Journal of Preventive Medicine and Public Health

Original Articles

Impact of Physical Activity on the Association Between Unhealthy Adolescent Behaviors and Anxiety Among Korean Adolescents: A Cross-sectional Study: Hyo-jung Lee, Jeong Pil Choi, Kunhee Oh, Jin-Young Min, Kyoung-Bok Min; J Prev Med Public Health. 2023;56(6):552-562. Published online November 15, 2023; DOI: https://doi.org/10.3961/jpmph.23.313

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Abstract Summary PDF: Objectives
Adolescents who engage in unhealthy behaviors are particularly vulnerable to anxiety. We hypothesized that participation in physical activity could influence the relationship between anxiety and unhealthy behaviors in adolescents. These behaviors include smoking, alcohol consumption, and unsafe sexual activity.
Methods
This study included 50 301 students from the first year of middle school to the third year of high school, all from Korea. The unhealthy adolescent behaviors examined included current alcohol consumption, current smoking, and unsafe sexual behavior. Anxiety levels were assessed using the Generalized Anxiety Disorder-7 questionnaire (GAD-7).
Results
The participants had a mean age of 15.19 years and an average GAD-7 score of 4.23. No significant differences were observed in GAD-7 score among exercising participants when categorized by smoking status (p=0.835) or unsafe sexual behavior (p=0.489). In contrast, participants in the non-exercise group who engaged in these behaviors demonstrated significantly higher GAD-7 scores (p<0.001 and 0.016, respectively). The only significant interaction was found between unsafe sexual behavior and exercise (p=0.009). Based on logistic regression analysis, within the non-exercise group, significant positive associations were observed between current smoking and anxiety (odds ratio [OR], 1.36; 95% confidence interval [CI], 1.18 to 1.57), as well as between unsafe sexual behavior and anxiety (OR, 1.33; 95% CI, 1.02 to 1.73). However, within the exercise group, no significant association was found between anxiety and either smoking or unsafe sexual behavior. Furthermore, no significant interaction was observed between unhealthy behaviors and exercise.
Conclusions
These findings are insufficient to conclude that physical activity influences the relationship between unhealthy behaviors and anxiety.; Summary

Korean summary
이 연구는 신체활동이 한국 청소년들사이에서 불안과 불건강행태간의 관계에 어떠한 영향을 미치는지 조사하였다. 이 연구에서 신체활동을 하지 않는 청소년에서만 흡연 및 불안전한 성행위와 같은 불건강행태와 불안 간의 유의미한 연관성을 보였음에도 불구하고, 이러한 불건강행태와 운동 간에는 같은 방향의 유의미한 상호작용이 관찰되지 않았다. 따라서 이 연구는 신체 활동이 청소년들의 불건강행태와 불안간의 관계에 직접 미치는 영향에 대해 명확하게 결론을 내릴 수 없었다.

Key Message
Among Korean adolescents, this study found that significant associations between unhealthy behaviors such as smoking and unsafe sex, and anxiety were only observed in adolescents who did not engage in physical activity. Despite this, no significant interaction was observed between these unhealthy behaviors and exercise. Contrary to popular belief, this study concludes that the evidence is insufficient to definitively say that physical activity influences the relationship between adolescent unhealthy behaviors and anxiety.

Changes in Adolescent Health Behavior and the Exacerbation of Economic Hardship During the COVID-19 Pandemic: A Cross-sectional Study From the Korea Youth Risk Behavior Survey: Chaeeun Kim, Haeun Lee, Kyunghee Jung-Choi, Hyesook Park; J Prev Med Public Health. 2024;57(1):18-27. Published online November 11, 2023; DOI: https://doi.org/10.3961/jpmph.23.306

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Abstract Summary PDF Supplementary Material: Objectives
This study investigated the association between exacerbated economic hardship during the coronavirus disease 2019 (COVID-19) pandemic and changes in the health behaviors of Korean adolescents.
Methods
We analyzed data from the 2021 Korea Youth Risk Behavior Survey and included 44 908 students (22 823 boys and 22 085 girls) as study subjects. The dependent variables included changes in health behaviors (breakfast habits, physical activity, and alcohol use) that occurred during the COVID-19 pandemic. The aggravation of economic hardship by COVID-19 and the subjective economic status of the family were used as exposure variables. Multiple logistic regression analysis was utilized to calculate the prevalence odds ratios (PORs).
Results
Severe exacerbation of a family’s economic hardship due to COVID-19 was negatively associated with the health behaviors of adolescents, including increased breakfast skipping (POR, 1.85; 95% confidence interval [CI], 1.55 to 2.21 for boys and POR, 1.56; 95% CI, 1.27 to 1.92 for girls) and decreased physical activity (POR, 1.37; 95% CI, 1.19 to 1.57 for boys and POR, 1.38; 95% CI, 1.19 to 1.60 for girls). These negative changes in health behaviors were further amplified when combined with a low subjective family economic status.
Conclusions
The experience of worsening household hardship can lead to negative changes in health behavior among adolescents. It is crucial to implement measures that address the economic challenges that arise from stressful events such as COVID-19 and to strive to improve the lifestyles of adolescents under such circumstances.; Summary

