Objectives: This study attempted to understand the relationship between handwashing knowledge, attitude and practice of middle school students and to provide the basic information for handwashing training of the students and help them to form a healthy habit. Methods: Data was collected by a standardized self-administered questionnaire between Sep. 20 to Oct. 6 2006 with a total of 710 students in 1, 2, 3 grades at 6 middle schools in metropolitan cities(490 students from four schools situated in an urban center, 220 from 2 in a suburban district). The data was then analyzed using the SPSS WIN 12.0 program, employing many statistical techniques such as chi-square($x^2$) test, t-test, ANOVA analysis with post hoc test, correlations analysis, and regression analysis. Results: The results of the study were as follows. First, total number of handwashing times of middle school students is 6.69 per day. 66.1% of the students used soap and most of the students washed hands for $6{\sim}10$ seconds(44.7%). Second, in the knowledge of handwashing, "both of the parents"(p<0.01), "catholic", "city"(p<0.05) were the highest and the practice of handwashing was active with "city", "high economic level"(p<0.05) and "both of the parents"(p<0.01). In the experience of teaching handwashing, "Yes" was 24.3% which was statistically significant with handwashing knowledge(p<0.05), attitude and practice(p<0.01). Third, in the correlation of handwashing knowledge, attitude and practice, there was statistical significancy between handwashing attitude and knowledge(p<0.01) and showed positive correlation with the knowledge(.534). The practice of handwashing has meaningful difference from the knowledge and the attitude and the coefficient of correlation shows positive co-relation in knowledge(.335) and attitude(0525). Fourth, based on the result for regression analysis with handwashing knowledge, attitude and practice as dependent variables, handwashing knowledge showed statistical significancy with sex, type of school(p<0.05) and residential area(p<0.01). There were also statistical significancy between handwashing attitude and knowledge(p<0.01) and between handwashing practice and religion, knowledge(p<0.05) and economic level, attitude(p<0.01). Conclusion: There were consistent results with handwashing knowledge, attitude and practice. If they had better knowledge, their attitude was more positive and if they had better knowledge and more positive attitude, their practice was active. The knowledge, attitude and practice of the students who learned about handwashing were higher than those of the students who had no experience of learning handwashing. To enhance handwashing habit of middle school students, the handwashing environment should be maintained. The training plans should also be made according to sex, type of school, economic level, residential area, and the consistent study on handwashing training is required.

Objective: The objective of this study is to identify the risk factors for falls among the Korean elderly population. Methods: We analyzed the data on 167 persons of 65 years of age or older who have experienced falls drawn from the Third Korea National Health and Nutrition Examination Survey. We conducted a cross-tabulation analysis and logistic regression analysis of the impact of the socio-demographic characteristics, health-related behavior, mobility, and morbidity upon the frequencies of falls. Results: Among the socio-demographic characteristics, gender(p<0.001), marital status(p<0.1), and the type of medical insurance(<0.1) were found to be statistically significant, Among the constraints on mobility, the severity of walking problems, (p<0.001) and depression(p<0.05) proved to be significant, As for variables related to health-related behavior, the level of routine physical activities (p<0.001) was found significant, Finally, rheumatism(p<0.1), osteoporosis(p<0.05), diabetes(p<0.1), urinary incontinence(p<0.01) were also significant. A logistic regression analysis of the incidence of falls revealed that urinary incontinence was the most important risk factor with an odds ratio of 2.7. Conclusion: Although a variety of factors affect the frequencies of falls in the elderly population, urinary incontinence proved to be the single most important risk factor. This finding implies that education for fall prevention is crucial for those with urinary incontinence.

Objectives: The purpose of this study was to verify the validity of the evaluation indicators on safety and health education programs provided to Korean industrial workers, by developing further. Methods: To develop the early evaluation indicator, the secondary analysis was made on 'Survey on Industrial safety & health trends', the national wide survey data product by Korea Occupational Safety & Health Agency, as well as the various examinations on literatures. To validate such developed evaluation indicator, 13 safety and health managers in Focus Group discussion to prove the reliability of the contents were composed. To confirm the face validity, the interview with 6 industrial safety and health education experts was held to study the appropriateness of the content. With the cooperation from Korea Occupational Safety & Health Agency, the structured survey was performed with the safety and health managers from 588 businesses who participated in the education program for the later half of 2006. In this study, the number of responses was randomly divided into 1:1 two groups, in which one group was for the Exploratory Factor Analysis and the other group was for the Confirmatory Factor Analysis. Results: The results were as follows. First, for the Structure category, 18 evaluation indicators were developed into 4 evaluation categories such as a preliminary examination, education staff and organization, education environment and rules/ regulation. Secondly, the Activity category was comprised of 10 evaluation indicators with respect to 2 areas of curriculum satisfaction and program evaluation. Finally, for the Output category, 9 evaluation indicators were developed into 2 evaluation areas such as documentation and information share and education effects. Conclusions: The evaluation indicators developed through this study will possibly develop and be applied to evaluation tools on safety and health education program, which may further become the standardized indicators to better operate the industrial safety and health education programs.

