOR], 21.4; 95% CI, 3.59 to 127.7 for Manggarai; aOR, 6.94; 95% CI, 1.81 to 26.6 for Sumba). Malaria awareness was significantly more common amongst high-SES adults in the Atoni group (aOR, 24.48; 95% CI, 8.79 to 68.21).
Conclusions
Low education levels and low SES were prominent contributors to lower levels of malaria awareness in rural ENTP. Interventions should focus on improving malaria awareness to these groups to support the Indonesian government’s national commitment to achieve a malaria elimination zone by 2030.
Summary

Citations

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  • The Declined Trend of Malaria over a Ten-year Period in the Rural East Nusa Tenggara Province, Indonesia: A Medical Record Analysis
    Maria Lobo, Robertus Dole Guntur, Damai Kusumaningrum, Yulianti Paula Bria
    Open Access Macedonian Journal of Medical Sciences.2024; 12(1): 107.     CrossRef
  • The Variation of Malaria Prevention Measures Knowledge and their Associated Factors in Rural East Nusa Tenggara Province, Indonesia
    Robertus Dole Guntur, Maria A. Kleden, Damai Kusumaningrum, Fakir M. Amirul Islam
    Open Access Macedonian Journal of Medical Sciences.2023; 11(E): 378.     CrossRef
Regional Differences in the Effects of Social Relations on Depression Among Korean Elderly and the Moderating Effect of Living Alone
Chanki Kim, Eun Jee Chang, Chang-yup Kim
J Prev Med Public Health. 2021;54(6):441-450.   Published online October 22, 2021
DOI: https://doi.org/10.3961/jpmph.21.337
  • 4,006 View
  • 143 Download
  • 7 Web of Science
  • 8 Crossref
AbstractAbstract AbstractSummary PDFSupplementary Material
Objectives
Socioeconomic disadvantages interact with numerous factors which affect geriatric mental health. One of the main factors is the social relations of the elderly. The elderly have different experiences and meanings in their social lives depending on their socio-cultural environment. In this study, we compared the effects of social relations on depression among the elderly according to their living arrangement (living alone or living with others) and residential area.
Methods
We defined social relations as “meetings with neighbors” (MN). We then analyzed the impact of MN on depression using data from the Korean Longitudinal Study of Aging Panel with the generalized estimating equation model. We also examined the moderating effect of living alone and performed subgroup analysis by dividing the sample according to which area they lived in.
Results
MN was associated with a reduced risk of depressive symptoms among elderlies. The size of the effect was larger in rural areas than in large cities. However, elderly those who lived alone in rural areas had a smaller protective impact of MN on depression, comparing to those who lived with others. The moderating effect of living alone was significant only in rural areas.
Conclusions
The social relations among elderlies had a positive effect on their mental health: The more frequent MN were held, the less risk of depressive symptoms occurred. However, the effect may vary depending on their living arrangement and environment. Thus, policies or programs targeting to enhance geriatric mental health should consider different socio-cultural backgrounds among elderlies.
Summary
Korean summary
본 연구는 사회적 관계가 노인의 우울에 미치는 영향이 독거 상태 및 거주 지역에 따라 달라지는지 확인하였다. 사회적 관계를 이웃과의 만남 빈도로 정의하고 고령화연구패널자료를 분석한 결과 사회적 관계의 효과 크기는 대도시에서 가장 작었고 독거의 조절효과는 농어촌에서만 유의하였다.

