The Let’s Eat Healthy and Move at School program for adolescents in South Korea: Program design, implementation, and evaluation plan using intervention mapping

Purpose@#This study aimed to systematically develop an obesity prevention program for adolescents to promote healthy eating and physical activity in schools. @*Methods@#The development of the Let's Eat Healthy and Move at School program for adolescents followed the six steps of intervention mapping (IM). IM is a widely used protocol for developing systematic and effective interventions based on theories and evidence. @*Results@#To better understand the problem and identify the needs of adolescents, interviews were conducted with teachers, school nurses, and students (step 1). In step 2, the desired behaviors and their determinants were established and combined into a matrix comprising 16 change objectives. In step 3, theoretical methods such as persuasive communication and consciousness-raising were chosen. The program was segmented into three educational activity sessions in step 4. In step 5, an implementation manual was developed for program instructors to ensure effective and accurate implementation. Finally, practices for evaluating the program's effectiveness and procedures were designed in step 6. @*Conclusion@#The Let’s Eat Healthy and Move at School program will provide adolescents with guidelines to promote healthy living and prevent obesity in everyday life using strategies for sustainable adolescent obesity prevention and management.

Factors influencing emergency medical competencies of health centers and fire stations in areas that are vulnerable to earthquakes

Objective@#This study aimed to investigate the factors influencing the emergency medical competency (EMC), perceived by the fire station and health center staff, in the areas where of emergency medical vulnerability where earthquakes had occurred. @*Methods@#This study was conducted between December 2019 and February 2020. A proper questionnaire was created to evaluate EMC in disaster situations and administered to the fire station and the health center groups. Descriptive variables of each group were calculated. The Kendall rank correlation analysis was used to measure the relationships between the demographic variables, disaster-related variables, and EMC. The factors influencing the EMC for both groups were investigated in the linear regression analysis. @*Results@#For a total of 200 respondents, the mean scores of EMC were 99.85±21.24 and 95.24±20.05 for the fire station (n=96) and the health center (n=104) groups, respectively (P=0.121). EMC was significantly correlated with age, years of service, job position, natural disaster experience, disaster relief service experience, and joint disaster response exercise (P<0.050). Linear regression analysis revealed that the duration of joint disaster response exercise (β=0.640, t=11.696) in Model 1 (F=136.806, P<0.001), the duration of joint disaster response exercise (β=0.627, P<0.001), and disaster rescue service experience (β=0.124, P<0.001) in Model 2 (F=72.431, P<0.001) were independently associated with EMC improvement. @*Conclusion@#Our findings indicate that the disaster preparedness program with a longer duration of joint disaster response exercise and more frequent disaster rescue service experience is necessary for improved and systematic response to a disaster.

Factors influencing emergency medical competencies of health centers and fire stations in areas that are vulnerable to earthquakes

Objective@#This study aimed to investigate the factors influencing the emergency medical competency (EMC), perceived by the fire station and health center staff, in the areas where of emergency medical vulnerability where earthquakes had occurred. @*Methods@#This study was conducted between December 2019 and February 2020. A proper questionnaire was created to evaluate EMC in disaster situations and administered to the fire station and the health center groups. Descriptive variables of each group were calculated. The Kendall rank correlation analysis was used to measure the relationships between the demographic variables, disaster-related variables, and EMC. The factors influencing the EMC for both groups were investigated in the linear regression analysis. @*Results@#For a total of 200 respondents, the mean scores of EMC were 99.85±21.24 and 95.24±20.05 for the fire station (n=96) and the health center (n=104) groups, respectively (P=0.121). EMC was significantly correlated with age, years of service, job position, natural disaster experience, disaster relief service experience, and joint disaster response exercise (P<0.050). Linear regression analysis revealed that the duration of joint disaster response exercise (β=0.640, t=11.696) in Model 1 (F=136.806, P<0.001), the duration of joint disaster response exercise (β=0.627, P<0.001), and disaster rescue service experience (β=0.124, P<0.001) in Model 2 (F=72.431, P<0.001) were independently associated with EMC improvement. @*Conclusion@#Our findings indicate that the disaster preparedness program with a longer duration of joint disaster response exercise and more frequent disaster rescue service experience is necessary for improved and systematic response to a disaster.

