• Asian Pacific Journal of Cancer Prevention
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• v.16 no.9
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• pp.3639-3644
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• 2015

Oral, cervical and breast cancers, which are either preventable and/or amenable to early detection and treatment, are the leading causes of cancer-related morbidity and mortality in India. In this paper, we describe implementation science research priorities to catalyze the prevention and control of these cancers in India. Research priorities were organized using a framework based on the implementation science literature and the World Health Organization's definition of health systems. They addressed both community-level as well as health systems-level issues. Community-level or "pull" priorities included the need to identify effective strategies to raise public awareness and understanding of cancer prevention, monitor knowledge levels, and address fear and stigma. Health systems-level or "push" and "infrastructure" priorities included dissemination of evidence-based practices, testing of point-of-care technologies for screening and diagnosis, identification of appropriate service delivery and financing models, and assessment of strategies to enhance the health workforce. Given the extent of available evidence, it is critical that cancer prevention and treatment efforts in India are accelerated. Implementation science research can generate critical insights and evidence to inform this acceleration.

• Health Policy and Management
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• v.10 no.4
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• pp.57-74
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• 2000

This study is conducted to compare how the Western.Oriental medical practitioners and health professionals perceive reciprocal development strategies respectively of Western.Oriental Medicine in Korea. A total of 3,273 persons were questioned by direct distribution, e-mail, and mail with a self-developed questionnaire. Of those questioned, 362 responded (the response rate of 11.1%), and of them n persons (Western medical practitioners 206, Oriental medical practitioners 90, and health professionals 64) were analyzed with SPSS for Windows. The results were as follows： The need for legislation on the mutual development system for Western.Oriental Medicine was recognized by 66.9% (218 persons) of respondents. Among them, largest group who agreed with this need was the health professionals. Western medical practitioners chose the "the difference of approach methods on the diseases between Western.Oriental Medicine" as their response, and Oriental medical practitioners ＆ health professionals selected "the indifference or bias of Western medical practitioners"as the reasons for the inactivity in developing a mutual system of Western.Oriental Medicine. Therefore, Western medical practitioners and health professionals selected the category of "the reformation of educational system", while Oriental medical practitioners selected the category of "the activation of joint research on Western.Oriental medical care" as the most important condition for setting a precedent. Also, Western medical practitioners preferred "cooperative health care system for Western medical care supported by Oriental medical care", but Oriental medical practitioners and health professionals preferred “cooperative health care system of Western.Oriental medicine on equal terms" In conclusion, Western '||'&'||' Oriental medical practitioners have to make every effort to close the gap between differing views through mutual understanding and respect if joint research of Western.Oriental medical care is to become a reality. The government should continuously enforce the health policy on development of a legal and systematic infrastructure for mutual development strategy of Western.Oriental Medicine in Korea.strategy of Western.Oriental Medicine in Korea.

• Journal of Preventive Medicine and Public Health
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• v.45 no.5
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• pp.283-290
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• 2012

Objectives: People who have chronic diseases, as well as gait imbalance or psychiatric drug use, may be susceptible to injuries from falls and slips. The purpose of this study was to evaluate the effect of musculoskeletal diseases on incidental fall-related injuries among adults in Korea. Methods: We analyzed data from the 4th Korea National Health and Nutrition Examination Survey (2007-2009), which are national data obtained by a rolling survey sampling method. The 1-year incidence of fall-related injuries was defined by health service utilization within the last year due to injury occurring after a slip and fall, and musculoskeletal diseases included osteoarthritis, rheumatoid arthritis, osteoporosis, and back pain. To evaluate the effects of preexisting musculoskeletal diseases, adults diagnosed before the last year were considered the exposed group, and adults who had never been diagnosed were the unexposed group. Results: The weighted lifetime prevalence of musculoskeletal disease was 32 540 per 100 000 persons. Musculoskeletal diseases were associated with a higher risk of fall-related injury after adjustment for sex, age, residence, household income, education, occupation, visual disturbance, paralysis due to stroke, and medication for depression (odds ratio [OR], 1.41; 95% confidence interval [CI], 1.03 to 1.93). As the number of comorbid musculoskeletal diseases increased, the risk of fall-induced injuries increased (p-value for trend <0.001). In particular, patients who had any musculoskeletal condition were at much higher risk of recurrent fall-related injuries (OR, 6.20; 95% CI, 1.06 to 36.08). Conclusions: One must take into account the risk of fall-related injuries and provide prevention strategies among adults who have musculoskeletal diseases.

