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Original Articles
Multilevel Analysis of the Relationship Between Prescribing Institutions and Medication Adherence Among Patients With Hypertension and Diabetes in Korea
Haryeom Ghang, Juhyang Lee
J Prev Med Public Health. 2023;56(6):504-514.   Published online October 5, 2023
DOI: https://doi.org/10.3961/jpmph.23.252
  • 1,370 View
  • 117 Download
AbstractAbstract AbstractSummary PDFSupplementary Material
Objectives
This study investigated the relationship between prescribing institutions and medication adherence among patients newly diagnosed with hypertension and diabetes.
Methods
This study investigated patients with new prescriptions for hypertension and diabetes in Korea in 2019 with using data collected from general health screenings. A multilevel logistic regression model was applied to explore the relationship between patients’ first prescribing institution and their medication adherence, defined as a medication possession ratio (MPR) over 80%.
Results
The overall adherence rates were 53.7% and 56.0% among patients with hypertension and diabetes, respectively. The intraclass correlation coefficients were 13.2% for hypertension and 13.8% for diabetes (p<0.001), implying that the first prescribing institution had a significant role in medication adherence. With clinics as the reference group, all other types of hospitals showed an odds ratio (OR) less than 1.00, with the lowest for tertiary hospitals (OR, 0.30 for hypertension; 0.45 for diabetes), and the next lowest in health screening specialized clinics (OR, 0.51 for hypertension; 0.46 for diabetes). Among individual-level variables, female sex, older age, higher insurance premium level, and residing in cities were positively associated with adherence in both the hypertension and diabetes samples.
Conclusions
This study showed that the prescribing institution had a significant relationship with medication adherence. When the first prescribing institution was a clinic, newly diagnosed patients were more likely to adhere to their medication. These results highlight the important role played by primary care institutions in managing mild chronic diseases.
Summary
Korean summary
2019년 일반건강검진을 통해 발견된 고혈압과 당뇨병의 신규 환자를 대상으로 복약순응도를 분석하였다. 그 결과 검진 후 첫번째 처방기관이 의원인 경우에 비해 다른 종별 의료기관인 경우 복약순응 오즈비가 모두 감소하였는데 상급종합병원이 가장 낮았고(고혈압 0.30, 당뇨병 0.45), 그 다음은 검진전문의원인 것으로 나타났다(고혈압 0.51, 당뇨병 0.46).
Key Message
This study investigated the relationship between prescribing institutions and medication adherence among patients newly diagnosed with hypertension and diabetes using general health screening data in Korea in 2019. The results showed that with clinics as the reference group, all other types of hospitals showed an odds ratio (OR) less than 1.00, with the lowest for tertiary hospitals (OR, 0.30 for hypertension; 0.45 for diabetes), and the next lowest in health screening specialized clinics (OR, 0.51 for hypertension; 0.46 for diabetes).
Lung Cancer Screening With Low-dose Chest Computed Tomography: Experience From Radon-contaminated Regions in Kazakhstan
Alexandra Panina, Dilyara Kaidarova, Zhamilya Zholdybay, Akmaral Ainakulova, Jandos Amankulov, Dias Toleshbayev, Zhanar Zhakenova, Arman Khozhayev
J Prev Med Public Health. 2022;55(3):273-279.   Published online April 14, 2022
DOI: https://doi.org/10.3961/jpmph.21.600
  • 5,992 View
  • 123 Download
  • 1 Web of Science
  • 3 Crossref
AbstractAbstract PDF
Objectives
The aim of this study was to present the baseline results of a pilot project conducted to evaluate the effectiveness of lung cancer screening using low-dose chest computed tomography (CT) in regions with excessive radon levels in the Republic of Kazakhstan.
Methods
In total, 3671 participants were screened by low-dose chest CT. Current, former, and never-smokers who resided in regions with elevated levels of radon in drinking water sources and indoor air, aged between 40 and 75 with no history of any cancer, and weighing less than 140 kg were included in the study. All lung nodules were categorized according to the American College of Radiology Lung Imaging Reporting and Data System (Lung-RADS 1.0).
Results
Overall, 614 (16.7%) participants had positive baseline CT findings (Lung-RADS categories 3 and 4). Seventy-four cancers were detected, yielding an overall cancer detection rate of 2.0%, with 10.8% (8/74) stage I and a predominance of stage III (59.4%; 44/74). Women never-smokers and men current smokers had the highest cancer detection rates, at 2.9% (12/412) and 6.1% (12/196), respectively. Compared to never-smokers, higher odds ratios (ORs) of lung cancer detection were found in smokers (OR,2.48; 95% confidence interval [CI], 1.52 to 4.05, p<0.001) and former smokers (OR, 2.32; 95% CI, 1.06 to 5.06, p=0.003). The most common histologic type of cancer was adenocarcinoma (58.1%).
Conclusions
Implementation of low-dose CT screening for lung cancer in regions with elevated radon levels is an effective method for both smokers and never-smokers.
Summary

