• Research in Community and Public Health Nursing
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• v.5 no.2
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• pp.109-129
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• 1994

Chronic health problems has become a major concern and challenge to the health care professionals today. Especially hypertension, one of the leading primary cause of death in Korea, is a typical chronic disease requiring adequate and continuous management. Though these hypertensives need to maintain desirable health practice by themselves for their life time, many previous studies indicated that most of the essential hypertensives have no specific symptoms and thus, reluctant to follow appropriate medical regimens causing the condition further aggravated and complicated. Self-care is an essential factor that keeps chronic patients in control of their health and wellness. Thus this study was conducted to identify the effect of the comprehensive self-regulation program as a nursing intervention on the promotion self-care performance and improvement in physical parameters of hypertensives. For this purpose, a one group quasi-experimental research with pre and post test design was used. The subjects of the study was consisted of thirty persons with mild or moderate essential hypertension from two companies in Cheong-ju city. The whole program was carried out from October, 1993 to February, 1994. The self-regulation program was consisted with group education on hypertension and self-care, self-regulation including the blood pressure self-monitoring and recording, recording of daily self-care activities, and encouraging and reinforcing self-efficacy through verbal persuation and enactive attainment. The subjects were asked to measure their own blood pressure by themselves twice per day and to record blood pressure and the daily self-care performance according to the instructions provided during the whole period of 9 weeks. The instruments used for data collection in this study were as follows : 1) Instruments used for measuring the knowledge about hypertension, multiple health locus of control, and perceived benifits and barriers were adapted from previous studies and modified by author to be fit for the subjects. 2) Self-efficacy scale and self-care performance record were developed by the author. 3) Physiological parameters included systolic / diastolic blood pressure, body weight, level of blood cholesterol, and 24hour ambulatory blood pressure. The post-experimental Cronbach's Alpha as the reliability test of scales were 0.703-0.897, an appropriate level of confidence. The effect of the program was analyzed by experimental stages ; the first week, the fifth week, and the ninth week since the experimental imput began. Data were analyzed by the SPSS PC+ program with paired t-test and t-test, repeated measure ANOVA, and pearson's correlation to de termine the effect of program. The results were as follows : 1) After the self-regulation program, scores on knowledge(t=-2.41, p=.011), perceived self-efficacy (F=5.60, p=.001), self-care performance(F=22.31, p=.0001) were significantly higher than those before the program. 2) After the program, both systolic and diastolic blood pressure were significantly lower than those before the program(F=10.89 -13.11, p=.0001). However in 24hour ambulatory blood pressure, systolic mean pressure was nearly significantly lower, but not in diastolic mean pressure. 3) After the program, the body weight was significant decresed(t=5.53, p=.0001), but the blood cholesterol level was not decreased significantly except in those cases with higher cholesterol level. 4) There were significant relationships between changes in self-care performance and diastolic pressure at 1st week (r=.3389, p=.033) and changes in self-care performance and systolic pressure at 9th week(r=.3651, p=.024). 5) There were significant relationship between perceived self-efficacy and self-care performance at 5th week(r=.5313, p=.001) and 9th week (r=.3026, p=.052). 6) After the program, internal health locus of control and perceived benefits did not show significant change, but perceived barriers was significantly lower than those before the program (t=3.57, p=.0001). From the above results, it can be concluded that 1) The self-regulation program is an effective nursing strategy to promote self-care performance of hypertensives and to lower the blood pressure. Thus this program can be recommended in the management of the hypertensives in workplaces and community settings. 2) The synthesis of Orem's self-care theory and Bandura's self-regulation & self-efficacy theory in this study was proved to enhance explanation and prediction of the change of self-care behavior. Thus the result of the study would contribute in development of the self-care theory and an expansion of practice-theory.

• Asian Pacific Journal of Cancer Prevention
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• v.17 no.8
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• pp.3721-3725
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• 2016

The liver fluke Opisthorchis viverrini is a serious health problem in Thailand. Infection is associated with cholangiocarcinoma (CCA), endemic among human populations in northeast and north Thailand where raw fish containing fluke metacercariae are frequently consumed. Recently, Thailand public health authorities have been organized to reduce morbidity and mortality particularly in the northeast through O. viverrini and CCA screening projects. Health modification is one of activities included in this campaign, but systemic guidelines of modifying and developing health behavior among liver fluke and CCA prevention in communities towards health belief and social support theory are still various and unclear. Here we review the guidelines for modifying and developing health behavior among populations in rural communities to strengthen understanding regarding perceived susceptibility, severity, benefits, and barriers to liver fluke and CCA prevention. This model may be useful for public health officers and related organizations to further health behavior change in endemic areas.

