• Health Policy and Management
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• v.33 no.4
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• pp.389-399
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• 2023

Background: The purpose of this study is to analyze the factors affecting the unmet healthcare needs of older people with chronic diseases in Korea and provide a basic research report to strengthen their access to medical care. Methods: In the 2020 older people survey data, 8,182 older people aged 65 or older who were diagnosed with one or more chronic diseases were the final subjects of the study. According to Andersen's behavioral model used in unmet healthcare needs, independent variables were composed of predisposing factors, possible factors, and necessary factors, and whether or not unmet healthcare needs was set as dependent variable. Results: Of the older people with chronic diseases, 1.6% experienced unmet healthcare needs, of which 55.9% experienced unmet healthcare needs for reasons related to economic burden, 31.6% physical constraints, and 12.5% time constraints. As a result of the analysis, older people with chronic diseases were more likely to experience unmet healthcare needs if they were relatively low in age, low in education level, no spouse, low in household income, poor subjective health, complex chronic diseases, and functional restrictions. However, by major reasons for experiencing unmet healthcare needs, living in rural areas were more likely to experience unmet healthcare needs due to physical constraints, and those who participated in economic activities and who had were more likely to experience unmet healthcare needs due to time burden. These results were not derived when only unmet healthcare needs was set as the dependent variable. Conclusion: This study emphasizes the need for an approach by cause of unmet medical occurrence by suggesting that there are differences in influencing factors by reason for experiencing unmet healthcare needs.

• Nutrition Research and Practice
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• v.11 no.3
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• pp.247-256
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• 2017

BACKGROUND/OBJECTIVES: Easy access to intervention and support for certain behaviors is important for obesity prevention and management. The available technology such as smartphone applications can be used for intervention regarding healthy food choices for obesity prevention and management in elementary-school students. The transtheoretical model (TTM) is comprised of stages and processes of change and can be adopted to tailored education for behavioral change. This study aims to develop TTM-based nutrition contents for mobile applications intended to change eating behaviors related to weight gain in young children. SUBJECTS/METHODS: A synthesized algorithm for tailored nutrition messages was developed according to the intake status of six food groups (vegetables, fruits, sugar-sweetened beverages, fast food and instant food, snacks, and late-night snacks), decision to make dietary behavioral changes, and self-confidence in dietary behavioral changes. The messages in this study were developed from December 2014 to April 2015. After the validity evaluation of the contents through expert consultation, tailored nutrition information messages and educational contents were developed based on the TTM. RESULTS: Based on the TTM, stages of subjects are determined by their current intake status, decision to make dietary behavioral changes, and self-confidence in dietary behavioral changes. Three versions of tailored nutrition messages at each TTM stage were developed so as to not send the same messages for three weeks at most, and visual materials such as figures and tables were developed to provide additional nutritional information. Finally, 3,276 tailored nutrition messages and 60 nutrition contents for applications were developed. CONCLUSIONS: Smartphone applications may be an innovative medium to deliver interventions for eating behavior changes directly to individuals with favorable cost-effectiveness. In addition, using the TTM for tailored nutrition education for healthy eating is an effective approach.

• Health Policy and Management
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• v.14 no.4
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• pp.88-113
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• 2004

Starting from April, 2003, new pre-review system has been introduced and implemented to reduce unnecessary conflict with medical care organizations caused by current retrospective claim review system and to enhance efficiency of review system. The main purpose of pre-review system is to educate doctors to contrive adequacy of medical services. This research mainly focuses on effectiveness of pre-review system's influence on physicians' behavior changes. The analysis-participants were drawn from 1,449 clinics which implemented pre-review system, since April of 2003. The research results are as followings. First, the amount per claim has reduced by $\\3,154$, days of visit per claim by 0.1 day, and amount per visit by $\\412$, which were statistically significant. Second, anesthesiologists have decreased in three indicators the most, and the internists had least of changes. Third, the amount per claim and days of visit per claims has dropped significantly on physicians with less periods of practice and physicians with more ages. Fourth, the clinics without the expensive medical equipments, the city clinics showed significant decrease on days of visit per claim. Fifth, in intervention methods, the one-to-one education showed more significant decrease on amount per visit rather than information feedback by paper. In conclusion, the pre-review system have an impact on self-imposed physician behavioral change. The outcome of this research may be utilized for future extension implementation of pre-review system. Furthermore, it is showed that ability of transitions in medical services review system according to the future transition of payment system and context of health service policy.

