• Asian Pacific Journal of Cancer Prevention
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• 제16권15호
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• pp.6605-6608
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• 2015

Background: Colorectal cancer is a major cause of morbidity and mortality throughout the world. Colorectal cancer screening is an optimal way for reducing of morbidity and mortality and a clinical decision support system (CDSS) plays an important role in predicting success of screening processes. DSS is a computer-based information system that improves the delivery of preventive care services. The aim of this article was to detail engineering of information requirements and work flow design of CDSS for a colorectal cancer screening program. Materials and Methods: In the first stage a screening minimum data set was determined. Developed and developing countries were analyzed for identifying this data set. Then information deficiencies and gaps were determined by check list. The second stage was a qualitative survey with a semi-structured interview as the study tool. A total of 15 users and stakeholders' perspectives about workflow of CDSS were studied. Finally workflow of DSS of control program was designed by standard clinical practice guidelines and perspectives. Results: Screening minimum data set of national colorectal cancer screening program was defined in five sections, including colonoscopy data set, surgery, pathology, genetics and pedigree data set. Deficiencies and information gaps were analyzed. Then we designed a work process standard of screening. Finally workflow of DSS and entry stage were determined. Conclusions: A CDSS facilitates complex decision making for screening and has key roles in designing optimal interactions between colonoscopy, pathology and laboratory departments. Also workflow analysis is useful to identify data reconciliation strategies to address documentation gaps. Following recommendations of CDSS should improve quality of colorectal cancer screening.

• 보건교육건강증진학회지
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• 제17권1호
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• pp.155-170
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• 2000

This study was aimed at preparing basic data required for establishment of a cancer screening program by examining the status of cancer screenings performed by women in a city and the factors that had an influence on cervical and breast cancers screening behavior of women. In order to find out the status of cervical and breast cancers screening and the factors having an influence on cervical and breast cancers screening behavior, 1,113 women were selected as study area and subjects by a random cluster sampling method, and the subjects were answered by questionnaires. The major results were as follows: 1. In the cases of the breast and the cervical cancers, 16.7% and 55.7% of the subjects turned out to have had one or more screenings respectively in their life-time. Also the rate of screening group of cervical and breast cancers was 16.7%, the rate of screening group of only cervical cancer was 38.9%, and the rate of non-screening group was 44.4%. 2. As to the screening pattern of cervical and breast cancer, there were significantly for age, income, occupation, married status, spouse, the factors associated with health promotion (doctor visiting, exercising), married age, number of children, and breast feeding(p〈0.05). 3. The factors associated with screening behaviors for cervical and breast cancers were age, income, occupation, married status, doctor visiting, exercising, married age, number of children, and breast feeding(p〈0.05). Based on the above-mentioned results obtained by this study, it was anticipated that this study may be playa vital role as basic data for the development and execution of cervical and breast cancers screening program for women in a community. And the analysis, done on the basis of the status of the cancer screening, of the influence factors on cervical and breast cancers screening behavior showed that for the development of a cancer screening program, the factors like age, social-economic class, married status, health promotion behavior, and reproductive characteristics should be considered.

• 대한간호학회지
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• 제33권2호
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• pp.236-245
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• 2003

Purpose: This study was to develop a screening model for identifying a high risk group of dementia and to develop and evaluate the web-based prevention program. Method: It was conducted in 5 phases. 1) Data were collected from dementia patients and non-dementia patients in a community. 2) A screening model of the high risk population was constructed. 3) The validity test was performed and the model was confirmed. 4) Four weeks-prevention program was developed. 5) The program was administered, and evaluated the effects. Result: The model consisted of age, illiteracy, history of stroke and hypercholesterolemia. The program was designed with 12 sessions, group health education using web-based individual instruction program, and 12 sessions of low-intensity physical exercise program. After the completion, their self-efficacy, and health behaviors in experimental group were significantly improved over those in the control group. The perceived barrier in the treatment group is significantly decreased. Conclusion: The screening model developed is very simple and can be utilized in diverse community settings. And the web based prevention program will encourage individual learning and timely feedback, therefore it can facilitate their active participation and promote health management behaviors at home.