Korean summary
이 연구는 코로나바이러스감염증-19 (COVID-19) 대유행 기간 악화된 가구의 경제적 상황과 청소년의 건강 행태 변화의 관련성을 청소년건강행태조사를 이용하여 분석하였다. 가구의 경제적 상황이 COVID-19로 인해 심각하게 악화된 경우, 청소년 건강 행태의 부정적인 변화와 연관성이 관찰되었다. 가구의 경제적 상황이 악화되는 경험은 청소년들의 건강 행태에 부정적인 변화를 초래할 수 있다. COVID-19와 같은 사회적 사건으로 인해 발생하는 경제적 어려움에 대응하는 조치를 마련하고, 이러한 상황에서 청소년들의 건강 행태를 개선하기 위한 개입이 필요하다.

Key Message
This study investigated the association between exacerbated economic hardship during the coronavirus disease 2019 (COVID-19) pandemic and changes in the health behaviors of Korean adolescents using the 2021 Korea Youth Risk Behavior Survey. Severe exacerbation of a family’s economic hardship due to COVID-19 was negatively associated with the health behaviors of adolescents. The experience of worsening household hardship can lead to negative changes in health behavior among adolescents. It is crucial to implement measures that address the economic challenges that arise from stressful events such as COVID-19 and to strive to improve the lifestyles of adolescents under such circumstances.

An Important Strategy to Improve Adolescent Health Literacy: COVID-19 Modules in High School in Indonesia: Nurina Hasanatuludhhiyah, Visuddho Visuddho, Abdul Khairul Rizki Purba, Annette d’ Arqom, Ancah Caesarina Novi Marchianti; J Prev Med Public Health. 2023;56(6):523-532. Published online November 1, 2023; DOI: https://doi.org/10.3961/jpmph.23.113

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Abstract Summary PDF: Objectives
During the second coronavirus disease 2019 (COVID-19) surge, cases increased sharply due to low awareness and compliance with measures to limit disease spread. Health literacy (HL) is an important component of public health initiatives, and schools are potential sources of health education to increase HL via the presentation of COVID-19 educational modules.
Methods
This cross-sectional study involved an online questionnaire administered to students from 5 high schools in Surabaya and Sidoarjo, Indonesia, 6-7 weeks after the start of government-issued directives restricting public gatherings. We collected data on each respondent’s age, gender, parental education, and socioeconomic variables. HL was determined by the Health Literacy Measure for Adolescents. We additionally measured their attitudes and behaviors related to preventing the spread of COVID-19. The students were asked if they watched the COVID-19 module at school, their feelings about vaccination, and preferred online sources of COVID-19-related information.
Results
Most of the 432 respondents had viewed COVID-19 modules at school. Module exposure was associated with significantly higher total and domain-specific HL and more positive attitudes toward government-issued COVID-19 restrictions on travel and public gatherings (p<0.05). However, behaviors to prevent COVID-19 spread and vaccine acceptance were not associated with module exposure. Most students chose social media as their source of COVID-19-related information.
Conclusions
Schools can provide information to increase adolescents’ HL and the public’s support for health initiatives to prevent or limit the spread of COVID-19.; Summary

Key Message
A cross-sectional study carried out on high school students during the second surge of COVID-19 in Indonesia revealed that they benefitted from the COVID-19 module. Students who viewed the module had higher scores on health literacy measures of adolescents (HELMA), had a more favorable attitude toward government-issued restrictive policies, and were more likely to have adequate health literacy, in regard to the ability to use health information. These imply schools as part of the public health response by providing education to increase adolescents’ health literacy and the public’s support for health initiatives to prevent and limit the spread of COVID-19.