Citations

Citations to this article as recorded by  
  • Lung cancer screening for never smokers: current evidence and future directions
    Kay Choong See
    Singapore Medical Journal.2024;[Epub]     CrossRef
  • Secondary prevention and treatment innovation of early stage non-small cell lung cancer: Impact on diagnostic-therapeutic pathway from a multidisciplinary perspective
    Giulia Pasello, Daniela Scattolin, Laura Bonanno, Francesca Caumo, Andrea Dell'Amore, Elena Scagliori, Mariaenrica Tinè, Fiorella Calabrese, Gaetano Benati, Matteo Sepulcri, Cristina Baiocchi, Michele Milella, Federico Rea, Valentina Guarneri
    Cancer Treatment Reviews.2023; 116: 102544.     CrossRef
  • Performance of Lung-RADS in different target populations: a systematic review and meta-analysis
    Yifei Mao, Jiali Cai, Marjolein A. Heuvelmans, Rozemarijn Vliegenthart, Harry J. M. Groen, Matthijs Oudkerk, Marleen Vonder, Monique D. Dorrius, Geertruida H. de Bock
    European Radiology.2023; 34(3): 1877.     CrossRef
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
  • 9,539 View
  • 135 Download
  • 5 Web of Science
  • 5 Crossref
AbstractAbstract AbstractSummary PDFSupplementary 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

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  • Prediction model of health checkup and cancer screening experience of elderly population using 2021 Community Health Survey
    Myeunghee Han
    Research in Community and Public Health Nursing.2024; 35: 140.     CrossRef
  • Sociodigital Determinants of eHealth Literacy and Related Impact on Health Outcomes and eHealth Use in Korean Older Adults: Community-Based Cross-Sectional Survey
    Myat Yadana Kyaw, Myo Nyein Aung, Yuka Koyanagi, Saiyud Moolphate, Thin Nyein Nyein Aung, Hok Ka Carol Ma, Hocheol Lee, Hae-Kweun Nam, Eun Woo Nam, Motoyuki Yuasa
    JMIR Aging.2024; 7: e56061.     CrossRef
  • Association between life satisfaction, self-esteem, and health checkup participation: A population-based longitudinal study in South Korea
    Seong-Uk Baek, Jin-Ha Yoon
    Preventive Medicine.2024; 189: 108127.     CrossRef
  • 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
Determinants of Adherence to Diabetes Screening in Iranian Adults With a Positive Family History of Diabetes
Narges Malih, Mohammad-Reza Sohrabi, Alireza Abadi, Shahnam Arshi
J Prev Med Public Health. 2021;54(3):190-198.   Published online April 7, 2021
DOI: https://doi.org/10.3961/jpmph.20.496
  • 3,822 View
  • 172 Download
  • 3 Web of Science
  • 5 Crossref
AbstractAbstract PDFSupplementary Material
Objectives
Insufficient evidence exists regarding factors that affect screening adherence among people with a family history of diabetes, who comprise roughly half of all patients with diabetes. Therefore, we aimed to identify the determinants of diabetes screening adherence in adults with a family history of diabetes who had not yet been diagnosed with diabetes.
Methods
This cross-sectional study was conducted at selected urban primary healthcare facilities in Tehran, Iran. The study population was clinically non-diabetic adults above 20 years of age with a family history of diabetes in at least 1 first-degree relative. All eligible people identified on randomly-selected days of the month were invited to join the study.
Results
Among 408 participants, 128 (31.4%) had received a fasting blood glucose check during the last year. Using binary logistic regression, the independent predictors of screening adherence were knowledge of adverse effects of diabetes such as sexual disorders (odds ratio [OR], 3.05) and renal failure (OR, 2.73), the impact of family members’ advice on receiving diabetes screening (OR, 2.03), recommendation from a healthcare provider to have a fasting blood glucose check (OR, 2.61), and intention to have a fasting blood glucose check within the next 6 months (OR, 2.85). Other variables that predicted screening adherence were age (OR, 1.05), job (being a housekeeper; OR, 3.39), and having a college degree (OR, 3.55).
Conclusions
Knowledge of the adverse effects of diabetes, physicians’ and healthcare providers’ advice about the benefits of early disease detection, and family members’ advice were independent predictors of screening adherence.
Summary

