• Journal of Korean Academy of Nursing
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• v.30 no.1
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• pp.160-170
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• 2000

The purpose of this study was to develop an explanatory model to predict factors related to continuous participation in the Pap smear screening among Korean women. A hypothetical model was constructed on the basis of Health Belief Model and extensive review of literature on the Pap smear screening. Exogeneous variables included in this model were knowledge, perceived sensitivity, perceived severity, negative and positive emotional responses and professional support from physicians and nurses. Endogeneous variables were threat to cervical cancer, perceived benefit of the Pap smear screening, perceived barrier, and the final outcome variable was continuous participation in the Pap smear screening. The hypothetical model was tested with an empirical study. The data was collected from 623 married women whose age range was 24 - 83 using a self-reported survey questionnaire which was developed by the researcher. It's Cronbach's alpha score ranged from .6478 to .9118. Data was collected at different locations in Seoul; a university hospital, a local health center, and apartment complexes. Data analysis was done using SPSS 7.5 WIN Program for descriptive statistics and LISREL 8.12a WIN Program for covariance structural analysis. In conclusion, threat, perceived benefit, perceived barrier, positive emotion and professional support had a significant direct effect on continuous participation in the Pap smear screening among Korean women. The results of this study also showed that perceived barrier had the most significant direct effect on continuous participation in the Pap smear screening while negative emotional response had the most significant direct effect on perceived barrier. It can be suggested that decreasing perceived barrier by reducing negative emotional responses may be the most effective strategies for increasing continuous participation in the Pap smear screening among married Korean women.

• Journal of Preventive Medicine and Public Health
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• v.34 no.3
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• pp.237-243
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• 2001

Objectives : To examine the screening rate of cervical cancer in women and to find out the predictive factors for participation in cervical cancer screening programs within their life-time and within the last two years. Methods : The data was based on self-reported questionnaires from 1,613 women whose ages ranged from 26 to 60 years; this survey was peformed between December 1999 and January 2000. This study analyzed the predictive factors for participation in cervical cancer screening programs within their life-time and within the last two years. A logistic regression analysis was performed in order to derive the significant variables from the predisposing factors(demographic factor, health promotion behavior, reproductive factor), intervention factors(information channel, relation with medical stan, and proximal factors(attitude, social influence, self-efficacy). All analyses were peformed by the PC-SAS 6.12. Results : Our analyses showed that the screening rate for the women who received a cervical cancer screening(Pap smear) more than once within their life-time was 56.1% while those who had received one within the last two years was 34.5%. The significant factors for participation in cervical cancer screening program within their life-time were their income, married age, health promotion score, relation with medical staffs, social influence, and self-efficacy. On the other hand, age, number of pregnancies, menarche age, relation with medical staffs, social influences, and self-efficacy were significant factors for those being screened within the last two years. The predictive power of the logit model within their life-time was 68.8% and that within the last two years was 66.6%. Conclusion : The predictive factors for participation in cervical cancer screening program within their life-time are different from those for within the last two years. and that women's relations with medical staffs and social influences were the critical factors impacting on cervical cancer screening rates.

• Research in Community and Public Health Nursing
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• v.30 no.4
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• pp.508-517
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• 2019

Purpose: The aim of this study was to identify the participation rate of the National Health Screening Program (NHSP) and its influencing factors by cognitive function level in Korean older adults. Methods: This study was a secondary analysis using data from the survey of the Korean Longitudinal Study of Aging in 2016. The data were analyzed using 𝑥² test and multiple logistic regression. Results: The participation rates of the NHSP in the mild cognitive impairment group (79.6%) and the suspected dementia group (58.0%) were lower than the normal cognitive function group (88.1%). The factors influencing NHSP varied by cognitive function level. Especially, in the suspected dementia group, higher participation rates of the NHSP were associated with living in rural areas, enrollment in private health insurance, no depressive symptoms, participation in social activities, and no living with children. Depression and participation in social activities influenced participation in NHSP in all groups. Conclusion: This study suggests that interventions differentiated by cognitive function level are important for increasing the participation in the health screening.