Current Status and Needs Assessment for Obesity Prevention and Management Project at Public Health Centers

Purpose@#The obesity prevention and management program led by public health centers are important in the community.This study aims to identify the current status of obesity prevention and management programs at public health centers and perceptions regarding facilitators and barriers when implementing programs. @*Methods@#This study used a concurrent mixed methods design. A survey was conducted to investigate the current status and infrastructure of the obesity prevention and management program at eighty-three public health centers nationwide. Nine program managers and six local residents with experience in the program were interviewed by using a semi-structured questionnaires. @*Results@#Most of the infrastructure facilities for the program were inadequate, and insufficient budgets and lack of professional staff were identified as barriers. Facilitators included diversification of program delivery methods, operator competence, and visible outcomes and rewards. For the effectiveness of the program, it is vital to have adequate assistants, a sufficient budget, various promotional methods, and connections with various institutions in the community. On this basis, it is acknowledged that the public health center serves as a platform for preventing and managing obesity in the community. Conclusion: It is expected that infrastructure improvements in public health centers and the link with community resources are needed. In addition, there is an urgent need to set standards for obesity prevention and management programs implemented in public health centers to ‘resolve regional disparities’.

Factors Affecting Suicidal Ideation in Elderly Attending Community Senior Centers / 農村醫學 地域保健

OBJECTIVES: As suicide among the elderly population has been a critical issue in Korea, this study aimed to evaluate correlations of suicidal ideation with protective and risk factors among elderly who reside in a rural community. METHODS: A total of 157 elders from Gyeongju city, who had attended senior centers in, were enrolled to answer questionnaires including the Geriatric Depression Scale Short Form-Korea and the Scale for Suicidal Ideation. Data were analyzed using SPSS 18.0K for Windows, and included t-test, Pearson correlation, and a three-step hierarchical multiple regression analyses. RESULTS: Using the hierarchical regression analyses for predicting the elderly's suicidal ideation, male gender and social group variables were entered as predictors in the first step(adjusted R2=0.107, P<0.05). Pain, ADLs, family support variables were not entered in the second step. Depression variable was the only predictor in the third step(adjusted R2=0.384, P<0.001). CONCLUSIONS: Although this study confirmed the impact of depression on the suicidal ideation, elderly with risk factors including male gender and social isolation should receive a special attention from community health care professionals.

Can medical drama motivate students to have an interest in the healthcare professionalism? / 한국의학교육

PURPOSE: This study was planned to evaluate that a lecture employing medical drama could motivate students to have an interest in the professionalism of healthcare personnel, which has currently become a critical subject in the field of medical education. METHODS: We analyzed subject headings, learning objectives, and further plans developed by students and their responses after two drama modules, 'car crash' and 'refusal of instruction', which were selected based on the conditions made by our faculty members, were given through video or paper to our 121 second-grade medical and nursing students in year 2012. RESULTS: Meaningful subject headings and learning objectives developed by students were 58.2%~60.0% and 36.8%~38.0% and significantly more in the 'refusal of instruction' than the 'car crash' (p=0.000). According to the students' major, medical students developed significantly more than nursing students (p=0.000). In the analysis of responses, 91.7% of students reported as impressive to the educational modules and 55.3% of them described their ideas associated with healthcare professionalism. CONCLUSION: Our study results suggest a possibility that the educational module employing selected medical drama could motivate students' healthcare professionalism.

Healthy Eating Habits Related to Normal Weight Maintenance among Female University Students / 대한지역사회영양학회지

In order to investigate how to maintain normal weight under independent living conditions, twenty female university students were enrolled and asked to complete a questionnaire over a 10- day study period. T-test, Spearman's correlation and multiple regression analysis were applied to describe characteristics of weight maintainers'habits on a daily basis. The results were as follows: They always comsumed small or moderate-sized meals. 2~3 co-eaters usually had dinner together at home while not watching TV. They also showed healthy eating behaviors such as no snacking, very little amounts of soft drinks, coffee and alcohol consumption. The always normal weight maintainers, however, were not physically active at all. When being with co-eater(s), they ate larger-sized dinners (beta = 0.585, R2= 30.6), and the more co-eaters they had at the dinner table, the greater BMI they got (beta = 0.547, R2= 29.9). As a result of this study, encouraging young adult people to exercise on a regular basis is required, even though they seem to succeed in maintaining normal weight without being active physically. Further study is necessary to investigate how co-eaters would influence the amount of food eaten.