Citations

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  • Association between area deprivation index and concerns to COVID-19: A multi-level analysis of individual and area factors
    Doo Woong Lee, Jieun Jang, Jaeyong Shin
    SSM - Population Health.2024; 25: 101580.     CrossRef
  • Nutritional Risk, Depression, and Physical Function in Older People Living Alone
    Jeong-Hye Park, Se-Won Kang
    Healthcare.2024; 12(2): 164.     CrossRef
  • Urban-Rural Differences in Prevalence of Depressive Symptoms and Its Related Factors Among Older Adults: Findings from the Korean Longitudinal Study of Aging
    Bongjeong Kim, Jinseub Hwang, Dohyang Kim, Soo Jin Kang
    Research in Community and Public Health Nursing.2024; 35: 51.     CrossRef
  • The Effectiveness of Digital Interactive Intervention on Reducing Older Adults’ Depressive and Anxiety Symptoms: A Systematic Review and Meta-Analysis
    Xinyu Shi, Jiaxin Zhang, Hailiang Wang, Yan Luximon
    Gerontology.2024; 70(9): 991.     CrossRef
  • Global rural health disparities in Alzheimer's disease and related dementias: State of the science
    Lisa Ann Kirk Wiese, Allison Gibson, Marc Aaron Guest, Amy R. Nelson, Raven Weaver, Aditi Gupta, Owen Carmichael, Jordan P. Lewis, Allison Lindauer, Samantha Loi, Rachel Peterson, Kylie Radford, Elizabeth K. Rhodus, Christina G. Wong, Megan Zuelsdorff, La
    Alzheimer's & Dementia.2023; 19(9): 4204.     CrossRef
  • Living alone and the risk of depressive symptoms: a cross-sectional and cohort analysis based on the China Health and Retirement Longitudinal Study
    Guangjun Zheng, Biying Zhou, Zhenger Fang, Chunxia Jing, Sui Zhu, Mingliang Liu, Xia Chen, Lei Zuo, Haiyan Chen, Guang Hao
    BMC Psychiatry.2023;[Epub]     CrossRef
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    Daolin Wu, Fuwei Liu, Shan Huang
    Frontiers in Psychiatry.2022;[Epub]     CrossRef
  • Effects of Serious Games on Depression in Older Adults: Systematic Review and Meta-analysis of Randomized Controlled Trials
    Yesol Kim, Soomin Hong, Mona Choi
    Journal of Medical Internet Research.2022; 24(9): e37753.     CrossRef
The Association of Perceived Neighborhood Walkability and Environmental Pollution With Frailty Among Community-dwelling Older Adults in Korean Rural Areas: A Cross-sectional Study
Mi-Ji Kim, Sung-Hyo Seo, Ae-Rim Seo, Bo-Kyoung Kim, Gyeong-Ye Lee, Yeun-Soon Choi, Jin-Hwan Kim, Jang-Rak Kim, Yune-Sik Kang, Baek-Geun Jeong, Ki-Soo Park
J Prev Med Public Health. 2019;52(6):405-415.   Published online October 24, 2019
DOI: https://doi.org/10.3961/jpmph.19.166
  • 9,298 View
  • 147 Download
  • 12 Crossref
AbstractAbstract AbstractSummary PDFSupplementary Material
Objectives
The aim of this study was to evaluate the associations of frailty with perceived neighborhood walkability and environmental pollution among community-dwelling older adults in rural areas.
Methods
The participants were 808 community-dwelling men and women aged 65 years and older in 2 rural towns. Comprehensive information, including demographics, socioeconomic status, grip strength, polypharmacy, perceived neighborhood environment (specifically, walkability and environmental pollution), and frailty, was collected from participants using face-to-face interviews conducted between June and August 2018. Perceived neighborhood walkability was measured using 20 items that were selected and revised from the Neighborhood Environment Walkability Scale, the Neighborhood Walkability Checklist from the National Heart Foundation of Australia, and the Physical Activity Neighborhood Environment Survey. The Kaigo-Yobo Checklist was used to assess participants’ frailty.
Results
The overall prevalence of frailty in this community-dwelling population was 35.5%. Sex, age, cohabitation status, educational attainment, employment status, grip strength, and polypharmacy were significantly associated with frailty. In the logistic regression analysis, frailty was associated with low perceived neighborhood walkability (adjusted odds ratio [aOR], 0.881; 95% confidence interval [CI], 0.833 to 0.932; p<0.001) and severe perceived neighborhood environmental pollution (aOR, 1.052; 95% CI, 1.017 to 1.087; p=0.003) after adjusting for sex, age, cohabitation status, educational attainment, employment status, monthly income, grip strength, and polypharmacy.
Conclusions
More studies are warranted to establish causal relationships between walkability and environmental pollution and frailty.
Summary
Korean summary
본 연구는 우리나라 농촌지역 노인들이 인지하는 지역 환경과 노쇠의 연관성을 확인하기 위하여 자기보고식 설문지로 인지된 보행편의성 및 환경오염을 측정하였고, Kaigo-Yobo 평가척도로 노쇠를 평가하였다. 연구 결과, 노쇠에 영향을 미칠 것으로 예상되는 변수들을 통제한 후에도 인지된 보행편의성의 감소와 인지된 환경오염의 증가는 노쇠와 관련성이 있었다.