• Women's Health Nursing
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• v.10 no.2
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• pp.150-161
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• 2004

The importance of screening or repeat screening for cervical and breast cancer is well known to decrease the chance of death from cancer. Few data is avaliable regarding factors associated with participation in cervical and breast cancer screening and repeat screening examinations. This study was to investigate the associations of demographic factors, health status and cancer risk recognition, attitude to cancer screening, health behaviors, and inhibiting or facilitating factors to cervical and breast cancer screening with participation in the screening tests. Data was collected with self-administrated questionnaires from 342 women, aged 40 to 69 years. The cancer screenings were classified into have had or never groups and repeat or not repeated groups. In the case of cervical and breast cancer screening, the have had group was 90 (26.3%), and 82 (24.0%) and the repeat group was 17 (5.0%), and 13 (3.8%) respectively. According to logistic regression analysis, age (<60 vs ${\geq}60$ : OR=3.25, 95% CI=1.27-8.26), breast cancer screening (Do vs Don't : OR=14.49, 95% CI=7.46-27.78) and other person's cancer (Yes vs No : OR=4.27, 95% CI=1.01-18.05) were statistically significantly associated with participation in screening for cervical cancer. Regular exercise (Do vs Don't : OR=2.76, 95% CI=1.30-5.88) and cervical cancer screening (Do vs Don't : OR=13.70, 95% CI=7.09-26.32) were statistically significantly related to participation in screening for breast cancer.

• 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.

• Journal of Preventive Medicine and Public Health
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• v.40 no.6
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• pp.505-511
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• 2007

Objectives : While cervical cancer is one of the leading cancers among women worldwide, there are a number of effective early detection tests available. However, the participation rates in cervical cancer screening among Korean women remain low. After the nationwide efforts in 1988 and thereafter to encourage participation in cervical cancer screening, few studies have investigated the effects of socioeconomic inequality on participation in cervical cancer screening. The purpose of this study was to investigate 1) the level of socioeconomic disparities in receiving cervical cancer screening by age group and 2) if there was an improvement in reducing these disparities between 1995 and 2001. Methods : Using data from the Korean National Health Status, Health Behavior and Belief Survey in 1995, the Korean National Health and Nutrition Examination Surveys from 1998 and 2001 (sample sizes of 2,297, 3,738, and 3,283), age-standardized participation rates were calculated according to education level, equivalized household income, and job status. Odds ratios and the relative inequality index (RII) were also calculated after controlling for age. Results : Women with lower education levels were less likely to attend the screening test, and the disparities by education level were most pronounced among women aged 60 years and older. The RIIs among women 60 years and older were 3.64, 4.46, and 8.64 in 1995, 1998, and 2001, respectively. Higher rates of participation were reported among those in the highest income category, which was more notable among the middle aged women (40s and 50s). An inconsistent trend in the rate of participation in cervical cancer screening by occupational level was found. Conclusions : Indicators of socioeconomic position seem to have varying impacts on the inequalities in the rates of participation in cervical cancer screening according to age group. These results demonstrate the need for more aggressive and age-based interventions and policy programs to eliminate the remaining inequalities.

• Health Policy and Management
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• v.24 no.2
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• pp.172-180
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• 2014

Background: People with disabilities have higher prevalence rates and earlier onset of chronic disease than the non-disabled; therefore, their participation in health screening is important. This study evaluates the participation rate and trends in health screening of people with disabilities, and examines the association between their participation rate and disability characteristics, and socioeconomic status. Methods: Data on disability-related characteristics were collected from the National Disability Registry, and participants' corresponding health examination data were taken from the Korean National Health Insurance Corporation between 2002 and 2011. A total of 873,819 participants aged ${\geq}20$ years were analyzed in this study. Results: The rate of participation of people with disabilities in health screening has increased each year, but their participation rate is lower than that of the total population. The participation rate was lower in females than in males; the elderly group than in the younger group; those who live in city areas than rural areas; self-employed for health insurance than employees; those with an internal organ disability than those with an external physical disability; those with a severe disability than those with a mild disability; and those with a short-term disability than for those with a long-term disability. Conclusion: The factors associated with participation rate are age, sex, socioeconomic status, and disability characteristics. These findings indicate that health check-ups of people with disabilities should be promoted using an approach that takes into account the large individual differences in socioeconomic status and disability characteristics in this population.