Objectives: The purpose of this study was to identify the major health problems of poor children, and to provide basic information for developing health care program for low income children in underserved area. Methods: Health data were collected through medical examination(KAHP Social Welfare Service) and analysed for 3,081 poor children in 106 local children's centers nationwide. Results: 1. The mean height and weight of poor children were lower than those of nonpoor children. The differences were increased by age. 2. The rate of relative low weight was higher in poor children than in nonpoor children. On the contrary, The obesity rate was higher in nonpoor children than in poor children. 3. Poor children were more likely to have vision problem, anemia, high blood pressure, and oral health problems than nonpoor children. 4. The Health problems of children were the most serious in single father family. Conclusion: In order to improve children's health status, health promotion program for poor children should be developed and implemented. Health promotion program should include activities including regular health examination, home visiting, nutrition support, managed health care, health counseling and education. And the community support network was suggested for the efficacy of the program, including home, school and community.

Background: Health promotion services should be provided based on clients' health promotion needs. To provide health promotion services for elementary students in Korea, health promotion needs by geographical regions should be analyzed. Purpose: To analyze elementary students' health behaviors by regions. Method: Elementary students of 4018 from large cities, 1636 from medium sized cities, 328 from rural areas were included. Data collection was done using items from National Health and Nutrition Survey and was collected by mail from schools. For data analysis, Chi-square test and multiple logistic regression were utilized. Result: From comparison of health behaviors, there were no significant differences between large cities and medium sized cities. However, there were significant differences between urban students and rural students in terms of fast food intake, breakfast, soft drink intake, sleeping hours, tooth brush, and obesity. Conclusion: Health promotion services, especially correcting unhealthy eating behaviors for rural elementary students should be focused.

Object: To analyze the effect of a media-campaign for "walking exercise participation improvement", which impacted walking-related awareness and behavior change of residents in Seoul. Method: This study used three campaign media including printing information, walking exercise indication board and a public advertisement of cable TV to lead a walking-related awareness change and practice frequency(number of days per week walking) and time(minutes per day walking) of walking exercise. To evaluate the exposure and message-recall levels of a campaign and effects of awareness change and walking practice, this study used a questionnaire survey(N=377). Result: 1) Group of exposure to campaign more participate and had the higher frequency(p=.015) and time(p=.023) in walking exercise and in comparison with group of nonexposure. 2) Group of changed awareness to campaign more participate and had the higher frequency and time in walking exercise and in comparison with group of no changed perception(p <.05). 3) Level of message recall of ${\ulcorner}$printing information${\lrcorner}$ was associated with number of days per week walking, and level of message recall of ${\ulcorner}$public advertisement of cable TV${\lrcorner}$ was associated with minutes per day walking at a statistically significant level(p <.05). Conclusion: These results suggest that media campaign can enhance the success of community-based efforts to promote awareness change and walking practice.

Purpose: The Purpose of this study was to investigate the effects of the '5&6 smoking cessation program - six classes in five weeks' on the high school students' perception and smoking behavior. Methods: The data collection was done from November to December, 2006. This study was designed using nonequivalent control group pretest - posttest. Experimental group had 24 students, control group had 41 students. The '5&6 smoking cessation program' was applied to the experimental group for two hours per session during five weeks. Data analysis was done using descriptive statistics, X2-test, Fisher's exact test, Independent-samples t-test, Paired t-test, Cronbach's coefficient alpha. Results: The experimental group showed significant increase on smoking self-efficacy, stage of smoking cessation behavior change and significant decrease on daily smoking amount, dependancy of nicotine, urine cotinine level than control group. But the experimental group was not significantly changed at self-awareness, Pros. for smoking and Cons. for smoking. Conclusion: In conclusion, the results of this study showed that the 5&6 smoking cessation program, which focuses on self-awareness, is effective in adolescent's smoking cessation behaviors.

