Journal of Preventive Medicine and Public Health

Volume 58(3); May 2025

Cohort Profile

Etiome Study Using Molecular Epigenetic Markers and Lung Organoid in Korean School Meal Service Workers (Etiome Study in S-meal Workers): Study Protocol: Sungji Moon, Soseul Sung, Sue K. Park; J Prev Med Public Health. 2025;58(3):231-240. Published online April 10, 2025; DOI: https://doi.org/10.3961/jpmph.25.020

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Abstract Summary PDF Supplementary Material: School meal service workers may face an increased risk of lung cancer due to the nature of their work. This study aims to assess environmental exposure levels during occupational cooking among these workers in Seoul, Korea, and to examine the associations with carcinogen-associated biomarkers. Additionally, the study seeks to verify lung carcinogenesis through experiments using lung organoids treated with carcinogens, such as polycyclic aromatic hydrocarbons (PAHs) and particulate matter. Here, we introduce the study protocol and outline our research strategies. This etiome study employs molecular epidemiological approaches involving at least 200 school meal service workers from 25-30 school cafeterias in Seoul, as well as in vitro lung organoid experiments. The study includes a questionnaire survey to analyze workers’ occupational environments, focusing on exposure to hazardous substances such as cooking oil fumes and assessing the use of personal protective equipment (e.g., masks) and the presence of ventilation systems. We measure molecular epigenomic biomarkers, including PAH adducts and metabolites along with methylation markers, in the exposure and control groups. Additionally, lung organoid experiments are performed to investigate the potential for lung cancer development due to respiratory carcinogen exposure in cooks. This study is expected to contribute to health risk assessments and the establishment of preventive strategies for meal service workers.; Summary

Korean summary
조리업 종사자의 폐암 발생 위험도가 높다고 보고되지만 실제 발암 물질에 어느정도 노출되어 있는지 전 세계적으로 아직까지 밝혀진 바 없습니다. 본 연구는 서울시내 학교 조리업 종사자 모집과 발암물질 노출 마커 측정 대한 방법론적인 논문이며 향후 추적 관찰할 수 있는 코호트 연구에 대한 초석 역할을 합니다.

Key Message
Although previous studies have reported an increased risk of lung cancer among cooking workers, the extent of their exposure to carcinogens has not yet been well characterized globally. This study presents the methodology for recruiting school cooking workers in Seoul and measuring biomarkers of carcinogen exposure. It serves as a foundational step toward establishing a prospective cohort for long-term follow-up.

Original Articles

Multi-group Causal Model of Mental Health Literacy and Helping Behavior Toward People at Risk of Depression Among Thai and Vietnamese Health Science Students: Anchalee Jansem, Ungsinun Intarakamhang, Charin Suwanwong, Krittipat Chuenphitthayavut, Sudarat Tuntivivat, Khuong Le, Le Thi Mai Lien, Pitchada Prasittichok; J Prev Med Public Health. 2025;58(3):241-249. Published online January 13, 2025; DOI: https://doi.org/10.3961/jpmph.24.449

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Abstract Summary PDF: Objectives
Depression affects 23.3% of Thai and 15.2% of Vietnamese health science students, rates that exceed the global average of 4.4%. This study compared the causal models of mental health literacy and helping behavior toward individuals at risk of depression between these 2 groups.
Methods
This cross-sectional study was conducted from April 2023 to October 2023 and included 422 students from Thailand and Vietnam, who were studying medicine, nursing, psychology, and physical therapy. Stratified random sampling was used to select 211 students from each country. Data collection was performed using a Likert scale, which showed total-item correlations ranging from 0.24 to 0.83 and Cronbach’s alpha values between 0.74 and 0.86. The data were analyzed using a structural equation model.
Results
The causal models were consistent with the empirical data. The helping behavior of students toward peers at risk of depression was significantly influenced by their mental health literacy (effect size [ES], 0.91). This influence was also mediated indirectly by self-efficacy (ES, 0.18), positive attitudes (ES, 0.29), and social support (ES, 0.77). Collectively, these factors accounted for 83% of the variance in helping behavior. Social support had a more pronounced effect on mental health literacy among Vietnamese students than among their Thai counterparts (ES, 0.46 vs. 0.27, p<0.05). Conversely, positive attitudes had a stronger influence among Thai students than among Vietnamese students (ES, 0.17 vs. 0.01, p<0.05).
Conclusions
The causal models of helping behavior among Thai and Vietnamese health science students exhibited no significant differences. However, improving mental health literacy is crucial, as it significantly impacts helping behavior.; Summary