• Journal of Preventive Medicine and Public Health
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• v.39 no.6
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• pp.511-519
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• 2006

Objectives : As the disabled have higher prevalence rates and earlier onsets of chronic diseases than the non-disabled, their participation in mass screening is important for the early detection and intervention of chronic diseases. Nevertheless, in Korea, the disabled have lower participation rates in mass screening services than the non-disabled. The purpose of the study was to find determinants for the participation in the National Health Insurance (NHI) mass screening program among the disabled. Methods : In this study, the NHI mass screening data of 423,076 disabled people, which were identified using the National Disability Registry (2003), were analyzed. Of the factors affecting the participation rates in mass screenings, the following variables were included for the analysis: socioeconomic stati, such as sex, age, category of health insurance program, region and income, disability characteristics, such as disability type, and severity. A multiple logistic regression analysis was used to evaluate the association between the participation rates, disability characteristics variables and demographic variables. Results : The participation rate in mass screening of the disabled was 41.3%, but was lower in females, an age of more than 70 years, self-employed and for those with an average monthly insurance premium over 133,500 Won and in metropolitan legions. The participation rate was 1.31 times lower in females than males (95% CI=1.29-1.33); 3.50 times lower in the elderly (more than 70 years) than the younger (95% CI=3.33-3.67); 1.43 times lower in those who live in metropolitan areas (95% CI=1.40-1.46); 2.59 times lower for those in a health Insurance program for the self-employed than for employees (95% CI=2.56-2.63), 1.19 times lower for the higher income (more than 133,500) than the lower income group (4,400-22,000) for the average monthly insurance premium (95% CI=1.15-1.23): 2.04 times lower for those with brain palsy and stroke disabilities than with auditory impairments (95% CI: 1.97-2.11) and 3.27 times for those with severe compared to mild disabilities (95% CI=3.15-3.40). Conclusions : The disabled with high severity, and locomotive and communication disabilities have lower participation rates in mass screening services in Korea.

• Journal of Preventive Medicine and Public Health
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• v.38 no.1
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• pp.93-100
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• 2005

Background : Cancer is the leading cause of death and one of the largest burdens of disease in Korea. In 1996, the Ten year Plan for Cancer Control was formulated and the government then adopted the plan as a national policy. As part of this plan, the National Cancer Screening Program (NCSP) for Medicaid recipients was formulated, and the government adapted this in 1999. For low-income beneficiaries of the National Health Insurance Corporation (NHIC), the screening program has been in place since 2002. In 2002, the target cancers of NCSP were stomach, breast and cervical cancer. This study was conducted to examine the relationships between the participation rate, the abnormal screening rate and the socio-demographic factors associated with participation in the screening program. Methods : To analyze the participation rate and abnormal rate for the NCSP, we used the 2002 NCSP records. The information on the socio-demographic factors was available from the database of the beneficiaries in the NHIC and Medicaid. Results : The participation rate of the Medicaid beneficiaries for the stomach, breast and cervical cancer screening were 9.2%, 15.5% and 15.0%, respectively, and 11.3% and 12.5%, except cervical cancer which wasn't be included in the NCSP, for the beneficiaries of the NHIC. The abnormal rate of stomach, breast and cervical cancer screening were 25.7%, 11.2% and 21.0%, respectively, for the beneficiaries of Medicaid and 42.6% and 19.4% for the beneficiaries of the NHIC. On the multiple logistic regression analysis, gender, age and place of residence were significantly associated with participation rates of the NCSP. For stomach cancer, women participated in the NCSP more than men. The participation rate was higher among people in their fifties and sixties than for those people in their forties and those people over seventy years in age. For the breast and cervical cancer, people in their fifties were more likely to participate in the NCSP than people in their forties and people over sixty. For the place of residence, people in the rural areas participated more than those people in any other places. Conclusions : The above results show that the participation rate and abnormal rate were significantly associated with the socio-demographic factors. To improve the participation rate for the NCSP, more attention should be given to the underserved groups.

• Health Policy and Management
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• v.26 no.4
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• pp.382-389
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• 2016

Background: National cancer screening reduces mortality from stomach, colon, breast, and cervical cancer. However, cancer screening rates remain lower than 50% in Korea. This research was designed to make effective guidelines for cancer screening promotion to increase participation rate in cancer screening. Methods: Data was collected from Incheon regional cancer center's telephone survey 'Recognition of cancer prevention and control' of 861 Incheon citizens over age 40. Logistic regression was used to analyse a relationships between cancer screening rates and promotional methods. PASW SPSS ver. 18.0 program (SPSS Inc., Chicago, IL, USA) was used for statistical analysis. Results: About 27.4% of respondents (236 of 861 respondents) have recognized the promotional program of Incheon regional cancer center for cancer screening participation. Cancer screening rate was associated with age group, educational level for stomach cancer, age group, bus advertisement (odds ratio, 1.19 to 2.75) for colon cancer, educational level, residential area for breast cancer, and age group for cervical cancer. Conclusion: There was relationship between stomach cancer screening rates and promotional methods. Therefore, cancer screening promotion guidelines to increase participation rate should be considered.