• Asian Pacific Journal of Cancer Prevention
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• v.16 no.13
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• pp.5439-5444
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• 2015

Background: One of the main causes of delay in diagnosis of oral cancer is lack of awareness about aetiology and symptoms among the general population. The aim of this study was to assess the knowledge and practice of patients regarding oral cancer and their attitude towards tobacco cessation. Materials and Methods: This study was carried out in Isfahan-Iran in 2014. A 29-item self-administrated questionnaire was designed and piloted and distributed to patients attending dental clinics. Questions were focused on awareness about oral cancer risk factors, signs and symptoms, places in the mouth which are more susceptible and attitude toward tobacco cessation. Chi-square, T-test, ANOVA and logistic regression tests were used for statistical analysis. Results: A total of 546 valid completed questionnaires were obtained. The mean knowledge score of patients was 4.1(${\pm}2.7$) out of 13. Some 80% of patients did not know about early manifestations of oral cancer. Only 18% knew the most likely sites of oral cancer. Only 43.1% and 65.2% of patients reported alcohol and tobacco consumption as the main risk factors but they had a fair knowledge about other risk factors. There was no significant difference in Knowledge level between patients regarding their sex, educational levels and age. Most patents (90%) expected their dentists to warn them about the harmful effects of smoking and showed willingness to quit if recommended. Conclusions: Knowledge about oral cancer was found to be quite low. It seems necessary to increase the level of public awareness using educational programs with cooperation of dentists in tobacco cessation programs.

• Journal of Preventive Medicine and Public Health
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• v.57 no.1
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• pp.65-72
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• 2024

Objectives: Protecting people against financial hardship caused by illness stands as a fundamental obligation within healthcare systems and constitutes a pivotal component in achieving universal health coverage. The objective of this study was to analyze the prevalence and determinants of catastrophic health expenditures (CHE) in Iran, over the period of 2013 to 2019. Methods: Data were obtained from 7 annual national surveys conducted between 2013 and 2019 on the income and expenditures of Iranian households. The prevalence of CHE was determined using a threshold of 40% of household capacity to pay for healthcare. A binary logistic regression model was used to identify the determinants influencing CHE. Results: The prevalence of CHE increased from 3.60% in 2013 to 3.95% in 2019. In all the years analyzed, the extent of CHE occurrence among rural populations exceeded that of urban populations. Living in an urban area, having a higher wealth index, possessing health insurance coverage, and having employed family members, an employed household head, and a literate household head are all associated with a reduced likelihood of CHE (p<0.05). Conversely, the use of dental, outpatient, and inpatient care, and the presence of elderly members in the household, are associated with an increased probability of facing CHE (p<0.05). Conclusions: Throughout the study period, CHE consistently exceeded the 1% threshold designated in the national development plan. Continuous monitoring of CHE and its determinants at both household and health system levels is essential for the implementation of effective strategies aimed at enhancing financial protection.

• Journal of Preventive Medicine and Public Health
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• v.40 no.6
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• pp.461-466
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• 2007

Objectives : The purpose of this study was to examine the determinants of sterilization in South Korea. Methods : This study was based on the data from the Korea National Fertility Survey carried out in the year 2000 by the Korea Institute of Health and Social Affairs. The subjects of the analysis were 4,604 women and their husbands who were in their first marriage, in the age group of 15-49 years. The data were analyzed by multiple logistic regression analysis. Results : Consistent with the findings of previous studies, the woman#s age and the number of total children increased the likelihood of sterilization. In addition, the year of marriage had a strong positive association with sterilization. Interestingly, the number of surviving sons tended to increase the likelihood of sterilization, whereas the woman#s education level and age at the time of marriage showed a negative association with sterilization. Religion, place of residence, son preference, and the husband#s education level, age and type of occupation were not significant determinants of sterilization. Conclusions : The sex of previous children and lower level of education are distinct determinants of sterilization among women in South Korea. More studies are needed in order to determine the associations between sterilization rate and decreased fertility.

• Journal of Preventive Medicine and Public Health
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• v.43 no.3
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• pp.205-212
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• 2010