As overweight and obese people have increased, obesity management programs have generated much concern in Korea. Many types of obesity management programs were operated, aimed at reducing weight, BMI, body fat percentage and so on. This study was conducted to review the features of studies in obesity management programs and systematically assess the effects which were published from 1995 to 2006 in Korea. Databases were systematically searched for published data in Korea. It were KISS (Korean studies information services system) and KERIS (Korean Education research information system), which were major literature search systems for all academic fields in Korea. Total 114 studies were initially identified, of which 21 satisfied our inclusion data. The effects of obesity management programs were assessed on the results in weight, BMI (body mass index), HDL (high density lipids), body fat percentage, self-efficacy. Effect size estimated on the equation of M1 - M2 / Sp, where M1 was mean of the experimental group, M2 was the mean of control group, and Sp was the pooled standard deviation. Magnitude of effect size was interpreted by using Cohen's definition. Cohen described small, medium, and large effect sizes as 0.2, 0.5, and 0.8 respectively. The studies about obesity management programs were the most published in 2005(26.1%). Obesity management programs were popularly operated as the type of 12 weeks intervention, exercise intervention(52.4%), quasi-experimental study(85.7%). Ten studies reported significant effects on weight, and nine studies reported significant effects on BMI and HDL. Only five and three studies reported significant effects on body fat percentage and self-efficacy respectively. The effects of each outcome were generally significant when the studies included these elements, intervention over 10 weeks, evaluation over 3 times, a comprehensive program (exercise, nutrition education, behavior modification) and reinforcing factors (self-monitoring, group discussion, one's goal setting, and etc.). Effective obesity management programs should contain these essential elements and objectives of obesity management programs must be set out evident at the beginning. The participants should be registered, educated and evaluated by continuous obesity management programs.

This study was intended to provide basic data for developing an oral health management program for diabetic patients by understanding their oral health condition and defining the influence of diabetes on oral health. The following results were obtained through intraoral examination and questionnaire surveys done on one hundred and twenty two diabetic outpatients who visited endocrine department at Yeungnam University in Daegu and internal medicine department at Chungmu hospital in Cheonahn for 4 months from November, 2005 to February, 2006. DMF index according to the gender was significantly higher in females only in Filling index (p <0.05). Missing index increased as the age increased (p <0.001). Papillary bleeding index was significantly higher in females (p <0.05). Several indices which show oral status significantly higher as the duration of diabetes increased and as the blood sugar level before meal was higher (p <0.01, p <0.05). In a group that received oral hygiene education, several indices which show periodontal status were significantly lower than those in a group that didn't have it (p <0.001). According to the results, not only diabetic control but also general oral care should be included in self-management education for diabetic patients and this should be accomplished by appropriate oral health education program and staffs.

To commonly apply the ${\ulcorner}$Measurement parameter for housewives for rearing-related supports of a husband${\lrcorner}$ in Korea and Japan, the current study conducted to confirm the relationship between recognition of a housewife for rearing-related supports of a husband and mental health after reviewing the appropriateness of the parameter. For the statistical analysis, 829 married Korean women in D city and 1,302 Japanese women in S city having children before entering a school were subjected for the study. For reviewing the appropriateness of the parameter, the simultaneous factor analysis that adopted the structural equation modeling was used. As the result of the analysis, 10 categories of factor structural model comprising the ${\ulcorner}$Recognition of a housewife for rearing-related supports of a husband${\lrcorner}$ resulted with the secondary model which sets of ${\ulcorner}$Recognition for emotional support${\lrcorner}$, ${\ulcorner}$Recognition for instrumental support${\lrcorner}$ and ${\ulcorner}$Recognition for information support${\lrcorner}$ as the primary factor and ${\ulcorner}$Recognition of a housewife for rearing-related supports of a husband${\lrcorner}$ as the secondary factor, and the model was found to be appropriate for the data in Korea and Japan. The result is considered to prove the constructs validity of ${\ulcorner}$Recognition of a housewife for rearing-related supports of a husband${\lrcorner}$ parameter. In addition, the relationship between ${\ulcorner}$Recognition of a housewife for rearing-related supports of a husband${\lrcorner}$ and mental health(GHQ) was reviewed by using multiple indicator model, and found the similarity of Korean and Japanese data. The scores measured by using the above parameter resulted to show high relationship with educational level of housewife, family configuration, and number of children.

Objectives: A content analysis was conducted to examine whether the current school textbooks providing smoking information are effective or not. Methods: The authors reviewed 111 qualified textbooks using elementary through high schools during 2006-2007 academic year in Korea. Educational components were coded with an analysis tool developed through the present research. Result: Tobacco education components were narrowly focused on long-term physiological consequences of tobacco use, addictiveness, and harmful ingredients and they were repetitively shown in the textbooks. Negative health consequences such as lung cancer were emphasized 10 times among 12 smoking-related textbooks. Educational messages or contents are mainly based on medical knowledge (72%) rather than psycho-social components. The US school-based smoking prevention programs, however, employ psycho-social approach with cognitive and life-skill components and they contain only 7-17% of smoking-related medical knowledge. In order to increase psycho-social smoking prevention components in Korean textbooks, the present study identified social subjects of textbooks (and relating core sessions) for elementary, middle, and high school. It also provided guidelines for school instructors to use. Conclusion: Adolescent smoking behavior is not caused by the deficit of health information, but mostly by social influences including media and peer pressure. School textbooks proving smoking information need to increase psycho-social context. One of the most effective ways as a psycho-social smoking prevention program is to use social subjects (or curriculum) of textbooks such as social studies, ethics, social cultures, social environment, and home management.