Association Between Parental BMI and Offspring’s Blood Pressure by Mediation Analysis: A Study Using Data From the Korean National Health and Nutrition Examination Survey: Hyowon Choi, Hunju Lee, Yeon-Soon Ahn; J Prev Med Public Health. 2023;56(6):533-541. Published online October 30, 2023; DOI: https://doi.org/10.3961/jpmph.23.289

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Abstract Summary PDF Supplementary Material: Objectives
This study analyzed the relationship between parental body mass index (BMI; BMI_p) and hypertension in their adolescent offspring (HTN_a), focusing on the mediating effect of adolescents’ BMI (BMI_a).
Methods
Utilizing data from the Korea National Health and Nutrition Examination Survey, including participants aged 12-18, we conducted a mediation analysis while controlling for confounding factors such as age, sex, physical activity, dietary habits, household income quartile, and parents’ alcohol and smoking habits.
Results
The study included a total of 5731 participants, of whom 3381 and 5455 participants had data on fathers’ and mothers’ BMI, respectively. For adolescent systolic blood pressure (SBP_a), the father’s BMI (BMI_f) had a significant total effect (β, 0.23; 95% confidence interval [CI], 0.12 to 0.34) and average controlled mediated effect (ACME) (β, 0.27; 95% CI, 0.23 to 0.32), but the average direct effect (ADE) was not significant. The mother’s BMI (BMI_m) had a significant total effect (β, 0.17; 95% CI, 0.09 to 0.25), ACME (β, 0.25; 95% CI, 0.22 to 0.28) and ADE (β, -0.08; 95% CI, -0.16 to 0.00). For adolescent diastolic blood pressure, both BMI_f and BMI_m had significant ACMEs (β, 0.10; 95% CI, 0.08 to 0.12 and β, 0.09; 95% CI, 0.07 to 0.12, respectively), BMI_m had a significant ADE (β, -0.09; 95% CI, -0.16 to -0.02) but BMI_f had an insignificant ADE and total effect.
Conclusions
The study found that parental BMI had a significant effect on SBP_a, mediated through BMI_a. Therefore, a high BMI in parents could be a risk factor, mediated through BMI_a, for systolic hypertension in adolescents, necessitating appropriate management.; Summary

Korean summary
본 연구를 통해 부모의 BMI가 청소년기의 BMI를 매개하여 청소년의 수축기 혈압에 영향을 미침을 확인할 수 있었습니다. 그러나 본 연구는 단면적인 데이터를 활용하였으며, 후향적 연구로 이에 대한 한계를 가지고 있으며, 이후 이에 대한 추가 연구가 필요합니다.

Key Message
This study was able to confirm that parents' BMI mediated their BMI during adolescence and affected systolic blood pressure in adolescents. However, this study utilized cross-sectional data, and has limitations on this as a retrospective study, so further studies are needed.

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

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Abstract 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

Citations to this article as recorded by

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

Discrete-time Survival Analysis of Risk Factors for Early Menarche in Korean Schoolgirls: Yong Jin Gil, Jong Hyun Park, Joohon Sung; J Prev Med Public Health. 2023;56(1):59-66. Published online December 29, 2022; DOI: https://doi.org/10.3961/jpmph.22.428

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Abstract Summary PDF: Objectives
The aim of this study was to evaluate the effect of body weight status and sleep duration on the discrete-time hazard of menarche in Korean schoolgirls using multiple-point prospective panel data.
Methods
The study included 914 girls in the 2010 Korean Children and Youth Panel Study who were in the elementary first-grader panel from 2010 until 2016. We used a Gompertz regression model to estimate the effects of weight status based on age-specific and sex-specific body mass index (BMI) percentile and sleep duration on an early schoolchild’s conditional probability of menarche during a given time interval using general health condition and annual household income as covariates.
Results
Gompertz regression of time to menarche data collected from the Korean Children and Youth Panel Study 2010 suggested that being overweight or sleeping less than the recommended duration was related to an increased hazard of menarche compared to being average weight and sleeping 9 hours to 11 hours, by 1.63 times and 1.38 times, respectively, while other covariates were fixed. In contrast, being underweight was associated with a 66% lower discrete-time hazard of menarche.
Conclusions
Weight status based on BMI percentiles and sleep duration in the early school years affect the hazard of menarche.; Summary

Korean summary
초경연령의 조기화는 세계적인 현상이나 유독 우리나라에서는 그 단축속도가 매우 빠르나. 그 위험요인은 비만 이외에 확립되어 있지 못하다. 본 연구는 한국아동청소년패널의 2010-16년도까지 추적관찰된 914 명의 여아 자료를 Gompetz 회귀모형 (다중 분절형 생존분석모형)을 통해 분석하였며, 그 결과 과체중은 1년의 초경연령 단축을 유발할 위험도가 정상체중 여아에 비해 1.63배, 수면시간이 충분하지 못한 여아는 충분한 수면을 취하는 여아에 비해 1년의 초경연령 단축이 발생할 위험도가 1.38배 높은 것으로 나타났다.

