Journal of Preventive Medicine and Public Health

Original Articles

Health Behaviors Before and After the Implementation of a Health Community Organization: Gangwon’s Health-Plus Community Program: Joon-Hyeong Kim, Nam-Jun Kim, Soo-Hyeong Kim, Woong-Sub Park; J Prev Med Public Health. 2023;56(6):487-494. Published online August 17, 2023; DOI: https://doi.org/10.3961/jpmph.23.121

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Objectives
Community organization is a resident-led movement aimed at creating fundamental social changes in the community by resolving its problems through the organized power of its residents. This study evaluated the effectiveness of health community organization (HCO), Gangwon’s Health-Plus community program, implemented from 2013 to 2019 on residents’ health behaviors.
Methods
This study had a before-and-after design using 2011-2019 Korea Community Health Survey data. To compare the 3-year periods before and after HCO implementation, the study targeted areas where the HCO had been implemented for 4 years or longer. Therefore, a total of 4512 individuals from 11 areas with HCO start years from 2013 to 2016 were included. Complex sample multi-logistic regression analysis adjusting for demographic characteristics (sex, age, residential area, income level, education level, and HCO start year) was conducted.
Results
HCO implementation was associated with decreased current smoking (adjusted odds ratio [aOR], 0.73; 95% confidence interval [CI], 0.57 to 0.95) and subjective stress recognition (aOR, 0.79; 95% CI, 0.64 to 0.97). Additionally, the HCO was associated with increased walking exercise practice (aOR, 1.39; 95% CI, 1.13 to 1.71), and attempts to control weight (aOR, 1.36; 95% CI, 1.12 to 1.64). No significant negative changes were observed in other health behavior variables.
Conclusions
The HCO seems to have contributed to improving community health indicators. In the future, a follow-up study that analyzes only the effectiveness of the HCO through structured quasi-experimental studies will be needed.

Summary

Korean summary
건강주민운동은 지역사회 건강지표 향상에 기여한 것으로 보여진다. 따라서 주민참여형 건강증진사업이 주민들의 건강을 향상하기 위해서는 주민이 주체가 되어 조직화된 힘으로 지역사회의 근본적인 변화를 만들어가는 주민운동의 관점으로 시행될 필요가 있다.

Key Message
The Health Community Organization (HCO) appears to contribute to the enhancement of community health indicators. Therefore, in order to improve the health of residents through community-based participatory health promotion programs, it is necessary to implement them from the perspective of the HCO in which residents organize themselves as a mobilized force to bring about fundamental changes in the community.

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Prevalence and trends of cigarette smoking among adults with HIV infection compared with the general population in Korea
Boyoung Park, Yoonyoung Jang, Taehwa Kim, Yunsu Choi, Kyoung Hwan Ahn, Jung Ho Kim, Hye Seong, Jun Yong Choi, Hyo Youl Kim, Joon Young Song, Shin-Woo Kim, Hee Jung Choi, Dae Won Park, Young Kyung Yoon, Sang Il Kim
Epidemiology and Health.2024; 46: e2024097. CrossRef

Women’s Empowerment Facilitates Complete Immunization in Indonesian Children: A Cross-sectional Study: Gede Benny Setia Wirawan, Ni Luh Zallila Gustina, Putu Harrista Indra Pramana, Made Yuliantari Dwi Astiti, Jovvita Jonathan, Fitriana Melinda, Teo Wijaya; J Prev Med Public Health. 2022;55(2):193-204. Published online March 8, 2022; DOI: https://doi.org/10.3961/jpmph.21.592