Citations

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  • Effect of walkability on the physical activity of hemodialysis patients: a multicenter study
    Yoichi Sato, Naoto Usui, Yoshifumi Abe, Daisuke Okamura, Yota Kuramochi, Sho Kojima, Nobuto Shinozaki, Yu Shimano, Nobuyuki Shirai, Kenta Mikami, Yoji Yamada, Masakazu Saitoh
    Renal Replacement Therapy.2024;[Epub]     CrossRef
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    Myung Ja Kim, C. Michael Hall
    Current Issues in Tourism.2023; 26(2): 171.     CrossRef
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    Nicola Veronese, Laura Maniscalco, Domenica Matranga, Guido Lacca, Ligia J. Dominguez, Mario Barbagallo
    Journal of the American Medical Directors Association.2023; 24(4): 475.     CrossRef
  • Associations of Perceived and Objective Neighborhood Environment Attributes with Walking in Older Adults: A Cross-Sectional Study
    Faezeh Behnamifard, Zohre Shafieiyoun, Mostafa Behzadfar
    Journal of Urban Planning and Development.2023;[Epub]     CrossRef
  • Frailty in Older Adults and Internal and Forced Migration in Urban Neighborhood Contexts in Colombia
    Herney Rengifo-Reina, Tonatiuh Barrientos-Gutiérrez, Nancy López-Olmedo, Brisa N. Sánchez, Ana V. Diez Roux
    International Journal of Public Health.2023;[Epub]     CrossRef
  • The Effects of Neighborhood Physical and Social Environment on Physical Function among Japanese Community-Dwelling Older Adults: A One-Year Longitudinal Study
    Masataka Ando, Naoto Kamide, Miki Sakamoto, Yoshitaka Shiba, Haruhiko Sato, Akie Kawamura, Shuichiro Watanabe
    International Journal of Environmental Research and Public Health.2022; 19(13): 7999.     CrossRef
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    Jixiang Xu, Yingwei Chen, Yujie Wang, Junling Gao, Limei Huang
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  • Differences in the Association of Neighborhood Environment With Physical Frailty Between Urban and Rural Older Adults: The Korean Frailty and Aging Cohort Study (KFACS)
    Yuri Seo, Miji Kim, Hayoung Shim, Chang Won Won
    Journal of the American Medical Directors Association.2021; 22(3): 590.     CrossRef
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    Federica Gaglione, Caitlin Cottrill, Carmela Gargiulo
    Transportation Research Part D: Transport and Environment.2021; 90: 102687.     CrossRef
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    Rui Xu, Qiufang Li, Feifei Guo, Maoni Zhao, Luyao Zhang
    BMJ Open.2021; 11(4): e043494.     CrossRef
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    Yuri Seo, Miji Kim, Hyungeun Shin, Changwon Won
    International Journal of Environmental Research and Public Health.2021; 18(12): 6292.     CrossRef
  • Frailty Status and Transport Disadvantage: Comparison of Older Adults’ Travel Behaviours between Metropolitan, Suburban, and Rural Areas of Japan
    Takumi Abe, Akihiko Kitamura, Satoshi Seino, Yuri Yokoyama, Hidenori Amano, Yu Taniguchi, Mariko Nishi, Yu Nofuji, Tomoko Ikeuchi, Takemi Sugiyama, Shoji Shinkai
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Association Between Convenience of Transportation and Unmet Healthcare Needs of Rural Elderly in Korea
Youngeun Choi, Kiryong Nam, Chang-yup Kim
J Prev Med Public Health. 2019;52(6):355-365.   Published online October 3, 2019
DOI: https://doi.org/10.3961/jpmph.19.172
  • 9,923 View
  • 219 Download
  • 26 Crossref
AbstractAbstract AbstractSummary PDFSupplementary Material
Objectives
In rural areas of Korea, where public transportation infrastructure is lacking and alternative systems are poor, the elderly experience inconveniences in using healthcare, although their need is high. This study aimed to analyze the association between the convenience of transportation and unmet healthcare needs among the rural elderly.
Methods
The data used were collected in the 2016 Community Health Survey among rural elderly individuals aged 65 or older. Dependent variable was the unmet healthcare needs, explanatory variable was the convenience of transportation. The elderly were divided into 3 groups: with no driver in the household, with a driver, and the elderly individual was the driver (the self-driving group). Covariates were classified into predisposing, enabling, and need factors. They included gender, age, education, income, economic activity, household type, motor ability, subjective health level, number of chronic diseases, anxiety/depression, and pain/discomfort. The data were analyzed using logistic regression and stratification.
Results
A significant association was found between the convenience of transportation and unmet healthcare needs. When examined unadjusted odds ratio of the group with a driver in the household, using the group with no driver as a reference, was 0.61 (95% confidence interval [CI], 0.54 to 0.68), while that of the self-driving group was 0.34 (95% CI, 0.30 to 0.38). The odds ratios adjusted for all factors were 0.69 (95% CI, 0.59 to 0.80) and 0.79 (95% CI, 0.67 to 0.91).
Conclusions
We confirmed a significant association between inconvenient transportation and unmet healthcare needs among the rural elderly even after adjustment for existing known factors. This implies that policies aimed at improving healthcare accessibility must consider the means of transportation available.
Summary
Korean summary
대중교통 인프라가 부족하고 대안적 교통수단 체계가 미흡한 농촌 지역 노인들은 의료 필요는 높으나 도보이동이나 불편한 이동수단을 이용하기 어려워 의료이용에 불편을 겪는다. 본 연구는 의료접근성 향상과 불평등한 접근성 문제에 대한 제안의 근거 마련을 목적으로 질병관리본부 지역사회건강조사 데이터를 이용하여 농촌 노인의 이동수단의 편의성과 미충족의료 경험의 연관성을 살펴보았다. 분석결과 농촌지역 노인에게 교통편 불편은 미충족의료 경험의 주된 이유로 나타났고 기존에 알려진 요인들을 보정한 후에도 이동수단의 편의성과 미충족의료 경험 사이에 유의한 관계가 있음을 확인하였다.