• Quality Improvement in Health Care
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• v.14 no.1
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• pp.77-91
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• 2008

Objectives : The purpose of this study was to survey the opinion and attitude of hospital managers toward the hospital evaluation program. Method : Managers of 157 hospitals which had participated in the hospital evaluation program were requested to respond to structured self-administered questionnaire. The questionnaire was composed with five categories: the preparation for the hospital evaluation program, the expertise levels of surveyors, the process and contents of the hospital evaluation program, the applying strategies for the result of the hospital evaluation to manager's work at their hospitals, and the main points to improve the hospital evaluation program. Result : 135 out of the 157 subjects completed the questionnaire, and the overall response rate was 86%. The hospital managers answered that they didn't have enough information such as the scoring rule of the standards, the process of the evaluation, and how to ask and get an answer to prepare the hospital evaluation. Furthermore, they estimated that the surveyors weren't specialized enough and didn't give a chance of checking over the result of the evaluation. In addition, they experienced that the result and feedback of the evaluation weren't enough information to be used as a guideline to improve in hospital management. Managers of the hospitals responded that the standards and method of survey in the hospital evaluation system should be reformed. Conclusion : Most of the responded managers seemed to have negative opinion on the hospital evaluation system, even though they were pushed up for interest in quality. Further studies and extensive evaluation of the hospital evaluation program are needed to bring up various information such as receptiveness and effectiveness.

• Journal of Korean Society for Quality Management
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• v.48 no.3
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• pp.493-510
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• 2020

Purpose: As of July 31, there were 14,336 confirmed cases of COVID-19 in South Korea, including 301 deaths. Since the daily confirmed number of cases hit 909 on February 29, the spread of the disease had gradually decreased due to the active implementation of preventive control interventions, and the daily confirmed number had finally recorded a single digit on April 19. Since May, however, the disease has re-emerged and retaining after June. In order to eradicate the disease, it is necessary to suggest suitable forward preventive strategies by predicting future infectivity of the disease based on the cases so far. Therefore, in this study, we aim to evaluate the transmission potential of the disease in early phases by estimating basic reproduction number and assess the preventive control measures through effective reproduction number. Methods: We used publicly available cases and deaths data regarding COVID-19 in South Korea as of July 31. Using ensemble model integrated stochastic linear birth model and deterministic linear growth model, the basic reproduction number and the effective reproduction number were estimated. Results: Estimated basic reproduction number is 3.1 (95% CI: 3.0-3.2). Effective reproduction number was the highest with 7 on February 15, decreased as of April 20. Since then, the value is gradually increased to more than unity. Conclusion: Preventive policy such as wearing a mask and physical distancing campaigns in the early phase of the outbreak was fairly implemented. However, the infection potential increased due to weakening government policy on May 6. Our results suggest that it seems necessary to implement a stronger policy than the current level.

• Journal of Preventive Medicine and Public Health
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• v.40 no.3
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• pp.213-217
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• 2007

Objectives : This study aimed to calculate the survival rates of cancer patients in Jeju Island residents from 2000 to 2001, based on their major primary sites of occurrence. Methods : Data were extracted from the database of the Jejudo Cancer Registry (JCR). The eligible population comprised 2,382 cancer cases, whose cancers were diagnosed from 1 January 2000 through 31 December 2001. Of the eligible population, 1,438 patients with 5 major cancers defined by the level of incidence rates were selected as the study participants. The period of survival for each case was calculated from the date of first diagnosis to the date of death, or the end of follow-up, i.e., 31 December 2003. The observed survival rates (OSR) and relative survival rates (RSR) were calculated according to sex, age-group, and primary sites of occurrence. Results : The 3-year OSR and RSR in 5 major cancers were higher in women than in men except 75 year-old over group. The 3-year RSR of stomach, colorectum, liver, and lung in both sexes were 61.0%, 62.6%, 24.7%, and 22.8%, respectively. The respective rates in JCR showed some statistically significant differences from those in the Korea Central Cancer Registry (KCCR). Conclusions : These results would suggest some clues about prognostic factors of major cancers in Korean, and could apply to planning and evaluating of cancer control strategies in Jeju Island.

• Journal of Preventive Medicine and Public Health
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• v.48 no.1
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• pp.38-47
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• 2015

Objectives: Controlling blood pressure is a key step in reducing cardiovascular mortality in older adults. Gender differences in patients' attitudes after disease diagnosis and their management of the disease have been identified. However, it is unclear whether gender differences exist in hypertension management among older adults. We hypothesized that gender differences would exist among factors associated with hypertension diagnosis and control among community-dwelling, older adults. Methods: This cross-sectional study analyzed data from 653 Koreans aged ${\geq}60years$ who participated in the Korean Social Life, Health, and Aging Project. Multiple logistic regression was used to compare several variables between undiagnosed and diagnosed hypertension, and between uncontrolled and controlled hypertension. Results: Diabetes was more prevalent in men and women who had uncontrolled hypertension than those with controlled hypertension or undiagnosed hypertension. High body mass index was significantly associated with uncontrolled hypertension only in men. Multiple logistic regression analysis indicated that in women, awareness of one's blood pressure level (odds ratio [OR], 2.86; p=0.003) and the number of blood pressure checkups over the previous year (OR, 1.06; p=0.011) might influence the likelihood of being diagnosed with hypertension. More highly educated women were more likely to have controlled hypertension than non-educated women (OR, 5.23; p=0.013). Conclusions: This study suggests that gender differences exist among factors associated with hypertension diagnosis and control in the study population of community-dwelling, older adults. Education-based health promotion strategies for hypertension control might be more effective in elderly women than in elderly men. Gender-specific approaches may be required to effectively control hypertension among older adults.