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Abstract PDF

Objectives
The primary objective of this study was to examine the effect of women’s empowerment on the immunization of Indonesian children. The secondary objective was to examine the effect of wealth as a factor modifying this association.
Methods
We utilized data from the 2017 Indonesian Demographic and Health Survey (IDHS). The subjects were married women with children aged 12-23 months (n=3532). Complete immunization was defined using the 2017 IDHS definition. Multiple components of women’s empowerment were measured: enabling resources, decision-making involvement, and attitude toward intimate partner violence. The primary analysis was conducted using binomial logistic regression. Model 1 represented only the indicators of women’s empowerment and model 2 controlled for socio-demographic variables. Subgroup analyses were conducted for each wealth group.
Results
The primary analysis using model 1 identified several empowerment indicators that facilitated complete immunization. The analysis using model 2 found that maternal education and involvement in decision-making processes facilitated complete immunization in children. Subgroup analyses identified that wealth had a modifying effect. The indicators of women’s empowerment were strong determinants of complete immunization in lower wealth quintiles but insignificant in middle-income and higher-income quintiles.
Conclusions
To our knowledge, this study is the first to explore women’s empowerment as a determinant of child immunization in Indonesia. The results indicate that women’s empowerment must be considered in Indonesia’s child immunization program. Women’s empowerment was not found to be a determinant in higher wealth quintiles, which led us to rethink the conceptual framework of the effect of women’s empowerment on health outcomes.

Summary

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Factors associated with decision-making autonomy in healthcare utilization among married women from the Indonesia demographic health survey 2017
Sofa D. Alfian, Meliana Griselda, Mochammad A. A. Pratama, Sameer Alshehri, Rizky Abdulah
Scientific Reports.2025;[Epub] CrossRef
Of Money and Men: A Scoping Review to Map Gender Barriers to Immunization Coverage in Low- and Middle-Income Countries
Anna Kalbarczyk, Natasha Brownlee, Elizabeth Katz
Vaccines.2024; 12(6): 625. CrossRef
Health Beliefs and Socioeconomic Determinants of COVID-19 Booster Vaccine Acceptance: An Indonesian Cross-Sectional Study
Gede Benny Setia Wirawan, Ngakan Putu Anom Harjana, Nur Wulan Nugrahani, Pande Putu Januraga
Vaccines.2022; 10(5): 724. CrossRef

The Effect of an Empowerment Program on the Health-promoting Behaviors of Iranian Women Workers: A Randomized Controlled Trial: Fatemeh Noori, Zahra Behboodimoghadam, Shima Haghani, Shahzad Pashaeypoor; J Prev Med Public Health. 2021;54(4):275-283. Published online June 24, 2021; DOI: https://doi.org/10.3961/jpmph.21.088

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Abstract PDF

Objectives
The workplace is an ideal place for encouraging health-promoting behaviors. Therefore, the aim of the present study was to determine the effect of an empowerment program on the health-promoting behaviors of women workers.
Methods
This randomized clinical trial was conducted with 80 women workers employed at a food packaging facility in 2020. The subjects were selected using convenience sampling and were classified into intervention and control groups using block randomization. An empowerment program for women workers was conducted across 6 sessions based on an empowerment model. Data collection tools included a demographic questionnaire and the Health Promoting Lifestyle Profile-II, which participants completed both before the program and 8 weeks after the last session. Data analysis was performed in SPSS version 16 using descriptive analysis and inferential statistics.
Results
There were no significant differences between the 2 groups in various health-promoting behaviors before the program. However, the intervention group’s scores for nutrition (34.92±1.09 vs. 27.87±4.23), physical activity (24.40±2.94 vs. 17.40±5.03), stress management (26.35±2.60 vs. 23.05±4.27), spiritual growth (34.02±3.00 vs. 30.22±5.40), interpersonal relationships (30.82±2.38 vs. 27.60±4.61), and health responsibility (31.60±2.71 vs. 28.22±4.59) were significantly higher than the control group’s 8 weeks after the program had ended. Moreover, there was a significant difference in the total score of health-promoting behaviors for the intervention group compared to the control group (179.00±9.22 vs. 151.42±20.25, p=0.001).
Conclusions
An empowerment program for women workers led to significant improvements in the health-promoting behaviors of the participants. Similar programs can ultimately improve women’s health in the workplace.

