사회생태모형에 기초한 보건소 건강증진 프로그램 이용 분석

Analysis of the utilization of health promotion program in health care centers based on a socio ecological model

  • 발행 : 2008.09.30

초록

Purpose: The research was performed to distinguish the group of users of the health promotion programs in health care center, to identify the characteristics of this group, and to investigate the factors that have influence on the use of the health programs. The specific research purposes are: First, to compare the group which uses the health promotion program of health care center and that which does not. Second, to analyze the factors that have influence on the use of the health promotion program. Method: This study was done from November 15th 2006 and March 30th 2007. The study subjects were Seoul and Provinces. Seoul was divided into 4 areas of eastern western, northern, and southern area. Provinces were Gimchon, Gumi and Sosan. From each area, one health care center was chosen from the ones that wanted to participate. Total number of observations was 994. The survey questionnaire consisted of individual, interpersonal, organizational, community, policy factors based on socio-ecological model. The analysis method was logistic regression. Results: Odds ratios of individual factors is sex(1.39), age(1.05), marriage status(1.71) severity(1.20). Odds ratios of interpersonal factors is use and support of family(1.96), use and support of resource persons like friends and neighbor(4.58). Odds ratios of organizational factors is the comfortness of space(0.74), the satisfaction of health care center facility(1.40), kindness of employ(1.97). Odds ratios of community factors is health care center program recognition(1.70). Odds ratios of policy factors is advertisement(4.69) and expense(1.42). Conclusion: Socio-ecological model of health promotion in health care center is obtained based on five factors and health planners should consider these determinants of health promotion program in health care center and develop intervention methods.