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How Much Do Older Adults Living Alone in Rural South Korea Know About Dementia?
Mi Sook Kim, Dong-Soo Shin, Yong-jun Choi, Jin Soon Kim
J Prev Med Public Health. 2018;51(4):188-195.   Published online June 19, 2018
DOI: https://doi.org/10.3961/jpmph.17.084
  • 6,348 View
  • 145 Download
  • 2 Crossref
AbstractAbstract PDF
Objectives
This study aimed to examine the level of dementia knowledge of older Korean adults living alone in rural areas and to identify related factors.
Methods
A cross-sectional descriptive design was applied. The participants were 231 older adults living alone who were recruited from 12 of the 13 primary health care posts in the rural area of Chuncheon. Participants’ level of dementia knowledge was assessed using the Dementia Knowledge Scale. Data were analyzed using descriptive statistics, and the t-test, analysis of variance, chi-square test, and Mann-Whitney test were applied.
Results
Participants’ mean age was 77.3±5.4 years, and women comprised 79.7% of the sample. Over half of the participants (61.9%) had no formal education, and all the participants were enrolled in Medical Aid. The participants’ average percentage of correct answers was 61.6%. The highest rate (94.4%) was for the item “Dementia can change one’s personal character.” The item with the lowest proportion of correct answers was “Dementia is not treatable” (23.4%). Dementia knowledge was significantly associated with age, education, health coverage, source of living expenses, and dementia risk.
Conclusions
Dementia knowledge among Korean rural older adults living alone was relatively low. Participants’ misconceptions about symptoms and treatment could hinder them from seeking early treatment. The results of this study suggest the need for active outreach and health care delivery for rural older adults living alone in South Korea.
Summary

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    Seok Jong Chung, Jee Eun Lee, Dong Wook Kim, So Ra Yoon, Dong Gyo Shin, Moon Young Choi, Jun Hong Lee
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Brief Report
Throat Carriage Rate and Antimicrobial Resistance of Streptococcus pyogenes In Rural Children in Argentina
Gastón Delpech, Mónica Sparo, Beatriz Baldaccini, Gisela Pourcel, Sabina Lissarrague, Leonardo García Allende
J Prev Med Public Health. 2017;50(2):127-132.   Published online January 4, 2017
DOI: https://doi.org/10.3961/jpmph.15.073
  • 7,709 View
  • 195 Download
  • 8 Crossref
AbstractAbstract PDF
Objectives
The aim of this study was to determine the prevalence of asymptomatic carriers of group A β-hemolytic streptococci (GAS) in children living in a rural community and to investigate the association between episodes of acute pharyngitis and carrier status.
Methods
Throat swabs were collected from September to November 2013 among children 5-13 years of age from a rural community (Maria Ignacia-Vela, Argentina). The phenotypic characterization of isolates was performed by conventional tests. Antimicrobial susceptibility was assayed for penicillin, tetracycline, chloramphenicol, erythromycin, and clindamycin (disk diffusion). The minimum inhibitory concentration was determined for penicillin, cefotaxime, tetracycline, and erythromycin.
Results
The carriage of β-hemolytic streptococci was detected in 18.1% of participants, with Streptococcus pyogenes in 18 participants followed by S. dysgalactiae ssp. equisimilis in 5. The highest proportion of GAS was found in 8 to 10-year-old children. No significant association between the number of episodes of acute pharyngitis suffered in the last year and the carrier state was detected (p>0.05). Tetracycline resistance (55.5%) and macrolide-resistant phenotypes (11.1%) were observed. Resistance to penicillin, cefotaxime, or chloramphenicol was not expressed in any streptococcal isolate.
Conclusions
The present study demonstrated significant throat carriage of GAS and the presence of group C streptococci (S. dysgalactiae ssp. equisimilis) in an Argentinian rural population. These results point out the need for continuous surveillance of GAS and non-GAS carriage as well as of antimicrobial resistance in highly susceptible populations, such as school-aged rural children. An extended surveillance program including school-aged children from different cities should be considered to estimate the prevalence of GAS carriage in Argentina.
Summary