• Health Policy and Management
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• v.31 no.2
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• pp.197-206
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• 2021

Background: The purpose of this study was to identify factors affecting unmet healthcare needs due to physical accessibility by residential area by utilizing the Korea Community Health Survey (KCHS). Methods: Andersen's medical service behavioral model was applied to analyze the enabling factors, predisposing factors, and needs factors of unmet healthcare needs focusing on residential areas. This study used data from the KCHS (2017-2019, n=440,792). We used multivariate survey logistic regression analysis in order to identify affecting factors. Sub-group analysis was conducted in order to evaluate the effects of residential areas. Results: Some participants (2,621, 0.59%) had experienced unmet healthcare needs due to physical accessibility and 2,047 subjects (78.1%) of them lived in rural areas. Multivariate survey logistic regressions revealed that experience of unmet healthcare needs due to physical accessibility increased when people lived in rural areas (odds ratio [OR], 3.95; 95% confidence interval, 3.46-4.51). Conclusion: This study showed that despite the development of transportation and efforts to alleviate medical inequality, residents in rural areas may still have higher experience of unmet healthcare needs due to physical accessibility compared to the metropolitan city regardless of any other sub-group differences (OR range, 1.90-6.31). This study suggested that government and policymakers should identify the causes of the experience of unmet healthcare needs due to physical accessibility and should develop policies to alleviate those healthcare disparities.

• Korean Journal of Agricultural Science
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• v.44 no.2
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• pp.296-307
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• 2017

Globally, consumers' enormous and increasing appetite for meat is one of the biggest causes of climate change because livestock industry emits more greenhouse gas than transportation. The purpose of this study is to analyze consumer awareness about the impact of meat consumption on sustainability in response to climate change. Based on the theory of planned behavior, the attitudes, subjective norms, perceived behavioral control, prior knowledge, and risk perception variables were analyzed to evaluate the impact of climate change awareness over consumer behavior on meat consumption. Major findings are as follows: consumers were aware of climate change but has made few changes to their meat consumption. In addition, changes in meat consumption were found to be caused by health safety concerns, such as disease outbreaks. Significant variables related to meat consumption patterns associated to climate change impacts were household income, age, attitude, subjective norm, perceived behavioral control, and prior knowledge. These results suggest some implications for policy. There is a need for public relations and education to make the public aware of and better understanding of link between climate change and diet. Also, government should make efforts to raise awareness of mitigation of climate change such as comprehensive food labels which are identifying lesser impacts on climate and better dietary guideline instructions which would include coping with climate change.

• Journal of Korean Neuropsychiatric Association
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• v.57 no.3
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• pp.235-243
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• 2018

Treatment of schizophrenia has as its ultimate goals, the functional recovery of the patients and improvement of their quality of life. While antipsychotic medication is the fundamental method for treating schizophrenia, it has certain limitations in terms of treating the illness beyond its positive symptoms. Therefore, psychosocial intervention should be used in tandem with pharmacological methods in treating schizophrenia. The efficacy of several modes of psychosocial intervention for improving outcomes in schizophrenia is well attested. Approximately 10 modes of psychosocial intervention have been recommended based on existing evidence, including family intervention, cognitive behavioral therapy, supported employment, early intervention services, lifestyle intervention for physical health enhancement, treatment of comorbid substance abuse, assertive community treatment, cognitive remediation, social skills training, and peer support. Ideally, these interventions are offered to patients in combination with one another. Over the last decade, increased emphasis has been placed on early detection and intervention, with particular focus on long-term recovery. Early intervention with comprehensive psychosocial interventions should be enacted promptly from the initial detection of schizophrenia.

• Korean Journal of Health Education and Promotion
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• v.21 no.2
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• pp.55-85
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• 2004

The problems of health in poor peoples are various and difficult things to solve it. They are highly susceptible to chronic disease because of bad environment and It is hard to access to medical services because of their Socio-demographic status. Therefore, it is important to address the problem of prevention of chronic disease and health promotion aspect. The purpose of this study was to determine the relationships among the health status, health behaviors and health practices of poor people in urban slum area. The subject of this study were 298 poor peoples who live in poor area in Daegu metropolitan city and they were asked to answer the survey questionnaires modified for Korean from behavioral risk factor surveillance system of Centers for Disease Control and Prevention USA. The result of the study were as follows； (1) There were significant relationships between health status (prevalence of chronic disease and perceived general health) and socio-demographic factor such as occupation, existence of spouse, number of family educational level, type of medical security. (2) There were some relationships between health risk behaviors such as smoking, drinking and obesity and health status of subject especially in female obesity.(3) There were relationships among health concern activity, prevalence of chronic disease and some social factor such as educational level and occupation. (4) There were relationships among health practice, health concern activity, health status and socio-demographic factors of subject. This study suggest that health status, socio-demographic status, health concerns and health promotion activity of study populations were associated and It is very important things supporting the poor people in the level of community and nation to practice healthy behaviors themselves.