Key Message
This study compared causal models of mental health literacy (MHL) and helping behavior toward people at risk of depression between Thai and Vietnamese health science students. Findings indicated that MHL significantly impacted helping behavior (effect size [ES], 0.91), mediated indirectly by self-efficacy (ES, 0.18), positive attitudes (ES, 0.29), and social support (ES, 0.77), with no significant differences in the overall causal models between groups. However, variations in effects were noted, such as social support having a more pronounced effect on MHL among Vietnamese students than their Thai counterparts (ES, 0.46 vs. 0.27), while positive attitudes had a stronger influence among Thai students (ES, 0.17) than Vietnamese (ES, 0.01).

Asthma Exacerbation in Indonesia: Analysis of Mental, Socio-demographic, Behavioral, and Biological Risk Factors Using the 2018 Indonesian Basic Health Research: Siti Isfandari, Sulistyowati Tuminah, Laurentia Konadi Miharja; J Prev Med Public Health. 2025;58(3):250-259. Published online May 16, 2025; DOI: https://doi.org/10.3961/jpmph.24.719

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Abstract Summary PDF: Objectives
Asthma represents a significant global health burden, with exacerbations impacting quality of life. Although risk factors for asthma exacerbation (AE) have been identified, data specific to Indonesia remain scarce. We investigated risk factors for AE among Indonesian adolescents and adults.
Methods
A cross-sectional analysis of the 2018 National Health Survey was conducted, including Indonesian participants aged 15 and older with diagnosed asthma. Logistic regression was employed to identify risk factors for AE.
Results
A total respondents aged 15 years or older were 706 689 participants. The prevalence of asthma was 2.6% (18 574 participants). Among individuals with asthma, 59.7% experienced exacerbation, and 21.4% reported symptoms indicating emotional distress (ED). Both ED and diagnosed heart disease (DHD) were linked to increased odds of AE, with adjusted odds ratios (aORs) of 1.27 (95% confidence interval [CI], 1.18 to 1.37) and 1.21 (95% CI, 1.06 to 1.38), respectively. Being diagnosed with asthma at age 15 or older was associated with an aOR of 1.56 (95% CI, 1.45 to 1.66). Those with lower socioeconomic status (SES) also faced comparatively high risk (aOR, 1.37; 95% CI, 1.23 to 1.52). In contrast, physical activity was inversely related to AE (aOR, 0.72; 95% CI, 0.64 to 0.81).
Conclusions
ED, DHD, lower SES, and later-onset asthma were identified as significant risk factors for AE. This underscores the need for comprehensive asthma management strategies that prioritize mental health, cardiovascular health, and early intervention. Addressing these factors could substantially reduce the burden of AE in Indonesia. Further longitudinal studies are necessary to elucidate the causal relationships involved and evaluate the effectiveness of targeted interventions.; Summary

Key Message
Asthma represents a significant global health burden, with exacerbation impacting individual quality of life. Emotional distress, diagnosed heart disease, asthma diagnosis after the age of 15 years, and lower socioeconomic status were associated with an increased risk of asthma exacerbation, while physical activity was not. Our findings underscore the importance of addressing mental health comorbidities, encouraging physical activity, and considering socioeconomic disparities when developing asthma management strategies. Educating patients about asthma and its triggers can reduce exacerbations and improve disease control. Since asthma severity differs across individuals and age groups, clinicians must regularly monitor patients and adjust treatment as needed.

Association Between Non-adherence to Diabetes Management and Poor Sleep Quality Based on the Korean Community Health Survey: Horim A. Hwang, Hyunsuk Jeong, Hyeon Woo Yim; J Prev Med Public Health. 2025;58(3):260-268. Published online January 14, 2025; DOI: https://doi.org/10.3961/jpmph.24.486

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Abstract Summary PDF Supplementary Material