Intervention to Improve Menstrual Health Among Adolescent Girls Based on the Theory of Planned Behavior in Iran: A Cluster-randomized Controlled Trial: Fatemeh Darabi, Mehdi Yaseri; J Prev Med Public Health. 2022;55(6):595-603. Published online November 30, 2022; DOI: https://doi.org/10.3961/jpmph.22.365

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Abstract PDF: Objectives
Poor menstrual health may lead to school absenteeism and adverse health outcomes for adolescents. The purpose of this study was to determine the effect of pubertal and menstrual health education on health and preventive behaviors among Iranian secondary school girls.
Methods
A quasi-experimental study was conducted to evaluate the effectiveness of a health intervention program. A total of 578 students (including intervention and control participants) in 12 schools in Tehran Province, Iran were included by multistage random sampling. The program comprised seven 2-hour educational sessions. After confirming the reliability and validity of a researcher-made questionnaire, that questionnaire was used to collect the required data, and the groups were followed up with after 6 months.
Results
After the educational intervention, the mean scores of menstrual health-related knowledge and constructs of the theory of planned behavior were significantly higher in the intervention group than in the control group (p<0.001 for all dimensions).
Conclusions
The results of this study emphasize the effectiveness of menstrual health interventions in schools. These findings should also encourage health policy-makers to take committed action to improve performance in schools.; Summary

The Impact of Household Economic Deterioration Caused by the COVID-19 Pandemic and Socioeconomic Status on Suicidal Behaviors in Adolescents: A Cross-sectional Study Using 2020 Korea Youth Risk Behavior Web-based Survey Data: Sanggu Kang, Yeri Jeong, Eun Hye Park, Seung-sik Hwang; J Prev Med Public Health. 2022;55(5):455-463. Published online September 12, 2022; DOI: https://doi.org/10.3961/jpmph.22.241

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Abstract Summary PDF Supplementary Material

Objectives
Economic hardship has a serious impact on adolescents’ mental health. The financial impact of the coronavirus disease 2019 (COVID-19) pandemic was more severe for low-income families, and this also impacted adolescents. This study aimed to examine the associations of economic deterioration (ED) caused by the COVID-19 pandemic and low socioeconomic status (SES) with adolescents’ suicidal behaviors.
Methods
This study analyzed data from the 2020 Korea Youth Risk Behavior Web-based Survey, which included 54 948 middle and high school students. Odds ratios (ORs) of suicidal ideation, suicidal planning, and suicide attempts related to ED and SES were calculated using multivariable logistic regression. We calculated relative excess risks due to interaction to assess additive interactions.
Results
The ORs for suicidal ideation, suicidal planning, and suicide attempts related to combined severe ED and low SES were 3.64 (95% confidence interval [CI], 3.13 to 4.23), 3.88 (95% CI, 3.09 to 4.88), and 4.27 (95% CI, 3.21 to 5.69), respectively.
Conclusions
ED and low SES were significantly associated with suicidal behaviors in adolescents. Although no significant additive interaction was found, the ORs related to suicidal ideation, suicidal planning, and suicide attempts were highest among adolescents from low-income families with severe ED. Special attention is needed for this group, considering the increased impact of economic inequality due to the COVID-19 pandemic.

Summary

Korean summary
청소년의 정신건강은 가정의 경제상황에 크게 영향을 받는다. 청소년건강행태조사(KYRBS)(2020)에 참여한 54948명의 중고등학생을 대상으로 가정의 기존 경제적 형편과 코로나19로 인한 가정경제 악화가 자살위험에 미치는 영향을 분석하였다. 그 결과 자살사고, 자살계획, 자살시도 모두 코로나19로 인한 경제상황 악화 정도가 심한 저소득층 가정 청소년에서 위험이 제일 높은 것으로 확인되었다. 코로나19(COVID-19)로 인해 심화된 경제적 불평등이 청소년 정신건강 불평등으로 이어지지 않게 하기 위한 개입이 필요하다.

Citations

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Latent class analysis of health behaviors, anxiety, and suicidal behaviors among Korean adolescents
Mi-Sun Lee, Hooyeon Lee
Journal of Affective Disorders.2024; 354: 339. CrossRef
Letter to the Editor: Addressing Children’s Mental Health Issues Related to Economic Changes Caused by the COVID-19 Pandemic
Dalmacito A. Cordero
Journal of Preventive Medicine and Public Health.2023; 56(1): 95. CrossRef
Effects of COVID-19 outbreak on Korean adolescents: Impact of altered economic perception on physical activity, sedentary behavior, and stress levels in an age-, gender-, and BMI-matched study
Jisu Kim, In-Whi Hwang, Jeong-Hui Park, Youngdeok Kim, Jung-Min Lee, Sandra Celina Fernandes Fonseca
PLOS ONE.2023; 18(11): e0294270. CrossRef