• 가정∙방문간호학회지
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• 제28권2호
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• pp.186-196
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• 2021

Purpose: Breast cancer is becoming increasingly prevalent among young Korean women. During pregnancy, women's concern regarding their breasts heightens. Thus, pregnancy provides a window of opportunity for breast cancer prevention and management along with antenatal care. This study developed and evaluated an integrated breast health program for pregnant women. Methods: This study employed a non-equivalent control group and non-synchronized design (22 experimental, 29 control). Women pregnant for over 28 weeks participated. The two-session integrated breast health program focused on breast management during breastfeeding and education about breast cancer prevention and early screening. Results: During the early postpartum period (within three months after the program), there were statistically significant differences in knowledge and attitude about breast cancer and breast self-examination before and after the program. There were also statistically significant differences in BSE at 6 and 12 months after the program and mammography at 12 months after the program. However, there were no statistically significant differences in clinical breast examination and breast ultrasonography at 6 and 12 months after the program. Conclusion: The integrated breast health management program was effective in increasing knowledge and improving attitudes regarding breast cancer, BSE, and early screening practices among pregnant women. Further studies should consider providing breast health programs differently for each phase of pregnancy and continuing the same after delivery.

• Asian Pacific Journal of Cancer Prevention
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• 제14권3호
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• pp.2141-2146
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• 2013

Cervical cancer is the third most common form of cancer that strikes Malaysian women. The National Cancer Registry in 2006 and 2007 reported that the age standardized incidence (ASR) of cervical cancer was 12.2 and 7.8 per 100,000 women, respectively. The cumulative risk of developing cervical cancer for a Malaysian woman is 0.9 for 74 years. Among all ethnic groups, the Chinese experienced the highest incidence rate in 2006, followed by Indians and Malays. The percentage cervical cancer detected at stage I and II was 55% (stage I: 21.0%, stage II: 34.0%, stage III: 26.0% and stage IV: 19.0%). Data from Ministry of Health Malaysia (2006) showed a 58.9% estimated coverage of pap smear screening conducted among those aged 30-49 years. Only a small percentage of women aged 50-59 and 50-65 years old were screened, 14% and 13.8% coverage, respectively. Incidence of cervical cancer was highest (71.6%) among those in the 60-65 age group (MOH, 2003). Currently, there is no organized population-based screening program available for the whole of Malaysia. A pilot project was initiated in 2006, to move from opportunistic cervical screening of women who attend antenatal and postnatal visits to a population based approach to be able to monitor the women through the screening pathway and encourage women at highest risk to be screened. The project was modelled on the screening program in Australia with some modifications to suit the Malaysian setting. Substantial challenges have been identified, particularly in relation to information systems for call and recall of women, as well as laboratory reporting and quality assurance. A cost-effective locally-specific approach to organized screening, that will provide the infrastructure for increasing participation in the cervical cancer screening program, is urgently required.

• Asian Pacific Journal of Cancer Prevention
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• 제17권2호
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• pp.569-573
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• 2016

Background: A colorectal cancer screening program was piloted in two districts of Kedah in 2013. There is scarcity of information on colorectal cancer screening in Malaysia. Objective: Thus, this research was conducted to evaluate the colorectal cancer screening program in the districts to provide insights intop its efficacy. Materials and Methods: A cross sectional study was conducted using data on the colorectal cancer screening program in 2013 involving Kota Setar and Kuala Muda districts in Malaysia. We determined the response rate of immunochemical fecal occult blood test (iFOBT), colonoscopy compliance, and detection rates of neoplasia and carcinoma. We also compared the response of FOBT by demographic background. Results: The response rate of FOBT for first iFOBT screening was 94.7% while the second iFOBT screening was 90.7%. Participants from Kuala Muda district were 27 times more likely to default while Indians had a 3 times higher risk of default compared to Malays. The colonoscopy compliance was suboptimal among those with positive iFOBT. The most common finding from colonoscopy was hemorrhoids, followed by tubular adenoma. Detection rate of carcinoma and neoplasia for our program was 1.2%. Conclusions: In summary, the response rate of iFOBT was encouraging but the colonoscopy compliance was suboptimal which led to a considerably low detection rate.