Objectives
Adhering to management guidelines, including routine follow-up and education, is crucial for the effective management of chronic diseases such as diabetes. Uncontrolled diabetes is linked to poor sleep quality. We used nationally representative data from community-dwelling Koreans to investigate potential associations between non-adherence to diabetes management and poor sleep quality.
Methods
Of the 228 340 participants in the 2018 Korea Community Health Survey, we analyzed data from 68 246 participants aged 65 years and older. Based on their diabetes status and adherence to diabetes-related tests (glycated hemoglobin, fundus examination, and urine microalbuminuria) and management education, study participants were divided into 3 groups: no diabetes, adherence, and non-adherence. Outcome variables included poor overall sleep quality and sleep disturbances, as measured by the Pittsburgh Sleep Quality Index.
Results
The study included 934 participants in the adherence group (2.0%) and 13 420 in the non-adherence group (20.2%). Participants displaying non-adherence were significantly more likely to report poor overall sleep quality (adjusted odds ratio [aOR], 1.09; 95% confidence interval [CI], 1.04 to 1.13) and to experience sleep fragmentation, nocturia, pain during sleep, and difficulty falling asleep compared to participants without diabetes. Even in the earlier stage of diabetes, non-adherent participants were more likely to report poor sleep quality (aOR, 1.06; 95% CI, 1.00 to 1.18).
Conclusions
Patients with diabetes who do not follow management guidelines are more likely to experience poor sleep quality than those without diabetes. Emphasizing diabetes management and increasing awareness of management strategies may improve sleep quality among patients with this disease.

Summary

Korean summary
혈당조절이 되지 않는 당뇨병이 수면 관련 문제의 발생 위험을 높이는 것은 기존 연구에서 알려져 있었으나, 당뇨관리 여부가 지역사회에 거주하는 당뇨환자들의 수면의 질에 미치는 영향은 충분히 탐구 되지 않았었다. 당뇨 관리 (연 2회 이상 당화혈색소 검사, 매년 당뇨합병증 검사, 당뇨관리교육 이수)에 순응하지 않는 당뇨환자들은 당뇨가 없는 일반인들에 비해 수면 문제를 호소할 가능성이 유의하게 높은 것이 확인되었다. 이는 당뇨 유병기간으로 층화분석하였을때도 일관되게 확인되었다.

Key Message
Uncontrolled diabetes is associated with increased risk of sleep-related problems, but the knowledge on the impact of poor diabetes management on the sleep quality of community dwelling patients with diabetes is limited. Diabetes patients who did not adhere to diabetes management (<2 hemoglobin A1c tests, did not take diabetes complication test, or received diabetes management education) were more significantly more likely to report overall poor sleep quality than those without diabetes. The above association remained significant when the patients were stratified by diabetes duration.

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Assessment of Sleep Quality and Its Determinants Among Patients with Type 2 Diabetes Mellitus in Mogadishu, Somalia: A Cross-Sectional Study
Nur Mohamed, Rahma Haji Mohamud, Fadumo Hilowle, Tigad Ali, Yusuf Abdirisak Mohamed, Adan Gabow, Hawa Mohamed, Nor Sidow, Mohamed Sheikh Hassan, Mohamud Waberi
Diabetes, Metabolic Syndrome and Obesity.2025; Volume 18: 1949. CrossRef

Associations Between Multiple Falls and Mental Health Indices in Korean Older Adults: A Cross-sectional Study: Chaelyn Lim, Hyun-Jin Son, Byung-Gwon Kim, Byeng-Chul Yu, Jiwon Kim, Young-Seoub Hong; J Prev Med Public Health. 2025;58(3):269-277. Published online January 14, 2025; DOI: https://doi.org/10.3961/jpmph.24.482

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Abstract Summary PDF Supplementary Material: Objectives
This study was performed to investigate the prevalence of falls, mental health issues, and health behaviors among older adults, as well as to analyze the association between multiple falls and mental health status in this population.
Methods
We utilized data from the 2017, 2019, and 2021 Korean Community Health Survey, a nationwide survey organized by region and conducted by the Korea Disease Control and Prevention Agency. Participants were categorized into no-fall, single-fall, and multiple fall groups based on responses to an index question regarding fall experiences and the number of such incidents reported in the survey. The chi-square test was applied to understand the characteristics of the elderly population in the community. Subsequently, multinomial logistic regression analysis was conducted to clarify the association between falls and mental health.
Results
Integrated data analysis revealed that 11.3% of participants experienced a single fall, while 5.7% reported multiple falls. Participants from low-education and low-income backgrounds exhibited relatively high rates of falls. Additionally, non-drinkers and non-smokers reported falls more frequently than their counterparts who consumed alcohol and smoked. Multinomial logistic regression revealed significant associations between multiple falls and mental health factors. In particular, the severity of depression was directly proportional to the likelihood of experiencing multiple falls, with an odds ratio of 2.95 (95% confidence interval, 2.49 to 3.50).
Conclusions
We identified associations between various mental health-related factors—including sleep duration, subjective stress, the presence of depression, and Patient Health Questionnaire-9 score—and the occurrence of multiple falls.; Summary