This study reviews the amount and expenditures in national health promotion fund from 1997 to 2006, to analyse the problems and provide the future direction of health promotion fund programs. This study suggested the guide for future plans and the scope and contents of health promotion fund programs, priority and fund budgetary allocation, and operation organization. It is needed to revise health promotion law and enforcement decree of the health promotion act. The fund should be used in limited 9 areas related to healthy life activities: (1)Anti-smoking actions, (2)To support activities leading to a healthy life, (3)Public health education and development of materials, (4)Investigation and research regarding community health matters, (5)Public nutrition management activities, (6)Oral health management activities, (7)Physical exercises for health promotion, (8)Foundation related to supporting healthy life style practice society, (9)Expenses necessary for the management and operation of the fund. And also, in order to improve the performance of health promotion, it is considered to reform the operation system including organization.

The purpose of this study was to identify the current problems of school health education policies and practices in Korea, and to establish the strategies to improve the effectiveness and efficiency of school health education program. The severity of adolescents's health problems including obesity, smoking, drug abuse, teen pregnancy, etc has been increased recently and coping strategies to deal with these problems became urgent. The role of school as a key setting for health education should be empathized. However, there were limitations for the effectiveness of school health education in Korea because of the lack of recognition about the importance, guiding principles of the school health education by the school health related law, life skill-focused curriculum, capacity of teachers for health education, and linkage between school and community. In order to improve the effectiveness of school health education, establishment of infrastructure, national and local health education standard, and operating principles for the school health education program should be provided. Life skill-focused health education curriculum should be developed for the effective health education. Teacher training and education also should be the essential component of school health education program. For the improvement of efficiency in school health education practices, cooperation with family and community support system would be necessary.

The hospital setting provides many opportunities for health promotion. There are many health professionals including physicians, nurses, medical technicians who have close contact with patients and their family. Health professionals are very influential to arouse the awareness about health and illness, and to motivate to change lifestyle among patients. Thus health professionals are most effective and important human resources for health education for patients to improve recovery rates and to promote health. In spite of the importance of health professionals' role in health promotion, the Korean government has provided little support for their health education for patients. Most of the health professionals have not learned about health education theories and skills, and have little attention to educate patients to change their lifestyle. Also the health professionals themselves have relatively poor lifestyle compared with advanced western countries. To improve health education for patients and their family, following strategies and policies should be considered: reinforcing curriculum for health education in college and training course, providing practical incentives for patient education, capacity building for health education and developing guideline for patient education, training health educators, networking and collaborating between community health center and hospitals, promoting the importance of health education among patients, researching and developing health education theory and practice including cost-benefit of health education.

Health education aims at behavior change rather than just delivering health knowledge to people. In Korea health education activities in public sector began in 1960 and they were included in the primary prevention program in communities. This article reviewed current health education programs in healthy living practice programs provided by local public health centers in Korea and drew implications for the future role of health education in community setting. Health education has been a core function of the National Health Promotion programs in the nation since the enactment of the National Health Promotion Law in 1995. The National Health Promotion programs are funded by the National Health Promotion Fund which are drawn from tobacco tax. The National Health Promotion programs include healthy living practice programs (smoking prevention and cessation programs, moderate alcohol use programs, physical activity promotion programs, and nutrition programs), chronic disease prevention programs, oral health programs and public hygiene programs. Methods of the National Health Promotion programs include health education, health counseling, health class, health information management, survey and research. Smoking prevention and cessation programs include smoking cessation clinic, smoking cessation education, non-smoking environment program, and non-smoking campaign. Moderate alcohol use programs include alcohol use education, moderate alcohol use campaign, alcohol use counseling, and alcohol free environment programs. Physical activity promotion programs include obesity control, targeted exercise program, and exercise civic group programs. Nutrition programs include nutrition management, obesity management, nutrition education, breakfast eating program, and nutrition counseling and treatment programs. The health education programs in community are not efficient today because there are many overlapping contents and short term goals. Community health education programs needs to be more comprehensive. Workforce development is another big issue at the moment because the National credential program will begin in 2009. Variety of community health education programs should be developed and funded by the national health promotion fund.