Summary

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Participatory Approaches in the Context of Research Into Workplace Health Promotion to Improve Physical Activity Levels and Reduce Sedentary Behavior Among Office-Based Workers: Scoping Review
Aidan John Buffey, Christina Kate Langley, Brian P Carson, Alan E Donnelly, Jon Salsberg
JMIR Public Health and Surveillance.2024; 10: e50195. CrossRef
Perceived lack of behavioral control is a barrier to a healthy lifestyle in post-menopause: a qualitative study
Khadijeh Khademi, Mohammad Hossein Kaveh, Mahin Nazari, Abdolrahim Asadollahi
Journal of Health, Population and Nutrition.2024;[Epub] CrossRef
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M. Rocío Jiménez-Mérida, Manuel Vaquero-Abellán, José M. Alcaide-Leyva, Vanesa Cantón-Habas, Elena Raya-Cano, Manuel Romero-Saldaña
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Anna Bratt, Cecilia Fagerström
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Role of Information and Communication Technology and Women’s Empowerment in Contraceptive Discontinuation in Indonesia: Omas Bulan Samosir, Ayke Soraya Kiting, Flora Aninditya; J Prev Med Public Health. 2020;53(2):117-125. Published online February 12, 2020; DOI: https://doi.org/10.3961/jpmph.19.300

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Abstract PDF

Objectives
This study investigated the role of information and communication technology and women’s empowerment in contraceptive discontinuation in Indonesia.
Methods
The study used data from the 2017 Indonesia Demographic and Health Survey and monthly contraceptive calendar data. A Gompertz proportional hazards model was used for analysis.
Results
The 12-month contraceptive discontinuation rate was higher among women who had used the Internet in the past year, women who were mobile phone owners, and women who reported having fully participated in household decision-making than among their counterparts. These factors significantly impacted the risk of contraceptive discontinuation in Indonesia, even after controlling for contraceptive method, age, parity, contraceptive intent, education, work status, place of residence, and wealth status.
Conclusions
After adjustment for the control variables, a higher risk of contraceptive discontinuation was associated with having used the Internet in the past year, owning a mobile phone, and not participating in household decision-making. Higher contraceptive discontinuation risk was also associated with using contraceptive pills, older age, lower parity, intent of spacing births, more education, current unemployment, and rural residence, and the risk was also significantly higher for those in the lowest household wealth quintile than for those in the fourth household wealth quintile. The association of contraceptive discontinuation with the use of modern information and communication technology and relatively disempowerment in household decision-making may imply that information regarding family planning and contraception should be conveyed via social media as part of setting up an eHealth system. This must include a strong communication strategy to empower and educate women in contraceptive decision-making.

Summary

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Ashim Kumar Nandi, Ann-Zofie Duvander
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Christiane Borges do Nascimento Chofakian, Ana Luiza Vilela Borges
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Amanuel Defar Bande, Tilahun Bayene Handiso, Habtamu Wude Hanjelo, Belayneh Hamdela Jena
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Salima Meherali, Komal Abdul Rahim, Sandra Campbell, Zohra S. Lassi
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Open Access Macedonian Journal of Medical Sciences.2021; 9(E): 1363. CrossRef

English Abstract

Power Estimation and Follow-Up Period Evaluation in Korea Radiation Effect and Epidemiology Cohort Study.: In Seong Cho, Minkyo Song, Yunhee Choi, Zhong Min Li, Yoon Ok Ahn; J Prev Med Public Health. 2010;43(6):543-548.; DOI: https://doi.org/10.3961/jpmph.2010.43.6.543

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Abstract PDF

OBJECTIVES
The objective of this study was to calculate sample size and power in an ongoing cohort, Korea radiation effect and epidemiology cohort (KREEC). METHOD: Sample size calculation was performed using PASS 2002 based on Cox regression and Poisson regression models. Person-year was calculated by using data from '1993-1997 Total cancer incidence by sex and age, Seoul' and Korean statistical informative service. RESULTS: With the assumption of relative risk=1.3, exposure:non-exposure=1:2 and power=0.8, sample size calculation was 405 events based on a Cox regression model. When the relative risk was assumed to be 1.5 then number of events was 170. Based on a Poisson regression model, relative risk=1.3, exposure:non-exposure=1:2 and power=0.8 rendered 385 events. Relative risk of 1.5 resulted in a total of 157 events. We calculated person-years (PY) with event numbers and cancer incidence rate in the non-exposure group. Based on a Cox regression model, with relative risk=1.3, exposure:non-exposure=1:2 and power=0.8, 136 245PY was needed to secure the power. In a Poisson regression model, with relative risk=1.3, exposure:non-exposure=1:2 and power=0.8, person-year needed was 129517PY. A total of 1939 cases were identified in KREEC until December 2007. CONCLUSIONS: A retrospective power calculation in an ongoing study might be biased by the data. Prospective power calculation should be carried out based on various assumptions prior to the study.

