• Journal of Preventive Medicine and Public Health
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• v.55 no.2
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• pp.153-163
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• 2022

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.

• Journal of Korean Institute of Industrial Engineers
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• v.29 no.3
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• pp.239-246
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• 2003

Individual items are produced continuously from an industrial process. Each item is checked to determine whether it satisfies a lower screening limit for the quality characteristic which is the weight of an expensive ingredient. If it does, it is sold at a regular price; if it does not, it is reprocessed or sold at a reduced price. The process mean may be adjusted to a higher value in order to reduce the proportion of the nonconforming items. Using a higher process mean, however, may result in a higher production cost. In this paper, the optimal process mean and lower screening limit are determined in situations where the probability that an item functions well is given by a logistic function of the quality characteristic. Profit models are constructed which involve four price/cost components; selling prices, cost from an accepted nonconforming item, and reprocessing and inspection costs. Methods of finding the optimal process mean and lower screening limit are presented and numerical examples are given.

• Korean Journal of Health Education and Promotion
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• v.23 no.2
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• pp.77-89
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• 2006

Objectives: Recent studies have shown that tailoring to women's individual beliefs and stage of cancer screening adoption increase the probability that cancer screening will ensue. To identify variables associated with cancer screening behavior, many studies for cancer screening have used the Transtheoretical Model(TTM). This study was carried out to identity the cognitive and behavioral factors associated with breast cancer screening by stages of change among women, forties aged. Methods: Building on the TTM constructs, we collected the data to test the association with cognitive and behavioral factors for breast cancer screening by stage of change among women, forties aged (N=232), using the self-reported questionnaire. The stages of change were grouped according to screening participation and intention for breast cancer as precontemplation, contemplation, preparation, action, and maintenance. We found out the association between breast cancer screening and cognitive and behavioral factors, and testified the difference between stages of change by chi-square test, one-way ANOVA, and multiple comparison analysis(Duncan test). Results: Analyses of 232 women showed that participation on mammography was 68.1% within lifetime and 46.1% within last 2 years, and we found out the association with breast cancer screening participation, intention and cognitive-behavioral factors. The stages of change based on participation and intention were different from the decisional balance, the screening attitude, and the self-efficacy(p<0.01). The decisional balance was differ from stages of change because the difference on opinions about pros(positives) and cons(negative) were likely to significant by stages of change(p<0.05, p<0.01). Conclusion: To increase the screening rate for breast cancer, it should be developed the tailored message and recommend guideline. And the tailored message should be designed to increase the pros of breast cancer screening(mammography) and to decrease the cons, and considered the woman's stage of adoption.

• Korean Journal of Health Education and Promotion
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• v.22 no.2
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• pp.97-110
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• 2005

Objectives: Recent studies have shown that tailored messages for cancer screening to the beliefs and stage of cancer screening behavior of individual women increases the take-up probability. Many studies on cancer screening have used the Transtheoretical Model (TTM) to identify variables associated with cancer screening behavior. This study was carried out to identify the cognitive-behavioral factors associated with stomach cancer screening among women aged 40 years and over, and to develop and evaluate a tailored educational program for stomach cancer screening by stages of change. Methods: Building on the TTM constructs, we conducted a quasi-experimental study(N=283) to test the effectiveness of a tailored educational program for endoscopic stomach cancer screening. We carried out pre and post tests in the experimental group(N=162) and the control group(N=121), and the experimental group was subdivided into an on-line group(N=81) and an off-line group(N=81) by educational methodology using e-mail and the postal service. We used the chi-square test, trend test, and paired t-test to test the effectiveness of the program for stomach cancer using a tailored stage-matched messages. Results: To examine the effectiveness of the program for stomach cancer screening by the tailored stage-matched messages, the stage-matched materials were offered to the experimental group(N=162) four times for 4 weeks. The stage-matched materials consisted of the four types for stomach cancer. The tailored message was effective in changing the cognitive-behavioral factors, such as experience process, behavior process, con opinion for stomach cancer, self-efficacy, and the behavioral stages for stomach cancer screening. The stomach cancer screening adherence was higher for the stage-matched materials using postal mail than for those using e-mail. Conclusion: To improve the stomach cancer screening rate, the use of tailored messages for stomach cancer screening will be generated using an expert system. Therefore the implementation of tailored educational program will be supported a partnership between public and private health organizations and increasing awareness of the necessity of community-based interventions.