Determinants of Depression in Indonesian Youth: Findings From a Community-based Survey: Indri Yunita Suryaputri, Rofingatul Mubasyiroh, Sri Idaiani, Lely Indrawati; J Prev Med Public Health. 2022;55(1):88-97. Published online December 28, 2021; DOI: https://doi.org/10.3961/jpmph.21.113

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Abstract PDF

Objectives
This study investigated the determinants of depression in adolescents and young adults.
Methods
The present study analyzed data from the 2018 Indonesia Basic Health Survey (Riset Kesehatan Dasar; RISKESDAS). The study subjects were adolescents (15-17 years old) and young adults (18-24 years old). In total, 64 179 subjects were included. Univariable, bivariable, and multivariable logistic regression analyses were performed to determine associations between youths’ characteristics, risky behavior, chronic disease, parents’ health, and youths’ depression.
Results
The prevalence of depression was 5.1% in adolescents and 5.6% in young adults. The risk factors for depression in adolescents were being women (adjusted odds ratio [aOR], 3.53; 95% confidence interval [CI], 2.89 to 4.30; p<0.001), an ex-smoker (aOR, 2.99; 95% CI, 2.10 to 4.25; p<0.001), or a current smoker (aOR, 2.60; 95% CI, 1.97 to 3.44; p<0.001); consuming alcohol (aOR, 2.00; 95% CI, 1.33 to 3.01; p=0.001), having a chronic disease (aOR, 2.64; 95% CI, 1.41 to 4.96; p=0.002); maternal depression (aOR, 2.47; 95% CI, 1.97 to 3.09; p<0.001); and paternal depression (aOR, 2.63; 95% CI, 1.98 to 3.50; p<0.001). In young adults, the risk factors were being women (aOR, 2.23; 95% CI, 1.82 to 2.75; p<0.001) or an ex-smoker (aOR, 2.47; 95% CI, 1.67 to 3.67; p<0.001), consuming alcohol (aOR, 2.42; 95% CI, 1.89 to 3.09; p<0.001), maternal depression (aOR, 3.12; 95% CI, 2.54 to 3.84; p<0.001), and paternal depression (aOR, 2.80; 95% CI, 2.17 to 3.63; p<0.001).
Conclusions
Being women, smoking, drinking alcohol, having a chronic disease, and having a parent with depression were crucial factors associated with youth depression. Mental health screening, prevention, and treatment should involve collaboration among primary healthcare, schools, universities, professionals, and families.

Summary

Citations

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Mental health issues and quality of life amongst school-based adolescents in Indonesia
Andry Juliansen, Rivaldo Steven Heriyanto, Michelle Patricia Muljono, Charista Lydia Budiputri, Yulita Delfia Sari Sagala, Gilbert Sterling Octavius
Journal of Medicine, Surgery, and Public Health.2024; 2: 100062. CrossRef
Social participation among individuals with depression is associated with the use of informal healthcare facilities: findings from the Indonesian family life survey-5
Sofa D. Alfian, Clara F. Kusuma, Imam A. Wicaksono, Irma M. Puspitasari, Martin Wawruch, Rizky Abdulah
Current Psychology.2024;[Epub] CrossRef
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Yusni Yusni, Safrizal Rahman
Islamic Guidance and Counseling Journal.2024;[Epub] CrossRef
Barriers and facilitators to access mental health services among people with mental disorders in Indonesia: A qualitative study
Lafi Munira, Pranee Liamputtong, Pramon Viwattanakulvanid
Belitung Nursing Journal.2023; 9(2): 110. CrossRef

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

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Abstract 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

Citations

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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
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Sexual Intercourse and Its Correlates Among School-aged Adolescents in Indonesia: Analysis of the 2015 Global School-based Health Survey: Anissa Rizkianti, Iram Barida Maisya, Nunik Kusumawardani, Christine Linhart, Jerico Franciscus Pardosi; J Prev Med Public Health. 2020;53(5):323-331. Published online August 7, 2020; DOI: https://doi.org/10.3961/jpmph.20.028

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Abstract PDF

Objectives
This study aimed to determine the prevalence and correlates of sexual intercourse among junior secondary and high school students in Indonesia from the 2015 Global School-based Health Survey (GSHS).
Methods
The survey was conducted among 11 110 students from 75 schools in Indonesia using a self-administered questionnaire. Univariate and multivariate analyses were conducted to explore associations between sexual intercourse and socio-demographic variables, substance use, mental distress, and protective factors.
Results
Overall, 5.3% of students reported having ever had sex (6.9% of boys and 3.8% of girls). Of students who engaged in sexual intercourse, 72.7% of boys and 90.3% of girls had an early sexual debut (before reaching the age of 15) and around 60% had multiple sex partners. Sexual intercourse was associated with gender, school grade, smoking, alcohol consumption, drug use, suicidal ideation, truancy, peer support, and parental supervision.
Conclusions
These findings indicate a pressing need to develop more comprehensive sexual health education in the national curriculum. An effective strategy should also address other risky behaviours.