Citations

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  • The association between sociodemographic characteristics, clinical indicators and body mass index in a population at risk of type 2 diabetes: A cross-sectional study in two Colombian cities
    Yenifer Diaz Montes, Tania Acosta Vergara, Rafael Tuesca Molina, Gillian Martinez Guerrero, Luis A. Anillo Arrieta, Pablo Aschner, Jorge Acosta-Reyes, Victor Florez-Garcia, Edgar Navarro Lechuga, Noël C. Barengo
    Primary Care Diabetes.2024; 18(4): 458.     CrossRef
  • Socio-personal factors affecting adherence to treatment in patients with type 2 diabetes: A systematic review and meta-analysis
    Nahid Shahabi, Yadolah Fakhri, Teamur Aghamolaei, Zahra Hosseini, Atefeh Homayuni
    Primary Care Diabetes.2023; 17(3): 205.     CrossRef
  • Clinical traits and systemic risks of familial diabetes mellitus according to age of onset and quantity: an analysis of data from the community-based KoGES cohort study
    Ju-Yeun Lee, Kyungsik Kim, Sangjun Lee, Woo Ju An, Sue K. Park
    Epidemiology and Health.2023; 45: e2023029.     CrossRef
  • BİR ÜNİVERSİTE AKADEMİSYENLERİNİN SAĞLIK DAVRANIŞLARINA VE TARAMA PROGRAMLARINA UYUMU: KESİTSEL BİR ÇALIŞMA
    Hatice İKİIŞIK, Sibel SAKARYA
    ESTÜDAM Halk Sağlığı Dergisi.2022; 7(1): 98.     CrossRef
  • Association between a family history of diabetes and carotid artery atherosclerosis in Korean adults
    Sun Young Shim, Ga Bin Lee, Jee-Seon Shim, Sun Jae Jung, Hyeon Chang Kim
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Brief Report
A Cross-sectional Study of Cancer Knowledge and Beliefs Among Faith-based Chinese in the USA Versus Taiwan
Su-I Hou, Xian Cao
J Prev Med Public Health. 2019;52(1):60-65.   Published online January 20, 2019
DOI: https://doi.org/10.3961/jpmph.17.051
  • 4,679 View
  • 116 Download
AbstractAbstract PDF
Objectives
This study examined cancer knowledge, beliefs, and practice among faith-based Chinese in the USA versus Taiwan to gain better understandings on how environment and culture might play a role for tailored cancer education programs.
Methods
A self-administered survey included a validated 10-item Cancer Screening Belief Scale (CSBS), an 8-item Cancer Screening Knowledge Test (CSKT), and a 14-item cancer Warning Signs Test (CWST) was administered. Participants were recruited from 9 Chinese churches (5 in the USA and 4 in Taiwan).
Results
A total of 372 Chinese participated, 50% lived in the USA and 50% in Taiwan. Mean age was 44.31 (standard deviation, 14.74), 60% males, and majority had college education (85%). Taiwan participants scored higher on both CSKT (6.13 vs. 5.52; p<0.001) and CWST (6.80 vs. 5.38; p<0.001). Although perceived screening benefits and barriers were similar, Taiwan participants endorsed higher on screening norms (11.67 vs. 10.82; p<0.001). Taiwan participants also indicated more doctor recommending cancer screenings (42.1% vs. 29.6%; p=0.015), USA participants were more likely to have had annual health exams (65.4% vs. 48.9%; p=0.002). Regression results showed that those resided in the USA were 2.38 times more likely to report annual health exams. Married status (odds ratio [OR], 2.85), college education (OR, 2.38), doctor’s recommendation (OR, 2.87), no family cancer history (OR, 2.47), and those with lower barriers were significant factors on annual health exams.
Conclusions
Taiwan participants scored higher on cancer knowledge and screening norms, while more USA participants reported annual health exams. Taiwan’s universal healthcare might play a role on the different healthcare seeking patterns.