Summary

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Jandee Lee, Seonhyang Jeong, Hwa Young Lee, Sunmi Park, Meesson Jeong, Young Suk Jo
Endocrinology and Metabolism.2023; 38(6): 720. CrossRef
Cancer Risk in Adult Residents near Nuclear Power Plants in Korea - A Cohort Study of 1992-2010
Yoon-Ok Ahn, Zhong Min Li
Journal of Korean Medical Science.2012; 27(9): 999. CrossRef

Original Articles

Comparison of Job Stressors between Managers and Employees in White-Collar Workers of an Electric Company.: Jin Kook Tak, Kang Sook Lee, Hyun Sook Hong; Korean J Prev Med. 2002;35(2):160-168.

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Abstract PDF: OBJECTIVES
This study was intended to investigate the differences of job stressors between managers and low level employees among white-collar workers. Another objective of this study was to examine whether the effects of job stressors on mental health differ between the two groups. METHODS: Data was obtained from 204 managers and 251 low level employees who were employed in white-collar jobs. Fourteen job stressors and seven job stress variables were measured. RESULTS: Among the 14 job stressors, role overload, job insecurity, and work-family conflict were higher job stressors for the manager group whereas role conflict, work-aptitude incongruity, participation in decision making, and promotion problems were higher job stressors for the low level of employees. There were no differences in job stress scores between the two groups. However, differences in the effects of job stressors on job stress were found between the two groups. For the manager group, job insecurity, work-aptitude incongruity, and work-family conflict significantly affected in explanation of job stress whereas for the low level employees, role underload, peer satisfaction, and environmental problems significantly explaining the job stress variables. CONCLUSIONS: There were significant differences in job stressors between managers and low level employees among white-collar workers. Additionally there were differences in the effects of job stressors on job stress between the two groups.; Summary

Distribution af active physicians and their working areas after 10 years of graduation.: Seung Hum Yu, Tae Yong Sohn, Hyohn Joo Oh; Korean J Prev Med. 1996;29(3):429-438.

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Abstract PDF: The geographical distribution of active physicians who graduated from medical schools before 1985 were studied. Those who had emigrated, hold non-medical jobs, are in the military service, or work as public health physicians and resident staff were excluded from the study. A total of 27,728 physicians were analyzed. Our studies have shown a relationship between the location of the medical schools from the which the physicians have graduated and the geographical regions in which they practice. A statistically significant number of physicians are working near the medical colleges from which they have graduated. That is, those who had graduated from medical schools located in the southern area of the country are presently working in the same region. This relationship was shown to be especially significant for older physicians and female doctors, who work around the area of the medical colleges from which they graduated.; Summary

Geographical distribution of physician manpower by specialty and care level.: Seung Hum Yu, Sang Hyuk Jung, Byung Yool Cheon, Tae Yong Shn, Hyohn Joo Oh; Korean J Prev Med. 1993;26(4):661-671.

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Abstract PDF: In order to compare the geographical distribution of physician by level of medical care and specialty, a log linear model was applied to the annual registration data of the Korean Medical Association as of the end of December, 1991 which was supplemented from related institutions and adjusted with relevant sources. Those physicians in primary and secondary care institutions were not statistically significantly unevenly distributed by province-level catchment area. There were some differences in physician distribution among big cities, medium and small-sized cities, and counties; however, those physicians for primary care level were equitably distributed between cities and counties. Specialties for secondary care physicians were less evenly distributed in county areas than in city areas, and generalists are distributed more evenly in cities and counties than in big cities. There is a certain limitation due to underregistration in the annual physician registration to the Korean Medical Association; however, the geographical distribution of physicians has been improved quantitatively. It is strongly suggested that specialties and the level of medical care should be considered for further physician manpower studies.; Summary

Adequacy of Medical Manpower and Medical Fee for Newborn Nursery Care.: Jung Han Park, Soo Yong Kim, Sin Kam; Korean J Prev Med. 1991;24(4):531-548.