Korean summary
본 연구는 한국의 65세 이상 노인을 대상으로 낙상 경험과 정신건강 지표 간의 연관성을 분석한 단면 연구이다. 다회 낙상은 수면 시간, 주관적 스트레스, 우울감, PHQ-9 점수 등 다양한 정신건강 요인과 유의한 관련이 있었으며, 특히 우울증이 심할수록 낙상 발생 위험이 높아지는 경향을 보였다.

Key Message
Multiple falls among Korean older adults were significantly associated with mental health-related factors, including sleep duration, subjective stress, and Patient Health Questionnaire-9 (PHQ-9) scores. These results emphasize the need for comprehensive interventions targeting both physical and mental health to prevent recurrent falls in the elderly.

Association of Sedentary Lifestyle With Skeletal Muscle Strength and Mass in US Adolescents: Results From the National Health and Nutrition Examination Survey (2011-2014): Kun-Hee Oh, Jin-Young Min, Kang Seo, Kyoung-Bok Min; J Prev Med Public Health. 2025;58(3):278-288. Published online January 30, 2025; DOI: https://doi.org/10.3961/jpmph.24.614

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Abstract Summary PDF Supplementary Material

Objectives
Excessive sedentary behavior in youth is a major global issue, contributing to the rise in childhood obesity and metabolic diseases. International public health authorities have issued guidelines recommending that children and adolescents limit their daily sedentary time, including screen time. However, to date, no studies have explored the relationship between sedentary behavior as an exposure factor and skeletal muscle strength and mass as outcomes in this population. The present study investigated the association of sedentary behavior with handgrip strength (HGS) and appendicular lean mass (ALM) among United States adolescents.
Methods
A total of 1449 adolescent participants from the National Health and Nutrition Examination Survey (2011-2014) were included. Information on sedentary behavior, specifically daily sedentary time, was obtained through a self-reported questionnaire. Muscular parameters, including HGS and ALM, were measured. To adjust for differences in body size, these parameters were divided by body mass index (BMI) and weight. Linear regression analyses were performed to evaluate the associations between daily sedentary time and each muscular parameter, adjusting for age, sex, ethnicity, annual family income, and moderate-to-vigorous physical activity (MVPA).
Results
The linear regression analyses revealed negative associations between daily sedentary time and all muscular parameters, apart from absolute ALM. These included HGS (β, -0.265; standard error [SE], 0.074; p=0.001), HGS/BMI (β, -0.021; SE, 0.004; p<0.001), HGS/weight (β, -0.008; SE, 0.002; p<0.001), ALM/BMI (β, -0.008; SE, 0.003; p=0.010), and ALM/weight (β, -0.003; SE, 0.001; p=0.005).
Conclusions
After adjusting for MVPA, daily sedentary time was inversely associated with HGS, HGS/BMI, HGS/weight, ALM/BMI, and ALM/weight in United States adolescents.

Summary

Korean summary
소아청소년기의 과도한 좌식 습관은 소아 비만 등의 건강문제를 초래하여 전세계적인 공중보건학적 이슈가 되었고, 이에 따라 다수의 공중보건 관련 가이드라인에서 소아청소년의 일일 좌식 시간을 제한할 것을 권고하고 있다. 미국 국민건강영양조사(NHANES) 자료를 이용하여 15-19세 청소년을 대상으로 일일 좌식 시간과 각 근육 관련 변수(악력, 상대적 악력, 사지골격근량, 상대적 사지골격근량)의 상관관계를 선형 회귀분석을 통해 분석하였으며, 나이, 성별, 인종, 연간 가구 소득, 중-고강도 신체활동을 공변량으로 보정하였다. 미국 청소년에서 중-고강도 신체활동을 보정한 뒤에도, 일일 좌식 시간과 악력, 악력/BMI, 악력/체중, 사지골격근량/BMI, 사지골격근량/체중은 각각 음의 상관관계를 나타내었다.