Summary
Original Articles
Rates of Change to a Positive Result in Subsequent Screening Mammography in Korean Women: A Retrospective Observational Study
Jong-Myon Bae, Sang Yop Shin, Eun Hee Kim, Yoon-Nam Kim, Chung Mo Nam
J Prev Med Public Health. 2015;48(1):48-52.   Published online December 26, 2014
DOI: https://doi.org/10.3961/jpmph.14.042
  • 9,920 View
  • 82 Download
AbstractAbstract PDF
Objectives
This retrospective cohort study aimed at calculating some parameters of changes in the findings of the subsequent screening mammography (SSM) in female Korean volunteers.
Methods
The study included screenees aged 30 to 79 years who underwent SSM voluntarily after testing negative in the baseline screenings performed between January 2007 and December 2011. A change to a positive result was defined as category 4 or 5 by using the American College of Radiology Breast Imaging Reporting and Data System. The proportion of results that had changed to positive (CP, %) was calculated by dividing the number of cases with results that were positive in the SSM by the total number of study participants. The rate of results that had changed to positive (CR, cases per 100 000 screenee-months) was calculated by dividing the number of cases with results that were positive in the SSM by the total number of months of the follow-up period.
Results
The overall CP and CR in all age groups (n=77 908) were 2.26% and 93.94 cases per 100 000 screenee-months, respectively. The median CP interval in the subjects who had positive SSM results was 30 to 36 months, while that in the age group of 30 to 39 years was shorter.
Conclusions
Different screening intervals should be considered among women aged between 30 and 59 years. In addition, a strategy for a screening program should be developed for the age group of 30 to 39 years, in particular.
Summary
Mean Sojourn Time of Preclinical Gastric Cancer in Korean Men: A Retrospective Observational Study
Jong-Myon Bae, Sang Yop Shin, Eun Hee Kim
J Prev Med Public Health. 2014;47(4):201-205.   Published online July 31, 2014
DOI: https://doi.org/10.3961/jpmph.2014.47.4.201
  • 13,218 View
  • 100 Download
  • 11 Crossref
AbstractAbstract PDF
Objectives
This retrospective cohort study aimed to estimate the mean sojourn time (MST) of preclinical gastric cancer in Korean men.
Methods
The subjects consisted of voluntary male screenees aged 40 to 69 years who underwent subsequent screening gastroscopies after testing negative at a baseline screening performed between January 2007 and December 2011. A new case was defined if gastric cancer cells were present in the biopsy specimens obtained from gastroscopy. The follow-up period was calculated as the number of person-years between the date of baseline screening gastroscopy and positive findings at a subsequent screening. The MST was calculated using transition rates of gastric cancer to determine the best screening interval.
Results
Of the 171 979 voluntary male screenees, 61 688 (36%) underwent subsequent screening gastroscopies between January 2007 and December 2011. A total of 91 incident cases were found during 19 598 598 person-years of follow-up. The MST of gastric cancer was 2.37 years (95% confidence intervals, 1.92 to 2.96), and those aged 40 to 49 years had a shorter MST than those 50 to 69 years did.
Conclusions
These findings support the 2-year interval of screening recommended by the nationwide gastric cancer screening program in Korea. Further studies for the age-specific MST among women are needed.
Summary