• Journal of Practical Engineering Education
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• v.15 no.2
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• pp.495-502
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• 2023

Despite the fact that Korea has supported national cancer screening worldwide for a long time, the cancer screening screening rate is low compared to other health screenings and infant screening. In particular, women with disabilities show a lower screening rate for cervical cancer screening compared to women without disabilities. Therefore, from 2011 to 2019, this study investigated the trends in cervical cancer screening rates of women with disabilities and non-disabled women aged 30 and older, and analyzed the factors affecting cervical cancer screening of women with disabilities at the individual and regional level through the cervical cancer screening rates among regions. The purpose of this study is to identify the factors that affect regional variation by dividing into regions. From 2011~2019, the cervical cancer screening rate of people with disabilities was the highest in Daejeon and the lowest in Sejong and Jeju, and the gap in cervical cancer screening rate of people with disabilities by region was analyzed to be up to 13.1%.

• The Korean Journal of Applied Statistics
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• v.31 no.1
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• pp.123-137
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• 2018

A nonlinear mixed effects model is mainly used to analyze repeated measurement data in various fields. A nonlinear mixed effects model consists of two stages: the first-stage individual-level model considers intra-individual variation and the second-stage population model considers inter-individual variation. The individual-level model, which is the first stage of the nonlinear mixed effects model, estimates the parameters of the nonlinear regression model. It is the same as the general nonlinear regression model, and usually estimates parameters using the least squares estimation method. However, the least squares estimation method may have a problem that the estimated value of the parameters and standard errors become extremely large if the assumed nonlinear function is not explicitly revealed by the data. In this paper, a new estimation method is proposed to solve this problem by introducing the ridge regression method recently proposed in the nonlinear regression model into the first-stage individual-level model of the nonlinear mixed effects model. The performance of the proposed estimator is compared with the performance with the standard estimator through a simulation study. The proposed methodology is also illustrated using quantitative high throughput screening data obtained from the US National Toxicology Program.

• Journal of Preventive Medicine and Public Health
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• v.49 no.6
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• pp.343-348
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• 2016

Since noncommunicable diseases (NCDs) are generally controllable rather than curable, more emphasis is placed on prevention than on treatment. For the early detection of diseases, primary care physicians (PCPs), as well as general practitioners and family physicians, should interpret screening results accurately and provide screenees with appropriate information about prevention and treatment, including potential harms. The concept of quaternary prevention (QP), which was introduced by Jamoulle and Roland in 1995, has been applied to screening results. This article summarizes situations that PCPs encounter during screening tests according to the concept of QP, and suggests measures to face such situations. It is suggested that screening tests be customized to fit individual characteristics instead of being performed based on general guidelines. Since screening tests should not be carried out in some circumstances, further studies based on the concept of prevention levels proposed by Jamoulle and Roland are required for the development of strategies to prevent NCDs, including cancers. Thus, applying the concept of QP helps PCPs gain better insights into screening tests aimed at preventing NCDs and also helps improve the doctor-patient relationship by helping screenees understand medical uncertainties.

• Asian Pacific Journal of Cancer Prevention
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• v.14 no.7
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• pp.4005-4013
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• 2013

Background: Although breast cancer is a major public health worry among Asian women, adherence to screening for the disease remains an obstacle to its prevention. A variety of psycho-social and cultural factors predispose women to delay or avoidance of screening for breast cancer symptoms at the early stages when cure is most likely to be successful. Yet few interventions implemented to date to address this condition in this region have drawn on health behavior theory. Materials and Methods: This paper reviews the existing literature on several cognitive theories and models associated with breast cancer screening, with an emphasis on the work that has been done in relation to Asian women. To conduct this review, a number of electronic databases were searched with context-appropriate inclusion criteria. Results: Little empirical work was found that specifically addressed the applicability of health theories in promoting adherence to the current breast cancer prevention programs Among Asian women. However, a few studies were found that addressed individual cognitive factors that are likely to encourage women's motivation to protect themselves against breast cancer in this region of the world. The findings suggest that multi-level, socio-cultural interventions that focus on cognitive factors have much promise with this issue. Conclusions: Interventions are needed that effectively and efficiently target the personal motivation of at-risk Asian women to seek out and engage in breast cancer prevention. Concerning implications, personal motivation to seek out and engage in individual preventive actions for breast cancer prevention among Asian women is a timely, high priority target with practical implications for community development and health promotion. Further studies using qualitative, anthropologic approaches shaped for implementation in multi-ethnic Asian settings are needed to inform and guide these interventions.

• Journal of Preventive Medicine and Public Health
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• v.42 no.3
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• pp.177-182
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• 2009

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.

• Asian Pacific Journal of Cancer Prevention
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• v.13 no.3
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• pp.969-974
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• 2012

Mammography utilization is low in Iran compared with other countries. Here a cross-sectional survey design was used to investigate psycho-social and individual factors associated with mammography among 400 women asymptomatic of breast cancer. The study was carried out at the four outpatient clinics of Tehran during the period from July through October, 2009. We found that mammography screening was related to higher self-efficacy and women's occupation. Future tailored interventions on potential psycho-social determinants and specific demographic factors are critical in increasing mammography screening rates among Iranian women.