Key Message
Since excessive sedentary behavior in youth is a global issue, contributing to the childhood obesity, international public health authorities issued guidelines recommending that adolescents limit their daily sedentary time. For eligible study population of U.S. adolescents aged 15-19 year-old of NHANES, linear regression analyses were performed to evaluate the associations between daily sedentary time and each muscular parameter (HGS, relative HGS, ALM, and relative ALM), adjusting for age, sex, ethnicity, annual family income, and moderate-to-vigorous physical activity (MVPA). After adjusting for MVPA, daily sedentary time was inversely associated with HGS, HGS/BMI, HGS/weight, ALM/BMI, and ALM/weight in U.S. adolescents.

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Teenagers with Obesity at the Gym: Recommendations for Physical Activity, Diet, and Supplementation—A Narrative Review
Agnieszka Kozioł-Kozakowska, Małgorzata Wójcik, Paulina Mazur-Kurach, Dorota Drożdż, Anna Brzęk
Nutrients.2025; 17(11): 1798. CrossRef

Association Between Digital Addiction and Physical Activity in Korean Adults Across Age Groups: An Analysis of Community Health Survey Data: Kyungsin Lee, Inmyung Song; J Prev Med Public Health. 2025;58(3):289-297. Published online January 24, 2025; DOI: https://doi.org/10.3961/jpmph.24.683

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Abstract Summary PDF: Objectives
Extensive research has been conducted on digital addiction, particularly concerning internet, gaming, and smartphone use among adolescents and young adults. However, there is limited information about digital addiction in adults, especially in relation to physical activity (PA). This study investigated the prevalence of digital addiction among Korean adults and explored its association with PA across various age groups.
Methods
Using data from the 2023 Community Health Survey (n=231 752), this study estimated the prevalence of digital addiction, defined as experiencing impaired daily functioning due to excessive internet, gaming, or smartphone use. PA was defined as exercise and regular walking. Multiple logistic regression was conducted to examine the association between PA and digital addiction in the full sample and by age group (<40, 40-59, and ≥60 years).
Results
In 2023, the prevalence of digital addiction among adults was estimated to be 12.0%. Significantly higher odds of digital addiction were observed in younger age groups. Individuals who reported perceived stress or depression were at an increased risk for digital addiction. Conversely, PA was linked to a reduced risk of digital addiction, with odds ratios of 0.96 (p<0.05) for exercise and 0.93 (p<0.001) for regular walking. Notably, regular walking was associated with a reduced risk of digital addiction only in the 40-59 age group.
Conclusions
PA, particularly regular walking, is linked to a lower risk of digital addiction in Korean adults. Encouraging regular walking may help reduce digital addiction among middle-aged adults.; Summary

Korean summary
2023년 지역사회건강조사 자료를 분석한 결과, 한국 19세 이상 성인에서 디지털중독 유병률은 12.0%였으며, 규칙적인 신체활동은 낮은 디지털중독의 위험과 유의한 연관성이 있음을 확인하였다(운동 OR=0.96, p<0.05; 걷기 OR=0.93, p<0.001). 특히 중년층(40~59세)에서 규칙적인 걷기는 디지털중독의 위험 감소와 유의한 관련성을 보였다. 이 결과는 중년층을 대상으로 한 신체활동 증진이 디지털중독의 위험을 낮추는데 기여할 수 있음을 시사한다.

Key Message
Previous studies on digital addiction have focused on adolescents and young adults. We found that regular walking was associated with a lower risk of digital addiction, especially among adults aged 40 to 59 years. Physical activity may lower the risk of digital addiction in this age group.

Association Between Basic Immunization Status and Stunting in Toddlers Aged 12-59 Months in Indonesia: Eka Desi Purwanti, Siti Masitoh, Sudarto Ronoatmodjo; J Prev Med Public Health. 2025;58(3):298-306. Published online January 30, 2025; DOI: https://doi.org/10.3961/jpmph.24.230