Objectives: The prevalence of work-related musculoskeletal symptoms (WMS) among Korean dairy farmers has not been investigated. The purpose of this study was to assess the prevalence of WMS and to evaluate the relationship between WMS and risk factors. Methods: Self-developed questionnaires including the questionnaire developed by the Korean Occupational Safety and Health agency (KOSHA) were used to investigate WMS among dairy farmers in Gyeonggi Province, Korea. We informed selected dairy farmers about the study and sent the questionnaires by registered mail. They visited a public health center nearby or a branch of public health center on the appointed date and skillful researchers identified or conducted the questionnaires by interview. We analyzed 598 (32.8%) of the 1824 dairy farmers. Multiple logistic regression was implemented to estimate the odds ratios of risk factors. Results: The mean age of the respondents was $50.4{\pm}8.7$ years and the proportion of males was 63.0%. The prevalence of WMS at any site was 33.3%. The prevalence of neck WMS was 2.2%, shoulders 10.0%, arms/elbows 5.0%, hands/wrists/fingers 4.2%, low back 11.5%, and legs/feet 11.7%. The adjusted odds ratio of low back WMS for milking 4 or more hours per day was 4.231 (95% Cl = 1.124 - 15.932) and statistically significant. Low back WMS (2.827, 95% Cl = 1.545 - 5.174) was significantly decreased by education. Conclusions: Low back WMS increased with milking hours and milking 4 or more hours per day was significantly associated with low back WMS. Low back WMS was significantly reduced with education. We hope that there will be increased attention about WMS in dairy farmers and the subject of future investigations.

• Research in Community and Public Health Nursing
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• v.31 no.spc
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• pp.549-562
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• 2020

Purpose: This study aimed to identify individual- and regional-level factors associated with perceived good health and multimorbidity among older adults. Methods: Secondary analysis of the 2017 Korea Community Health Survey was conducted on a sample of 67,532 older adults. The individual level data set was combined with regional-level factors from the administrative data released on the Korea National Statistical Office website. Distribution of perceived good health and multimorbidity in 254 public health centers were calculated using sampling weights and presented as percentages. Multilevel logistic regression analyses were used to identify individual- and regional-level factors associated with perceived good health and multimorbidity. Results: Overall, 21.1% of subjects perceived their health to be good, ranging from 9.3% to 39.4% by region. The prevalence of multimorbidity was 15.9%, and varied between 6.6% and 22.6% by region. At the individual level, perceived good health was associated with men, younger age, higher educational levels, higher income levels, and those married and living with a partner and maintaining a healthy lifestyle. At the regional level, higher rates of health center personnel among public officials and higher levels of financial independence were associated with perceived good health. Multimorbidity was associated with marital status and healthy lifestyle, and higher rates of health center personnel among public officials. Conclusion: Regional factors such as health care personnel and local economy could affect population health. Our findings suggest the need to consider individual- and regional-level factors to promote good health among older adults and reduce the health gap by region.

• Journal of Preventive Medicine and Public Health
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• v.55 no.4
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• pp.342-350
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• 2022

Objectives: Human immunodeficiency virus (HIV) prevention among youth seems under-prioritised compared to other key populations. HIV knowledge and stigma are important parts of HIV prevention. To inform HIV prevention among youths, this study quantitatively analysed the associations between open communication regarding sexuality and sexual health, comprehensive HIV knowledge, and non-stigmatising attitudes in Indonesia. Methods: This study used data from the Indonesian Demographic and Health Survey (IDHS) 2017. The analysis included unmarried men and women aged 15-25 years old. Comprehensive HIV knowledge and a stigmatising attitude were defined according to the IDHS 2017. Open communication about sexuality and sexual health was defined as the number of people with whom participants could openly discuss these topics in their direct network of friends, family, and service providers, with a scale ranging from 0 to a maximum of 7. Primary analysis used binomial logistic regression with weighting adjustments. Results: The final analysis included 22 864 respondents. Twenty-two percent of youth had no one in their direct network with whom to openly discuss sexual matters, only 14.1% had comprehensive HIV knowledge, and 85.9% showed stigmatising attitudes. Youth mostly discussed sex with their friends (55.2%), and were less likely to discuss it with family members, showing a predominant pattern of peer-to-peer communication. Multivariate analysis showed that having a larger network for communication about sexuality and sexual health was associated with more HIV knowledge and less stigmatising attitudes. Conclusions: Having more opportunities for open sex communication in one's direct social network is associated with more HIV knowledge and less stigmatising attitudes.

• Journal of Preventive Medicine and Public Health
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• v.56 no.6
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• pp.487-494
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• 2023

Objectives: Community organization is a resident-led movement aimed at creating fundamental social changes in the community by resolving its problems through the organized power of its residents. This study evaluated the effectiveness of health community organization (HCO), Gangwon's Health-Plus community program, implemented from 2013 to 2019 on residents' health behaviors. Methods: This study had a before-and-after design using 2011-2019 Korea Community Health Survey data. To compare the 3-year periods before and after HCO implementation, the study targeted areas where the HCO had been implemented for 4 years or longer. Therefore, a total of 4512 individuals from 11 areas with HCO start years from 2013 to 2016 were included. Complex sample multi-logistic regression analysis adjusting for demographic characteristics (sex, age, residential area, income level, education level, and HCO start year) was conducted. Results: HCO implementation was associated with decreased current smoking (adjusted odds ratio [aOR], 0.73; 95% confidence interval [CI], 0.57 to 0.95) and subjective stress recognition (aOR, 0.79; 95% CI, 0.64 to 0.97). Additionally, the HCO was associated with increased walking exercise practice (aOR, 1.39; 95% CI, 1.13 to 1.71), and attempts to control weight (aOR, 1.36; 95% CI, 1.12 to 1.64). No significant negative changes were observed in other health behavior variables. Conclusions: The HCO seems to have contributed to improving community health indicators. In the future, a follow-up study that analyzes only the effectiveness of the HCO through structured quasi-experimental studies will be needed.