• Journal of Preventive Medicine and Public Health
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• v.44 no.6
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• pp.267-274
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• 2011

Objectives: We examined health care disparities in Korean urban homeless people and individual characteristics associated with the utilization of health care. Methods: We selected a sample of 203 homeless individuals at streets, shelters, and drop-in centers in Seoul and Daejeon by a quota sampling method. We surveyed demographic information, information related to using health care, and health status with a questionnaire. Logistic regression analysis was adopted to identify factors associated with using health care and to reveal health care disparities within the Korean urban homeless population. Results: Among 203 respondents, 89 reported that they had visited health care providers at least once in the past 6 months. Twenty persons (22.5%) in the group that used health care (n = 89) reported feeling discriminated against. After adjustment for age, sex, marital status, educational level, monthly income, perceived health status, Beck Depression Inventory score, homeless period, and other covariates, three factors were significantly associated with medical utilization: female sex (adjusted odds ratio [aOR, 15.95; 95% CI, 3.97 to 64.04], having three or more diseases (aOR, 24.58; 95% CI, 4.23 to 142.78), and non-street residency (aOR, 11.39; 95% CI, 3.58 to 36.24). Conclusions: Health care disparities in Seoul and Daejeon homeless exist in terms of the main place to stay, physical illnesses, and gender. Under the current homeless support system in South Korea, street homeless have poorer accessibility to health care versus non-street homeless. To provide equitable medical aid for homeless people, strategies to overcome barriers against health care for the street homeless are needed.

• Journal of Preventive Medicine and Public Health
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• v.55 no.5
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• pp.475-484
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• 2022

Objectives: This study aimed to determine the association between metabolic syndrome (MetS) and the incidence of colorectal cancer (CRC) in Korean women with obesity. Methods: Cancer-free women (n=6 142 486) aged 40-79 years, who underwent National Health Insurance Service health examinations in 2009 and 2010 were included. The incidence of CRC was followed until 2018. The hazard ratio (HR) of MetS for the incidence of colon and rectal cancer was analyzed according to body mass index (BMI) categories, adjusting for confounders such as women's reproductive factors. In addition, the heterogeneity of associations across BMI categories was assessed. Results: Women with MetS were at increased risk of colon and rectal cancer compared to women without MetS (HR, 1.20; 95% confidence interval [CI], 1.16 to 1.23 and HR,1.15; 95% CI, 1.11 to 1.20), respectively. The HR of MetS for colon cancer across BMI categories was 1.12 (95% CI, 1.06 to 1.19), 1.14 (95% CI, 1.08 to 1.20), and 1.16 (95% CI, 1.12 to 1.21) in women with BMIs <23.0 kg/m², 23.0-24.9 kg/m², and ≥25.0 kg/m², respectively. The HR of MetS for rectal cancer across corresponding BMI categories was 1.16 (95% CI, 1.06 to 1.26), 1.14 (95% CI, 1.05 to 1.23), and 1.13 (95% CI, 1.06 to 1.20). The heterogeneity of associations across BMI categories was not significant in either colon or rectal cancer (p=0.587 for colon cancer and p=0.927 for rectal cancer). Conclusions: Women with MetS were at increased risk of colon and rectal cancer. Clinical and public health strategies should be considered for primary CRC prevention with an emphasis on improving women's metabolic health across all BMI groups.

• Journal of Preventive Medicine and Public Health
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• v.49 no.4
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• pp.240-248
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• 2016

Objectives: Human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome (AIDS) adversely impacts food security in households of people living with HIV/AIDS (PLWHA). Little research has focused on food insecurity among PLWHA in India. The purpose of this study was to identify the prevalence of and factors relating to food security in households of PLWHA in the Siliguri subdivision of Darjeeling, West Bengal, India. Methods: A cross-sectional community-based study was carried out among 173 PLWHA residing in Siliguri and registered at the Anti-retroviral Therapy Centre of North Bengal Medical College & Hospital. Data was collected at the household level with interviews of PLWHA using a food security survey instrument. We analyzed the associations using logistic regression. Results: The prevalence of household food security among the participants was 50.9% (88/173). Five years or more of schooling, higher socioeconomic class and males were found to be significantly associated with a higher likelihood of food security. A later stage of the disease and the presence of other family members with HIV/AIDS were significantly associated with a lower likelihood of food security. The major coping strategies to deal with food insecurity in the acute phase HIV infection included borrowing money (56.1%), followed by spousal support, loans from microfinance institutions, banks, or money lenders, borrowing food, or selling agricultural products. Conclusions: The present study revealed that only about half of households with PLWHA were food secure. Prior interventions relating to periods of food and economic crisis as well as strategies for sustaining food security and economic status are needed in this area.