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Abstract PDF: To assess the adequacy of medical manpower and medical fee for the newborn nursery care, the author visited 20 out of 24 hospitals with the pediatric training program in Youngnam area between July 29 and August 14, 1991. Total number of newborn, both normal and sick, admission and discharge in 1--30 June 1991 was obtained from the logbook of nursery. Head nurse and staff pediatrician of the nursery were interviewed to get the current staffing for the nursery and their subjective opinion on the adequacy of nursery manpower and the difficulties in recruiting manpower. Average medical fee charged for the maternity and normal newborn nursery care was obtained from the division of self-audit of medical insurance claim of each hospital. Average minimum requirement of nursing care time for one normal newborn per day was 179.5 (+/-58.6) minutes; 2023(+/-50.7) minutes for the university hospitals and 164.2(+/-60.5) minutes for the general hospitals. The ratio of minimum requirement of nursing care time and available nursing time was 1.42 on the average. Taking the additional requirement of nursing care for the sick newborns into consideration, the ratio was 2.06. The numbers of R. N. and A. N. in the nurserys of study hospitals were 31%, and 17%, respectively, of the nursing manpower for the nursery recommended by the American Academy of Pediatrics. These findings indicate that the nursing manpower in newborn nursery is in severe shortage. Ninety percent of the head nurses and 85% of the staff pediatrician stated that the newborn nursery is short of R.N. and 75% of them said that the nurse's aide is also short. Major reason for not recruiting R.N. was the financial constraint of hospital. For the recruitment of nurse's aide, short supply was the second most important reason next to the financial constraint. However, limit of quarter in T.O. was the major reason for the national university hospitals. Average total medical fee for the maternity and newborn nursery cares of a normal vaginal delivery who stayed two nights and three days at hospital was 219,430Won. Out of the total medical fee, 20,323Won(9.3%) was for the newborn nursery care. In case of C-section delivery six nights and seven days, who stayed otal medical fee was 732,578Won and out of the total fee 76,937Won (12.0%) was for the newborn care. Cost for a newborn care per day by cost accounting was 16,141Won for the tertiary care hospitals and 14,576Won for the all other hopitals. The ratio of cost and the fee schedule of the medical insurance for a newborn care per day was 5.0 for the tertiary care hospitals and 4.9 for the all other hospitals. Considering the current wage level of the medical personnel, capital investment for the hospital facilities and equipments, and the cost for hospital maintenance, it is hard to expect adequate quality care in the newborn nursery under the current medical insurance fee schedule.; Summary

Projection of Physician Manpower Supply in Korea.: Seung Hum Yu, Woo Hyun Cho, Yong Ho Lee, Byung Yool Cheon; Korean J Prev Med. 1988;21(1):61-69.

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Abstract PDF: In this study, the number of physicians presently living in Korea thoroughly estimated by several means and, on this bases, their productivity and level of supply were estimated. The results were as follows : First, the number of physicians who did not notify the Korea Medical Association in May 1987 were 10,110, including 4,093 emigrant physicians(40.5%), 861 military medical officers, 745 public health doctors, and 107 decreased physicians. A total of 1,330 physicians could not be identified by any effort. Second, among the 34,897 registered physicians as of May 1987, 29,933(85.8%) were residing in Korea, 4,115 physicians(11.8%) had emigrated to other countries, and 849 physicians(2.4%) were decreased. Practicing physicians defined as those in Korea who were not retired, serving in the military, or completing residencies or internships, comprised 78.6%(27,414 physicians) of the total number of registered physicians. Third, it is estimated that in the year 2000 the number of registered physicians, physicians residing in Korea, and practicing physician will be 75,040, 64,038 and 57,655, respectively and these are increases of 115.0%, 113,9%, and 110.3%, respectively, compared to 1987. Fourth, the population physician ratio will be 759 to one physician in the year 2000. Fifth, the productivity of physicians, as calculated by relative values defining the productivity of 35 to 44 year-old male physicians as 10, will increase 110.7% in the year 2000 compare to that of 1987, and this increment is almost the same level as that of physicians supply. From the results of the present analysis of physicians manpower and supply projection, it can be recognized that the development of a regular notification system is necessary in order to identify precisely the number of physicians. Also a policy a physician supply is essential in order to adjust in advance the number of physicians, otherwise there will be surplus to the medical demand.; Summary