• 부모자녀건강학회지
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• 제11권1호
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• pp.49-60
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• 2008

This is an underlying study for expanding child growth and developmental screening program, which had been implemented as a part of maternal child health service in a certain public health center located in P City. This study attempted to develop system model to discover, consult and follow-up developmental disabilities in children in early stage. For the purpose of providing groundwork for further development of screening program, the system model was analyzed and evaluated. One of the focuses of this study was developing practical tool that can aid small number staffs of public health center to handle large number of patients. 9 types of developmental checklist by key month was developed to support understaffed public health center. These checklists were also supplied to other public health centers, greatly improving qualitative and quantitative development of screening project. Also, the 4-step program of operating and managing child growth and developmental screening was proved to be quite effective. Total 632 children were evaluated and 21 of them were suspected to have developmental problem. Among these children, 8 children were determined to receive regular supervision of public health center. Other 13 children were recommended to visit professional institution, but only 7 of them actually visited institution. Four of these children who visited professional institution are currently receiving treatment, while the other 3 children were determined to require close observation. Five times of screening education were provided to the staffs in public health center and personnel in charge of children in every district public center in P City. The purpose of this training was to improve individuals' capability to implement project and to establish basis for expanding child growth and developmental screening program. The participants were guided to have continuous attention for the project, and their knowledge, skill and recognition were greatly improved through educational training. Also, professional child consulting and education, including lecture for baby food and baby food menu exhibition, were given to parents. Through this opportunity, parents acquired higher understanding about baby food while the local residents' recognition for maternal child health service was greatly improved.

• 한국학교ㆍ지역보건교육학회지
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• 제20권2호
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• pp.25-36
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• 2019

Purpose: The purpose of this study was to examine the factors affecting of health screening among persons with disabilities. Method: The study examines the factors affecting of health screening using over 20 years of age who participated in the 2017 National survey of the disabled data. Subjects were 6,332 person with disabilities over 20 years of age. Data were analyzed using descriptive statistics, X2-test, multiple logistic regression with the SPSS win 21.0 program. Results: Health screening among persons with disabilities is differentiated with education level, marital status, Subjective House economic status, Health insurance, Economic activity, Type of disability, Grade of disability, Stress recognition, Depressive symptom, Suicidal thinking, Suicidal attempt, and grade of disability. The significant predictors of the health screening were age, Subjective House economic status, Economic activity, and Grade of disability. Conclusion: We should consider age, disability level, and economic level when developing a screening program for people with disabilities. Especially, the development and promotion of the health screening program for persons with disabilities and related education are required.

• Journal of Preventive Medicine and Public Health
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• 제43권1호
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• pp.62-72
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• 2010

Objectives: To identify factors associated with cancer screening intention using the Theory of Planned Behavior (TPB). Methods: Among 55,920 eligible persons for National Cancer Screening Program (NCSP) in J city, 1,100 individuals were contacted. Of these, 797 were interviewed using a structured questionnaire. Thirty-six responses were excluded due to incomplete data. The remaining 761 completed questionnaires were analyzed to find factors associated with cancer screening intention. Results: Cancer screening intention was significantly associated with behavioral attitude (p<0.01) and subjective norm (p<0.01), but not with perceived behavioral control (p=0.29) in the TPB model. These three constructs explained 29.7% of cancer screening intention in multiple linear regression analysis. External factors such as socio-demographic status, health and health behavior variables explained 8.9% of screening intention. Among them, household monthly income, past cancer screening experience, exercise and daily eating habit were significantly associated with screening intention. Conclusions: Cancer screening intention may be influenced by focusing attitude, subjective norm in TPB model and other external factors. However, further studies are warranted to identify factors influencing cancer screening intention and behavior.

• Asian Pacific Journal of Cancer Prevention
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• 제17권2호
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• pp.609-614
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• 2016

Background: Although breast cancer is the most common cancer in women, economic evaluation of breast cancer screening is not fully addressed in developing countries. The main objective of the present study was to analyze the cost-effectiveness of breast cancer screening using mammography in 35-69 year old women in an Iranian setting. Materials and Methods: This was an economic evaluation study assessing the cost-effectiveness of a population-based screening program in 35-69 year old women residing in rural areas of South east Iran. The study was conducted from the perspective of policy-makers of insurance. The study population consisted of 35- to 69-year old women in rural areas of Kerman with a population of about 19,651 in 2013. The decision tree modeling and economic evaluation software were used for cost-effectiveness and sensitivity analyses of the interventions. Results: The total cost of the screening program was 7,067.69 US$ and the total effectiveness for screening and no-screening interventions was 0.06171 and 0.00864 disability adjusted life years averted, respectively. The average cost-effectiveness ratio DALY averted US$ for screening intervention was 7,7082.5 US$ per DALY averted and 589,027 US $ for no-screening intervention. The incremental cost-effectiveness ratio DALY averted was 6,264 US$ per DALY averted for screening intervention compared with no-screening intervention. Conclusions: Although the screening intervention is more cost-effective than the alternative (noscreening) strategy, it seems that including breast cancer screening program in health insurance package may not be recommended as long as the target group has a low participation rate.