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Original Articles
A Qualitative Inquiry Into the Challenges of Medical Education for Retention of General Practitioners in Rural and Underserved Areas of Iran
Sajad Delavari, Mohammad Arab, Arash Rashidian, Saharnaz Nedjat, Rahmatollah Gholipour Souteh
J Prev Med Public Health. 2016;49(6):386-393.   Published online November 1, 2016
DOI: https://doi.org/10.3961/jpmph.16.062
  • 8,535 View
  • 162 Download
  • 9 Crossref
AbstractAbstract PDF
Objectives
General practitioners (GPs) retention in rural and underserved areas highly effects on accessibility of healthcare facilities across the country. Education seems to be a critical factor that affects GPs retention. Thus, the present study aimed at inquiry into medical education challenges that limit their retention in rural and underserved areas.
Methods
A qualitative approach was applied for the aim of this study. Data were gathered via 28 semi-structured interviews with experts at different levels of Iran’s health system as well as GPs who retained and refused to retain working in rural settings. Interviews mainly were performed face-to-face and in some cases via telephone during 2015 and then coded and analyzed using content analysis approach.
Results
Iran’s medical education is faced with several challenges that were categorized in four main themes including student selection, medical students’ perception about their field of study, education setting and approach, curriculum of medical education. According to experts this challenges could results in making GP graduates disinterested for practicing in rural and underserved areas.
Conclusions
Challenges that were found could have negative effects on retention. Modification in student’s perception about rural practice could be done via changing education setting and approach and curriculum. These modifications could improve GPs retention in rural and underserved areas.
Summary

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  • Identifying factors affecting dentists retention in deprived areas in Iran
    Mohammadreza Amiresmaeili, Majid Heidari Jamebozorgi, Azam Heidari Jamebozorgi
    The International Journal of Health Planning and Management.2022; 37(3): 1340.     CrossRef
  • Retention of dental practitioners in rural health services in Iran: Experiences from Kerman province
    Mohammadreza Amiresmaili, MajidHeidari Jamebozorgi, AzamHeidari Jamebozorgi, Morteza Arab-Zozani
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  • Influencing factors on the tendency of general practitioners to join in urban family physician program: a cross-sectional survey on Iranian physicians
    Mohsen Bayati, Arash Rashidian, Vahid Yazdi-Feyzabadi, Sajad Delavari
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  • Challenges Associated with the Education of Family Physicians in Iran: A Systematic Review
    Abtin Heidarzadeh, Bita Hedayati, Mark K. Huntington, Mehdi Alvandi, Alireza Aarabi, Babak Farrokhi, Marzieh Nojomi, Somayeh Noori Hekmat, Roksana Mirkazemi
    Journal of Medical Education.2022;[Epub]     CrossRef
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    A Heidarzadeh, M Nojomi, M Alvandi, A Mohammadi, F Mohseni, P Naghshpour
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    Nastaran Niroomand, Mohsen Bayati, Mozhgan Seif, Somayeh Delavari, Sajad Delavari
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  • Preferences of Medical Sciences Students for Work Contracts in Deprived Areas of Iran: A Discrete Choice Experiment Analysis


    Ali Kazemi Karyani, Behzad Karami Matin, Parisa Malekian, Delnia Moradi Rotvandi, Saeed Amini, Sajad Delavari, Shahin Soltani, Satar Rezaei
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    Rasoul Tabari-Khomeiran, Elham Ehsani-Chimeh, Ali Davoudi Kiakalayeh, Enayatollah Homaie Rad, Sajad Delavari
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Unsafe Disposal of Child Faeces: A Community-based Study in a Rural Block in West Bengal, India
Preeti PS, Sanjaya Kumar Sahoo, Dhiraj Biswas, Aparajita Dasgupta
J Prev Med Public Health. 2016;49(5):323-328.   Published online September 8, 2016
DOI: https://doi.org/10.3961/jpmph.16.020
  • 8,865 View
  • 175 Download
  • 20 Crossref
AbstractAbstract PDF
Objectives
A clean India is the responsibility of all Indians. One of the objectives of the Swachh Bharat Abhiyan (Clean India Initiative) is to bring about behavioural changes regarding healthy sanitation practices. While large-scale programs in India have increased latrine coverage, they have to some extent failed to bring behavioural changes ensuring optimal latrine use, including the safe disposal of child faeces, which is a significant source of exposure to faecal pathogens. Hence, this study was done to explore child faeces disposal practices in rural West Bengal and to elicit the determinants of unhygienic faeces disposal.
Methods
Data collection was done using an interview method among the mothers of 502 under-5 children, following a pre-designed, semi-structured schedule during house-to-house visits in a set of villages in the Hooghly district of West Bengal.
Results
The prevalence of unsafe disposal of child faeces was 72.4%, and maternal education, per capita income, and water source were found to be significantly associated with unsafe child faeces disposal.
Conclusions
This study draws attention to the unsafe disposal of child faeces in this area of India and raises questions about the efficiency of sanitation campaigns in rural India that focus on expanding coverage rather than emphasizing behavioural changes, which are crucial to ensure the safe disposal of child faeces. Thus, it is urgently necessary to strengthen efforts focusing on behavioural changes regarding the safe disposal of child faeces in order to minimise adverse health outcomes.
Summary