Summary

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Rahmi Lubis, Zahrotur R. Hinduan, Ratna Jatnika, Baydhowi Baydhowi, Hendriati Agustiani
INQUIRY: The Journal of Health Care Organization, Provision, and Financing.2022; 59: 004695802210878. CrossRef
Factors Related to Sexual Intercourse Among Korean Middle and High School Students
Joohee Shim, Jihyun Baek, Seungwoo Han
Frontiers in Public Health.2022;[Epub] CrossRef
Investigation of the Relationship Between Sociodemographic Characteristics and Sexual Health Behaviours of University Students
Şahika ŞİMŞEK ÇETİNKAYA, Esra DEMİRARSLAN
Gümüşhane Üniversitesi Sağlık Bilimleri Dergisi.2022; 11(2): 425. CrossRef
Knowledge, Attitude, and Practice Towards Reproductive Health Issue of Adolescents in Rural area, Indonesia: A Cross-sectional Study
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Comparison of Trends in Blood Pressure and the Prevalence of Obesity Among Korean and American Adolescents: A 12-Years Cross-sectional Study: Somi Heo, Seyoung Kwon, Yu-Mi Lee, Ji-Yeon Shin, Duk-Hee Lee; J Prev Med Public Health. 2020;53(1):45-55. Published online November 20, 2019; DOI: https://doi.org/10.3961/jpmph.19.198

4,589 View
195 Download
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Abstract Summary PDF Supplementary Material

Objectives
This study was conducted to explore recent trends in the prevalence of pediatric elevated blood pressure and hypertension (HTN) in Korea and the United States, applying the new HTN reference values for adolescents.
Methods
This study analyzed 17 339 (8755 Korean and 8584 American) adolescents aged 10 to 17 who participated in the Korea National Health and Nutrition Examination Survey and the National Health and Nutrition Examination Survey, respectively, between 2005 and 2016. HTN was defined using percentile-based reference values for non-overweight adolescents from 7 nations, and obesity was defined by body mass index (BMI) based on country-specific growth charts. All analyses were stratified by sex and year-over-year changes were evaluated by calculating the p for trend.
Results
Systolic blood pressure showed a statistically meaningful upward trend in Korean boys and girls, while diastolic blood pressure did not show any significant changes. Both systolic and diastolic blood pressure levels declined among United States boys and girls. The prevalence of elevated blood pressure and HTN remained similar in Korean adolescents, but declined in both sexes among United States adolescents. BMI increased in both sexes among Korean adolescents, although the overweight and obesity rates stayed the same. No significant trends were found in any obesity indices among United States adolescents. The prevalence of elevated blood pressure and HTN by obesity level was higher among Korean adolescents than among their United States peers in both sexes, and the gap became higher at more severe levels of obesity.
Conclusions
Despite the strong correlation between obesity and HTN, recent trends in the prevalence of HTN and obesity among Korean and United States adolescents were strikingly different. Follow-up studies are necessary to determine why the prevalence of HTN was more than twice as high among Korean adolescents than among their United States counterparts.

Summary

Korean summary
본 연구에서는 새로운 소아청소년 고혈압 기준을 이용하여, 최근 한국과 미국 소아청소년들의 혈압 및 고혈압 유병률의 변화 추이를 비교하였다. 비만과 고혈압간의 높은 관련성에도 불구하고 한국과 미국 소아청소년의 고혈압 유병률과 비만율은 서로 다른 변화 추이를 나타내었으며, 고혈압 발생에 있어서 한국 소아청소년들이 미국 소아청소년들보다 비만에 더 취약할 가능성을 나타내고 있어 이에 관한 후속연구가 필요하다.

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Melike TELLİOĞLU, Muammer YILMAZ, İnci ARIKAN, Yaşar ÇAKMAKÇI
Phoenix Medical Journal.2023; 5(1): 17. CrossRef
Combined associations of general obesity and central obesity with hypertension stages and phenotypes among children and adolescents in Zhejiang, China
Dong Zhao, Jiali Zhou, Danting Su, Yun Li, Weidi Sun, Boren Tan, Shuting Li, Ronghua Zhang, Peige Song
The Journal of Clinical Hypertension.2023; 25(11): 983. CrossRef
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International Journal of Epidemiology.2022; 51(4): 1190. CrossRef
Correlates of Undiagnosed Hypertension Among Chinese and Korean American Immigrants
Brittany N. Morey, Connie Valencia, Sunmin Lee
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Self-esteem as a Moderator of the Effects of Happiness, Depression, and Hostility on Suicidality Among Early Adolescents in Korea: Yeun-Soon Choi, Hee Kyoung Shin, Dae-Yong Hong, Jang-Rak Kim, Yune-Sik Kang, Baekgeun Jeong, Ki Soo Park, Key Hyo Lee; J Prev Med Public Health. 2019;52(1):30-40. Published online January 2, 2019; DOI: https://doi.org/10.3961/jpmph.18.095