Citations

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  • The Clinical Impact and Cost-Effectiveness of Surveillance of Incidentally Detected Gastric Intestinal Metaplasia: A Microsimulation Analysis
    Nikhil R. Thiruvengadam, Shashank Gupta, Seth Buller, Imad Awad, Devika Gandhi, Allison Ibarra, Gonzalo Latorre, Arnoldo Riquelme, Michael L. Kochman, Gregory Cote, Shailja C. Shah, Monica Saumoy
    Clinical Gastroenterology and Hepatology.2024; 22(1): 51.     CrossRef
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    Jae Myung Park, Songhee Cho, Ga-Yeong Shin, Jayoun Lee, Minjee Kim, Hyeon Woo Yim
    American Journal of Gastroenterology.2023; 118(12): 2166.     CrossRef
  • Effect and cost-effectiveness of national gastric cancer screening in Japan: a microsimulation modeling study
    Hsi-Lan Huang, Chi Yan Leung, Eiko Saito, Kota Katanoda, Chin Hur, Chung Yin Kong, Shuhei Nomura, Kenji Shibuya
    BMC Medicine.2020;[Epub]     CrossRef
  • Potential of non-invasive breath tests for preselecting individuals for invasive gastric cancer screening endoscopy
    Agne Krilaviciute, Christian Stock, Marcis Leja, Hermann Brenner
    Journal of Breath Research.2018; 12(3): 036009.     CrossRef
  • Screening Upper Endoscopy for Early Detection of Gastric Cancer
    Jeong Seop Moon
    Journal of Korean Medical Science.2018;[Epub]     CrossRef
  • Occurrence of gastric cancer in patients with atrophic gastritis during long-term follow-up
    Liming Zhang, Yulan Liu, Peng You, Guijian Feng
    Scandinavian Journal of Gastroenterology.2018; 53(7): 843.     CrossRef
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    Yun Sun Choi, Chan Soo So, Dong Hee Koh, Min Ho Choi, Hyun Joo Jang, Sea Hyub Kae, Jin Lee, Young Hee Choi
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    Jong-Myon Bae, Sang Yop Shin, Eun Hee Kim
    Cancer Research and Treatment.2015; 47(4): 564.     CrossRef
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    Jong-Myon Bae
    Epidemiology and Health.2014; 36: e2014010.     CrossRef
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    Il Ju Choi
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Review
Cancer Control Programs in East Asia: Evidence From the International Literature
Malcolm A. Moore
J Prev Med Public Health. 2014;47(4):183-200.   Published online July 31, 2014
DOI: https://doi.org/10.3961/jpmph.2014.47.4.183
  • 15,599 View
  • 180 Download
  • 15 Crossref
AbstractAbstract PDF
Cancer is a major cause of mortality and morbidity throughout the world, including the countries of North-East and South-East Asia. Assessment of burden through cancer registration, determination of risk and protective factors, early detection and screening, clinical practice, interventions for example in vaccination, tobacco cessation efforts and palliative care all should be included in comprehensive cancer control programs. The degree to which this is possible naturally depends on the resources available at local, national and international levels. The present review concerns elements of cancer control programs established in China, Taiwan, Korea, and Japan in North-East Asia, Viet Nam, Thailand, Malaysia, and Indonesia as representative larger countries of South-East Asia for comparison, using the published literature as a guide. While major advances have been made, there are still areas which need more attention, especially in South-East Asia, and international cooperation is essential if standard guidelines are to be generated to allow effective cancer control efforts throughout the Far East.
Summary