English Abstracts

A Multilevel Study on the Relationship between the Residential Distribution of High Class (Power Elites) and Smoking in Seoul.: Chang Seok Kim, Sung Cheol Yun, Hye Ryun Kim, Young Ho Khang; J Prev Med Public Health. 2006;39(1):30-38.

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Abstract PDF: OBJECTIVES
We examined whether the neighborhood socioeconomic position predicts the smoking rates after adjusting for individual socioeconomic position indicators. METHODS: Data were obtained from the 2001 Seoul Health Indicators Survey. The neighborhood socioeconomic position was the residential distribution of the high class (power elites), as measured by the location quotients (LQ) for each administrative dong (district). A high LQ denotes a high neighborhood socioeconomic status. The individual socioeconomic position included education, occupation and income. Age-adjusted smoking rates according to the LQ level were computed with the direct method. The total number of subjects in this study (26,022 men and 28,007 women) was the reference. A multilevel logistic regression analysis was conducted with the individuals at the first level and the neighborhoods at the second level to estimate the odds ratios of smoking with 95% confidence intervals. RESULTS: For men, the age-adjusted smoking rates increased with a decrease in the LQ. For women, the relationship between the age-adjusted smoking rate and the LQ was not clear. The odds of smoking for both genders were greater among those subjects with lower incomes and lower education. The manual occupational class had greater odds of smoking than the non-manual class for the males, while the odds ratio of smoking among females with a manual occupation tended to be lower than those females with a non-manual occupation. For the males, the LQ levels independently predicted smoking after adjustment for individual income. However, this relation between the LQ and smoking in males was explained by full adjustment for the individual socioeconomic position indicators (education, occupation and income). CONCLUSIONS: A low level of neighborhood socioeconom-ic position was associated with higher smoking rates among the men residing in Seoul. This association between the neighborhood socioeconomic position and smoking in men was explained by the individual socioeconomic position. Anti-smoking efforts to reduce geographical inequality in smoking should be directed at reducing the smoking rates between the individuals with different socioeconomic backgrounds in the metropolitan city of Seoul, South Korea.; Summary

Mediating Role of Empowerment in the Relations to Job and Organizational Factors, and Job Satisfaction and Organizational Commitment: Empirical Evidence from National University Hospital Employees.: Bang Seob Yoon, Hae Jong Lee; J Prev Med Public Health. 2005;38(3):315-324.

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Abstract PDF: OBJECTIVE
The aim of this study was to examined the mediating role of empowerment in relations to job and organizational factors, and job satisfaction and organizational commitment in hospital organizations. METHODS: Job variety, clarity, significance, and fitness were examined as the job factors, and security, reward justice, and organizational support as the organizational factors. Data were collected from 8 national university hospitals with 1, 289 data points used for the final analysis. RESULTS: All the job factors were found to positively influence empowerment, as were all the organizational factors, with the exception of reward justice. As hypothesiz -ed, empowerment had significant effects on both job satisfaction and organizational commitment, and was the most influential variable of all those examined. CONCLUSIONS: In the relations to job satisfaction, empowerment completely mediated job significance, security and organizational support, and partially mediated all other variables, with the exception of reward justice. In the relations to organizational commitment, empowerment completely mediated job variety and job fitness, and partially mediated all other variables, with the exception of reward justice. The theoretical and practical implications of these results have been discussed.; Summary

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