7,212 View
195 Download
7 Crossref

Abstract Summary PDF Supplementary Material

Objectives
The purpose of this study was to investigate the role of self-esteem as a moderator of the factors influencing suicidality among middle-schoolers.
Methods
Moderated multiple regression analysis was applied to assess the influence of happiness, depression, and hostility on suicidality and to determine the degree to which self-esteem served as a moderator of those relationships. Data were collected from 268 students at a middle school in Busan, Korea, using a self-administered structured questionnaire.
Results
Happiness, depression, and hostility had significant direct effects on suicidality. Self-esteem showed no direct effect, but had a significant moderating effect on the relationship between hostility and suicidal behavior.
Conclusions
These results suggest that various interventions, such as counseling programs, should be designed to alleviate hostility and depression and to enhance happiness and self-esteem among early adolescents.

Summary

Korean summary
본 연구는 중학생의 자살성향에 영향을 주는 주요 요인을 식별하고, 자아존중감의 조절효과를 확인하여 청소년 자살예방 방안 모색을 위한 실마리를 제공하고자 하였다. 실증자료의 분석 결과 자살성향에 행복, 우울, 적대감이 유의한 직접효과, 그리고 조절변수인 자아존중감이 적대감과 상호작용하여 유의한 조절효과를 보였다(p<0.05). 청소년 자살 예방의 실효성을 높이기 위해서는 행복감의 증진, 우울과 적대감의 완화 등 원인변수에 대한 개입과 동시에 조절변수인 자아존중감을 향상시키기 위한 가정과 학교의 체계적인 노력이 필요함을 시사한다.

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International Journal of Environmental Research and Public Health.2021; 18(20): 10623. CrossRef
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Ayla AÇIKGÖZ, Alper YILMAZ, Beste YILDIRIM, Ceren YILDIZ, Leyla YILDIZ, Umut YILDIRIM
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Brief Report

The Pyramid of Injury: Estimation of the Scale of Adolescent Injuries According to Severity: Hyejin Han, Bomi Park, Bohyun Park, Namsoo Park, Ju Ok Park, Ki Ok Ahn, Yang Ju Tak, Hye Ah Lee, Hyesook Park; J Prev Med Public Health. 2018;51(3):163-168. Published online May 23, 2018; DOI: https://doi.org/10.3961/jpmph.18.027

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161 Download
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Abstract PDF

Objectives
Due to their developmental characteristics, adolescents have a higher probability than other age groups of experiencing injuries caused by accidents, violence, and intentional self-harm. The severity and characteristics of injuries vary by the intentionality and mechanism of injury; therefore, there is a need for a national-level estimate of the scale and the severity of injuries in adolescents that takes these factors into account.
Methods
By using data from the Emergency Department-based Injury In-depth Surveillance Data, National Emergency Department Information System, the Korean National Hospital Discharge In-depth Injury Survey, and cause of death statistics, we calculated the emergency department (ED) visit rate, hospitalization rate, and death rate of injuries per 100 000 adolescents for each injury mechanism. The calculated rates were used to generate the injury pyramid ratio (ratio of death rate to hospitalization rate to ED visit rate) to visualize the scale and the severity of the injury.
Results
The mortality rate in adolescents due to injury was 10/100 000; the corresponding rates for hospitalization and ED visits were 1623 and 4923, respectively, resulting in an injury pyramid ratio with the general pyramid form, with a 1:162:492 ratio of deaths to hospitalizations to ED visits. The mortality rate due to suicide/intentional self-harm was 5/100 000, while 35 were hospitalized for this reason and 74 made ED visits. The pyramid ratio of 1:7:15 for intentional self-harm/suicide showed a steep pyramidal form, indicating considerable lethality. The mortality rate due to motor vehicle collisions (MVCs) was 3/100 000; 586 were hospitalized for this reason, while 1023 made ED visits. The pyramid ratio of 1:195:341 for MVCs showed a gradual pyramid form, indicating that the lethality was low and the scale of injury was high.
Conclusions
The main categories of injuries in adolescents were visualized in pyramid form, contributing to an understanding of the scale of each injury by mechanism in terms of levels of death, hospitalization, and ED visits. These findings will be helpful for understanding how to prioritize injuries in adolescents.