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    Anissa Mary Thomas Thattil, Twinkle Agrawal, Abdul Kader Surti, Stallon Sebastian, Kiyana Mirza, George Jacob, Farah Naaz Fathima
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    Getu Debalkie Demissie, Muluken Fekadie Zerihun, Daniale Tekelia Ekubagewargies, Yigizie Yeshaw, Tadeg Jemere, Bisrat Misganaw, Amare Tariku, Asmamaw Atnafu, Biniyam Sahiledengle
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    Lina Agestika, Neni Sintawardani, Umi Hamidah, Sikopo Nyambe, Taro Yamauchi
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    Moges Addis, Walelegn Worku, Laekemariam Bogale, Alebachew Shimelash, Eniyew Tegegne
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    Gloria D. Sclar, Valerie Bauza, Alokananda Bisoyi, Thomas F. Clasen, Hans-Joachim Mosler, Alison Parker
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    Lauren Sprouse, Anna Liles, Ryan Cronk, Valerie Bauza, James B. Tidwell, Musa Manga
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    Abdul-Aziz Seidu
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    Biniyam Sahiledengle, Zinash Teferu, Yohannes Tekalegn, Tadesse Awoke, Demisu Zenbaba, Kebebe Bekele, Abdi Tesemma, Fikadu Seyoum, Demelash Woldeyohannes, Harvie P. Portugaliza
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    Abdul-Aziz Seidu, Bright Opoku Ahinkorah, Kwaku Kissah-Korsah, Ebenezer Agbaglo, Louis Kobina Dadzie, Edward Kwabena Ameyaw, Eugene Budu, John Elvis Hagan, Srinivas Goli
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    Biniyam Sahiledengle
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    Abdul-Aziz Seidu, Ebenezer Agbaglo, Bright Opoku Ahinkorah, Louis Kobina Dadzie, Ishmael Bukari, Edward Kwabena Ameyaw, Sanni Yaya
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C-reactive Protein Concentration Is Associated With a Higher Risk of Mortality in a Rural Korean Population
Jung Hyun Lee, Hyungseon Yeom, Hyeon Chang Kim, Il Suh, Mi Kyung Kim, Min-Ho Shin, Dong Hoon Shin, Sang-Baek Koh, Song Vogue Ahn, Tae-Yong Lee, So Yeon Ryu, Jae-Sok Song, Hong-Soon Choe, Young-Hoon Lee, Bo Youl Choi
J Prev Med Public Health. 2016;49(5):275-287.   Published online August 23, 2016
DOI: https://doi.org/10.3961/jpmph.16.025
  • 9,749 View
  • 201 Download
  • 4 Crossref
AbstractAbstract PDFSupplementary Material
Objectives
C-reactive protein (CRP), an inflammatory biomarker, has been widely used as a preclinical marker predictive of morbidity and mortality. Although many studies have reported a positive association between CRP and mortality, uncertainty still remains about this association in various populations, especially in rural Korea.
Methods
A total of 23 233 middle-aged participants (8862 men and 14 371 women) who were free from cardiovascular disease, cancer, and acute inflammation (defined by a CRP level ≥10 mg/L) were drawn from 11 rural communities in Korea between 2005 and 2011. Blood CRP concentration was analyzed as a categorical variable (low: 0.0-0.9 mg/L; intermediate: 1.0-3.0 mg/L; high: 3.1-9.9 mg/L) as well as a continuous variable. Each participant’s vital status through December 2013 was confirmed by death statistics from the National Statistical Office. Cox proportional hazard models were used to assess the independent association between CRP and mortality after adjusting for other risk factors.
Results
The total quantity of observed person-years was 57 975 for men and 95 146 for women, and the number of deaths was 649 among men and 367 among women. Compared to the low-CRP group, the adjusted hazard ratio for all-cause mortality of the intermediate group was 1.17 (95% confidence interval [CI], 0.98 to 1.40) for men and 1.27 (95% CI, 1.01 to 1.61) for women, and the corresponding values for the high-CRP group were 1.98 (95% CI, 1.61 to 2.42) for men and 1.41 (95% CI, 1.03 to 1.95) for women. Similar trends were found for CRP evaluated as a continuous variable and for cardiovascular mortality.
Conclusions
Higher CRP concentrations were associated with higher mortality in a rural Korean population, and this association was more prominent in men than in women.
Summary