• Journal of Preventive Medicine and Public Health
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• v.43 no.3
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• pp.193-204
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• 2010

Objectives: The objective of this study was to analyze the causal relationship between smoking and depression using longitudinal data. Methods: Two waves of the Korea Welfare Panel collected in 2006 and 2007 were used. The sample consisted of 14 426 in 2006 and 13 052 in 2007 who were aged 20 and older. Smoking was measured by smoking amount (none/$\geq$ two packs). Depression was defined when the summated CESD (center for epidemiological studies depression)-11 score was greater than or equal to 16. The causal relationship between smoking and depression was tested using logistic regression. In order to test the causal effect of smoking on depression, depression at year 2 was regressed on smoking status at year 1 only using the sample without depression at year 1. Likewise, smoking status at year 2 was regressed on depression at year 1 only using those who were not smoking at year 1 in order to test the causal effect of depression on smoking. The statistical package used was Stata 10.0. Sampling weights were applied to obtain the population estimation. Results: The logistic regression testing for the causal relationship between smoking and depression showed that smoking at year 1 was significantly related to depression at year 2. Smoking amounts associated with depression were different among age groups. On the other hand, the results from the logistic regression testing for the opposite direction of the relationship between smoking and depression found no significant association regardless of age group. Conclusions: The study results showed some evidence that smoking caused depression but not the other way around.

• Journal of Preventive Medicine and Public Health
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• v.44 no.1
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• pp.2-8
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• 2011

Objectives: Public release of and feedback (here after public release) on institutional (clinics and hospitals) cesarean section rates has had the effect of reducing cesarean section rates. However, compared to the isolated intervention, there was scant evidence of the effect of repeated public releases (RPR) on cesarean section rates. The objectives of this study were to evaluate the effect of RPR for reducing cesarean section rates. Methods: From January 2003 to July 2007, the nationwide monthly institutional cesarean section rates data (1 951 303 deliveries at 1194 institutions) were analyzed. We used autoregressive integrated moving average (ARIMA) time-series intervention models to assess the effect of the RPR on cesarean section rates and ordinal logistic regression model to determine the characteristics of the change in cesarean section rates. Results: Among four RPR, we found that only the first one (August 29, 2005) decreased the cesarean section rate (by 0.81 percent) and continued to have an impact period through the last observation in May 2007. Baseline cesarean section rates (OR, 4.7; 95% CI, 3.1 to 7.1) and annual number of deliveries (OR, 2.8; 95% CI, 1.6 to 4.7) of institutions in the upper third of each category at before first intervention had a significant contribution to the decrease of cesarean section rates. Conclusions: We could not found the evidence that RPR has had the significant effect of reducing cesarean section rates. Institutions with upper baseline cesarean section rates and annual number of deliveries were more responsive to RPR.

• Health Policy and Management
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• v.31 no.2
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• pp.158-172
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• 2021

Background: Metabolic syndrome has been known as a risk of cardiovascular disease. Meanwhile, high sensitivity C-reactive protein (hs-CRP) is used as a predictor of cardiovascular disease. In this paper, we aimed to investigate the association between hs-CRP and metabolic syndrome. Method: A total of 7,633 were chosen as the study population from the 7th Korea National Health and Nutrition Examination Survey dataset (2016-2017). Our dependent variable was whether an individual had metabolic syndrome or not, and the independent variable of interest was hs-CRP which was categorized into three groups. The chi-square tests and hierarchical logistic regression analyses reflecting survey characteristics were conducted. All analyses were stratified by gender. Results: According to the adjusted model with all covariates, compared to individuals having the low risk of hs-CRP, those having its average risk were more likely to have metabolic syndrome in men (odds ratio [OR], 1.41; 95% confidence interval [CI], 1.12-1.76) and women (OR, 1.69; 95% CI, 1.33-2.16). Individuals having the high risk was not significantly different in men; however, they were more likely to have metabolic syndrome in women (OR, 2.03; 95% CI, 1.28-3.23). Conclusion: In an upcoming aging society, it is important to reduce the risk of metabolic syndrome to improve population health. This study suggests that hs-CRP may be used as a marker of the risk of metabolic syndrome in a gender-specific way, thereby contributing to enhancing awareness of the risk of metabolic syndrome among the general public.