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Abstract Summary PDF: Objectives
Immunization has been identified as a specific nutrition-related intervention to address the direct causes of stunting. This study examines the association between basic immunization status and stunting among toddlers in Indonesia.
Methods
We conducted a cross-sectional analysis using data from the 2021 Study of Indonesia’s Nutritional Status. A total of 70 267 toddlers, aged 12 months to 59 months, were examined. Cox regression was employed to calculate adjusted prevalence ratios (aPRs) with their 95% confidence intervals (CIs).
Results
The prevalence of stunting among children aged 12 months to 59 months in Indonesia was 23.1%, while 74.9% of children under 5 years old had complete basic immunization status. Multivariable analysis revealed a statistically significant association between basic immunization status and the incidence of stunting. Relative to toddlers with complete basic immunization, those with incomplete (partial) immunization were at a 1.18 times higher risk of stunting (aPR, 1.18; 95% CI, 1.15 to 1.22). Furthermore, toddlers who had not been immunized at all faced an even greater stunting risk (aPR, 1.27; 95% CI, 1.17 to 1.37). This association persisted after adjusting for variables such as maternal education, economic status, and the child’s birth weight.
Conclusions
Basic immunization status influences the incidence of stunting in toddlers aged 12 months to 59 months. Thus, parents must ensure that their children’s immunizations are completed according to the recommended schedule. Additionally, it is crucial to increase parental awareness regarding health service utilization, disease prevention, and the nutritional needs of toddlers.; Summary

Key Message
Stunting remains a major public health concern in Indonesia. Immunization is recognized as a specific nutrition-related intervention to address its direct causes. Using data from 70,267 toddlers aged 12–59 months, this study found that children with partial or no basic immunization had significantly higher risks of stunting (aPR 1.18 and 1.27, respectively) compared to fully immunized peers. Given the high stunting prevalence (23.1%) and suboptimal immunization coverage (74.9%), the findings underscore the need to strengthen immunization programs and enhance parental awareness of health service utilization, disease prevention, and the nutritional needs of young children.

Factors Associated With Premarital Screening Intention Among Young Adults With Higher Education in Indonesia: A Cross Sectional Study: Yuli Amran, Tsaniya Nurul Fasya, Hilda Salamah; J Prev Med Public Health. 2025;58(3):307-316. Published online April 21, 2025; DOI: https://doi.org/10.3961/jpmph.24.589

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Abstract Summary PDF Supplementary Material: Objectives
Premarital screening can reduce the risk of genetic disorders and sexually transmitted diseases by providing early detection before conception. College students represent a group of young adults with higher education who are approaching marriageable age. However, many students still lack a strong intention to undergo premarital screening in the future. Therefore, this study examines the factors influencing screening intentions among students at one of Indonesia’s leading universities, the State Islamic University (UIN) Jakarta.
Methods
This study used a cross-sectional design, with a total sample of 563 college students obtained through a multistage random sampling technique. Descriptive statistics were used to summarize the data, and ordinal logistic regression was applied for hypothesis testing.
Results
Among the 563 students, 97.0% indicated an intention to undergo premarital screening. The intention variable was classified into three levels: no/low (13.0%), moderate (43.5%), and high (43.5%). Ordinal logistic regression revealed that lower knowledge about premarital screening was significantly associated with a reduced intention to undergo screening (odds ratio [OR], 2.84; 95% confidence interval [CI], 1.58 to 5.10). In addition, negative attitudes toward premarital screening (OR, 2.85; 95% CI, 1.41 to 5.75), negative perceived behavioral control (OR, 1.63; 95% CI, 1.12 to 2.37), and being enrolled in a non-health-related field of study (OR, 1.96; 95% CI, 1.04 to 3.68) were significantly linked to lower screening intentions.
Conclusions
Comprehensive premarital health education is essential for young adults, even those with a high level of formal education. Such education not only improves knowledge but also promotes more positive perceptions and attitudes toward premarital screening.; Summary

Key Message
This study explored the key factors influencing college students’ intentions to undergo premarital screening. Although 97% expressed willingness, only 43.5% reported a high level of intention, which was significantly associated with limited knowledge, negative attitudes, reduced perceived behavioral control, and enrollment in non-health-related fields. These findings highlight the need for comprehensive premarital health education that enhances knowledge and fosters more favorable attitudes and perceptions, even among highly educated populations.