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  • Binary cutpoint and the combined effect of systolic and diastolic blood pressure on cardiovascular disease mortality: A community-based cohort study
    Ju-Yeun Lee, Ji Hoon Hong, Sangjun Lee, Seokyung An, Aesun Shin, Sue K. Park, Tariq Jamal Siddiqi
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Trends in Cigarette Use Behaviors Among Adolescents by Region in Korea
Nam Soo Hong, Keon Yeop Kim, Soon-Woo Park, Jong-Yeon Kim, Jisuk Bae, Won Kee Lee, Ki Su Kim
J Prev Med Public Health. 2011;44(4):176-184.   Published online July 29, 2010
DOI: https://doi.org/10.3961/jpmph.2011.44.4.176
  • 10,916 View
  • 63 Download
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AbstractAbstract PDF
Objectives

Understanding recent trends in cigarette smoking among adolescents is important in order to develop strategies to prevent cigarette smoking. The aim of this study was to compare recent trends in cigarette smoking for adolescents living in rural areas, small towns and metropolitan cities in Korea.

Methods

The raw data from the Korea Youth Risk Behavior Web-based Survey (KYRBWS) from 2005 to 2009 were used. Data were analyzed by using the method of complex survey data analysis considering complex sampling design. Logistic regression models were used to evaluate significant linear time trends in cigarette smoking. The indicators of cigarette use behaviors were 'current smoking rate', 'frequent smoking rate', 'heavy smoking rate' and 'smoking experience rate before 13 years of age'. All analyses were conducted according to gender.

Results

Statistically significant increasing trends in current smoking rate and frequent smoking rate were observed and borderline significant increasing trends in heavy smoking rate were shown among rural boys. Among metropolitan city boys, statistically significant increasing trends were also seen for frequent smoking. Statistically significant decreasing trends in current smoking rate were observed among small town and metropolitan city girls. Smoking experience rate before 13 years of age for rural girls decreased significantly.

Conclusions

Cigarette smoking prevalence among adolescents in the rural areas has increased in the last five years especially among boys. Our findings suggest that anti-tobacco program for adolescents should be conducted primarily for those in rural areas.