• Korean Journal of Occupational Health Nursing
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• v.7 no.1
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• pp.33-46
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• 1998

Introduction : In Korea, national attention to the workplace health promotion programs (HPP) for employees began in early 1990s. Governmental supports for the HPP and education programs have given to the employees. The purpose of this study is to find the performance degree of employees' health promoting lifestyle(HPL). Subjects and Methods : For this study, 615 employees who attended governmental educations were selected as research samples. The tool for measuring HPL used in this study was developed for Korean by In-Sook Park in 1995. It is composed of 4-point scaled 60 items and divided into 11 subcategories. The data were collected by self reporting questionnaires from June to December in 1997. Those data were analyzed percentile, mean, standard deviation, ANOVA, t-test with SAS program. Major findings are as follows; 1. The total mean score of the employees' HPL performance was 2.66. The average scores of 'harmonious relationships' category were the highest as 3.11, whereas the one of 'professional health maintenance' were the lowest as 2.02. The remains were 'sanitary life'(2.90), 'emotional support(2.85), 'regular diet'(2.84), 'self achievement'(2.78), 'healthy diet'(2.56), 'rest and sleep'(2.56), 'exercise and activity'(2.54), 'diet control'(2.53), 'self-control'(2.52). 2. The factors affecting HLP were category of industries and sex, age, marital status, education level, major, educational experience of health promotion, among personal characteristics. The employees of service industries, female, older age, married, nurse, educated for health promotion, graduated from junior college performed HLP more than the others. 3. The participation rates of employees for HPP were 12.4%, because of limited time and facilities and equipments. Recommendations; 1. The regulation for performing the health promotion programs in the industries is essential for activating industrial health promoting movement. 2. More governmental supports for educations and services for health promotion programs in the industries are needed. 3. For behavioral changes of the employees, the contents of educations have to consist of exercise and activity, rest and sleep, diet and smoking habits. 4. The evaluating studies for ready made health promotion programs in the industries are expected.

• Journal of Preventive Medicine and Public Health
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• v.39 no.5
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• pp.438-446
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• 2006

Objectives: We developed the predictive model for the incidence of colon cancer by utilizing the health screening data of the National Health Insurance in Korea. We also explored the characteristics of the high risk group for colon cancer. Methods: The predictive model was used to determine those people who have a high risk for colon cancer within 2 years of their NHI health screening, and we excluded the people who had already been treated for cancer or who were cancer patient. The study population is the insured of the NHI, aged 40 or over and they had undergone health screening from the year 2000 to 2004, according to NHI health screening formula. We performed logistic regression analysis and used SAS Enterprise Miner 4.1. Results: This study shows that there exists a higher rate of colon cancer in males than females. Also, for the population in their 60s, the incidence rate of colon cancer is much higher by 5.36 times than that for those people in their 40s. Amongst the behavioral factors, heavy drinking is the most important determinant of the colon cancer incidence (7.39 times in males and 21.51 times in females). Conclusions: Our study confirms that the major influencing factors for the incidence of colon cancer are drinking, lack of exercise, a medical history of colon polypus and a family history of colon cancer. As a result, we can choose the group that is at a high risk for colon cancer and provide customized medical information and selective management services according to their characteristics.

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.23
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• pp.10071-10077
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• 2015

Background: Cervical cancer has become a major public health problem worldwide. Iran, like other developing countries, is facing a number of challenges in managing the disease. This qualitative study documents challenges encountered in cervical cancer preventing programs in Iran. Materials and Methods: In-depth interviews were conducted with 28 participants including eleven patients with cervical cancer, three gynecologic oncologists, five specialists in Obstetrics and Gynecology, five midwives, three health care managers and one epidemiologist in Mashhad Iran, between May and December of 2012. The sample was selected purposively until data saturation was achieved. Data credibility verified via allocated sufficient time for data collection, using member checking and peer debriefing. Data analysis was carried out using conventional content analysis approach with ATLAS. ti software. Results: Findings from data analysis demonstrated 2 major themes and 6 categories about challenges of providing cervical cancer prevention programs including: individual and social challenges (cognitive/behavioral challenges and socio/cultural challenges) and health system challenges (stewardship, financing, competency of health care providers and access to services). Each category included some subcategories. Conclusions: Managing the cervical cancer prevention programs need to include the consideration of individuals, health care providers and health system challenges. Addressing the low level of knowledge, negative attitudes, socio cultural challenges, Poor intersectional collaboration and coordination and intra-sectional management, financing and competency of health care providers are essential steps toward significantly reducing the burdens of cervical cancer.