키워드

참고문헌

  1. 김문환, 남철현. 노인에 있어 건강행위연구, 한국노년학연구, 1997;17(1):148-158
  2. 김일호. 지역사회건강증진사업 평가 연구. 서울대학교 석사학위 논문. 2000
  3. 김주현. 혈액투석환자에게 적용한 지시적 심상요법의 효과. 서울대학교 박사학위 논문. 1995
  4. 남정자. 보건소의 건강증진 사업을 위한 보건교육전략. 보건교육 건강증진 학회지 2000;17(1): 171-184
  5. 모현희. 보건소 이용자에 대한 만족도 조사 연구. 연세대학교 석사학위 논문. 2000
  6. 문정순. 성인의 건강신념 측정도구 개발 연구. 연세대학교 박사학위논문. 1990
  7. 박재산. 보건소 이용자가 인지하는 보건의료서비스 길, 만족도, 재이용의사 및 타인권유 의향간의 인과관계분석. 보건행정학회지, 2005;15(3):60-78
  8. 배상수. 보건사업기획. 서울: 계축문화사. 2004
  9. 보건복지부. 건강증진.http://www.mw.go.kr/user . 2008
  10. 서영준, 이동현, 손동국, 정승원, 정애숙, 박남수, 김주경, 이희원, 이무식. 보건소 건강증진 사업 성과지표개발. 보건교육 건강증진 학회지, 2004;21(2):1-16
  11. 서영준, 정애숙, 박태선, 김주경, 박남수, 이희원. 보건소 건강증진사업 수행과정의 질평가. 보건교육 건강증진 학회지, 2003;20(1):1-17
  12. 서울특별시 한국보건사회연구원. 서울시민을 위한 건강증진프로그램. 한국보건사회연구원. 2002
  13. 석말숙. 노인의 주관적 안녕감에 대항 생태체게적 접근. 노인복지연구, 2004;26: 237-261
  14. 송근원, 강대창. 지역 보건 서비스의 산출에 영향을 미치는 요인. 보건행정학회지, 2003;13:69-73
  15. 송현종. 보건소 건강증진사업평가지표개발. 연세대학교 박사학위논문. 2003
  16. 이가언. 일 대도시 보건소 이용자의 보건의료서비스 만족도. 보건행정학회지, 2000;13(4):28-47
  17. 이건세. 보건소 및 광역 보건행정 기능강화 방안. 의료제도발전을 위한 정책과제 자료집. 2003
  18. 이선희, 조희숙, 박영숙, 김한중, 손명세, 박혜숙, 이지전, 이상욱. 보건소 건강증진사업에서의 전략적 사업영역결정. 보건행정학회지, 1998;8(2):110-124
  19. 이승은. 보건소 건강증진 사업의 지역사회자원 활용실태. 연세대학교 석사학위 논문. 2004
  20. 이태화. 이정렬, 김희순, 함옥경. 건강증진사업 시범 여부에 따른 지역주민의 사업인식과 참여도, 건강행위 비교연구. 대한간호학회지, 2005;35(3):461-468
  21. 이철민 조경숙 원소영 김열 유상호 이정운 최재경 윤대현 이종구. 금연 클리닉에서 남성의 장 단기 금연 성공과 관련된 요인: 2004년 보건소 금연 시범 사업 분석. 대한 임상건강증진학회지, 2006;6(1):37-45
  22. 이혜순. 보건행정서비스의 만족도에 영향을 미치는 요인 분석. 경성대학교 박사학위논문. 2002
  23. 채효숙. 건강신념모델을 이용한 대학생의 음주 관련 요인 분석. 연세대학교 석사학위 논문. 2001
  24. 최선희. 일 지역사회종합병원의 마케팅 실태에 관한 조사연구. 한양대학교 행정대학원 석사학위 논문. 1996
  25. 허순임, 최숙자. 논문소득수준에 따른 의료이용. 제7회 노동 패널 학술대회논문집. 2006
  26. Bandura. A. Social Cognitive Theory. Greenwich, CT. 1989
  27. Becker, M. H. The Tyranny of Health Promotion. Public Health Review, 1986;14:15-25
  28. Bronfenbrenner, U. The Ecology of Human Development: Experiments by nature and Design. Cambridge, MA; Harvard University Press, 1979
  29. Bull. S. & Shhlay. J. Promoting "Dual Protection" From Pregnancy and Sexually Transmitted Disease: A Social Ecological Approach", Health Promotion Practice, 2005;1(6):72-80
  30. Cheadle, A., Bruce, M., Diehr, P., Koepsell, T., Wagner, E., Wickezer, T. & Curry, S. An Empirical Exploration of a Conceptual Model for Community Based Health Promotion. International Quarterly of Community Health Education, 1989;13:329-363
  31. Etter. S. & Grzywacz. J. Worker's Perception of How Jobs Affect Health: A social Ecological Perspective. Journal of Occupational Health Psychology, 2001;69(3):101-113
  32. Fleury, J. & Lee. S. The Social Ecological Model and Physical Activity in African American Women, American Journal of Community Psychology, 2006;10
  33. Fleury. J., Lee. S. M., Matteson. B. & Belyea. M. Barriers to Physical Activity Maintenance After Cardiac rehabilitation. Journal of Cardiopulmonary rehabilitation, 2004;24:296-307 https://doi.org/10.1097/00008483-200409000-00002
  34. Glanz, K., Lewis, F & Rimer, B. Linking Theory, Research and Practice. in Health behavior and Health Education. San Frances; Jossey-Bass, 1997
  35. Green. L., Kreuter, M. W. Health Promotion Planning: An Educational and Environmental Approach, 2nd ed. Mayfield; Mountain View, CA, 1997
  36. Gregson. J, Foerster. S.B., Orr. R., Jones. L., Benedict. J., Clarke. B., Hersey. J., Lewis. J. & Zotz K. System, Environmental, and Policy Changes: Using the Social-Ecological Model as a Framework for Evaluating Nutrition Education and Social Marketing Programs with Low-Income Audiences, Journal of Nutrition Education, 2001;33:sup1, s4-s15 https://doi.org/10.1016/S1499-4046(06)60065-1
  37. Grzywacz. J.G. & Marks. N. Social Inequalities and Exercise during Adulthood: Toward an Ecological Perspective. Journal of Health and Social Behavior, 2001;42:202-220 https://doi.org/10.2307/3090178
  38. Grzywacz. J.G. & Fuqua. MS. The Social Ecologicy of Health Leverage Points and Linkages. Behavioral Medicine, 2000;26(3):101-115 https://doi.org/10.1080/08964280009595758
  39. King A. C., Stokols. D., Talen. E. & Brassington. G. S. Theoretical Approaches to the Promotion of Physical Activity. American Journal of Preventive Medicine, 2002;23(2S):15-25 https://doi.org/10.1016/S0749-3797(02)00470-1
  40. Linnan. L. Sorensen. G., Colditz. G., Klar. N. & Emmoms. K. Using Theory to Understand the Multiple Determinants of Low Participation in Work site Health Promotion Programs. Health Education & Behavior, 2001;28(5):591-607 https://doi.org/10.1177/109019810102800506
  41. McLeroy. K. R., Bibeau. D., Steckler. A. & Glanz, K. An Ecological perspective on Health Promotion Programs. Health Education Quarterly, 1988;15:351-377 https://doi.org/10.1177/109019818801500401
  42. McLeroy. K. Community-based interventions. American Journal of Public Health, 2003;93(4):529-33 https://doi.org/10.2105/AJPH.93.4.529
  43. Riley. B. L., Tayor. M. & Elliott. S. Determinants of implementing heart health promotion activities in Ontario public health units: a social ecological perspective. Health Education Research. 2001;16(4):425-441 https://doi.org/10.1093/her/16.4.425
  44. Sherer. M., Maddux. J.E. The self-efficacy scale : Construction & Validation. Psychological Report, 1982;;51:663-671 https://doi.org/10.2466/pr0.1982.51.2.663
  45. Sorenson. G., Linnan. L. & Hunt. M. K. Worksite-based research and initiatives to increase fruit and vegetable consumption. Preventive Medicine, 2004;39:S94-S100 https://doi.org/10.1016/j.ypmed.2003.12.020
  46. Stokols. D. Social Ecology and Behavioral Medicine: Implications for Training, Practice, and Policy. Behavioral Medicine, 2000;26(3):129-138 https://doi.org/10.1080/08964280009595760