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Special Article
Cost Effectiveness of Interventions to Promote Screening for Colorectal Cancer: A Randomized Trial
Swati Misra, David R. Lairson, Wenyaw Chan, Yu-Chia Chang, L. Kay Bartholomew, Anthony Greisinger, Amy McQueen, Sally W. Vernon
J Prev Med Public Health. 2011;44(3):101-110.   Published online May 17, 2010
DOI: https://doi.org/10.3961/jpmph.2011.44.3.101
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AbstractAbstract PDF
Objectives

Screening for colorectal cancer is considered cost effective, but is underutilized in the U.S. Information on the efficiency of "tailored interventions" to promote colorectal cancer screening in primary care settings is limited. The paper reports the results of a cost effectiveness analysis that compared a survey-only control group to a Centers for Disease Control (CDC) web-based intervention (screen for life) and to a tailored interactive computer-based intervention.

Methods

A randomized controlled trial of people 50 and over, was conducted to test the interventions. The sample was 1224 partcipants 50-70 years of age, recruited from Kelsey-Seybold Clinic, a large multi-specialty clinic in Houston, Texas. Screening status was obtained by medical chart review after a 12-month follow-up period. An "intention to treat" analysis and micro costing from the patient and provider perspectives were used to estimate the costs and effects. Analysis of statistical uncertainty was conducted using nonparametric bootstrapping.

Results

The estimated cost of implementing the web-based intervention was $40 per person and the cost of the tailored intervention was $45 per person. The additional cost per person screened for the web-based intervention compared to no intervention was $2602 and the tailored intervention was no more effective than the web-based strategy.

Conclusions

The tailored intervention was less cost-effective than the web-based intervention for colorectal cancer screening promotion. The web-based intervention was less cost-effective than previous studies of in-reach colorectal cancer screening promotion. Researchers need to continue developing and evaluating the effectiveness and cost-effectiveness of interventions to increase colorectal cancer screening.