Vulnerability Assessment and Enhanced Community-based Care and Management of Patients With Tuberculosis in Korea: A Crossover Design: Jeongmi Seo, Dawoon Jeong, In-Hyuk Lee, Jiyeon Han, Yunhyung Kwon, Eunhye Shim, Hongjo Choi; J Prev Med Public Health. 2025;58(3):317-325. Published online February 25, 2025; DOI: https://doi.org/10.3961/jpmph.24.597

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Abstract Summary PDF Supplementary Material: Objectives
People-centered care and social protection are critical for improving tuberculosis (TB) treatment outcomes. This study aimed to evaluate whether a vulnerability assessment tool, developed for an enhanced community-based care and management (ECCM) program in 2 Korean cities, could predict and improve final TB treatment outcomes based on patients’ vulnerability levels.
Methods
Treatment outcomes in the ECCM group were compared with those in a control group, stratified by vulnerability level. During stage 1, one city served as the intervention region and the other as the control, with a crossover in stage 2. The vulnerability assessment included all notified patients with TB, and those identified as highly vulnerable in the intervention group received social support following a consultation with a case manager.
Results
The vulnerability assessment tool demonstrated moderate predictive ability for unfavorable outcomes, with an area under the curve of 0.70 (95% confidence interval, 0.63 to 0.77). The patients with high vulnerability who received ECCM treatment demonstrated a 19.8-percentage point (%p) higher treatment success rate than the high vulnerability subcategory of the control group. ECCM also appeared to reduce loss to follow-up and TB-related mortality by 8.4%p and 7.3%p, respectively, although these findings should be interpreted with caution.
Conclusions
The results suggest that providing social support tailored to patient vulnerability at the time of diagnosis could improve TB treatment outcomes.; Summary

Korean summary
결핵 진단 시점의 임상적, 사회적, 그리고 결핵 관련 취약성 평가는 부정적인 치료 결과를 예측하는 데 유의미한 지표가 될 수 있다. 높은 취약성을 지닌 집단에 대해 지역사회 기반의 맞춤형 사례관리를 시행한 결과, 부정적 치료 결과를 일정 수준 감소시킬 수 있었다. 결핵의 사회적 결정요인과 노년 결핵환자 증가라는 역학적 상황은 지역사회 기반의 사회적 지원을 통해 개선 가능할 것이다.

Key Message
Clinical, social, and tuberculosis-related vulnerabilities assessed at the time of TB diagnosis can serve as meaningful predictors of unfavorable treatment outcomes. Community-based, ehnahced case management for highly vulnerable groups has been shown to reduce such negative outcomes to some extent. The social determinants of tuberculosis and the increasing prevalence of TB among the elderly may be addressed through community-based social support.

The Role of Time Preferences in Compliance With COVID-19 Preventive Behaviors in Iran: A Quasi-hyperbolic Discounting Approach: Moslem Soofi, Ali Kazemi Karyani, Shahin Soltani, Zahra Alipoor, Behzad Karamimatin; J Prev Med Public Health. 2025;58(3):326-335. Published online February 13, 2025; DOI: https://doi.org/10.3961/jpmph.24.453

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Abstract Summary PDF: Objectives
This study aimed to investigate the role of time preferences in compliance with coronavirus disease 2019 (COVID-19) preventive behaviors in an adult population of Iran.
Methods
A web-based questionnaire was utilized to conduct a cross-sectional survey of 672 Iranian adults. The parameters of time preferences were estimated using a quasi-hyperbolic discounting model, and the relationship between COVID-19 preventive behaviors and time preferences was examined using a probit regression model.
Results
A significant association was observed between the preventive behaviors of COVID-19 and the levels of patience and present-biased preferences among the study participants. Individuals who exhibited low levels of patience were found to be 12.8 percentage points less inclined to follow preventive behaviors compared to those with high levels of patience. The likelihood of having good preventive behaviors of COVID-19 was found to decrease by 14.3 percentage points among individuals with a present bias as opposed to those with a bias toward future.
Conclusions
Patience and present-biased preferences are important determinants of adopting preventive behaviors against COVID-19. These behavioral characteristics should be considered in the design of control and prevention programs. Considering people’s discounting behavior and time (in)consistency in their preferences in the design of COVID-19 policy interventions can provide valuable insights for developing tailored public health policy interventions.; Summary

Key Message
This study explored how time preferences—patience and present bias—affect compliance with COVID-19 preventive behaviors among Iranian adults. Using a web-based survey and quasi-hyperbolic discounting model, it found that those with low patience or present-biased preferences were less likely to follow preventive measures than those with high patience or future-oriented preferences. The findings highlight the need to consider time preferences in designing effective public health interventions to improve adherence to preventive measures.

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