Summary

Citations

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Burden of Childhood Injuries in India and Possible Public Health Interventions: A Systematic Review
Mohan Kumar, Vineet Kumar Pathak, Saparya Tripathi, Anita Upadhyay, Vivek V. Singh, Chandrakant Lahariya
Indian Journal of Community Medicine.2023; 48(5): 648. CrossRef
Joinpoint Regression About Injury Mortality and Hospitalization in Korea
Hyun Jin Park, Ui Jeong Kim, Won kyung Lee, Bohyun Park, Yoonhee Shin, Seonhwa Lee, Eun Jeong Choi, Nam-eun Kim, Ju Ok Park, Hyesook Park
Journal of Korean Medical Science.2022;[Epub] CrossRef
Identifying intentional injuries among children and adolescents based on Machine Learning
Xiling Yin, Dan Ma, Kejing Zhu, Deyun Li, Kyoung-Sae Na
PLOS ONE.2021; 16(1): e0245437. CrossRef
The injury mechanisms and injury pyramids among children and adolescents in Zhuhai City, China
Xiling Yin, Wencan Dai, Yukai Du, Deyun Li
BMC Public Health.2021;[Epub] CrossRef
Comparison of Intentional and Unintentional Injuries Among Chinese Children and Adolescents
Xiling Yin, Deyun Li, Kejing Zhu, Xiaodong Liang, Songxu Peng, Aijun Tan, Yukai Du
Journal of Epidemiology.2020; 30(12): 529. CrossRef
Global Lifetime and 12-Month Prevalence of Suicidal Behavior, Deliberate Self-Harm and Non-Suicidal Self-Injury in Children and Adolescents between 1989 and 2018: A Meta-Analysis
Kim-San Lim, Celine H. Wong, Roger S. McIntyre, Jiayun Wang, Zhisong Zhang, Bach X. Tran, Wanqiu Tan, Cyrus S. Ho, Roger C. Ho
International Journal of Environmental Research and Public Health.2019; 16(22): 4581. CrossRef

Original Article

Enrollment in Private Medical Insurance and Utilization of Medical Services Among Children and Adolescents: Data From the 2009-2012 Korea Health Panel Surveys: Dong Hee Ryu, Sin Kam, Young-Taek Doo; J Prev Med Public Health. 2016;49(2):118-128. Published online March 24, 2016; DOI: https://doi.org/10.3961/jpmph.16.003

8,188 View
107 Download
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Abstract PDF

Objectives
The purposes of this study were to examine the status of children and adolescents with regard to enrollment in private medical insurance (PMI) and to investigate its influence on their utilization of medical services.
Methods
The present study assessed 2973 subjects younger than 19 years of age who participated in five consecutive Korea Health Panel surveys from 2009 to 2012.
Results
At the initial assessment, less than 20% of the study population had not enrolled in any PMI program, but this proportion decreased over time. Additionally, the number of subjects with more than two policies increased, the proportions of holders of indemnity-type only (‘I’-only) and of fixed amount+indemnity-type (‘F+I’) increased, whereas the proportion of holders with fixed amount-type only (‘F’-only) decreased. Compared with subjects without private insurance, PMI policyholders were more likely to use outpatient and emergency services, and the number of policies was proportionately related to inpatient service utilization. Regarding out-patient care, subjects with ‘F’-only PMI used these services more often than did uninsured subjects (odds ratio [OR], 1.69), whereas subjects with ‘I’-only PMI or ‘F+I’ PMI utilized a broad range of inpatient, outpatient, and emergency services relative to uninsured subjects (ORs for ‘I’-only: 1.39, 1.63, and 1.38, respectively; ORs for ‘F+I’: 1.67, 2.09, and 1.37, respectively).
Conclusions
The findings suggest public policy approaches to standardizing PMI contracts, reform in calculation of premiums in PMI, re-examination regarding indemnity insurance products, and mutual control mechanisms to mediate between national health insurance services and private insurers are required.

Summary

Citations

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Pediatric Health Access and Private Medical Insurance: Based on the Ecology of Medical Care in Korea
Dong-Hee Ryu, Yong-jun Choi, Jeehye Lee
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Community-Based Health Insurance Increased Health Care Utilization and Reduced Mortality in Children Under-5, Around Bwindi Community Hospital, Uganda Between 2015 and 2017
Nahabwe Haven, Andrew E. Dobson, Kuule Yusuf, Scott Kellermann, Birungi Mutahunga, Alex G. Stewart, Ewan Wilkinson
Frontiers in Public Health.2018;[Epub] CrossRef

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