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Research Support, Non-U.S. Gov't
The Validity and Reliability of a Screening Questionnaire for Parkinson's Disease in a Community.
Jong Hun Kim, Hae Kwan Cheong, Chong Sik Lee, Sung Eun Yi, Kun Woo Park
J Prev Med Public Health. 2010;43(1):9-17.
DOI: https://doi.org/10.3961/jpmph.2010.43.1.9
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OBJECTIVES
Parkinson's disease is one of the most common neurodegenerative diseases in the elderly population. In order to estimate the prevalence of Parkinson's disease in the community, the application of a good screening tool is essential. We evaluated the validity and reliability of a Parkinson's disease screening questionnaire and propose an alternative measure to improve its validity for use in community surveys. METHODS: We designed the study in a three-phase approach consisting of a screening questionnaire, neurologic examination, and confirmatory examination. A repeated survey was administered to patients with disease detected in the community and on 150 subjects. We examined internal consistency using Cronbach's alpha test, test-retest reliability using the kappa statistic, and validity using sensitivity, specificity, and ROC curves. Unadjusted odds ratios were utilized for the estimation of weights for each questionnaire item. RESULTS: The Cronbach's alpha of the questionnaire was 0.708. The kappa statistic for test-retest reliability was good to generally fair in most of the items. When newly proposed weighting scores were used, the optimum cut-off value was 7/8. When cut-off value was 5/6 for surveying prevalence in a community, the sensitivity was 0.98, and the specificity was 0.61, with simultaneous improvement in reliability. CONCLUSIONS: We recommend 5/6 as the ideal cut-off value for the survey of PD prevalence in community. This questionnaire designed for the Korean community could help future epidemiologic studies of PD.
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English Abstracts
Factors Associated with Cancer Screening Intention in Eligible Persons for National Cancer Screening Program.
Rock Bum Kim, Ki Soo Park, Dae Yong Hong, Cheol Heon Lee, Jang Rak Kim
J Prev Med Public Health. 2010;43(1):62-72.
DOI: https://doi.org/10.3961/jpmph.2010.43.1.62
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AbstractAbstract PDF
OBJECTIVES
To identify factors associated with cancer screening intention using the Theory of Planned Behavior (TPB). METHODS: Among 55,920 eligible persons for National Cancer Screening Program (NCSP) in J city, 1,100 individuals were contacted. Of these, 797 were interviewed using a structured questionnaire. Thirty-six responses were excluded due to incomplete data. The remaining 761 completed questionnaires were analyzed to find factors associated with cancer screening intention. RESULTS: Cancer screening intention was significantly associated with behavioral attitude (p<0.01) and subjective norm (p<0.01), but not with perceived behavioral control (p=0.29) in the TPB model. These three constructs explained 29.7% of cancer screening intention in multiple linear regression analysis. External factors such as socio-demographic status, health and health behavior variables explained 8.9% of screening intention. Among them, household monthly income, past cancer screening experience, exercise and daily eating habit were significantly associated with screening intention. CONCLUSIONS: Cancer screening intention may be influenced by focusing attitude, subjective norm in TPB model and other external factors. However, further studies are warranted to identify factors influencing cancer screening intention and behavior.
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The Determinants of the Use of Opportunistic Screening Programs in Korea.
Sungwook Kang, Chang Hoon You, Young Dae Kwon
J Prev Med Public Health. 2009;42(3):177-182.
DOI: https://doi.org/10.3961/jpmph.2009.42.3.177
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AbstractAbstract PDF
OBJECTIVES
Both organized and opportunistic screening programs have been widely used in Korea. This paper examined the determinants of the use of opportunistic screening programs in Korea. METHODS: The subjects were a national stratified random sample of 10,254 people aged 45 or older from the first wave of the Korean Longitudinal Study of Ageing in 2006. A logit model was used to examine the determinants of the use of opportunistic screening programs in terms of the demographic and socioeconomic characteristics, the type of health insurance and the health status. RESULTS: Thirteen point seven percent of the individuals received opportunistic screening programs within 2 years from the time the survey was conducted in 2006. The individuals who graduated from college or who had even more education were 3.0 times more likely to use opportunistic screening programs compared with the individuals who were illiterate. The individuals who resided in urban areas and who had religious beliefs were more likely to receive opportunistic screening programs compared with their counterparts. Those who were in the first quartile for the total household assets were 2.6 times more likely to use opportunistic screening programs than those who were in the fourth quartile for the total household assets. Privately insured people were 1.6 times more likely to use opportunistic screening programs than those who were not insured. Finally, the individuals who self-assessed their health status as worst were 2.1 times more likely to use opportunistic screening programs compared individuals who self-assessed their health status as best. CONCLUSIONS: This study suggests that opportunistic screening programs can be an indicator for whether or not an individual is among the advantaged group in terms of their socioeconomic characteristics and type of health insurance.
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The Factors Associated with Changes in the Stage of Breast Cancer Screening Behavior among the Woman who are Eligible for the Korean National Cancer Screening Program.