Summary

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English Abstracts
Awareness, Treatment and Control of Hypertension and Related Factors in the Jurisdictional Areas of Primary Health Care Posts in a Rural Community of Korea.
Hyung Min Lee, Yu Mi Kim, Cheol Heon Lee, Jin Ho Shin, Mi Kyung Kim, Bo Youl Choi
J Prev Med Public Health. 2011;44(2):74-83.
DOI: https://doi.org/10.3961/jpmph.2011.44.2.74
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  • 102 Download
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AbstractAbstract PDF
OBJECTIVES
This study aimed to identify and assess the factors related to the awareness, treatment, and control of hypertension based on jurisdictional areas of primary health care posts in a rural community of Korea. METHODS: This study was performed on 4598 adults aged over 30 years in a rural community and we measured their blood pressure (BP) from October. 2007 to August. 2009. Hypertension is defined as a condition characterized by a systolic BP > or =140 mmHg, a diastolic BP > or =90 mmHg or reported treatment with antihypertensive medications. We analyzed the factors related with the prevalence, awareness, treatment and control of hypertension using chi-square test and multivariate logistic regression analysis. RESULTS: The age-adjusted prevalence of hypertension was 34.7%. The age-adjusted rates of hypertension awareness, treatment and control were 50.6%, 93.9% and 64.1%, respectively. Awareness of hypertension was related with increasing age. Higher awareness was found among men who were felt more stress, were obese and had hypercholesterolemia, and among women who were regulary taking medicine for hypertension, were obese and had diabetes mellitus. In women, the hypertension treatment was related a Medical aid and education for hypertension management. Controlled hypertension was more common among men who were educated about the management of hypertension and among women who had hypercholesterolemia. CONCLUSIONS: The awareness of hypertension was low and the control of hypertension was high compared with the nationwide data (KNHANES 2005). The results suggest that understanding the characteristics of hypertension in a community is important to perform a community based hypertension control program.
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    Min So Kim, Kyae Hyung Kim, Sang Min Park, Jong-goo Lee, Yeon Seo Ko, A Ra Cho, Yoon Su Ku
    Korean Journal of Family Medicine.2020; 41(2): 119.     CrossRef
  • Performance of a Community-based Noncommunicable Disease Control Program in Korea: Patients 65 Years of Age or Older
    Sun Mi Lim, Sung-Hyo Seo, Ki Soo Park, Young Hwangbo, Yeonok Suh, Sungin Ji, Jeongmook Kang, Hyeonji Hwang, Jose Rene Bagani Cruz, Yoon Hyung Park
    Journal of Korean Medical Science.2020;[Epub]     CrossRef
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    International Journal of Environmental Research and Public Health.2019; 16(5): 719.     CrossRef
  • Decrease in Smoking and Related Factor after the Price Raise of Tobacco in Hypertension Patients: Using 2015 Korea National Health and Nutrition Examination Survey
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  • Evaluation of Community-based Hypertension Control Programme in South Korea
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  • Prevalence, awareness, treatment and control of hypertension among adults in rural north-western China: a cross-sectional population survey
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  • Effects of a hypertension management program by Seongcheon primary health care post in South Korea: an analysis of changes in the level of knowledge of hypertension in the period from 2004 to 2009
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  • Prevalence, Awareness, Treatment, and Control of Hypertension among Saudi Adult Population: A National Survey
    Abdalla A. Saeed, Nasser A. Al-Hamdan, Ahmed A. Bahnassy, Abdelshakour M. Abdalla, Mostafa A. F. Abbas, Lamiaa Z. Abuzaid
    International Journal of Hypertension.2011; 2011: 1.     CrossRef
Change of Cognitive Function and Associated Factors among the Rural Elderly: A 5-Year Follow-up Study.
Sang Kyu Kim, Pock Soo Kang, Tae Yoon Hwang, Joon Sakong, Kyeong Soo Lee
J Prev Med Public Health. 2007;40(2):162-168.
DOI: https://doi.org/10.3961/jpmph.2007.40.2.162
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AbstractAbstract PDF
OBJECTIVES
This prospective population-based cohort study was conducted to evaluate the risk factors of cognitive impairment and the degree of cognitive function change through a 5-year follow-up. METHODS: The baseline and follow-up surveys were conducted in 1998 and 2003, respectively. Among 176 subjects who had normal cognitive function in the baseline study, 136 were followed up for 5 years. The cognitive function was investigated using the Korean version of the Mini-Mental State Examination (MMSE-K). The collected data were analyzed using SPSS and Stata. RESULTS: Of the 136 subjects analyzed, 25 (18.4%) were cognitively impaired. Old age and low social support in the baseline survey were risk factors for cognitive impairment after 5 years. In the generalized estimating equation for 128 subjects except severe cognitive impairment about the contributing factors of cognitive function change, the interval of 5 years decreased MMSE-K score by 1.02 and the cognitive function was adversely affected with increasing age, decreasing education and decreasing social support. CONCLUSIONS: Although the study population was small, it was considered that the study results can be used to develop a community-based prevention system for cognitive impairment.
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    Nam-Kyou Bae, Young-Soo Song, Eun-Sook Shin, Young-Chae Cho
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  • Toxicities and functional consequences of systemic chemotherapy in elderly Korean patients with cancer: A prospective cohort study using Comprehensive Geriatric Assessment
    Dong-Yeop Shin, Jeong-Ok Lee, Yu Jung Kim, Myung-Sook Park, Keun-Wook Lee, Kwang-Il Kim, Soo-Mee Bang, Jong Seok Lee, Cheol-Ho Kim, Jee Hyun Kim
    Journal of Geriatric Oncology.2012; 3(4): 359.     CrossRef
  • Apolipoprotein E Polymorphism and Cognitive Function Change of the Elderly in a Rural Area, Korea
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    Journal of Preventive Medicine and Public Health.2009; 42(4): 261.     CrossRef
Original Article
Investigation of Health Hazards in the Underground Storage Facilities of Ginger Roots.
Hyun Sul Lim, Geun Ryang Bae
Korean J Prev Med. 2002;35(1):72-75.
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OBJECTIVES
To evaluate the health hazards in the underground storage facilities of ginger roots. METHODS: The authors reviewed the emergency rescue records from the Seosan fire department over the period Jan 1, 1996 to Aug 31, 1999. The atmospheres in 3 different underground storage locations were analyzed for O2, CO2, CO, H2S and NH4. RESULTS: From the emergency records, we were able to identify 20 individuals that had been exposed to occupational hazards in the underground storage facilities. Among these 20 cases, 13 were due to asphyxiation (resulting in 7 deaths) and 7 were due to falls. In the first atmospheric tests, performed on Feb 25, 1998, the O2 level inside the underground storage facility, located about 5~6 meters below the surface, was 20.6% and the CO2 level was about 1,000 ppm. CO, H2S and NH4 were not detected. In the second tests on Jul 6, 1999, measurements of the O2 level at 3 meters below the surface in two different storage locations were 15.3 and 15.1%. And the O2 levels inside the storage facilities were 12.2 and 12.1%. The CO2 level was above 5,000 ppm (beyond upper limits of measurement). CO, H2S and NH4 were not detected. CONCLUSIONS: We conclude that asphyxiation in the underground storage facilities for ginger roots was not due to the presence of toxic gases such as CO, H2S and NH4, but rather the exclusion of oxygen by carbon dioxide was responsible for causing casualties. For the development of a hazard free working environment, safety education as well as improvements in storage methods are needed.
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JPMPH : Journal of Preventive Medicine and Public Health
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