Journal of Preventive Medicine and Public Health

Original Articles

A Multi-level Analysis of Factors Affecting Participation in Health Screenings in Korea: A Focus on Household and Regional Factors: So Yoon Park, Young-jeon Shin; J Prev Med Public Health. 2022;55(2):153-163. Published online October 27, 2021; DOI: https://doi.org/10.3961/jpmph.21.268

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Abstract Summary PDF Supplementary Material

Objectives
This study divided the factors that affect participation in health screenings into individual, household, and regional levels and conducted a multi-level analysis to identify the factors related to participation in health screenings.
Methods
Participants from the 2017 Community Health Survey were classified into 2 groups (under 40 and 40 or older). A multi-level logistic regression analysis was conducted to identify the factors that affected participation in health screenings.
Results
The screening rate of the participants was 69.7%, and it was higher among participants aged 40 and older (80.3%) than it was among participants younger than 40 (49.8%). At the individual level, the factors that influenced participation in health screenings included age, economic activity, smoking status, physician-diagnosed hypertension, and a moderate or high physical activity level. At the household level, the odds ratio of participation in health screenings was high for participants who lived in single-person households, lived with a spouse, earned a high monthly household income, and were not beneficiaries of national basic livelihood security. At the regional level, the odds ratio at the 95% confidence interval level of participation in health screenings was high for participants who had trust in the local community and lived in an area with a proportionally high social welfare budget.
Conclusions
This study analyzed nationalwide data and confirmed that individual, household, and regional characteristics affected participation in health screenings. Therefore, policies that prioritize the improvement of regional level factors and especially household level factors are likely to be the most effective for improving the screening rate.

Summary

Korean summary
이 연구는 건강검진 수검 여부에 영향을 미치는 요인을 개인, 가구, 지역수준으로 나누어 다수준 분석을 통해 분석하였다. 건강검진 수검여부에 개인 특성뿐만 아니라 개인을 둘러싼 가구와 지역의 특성도 영향을 미친다는 것을 확인하였다. 영향요인들의 유의성을 바탕으로, 건강검진 수검률 향상을 위한 정책을 수립할 때 지역수준 요인뿐만 아니라 특별히 가구수준 요인을 개선할 수 있는 정책을 우선하는 것이 효과적일 것이다.

Citations

Citations to this article as recorded by

Sex-specific Associations between Body Mass Index and Thyroid Cancer Incidence among Korean Adults
Kyoung-Nam Kim, Kyungsik Kim, Sangjun Lee, Sue K. Park
Cancer Epidemiology, Biomarkers & Prevention.2023; 32(9): 1227. CrossRef
Factors Associated with Willingness toward Organ Donation in China: A Nationwide Cross-Sectional Analysis Using a Social–Ecological Framework
Mengjun Zeng, Haomiao Li, Xiaohui Song, Jipin Jiang, Yingchun Chen
Healthcare.2023; 11(6): 824. CrossRef

Factors Affecting the Participation Rate in the Health Screening Program of Medical Insurance.: Sung Tae Youn, Han Joong Kim, Sun Ha Jee, Il Suh, Heechoul Ohrr; Korean J Prev Med. 2000;33(2):150-156.

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Abstract PDF: OBJECTIVE
To analyze the factors affecting the participation rate in the health screening program of medical insurance. METHOD: We investigated the factors associated with the participation rate in the health screening program in Korea. Data were collected at the aggregate level from 145 employee health insurance societies and 227 self-employed health insurance societies from 1995 to 1997. Data were also collected at the individual level from four health insurance societies. This study hypothesized that the participation rate of the health screening program was related to 1) the characteristics of its members and the size of the health insurance society; 2) the specifications of the health screening program; 3) the venue of the health screening institution and the interests of individuals in the health screening program; and 4) the activities of the health insurance society. We used bivariate and multiple regression models to examine the factors on the participation rate of the health screening program. RESULTS: First, in the case of dependents of on employee health insurance society, the ratio of dependents 40 years old and over, the average monthly contribution per household, the interest and satisfaction level of individuals in health screening, and the level of refunds for over-payment were all associated with the participation rate in the health screening program, accounting for 54.4% of the participation rate. Second, in case of those insured by the self-employed health insurance society, the interest and satisfaction level of individuals in health screening, the level of refunds for over-payment, and the performance level of on-the-spot health screening were statistically significant, accounting for 40.1% of the participation rate. CONCLUSION: The factors concerning the participation rate in the health screening program of medical insurance, in both a health insurance society and for individuals, were closely related to the age and gender of individuals and household contributions.; Summary