• Pediatric Infection and Vaccine
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• v.20 no.3
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• pp.147-160
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• 2013

Purpose: Although the overall incidence of hepatitis A in Korea has been decreasing recently, the adolescents born before the introduction of the hepatitis A vaccine remain to be highly vulnerable to outbreak. This study examines the unvaccinated adolescents' and their parents' knowledge and health beliefs toward hepatitis A vaccination. Methods: Healthy adolescents aged 13-19 years old who had no previous history of hepatitis A vaccine and hepatitis A infection, and their parents or legal guardians were the subjects of the study. The survey was conducted using a structured questionnaire based on the Health Belief Model, and examined the subjects' demographics, knowledge, and health beliefs (i.e., perceived susceptibility, severity, benefits, and barriers). Results: We included 157 adolescents and their parents/guardians (mean age: $16.0{\pm}1.6$ and $45.6{\pm}4.7$ years, respectively). The average knowledge item score for adolescents and parents was $6.4{\pm}3.7$ and $7.3{\pm}3.4$ (out of 18), respectively. Similarly, average Health Belief Model item scores were: susceptibility, $5.6{\pm}1.6$ and $5.9{\pm}1.7$ (range: 2-10); severity, $16.3{\pm}4.1$ and $18.3{\pm}3.6$ (range:5-25); benefits, $19.7{\pm}3.3$ and $20.6{\pm}2.1$ (range:5-25); and barriers, $41.3{\pm}8.9$ and $39.0{\pm}9.1$ (range:7-85). The major reason for not undergoing hepatitis A vaccination was lack of knowledge about its importance. Conclusions: Refresher health lectures about hepatitis A and the vaccine are needed by both the adolescents and their parents. Furthermore, the inclusion of hepatitis A vaccine in the national immunization program should be considered to reduce the risk of hepatitis A outbreak and to raise the vaccination coverage among the adolescents in Korea.

• Korean Journal of Community Nutrition
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• v.20 no.3
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• pp.165-177
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• 2015

Objectives: Based on individual and environmental characteristics of low-income children, we developed a nutrition education program for school-aged children from low-income families according to effective use in social welfare centers. Methods: We conducted in-depth group interviews to assess program needs in 28 participants, 10 low-income school-aged children and 9 of their care givers, 9 social workers and 9 care-givers. Theoretical backgrounds of our program were heath belief model and social cognitive theory considering motivation, action and environment characteristics. Results: Based on the findings of this qualitative study, we developed major program themes and contents. Five selected key themes were 'balanced diet', 'processed food', 'food hygiene and safety', 'Korean healthy traditional diet', and 'family cooking' to induce changes in dietary behaviors. Main findings of in-depth group interviews included 'child's active participation', 'simple and easy to understand messages', and 'environmental constraints' such as a lack of child care at home, limited budget of social welfare centers, and less qualified educators for nutrition and health. Each lesson was constructed as a 1-hour program particularly emphasizing activity-based programs, including cooking and teamwork exercises. Program contents in each session consisted of activities that could induce outcome and value expectations, self-efficacy, perceived benefits, and barriers and cues to actions regarding diet behavior. Conclusions: We developed a nutrition education programthat is rarely available for low-income children in Korea, considering theoretical bases. Further studies are needed to validate our program.

• Journal of dental hygiene science
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• v.13 no.4
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• pp.449-460
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• 2013

This study analyzes the processes of change in oral health behaviors induced by oral health education for 23 university students. To this end, we analyzed the changing patterns of the stages of change and motivational components for each oral health behavior. Additionally, we performed an in-depth interview-based investigation of the factors influencing such motivational components. Oral health education was performed twice with a concrete purpose of changing the participants' behaviors in complying with the practice of proper brushing and flossing as the main oral health management, and checking the nutrient facts as a good dietary habit. Upon completion of these two sessions of oral health education, the level of change in oral health behavior was assessed by measuring the stages of change and motivational components for each oral health behavior. In order to gain an in-depth understanding of the reasons for the changes that were demonstrated more markedly during the second education session than during the first session, collective interview surveys were carried out after the second session. The contents of the recorded interviews were categorized into subscales of distinctive concepts on the basis of the items of a health behavior model. The study had the findings as below. First, after the first and second education sessions, some behaviors showed positive changes from lower to higher levels of practice. Second, self-efficacy about oral health behavior was high or perceived barriers were low when its necessity and benefits were clearly perceived. Third, educational features such as the practice and participation-centered education, and examining their own oral conditions influenced the participants' oral health awareness and behavioral changes. There is a need for oral health education capable of leading to practical behavioral changes by establishing concrete strategies of deriving various motivational components at each stage of the processes of change.