Hyo Kyung Son, Sin Kam, Ki Soo Park, Jang Rak Kim, Rock Bum Kim, Sun Kyun Park
J Prev Med Public Health. 2009;42(2):109-116.
DOI: https://doi.org/10.3961/jpmph.2009.42.2.109
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AbstractAbstract PDF
OBJECTIVES
This study was performed to evaluate the relationships between psychosocial characteristics and changes in the stage of breast cancer screening behavior. METHODS: The 474 study subjects were randomly sampled from 21,459 women (age range, 40-70 years) who were eligible for the Korean National Cancer Screening Program in 2006 in Jinju, Gyeongsangnam-do. The information, including behaviors and sociodemographic characteristics, attitudes, subjective norms and self-efficacy, was collected by trained interviewers via home visits. The breast cancer screening stages were grouped as precontemplation, contemplation, action, maintenance and relapse, according to Rakowski. RESULTS: Of the 474 women, 18.8% were in the precontemplation stage, 23.3% were in the contemplation stage, 13.1% were in the action stage, 36.6% were in the maintenance stage, and 8.2% were in the relapse stage. The distribution of stages was associated with attitude, subjective norms and self-efficacy (p for trend<0.01). To investigate the overall relationship between the variables, we conducted a linear structural equation model analysis based on the theory of planned behavior. The subjective norms and self-efficacy influenced the stage of the women's screening behavior. CONCLUSIONS: We should target on self-efficacy about the screening behavior of women by performing timely, thoughtful interventions. The support from family members, friends and other people is crucial for women to undergo breast cancer screening and to improve the breast cancer screening rate.
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Original Article
Socioeconomic Disparities in Breast Cancer Screening among US Women: Trends from 2000 to 2005.
Jaeyoung Kim, Soong Nang Jang
J Prev Med Public Health. 2008;41(3):186-194.
DOI: https://doi.org/10.3961/jpmph.2008.41.3.186
  • 5,857 View
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  • 45 Crossref
AbstractAbstract PDF
OBJECTIVES
This study describes trends in the socioeconomic disparities in breast cancer screening among US women aged 40 or over, from 2000 to 2005. We assessed 1) the disparities in each socioeconomic dimension; 2) the changes in screening mammography rates over time according to income, education, and race; and 3) the sizes and trends of the disparities over time. METHODS: Using data from the Behavioral Risk Factor Surveillance System (BRFSS) from 2000 to 2005, we calculated the age-adjusted screening rate according to relative household income, education level, health insurance, and race. Odds ratios and the relative inequality index (RII) were also calculated, controlling for age. RESULTS: Women in their 40s and those with lower relative incomes were less likely to undergo screening mammography. The disparity based on relative income was greater than that based on education or race (the RII among low-income women across the survey years was 3.00 to 3.48). The overall participation rate and absolute differences among socioeconomic groups changed little or decreased slightly across the survey years. However, the degree of each socioeconomic disparity and the relative inequality among socioeconomic positions remained quite consistent. CONCLUSIONS: These findings suggest that the trend of the disparity in breast cancer screening varied by socioeconomic dimension. ontinued differences in breast cancer screening rates related to income level should be considered in future efforts to decrease the disparities in breast cancer among socioeconomic groups. More focused interventions, as well as the monitoring of trends in cancer screening participation by income and education, are needed in different social settings.
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English Abstract
Factors Associated with Gastric Cancer Screening of Koreans Based on a Socio-ecological Model.
Sang Soo Bae, Heui Sug Jo, Dong Hyun Kim, Yong Jun Choi, Hun Jae Lee, Tae Jin Lee, Hye Jean Lee
J Prev Med Public Health. 2008;41(2):100-106.
DOI: https://doi.org/10.3961/jpmph.2008.41.2.100
  • 5,560 View
  • 101 Download
  • 18 Crossref
AbstractAbstract PDF
OBJECTIVES
We measured behavioral factors associated with Koreans receiving gastric cancer screening based on a socio-ecological model, in part to develop strategies to improve cancer screening rates. METHODS: A telephone survey was conducted with 2,576 people chosen through stratified random sampling from April 1- May 31, 2004. Collected information included gastric cancer screening, socio-demographic factors, and socio-ecological factors at intrapersonal, interpersonal, community, and public policy levels. RESULTS: Among 985 survey respondents (380 men and 605 women), 402 had received gastric cancer screening. Logistic analysis was performed to compare those screened and unscreened. 'Age' was the only demographic factor that showed a statistically significant association with getting screening. People in their fifties (OR=1.731, 95% CI=1.190-2.520) and sixties (OR=2.098, 95% CI=1.301-3.385) showed a higher likelihood of getting screened, compared to those in the forties. 'Accessibility to a medical institution' was a significant factor related to having gastric cancer screening at the intrapersonal level. At the interpersonal level, recommendations by family members to be screened and a family practice of routine cancer screening were significantly related. People with frequent education about cancer screening or with stronger social feelings that cancer screening is necessary also demonstrated significantly higher tendencies to be screened. CONCLUSIONS: In conclusion, a socio-ecological model seems appropriate for explaining gastric cancer screening behavior and associated factors. Health planners should develop integrated strategies to improve cancer screening rates based on socio-ecological factors, especially at the interpersonal and community levels.
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