Factors Influencing Workers' Perception and Attitude Toward Special Periodic Health Screening Test.: Si Hyun Nam, Sin Kam, Jae Yong Park; Korean J Prev Med. 1995;28(2):334-346.

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Abstract PDF: To investigate the factors influencing workers' perception and attitude toward special periodic health screening test for workers, a survey with self-administered questionnaires was performed on 279 workers who had special periodic health screening test from september 1 to October 15, 1994. A study model was developed by modifying the health belief model. The end and intermediate response variables of the model were the voluntary participation and necessity perception on the special screening for workers, and The result of analysis was consistent with the study model. Rates for the necessity perception and voluntary participation on the special1 screening for workers were 77.2%, 79.2%, respectively. Factors influencing on the voluntary participation were necessity perception, benefit of special screening for workers, and cue to action. And on the necessity perception were susceptibility and severity to occupational disease, knowledge to special screening for workers, and support of company. General and occupational characteristics influencing on the susceptibility and severity to occupational disease were sex, age, educational level, work duration, and health education. On the knowledge to special screening for workers were age, educational level, work duration, and locus-of-control. On the benefit of special screening for workers were age, locus-of-control, pride on health, and health education. Therefore, to increase the voluntary participation and necessity perception on the special periodic health screening for workers, l) if a worker is judged as occupational disease, the judgment should be widely known in his workplace, 2) the screening result forms should be directly sent to the workers themselves, 3) for the positivity of employers, the campaign and education program subjected to them should be planned, 4) health education should give the first consideration to the younger, lower educational level, and newly employed women, and its frequency should be increased and it should be more frequently dealt with occupation-related subjects, and 5) the employers should have a careful concern in not being disadvantageous to workers due to result of screening.; Summary

English Abstract

Developing the Predictive Model for the Group at High Risk for Colon Cancer.: Ae Kyoung Lee, Sang Yi Lee, Il Soo Park, Su Young Kim, Tae Ho Yoon, Baek Geun Jeong; J Prev Med Public Health. 2006;39(5):438-446.

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Abstract PDF: OBJECTIVES
We developed the predictive model for the incidence of colon cancer by utilizing the health screening data of the National Health Insurance in Korea. We also explored the characteristics of the high risk group for colon cancer. METHODS: The predictive model was used to determine those people who have a high risk for colon cancer within 2 years of their NHI health screening, and we excluded the people who had already been treated for cancer or who were cancer patient. The study population is the insured of the NHI, aged 40 or over and they had undergone health screening from the year 2000 to 2004, according to NHI health screening formula. We performed logistic regression analysis and used SAS Enterprise Miner 4.1. RESULTS: This study shows that there exists a higher rate of colon cancer in males than females. Also, for the population in their 60s, the incidence rate of colon cancer is much higher by 5.36 times than that for those people in their 40s. Amongst the behavioral factors, heavy drinking is the most important determinant of the colon cancer incidence (7.39 times in males and 21.51 times in females). CONCLUSIONS: Our study confirms that the major influencing factors for the incidence of colon cancer are drinking, lack of exercise, a medical history of colon polypus and a family history of colon cancer. As a result, we can choose the group that is at a high risk for colon cancer and provide customized medical information and selective management services according to their characteristics.; Summary

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