• Journal of Distribution Research
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• v.17 no.1
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• pp.87-115
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• 2012

Introduction: In these days, a loyalty program is one of the most common marketing mechanisms (Lacey & Sneath, 2006; Nues & Dreze, 2006; Uncles et al., 20003). In recent years, Coalition Loyalty Program is more noticeable as one of progressed forms. In the past, loyalty program was operating independently by single product brand or single retail channel brand. Now, companies using Coalition Loyalty Program share their programs as one single service and companies to participate to this program continue to have benefits from their existing program as well as positive spillover effect from the other participating network companies. Instead of consumers to earn or spend points from single retail channel or brand, consumers will have more opportunities to utilize their points and be able to purchase other participating companies products. Issues that are related to form of loyalty programs are essentially connected with consumers' perceived view on convenience of using its program. This can be a problem for distribution companies' strategic marketing plan. Although Coalition Loyalty Program is popular corporate marketing strategy to most companies, only few researches have been published. However, compared to independent loyalty program, coalition loyalty program operated by third parties of partnership has following conditions: Companies cannot autonomously modify structures of program for individual companies' benefits, and there is no guarantee to operate and to participate its program continuously by signing a contract. Thus, it is important to conduct the study on how coalition loyalty program affects companies' success and its process as much as conducting the study on effects of independent program. This study will complement the lack of coalition loyalty program study. The purpose of this study is to find out how consumer loyalty affects affiliated brands, its cause and mechanism. The past study about loyalty program only provided the variation of performance analysis, but this study will specifically focus on causes of results. In order to do these, this study is designed and to verify three primary objects as following; First, based on opinions of Switching Barriers (Fornell, 1992; Ping, 1993; Jones, et at., 2000) about causes of loyalty of coalition brand, 'brand attractiveness' and 'brand switching cost' are antecedents and causes of change in 'brand loyalty' will be investigated. Second, influence of consumers' perception and attitude prior to joining coalition loyalty program, influence of program in retail brands, brand attractiveness and spillover effect of switching cost after joining coalition program will be verified. Finally, the study will apply 'prior brand preference' as a variable and will provide a relationship between effects of coalition loyalty program and prior preference level. Hypothesis Hypothesis 1. After joining coalition loyalty program, more preferred brand (compared to less preferred brand) will increase influence on brand attractiveness to brand loyalty. Hypothesis 2. After joining coalition loyalty program, less preferred brand (compared to more preferred brand) will increase influence on brand switching cost to brand loyalty. Hypothesis 3. (1)Brand attractiveness and (2)brand switching cost of more preferred brand (before joining the coalition loyalty program) will influence more positive effects from (1)program attractiveness and (2)program switching cost of coalition loyalty program (after joining) than less preferred brand. Hypothesis 4. After joining coalition loyalty program, (1)brand attractiveness and (2)brand switching cost of more preferred brand will receive more positive impacts from (1)program attractiveness and (2)program switching cost of coalition loyalty program than less preferred brand. Hypothesis 5. After joining coalition loyalty program, (1)brand attractiveness and (2)brand switching cost of more preferred brand will receive less impacts from (1)brand attractiveness and (2)brand switching cost of different brands (having different preference level), which joined simultaneously, than less preferred brand. Method : In order to validate hypotheses, this study will apply experimental method throughout virtual scenario of coalition loyalty program if consumers have used or available for the actual brands. The experiment is conducted twice to participants. In a first experiment, the study will provide six coalition brands which are already selected based on prior research. The survey asked each brand attractiveness, switching cost, and loyalty after they choose high preference brand and low preference brand. One hour break was provided prior to the second experiment. In a second experiment, virtual coalition loyalty program "SaveBag" was introduced to participants. Participants were informed that "SaveBag" will be new alliance with six coalition brands from the first experiment. Brand attractiveness and switching cost about coalition program were measured and brand attractiveness and switching cost of high preference brand and low preference brand were measured as same method of first experiment. Limitation and future research This study shows limitations of effects of coalition loyalty program by using virtual scenario instead of actual research. Thus, future study should compare and analyze CLP panel data to provide more in-depth information. In addition, this study only proved the effectiveness of coalition loyalty program. However, there are two types of loyalty program, which are Single and Coalition, and success of coalition loyalty program will be dependent on market brand power and prior customer attitude. Therefore, it will be interesting to compare effects of two programs in the future.