Eating and Exercise Behaviors of University Students by Weight Change Status / 대한지역사회영양학회지

Young adults are likely to start a new life style which may cause weight gain or obesity since leaving their parents for higher education or university. Whilst young people are slim in general, it is common to see them trying to manage their weight. Few studies have been carried out in Korea to support those changes in lifestyle that can result in weight gain in early adulthood. This study aims to identify prevalence of dieting as well as factors inducing weight gain among university students under unrestricted living conditions. A total of 99 university students were enrolled and asked to complete a questionnaire over a 3-day study period from June to September, 2008. T-test and chi-square-test were applied to compare each behavior between weight gainers and maintainers. Logistic regression was also used for further analysis. Half of the participants used 'eat less' and 'exercise' as a way of dieting, and weight gainers tried to control their weight significantly more than weight maintainers. Most participants were engaged in very little exercise and were more likely to watch TV and use a computer. The time of lunch was proven as the only factor to predict weight change in the participants. As a result of this study, an intervention to promote exercise with friends or as a group is required to makeup for the lack of exercise among young adults. Further studies are also necessary to investigate how each meal time a day relates to the amount of food eaten.

Do Obese Children Exhibit Distinguishable Behaviours from Normal Weight Children?-Based on Literature Review / 대한지역사회영양학회지

Since obesity has been a crucial issue regarding children's health in Korea, numerous studies have been conducted. However, it is difficult to locate studies that can help researchers and/or medical professionals who want to study behavioral differences between obese and normal weight (non-obese) children. The collected literature about obese childrens behaviors were accumulated by performing 'key word' searches from several web engines: 'obesity' 'children obesity' 'behavior' 'habit' 'eating behavior or habit' 'exercise' 'physical activity' and 'daily behavior'. The information was extracted and the behaviors were reviewed utilizing 30 papers that revealed any differences from normal weight children with at least p .05 level of significance. According to those studies, the obese children tended to skip meals more often as a method of losing weight. They also have an increased appetite, eat larger portions and rarely leave food on their plates. The obese children prefer to eat high fat, high calorie foods and eat faster than their normal weight counterparts. Also, the children usually eat alone and eat at irregular meal times. Beside the behaviors related to the standard three meals a day, obese children have high preferences for snacking. The children reported that with pocket money they usually eat certain types of snacks without parent approval. The children stated that they exercise more on a regular basis. However, when asked about their participation they were not likely to engage actively. Meanwhile, they tend to spend free time doing sedentary activities such as watching TV or playing on the computer. Since these studies used self -reported questionnaires with a small sample, size there may be difficulty in forming a basis about obese children's behaviors. Nevertheless, these findings are in accordance with other studies conducted in local as well as western countries. In conclusion, obese children have different daily behaviors or routines from normal weight children. It is recommended that altering these behavioral patterns to match those of normal weight children should be encouraged.

Analysis of Weight Maintenance Behavior among Female University Students / 대한지역사회영양학회지

Since the 1980's, despite the conclusion of a number of studies in Western countries focusing upon weight maintenance there has been no similar research in Korea which takes into account the contrasts of culture and eating habits between east and west. In order to identify eating, snacking and exercise behaviors, 24 female university students who have maintained weight for at least a year were enrolled for an 11 day study. Participants were required to sign into the program and complete the questionnaire, answering questions by concerning what they ate and did everyday. After excluding unanswered questions, data over 11 days were exported into the Microsoft Excel spreadsheet, then both ANOVA and Kendall's tau correlation were applied with SPSS. 75% of weight maintainers had normal BMI (18-23.5) in relation to Korean standard, and appeared to eat a main meal smaller than moderate in portion size. Only two days showed that amount of breakfast eaten negatively correlated with lunch (p < 0.05), while no correlations between amounts of lunch and dinner eaten over all study period. Compared with breakfast or lunch, dinner was usually larger in portion size, but some variables such as TV viewing, restaurant meals, number of people at dinner table seemed not correlated with amount of dinner eaten. In addition, the weight-maintainers reported they rarely consumed snacks or sweetened beverages. Unlike their western counterparts, few participants reported that they took part in regular exercise during the day, which may lead us to the conclusion that these young female weight maintainers seem to maintain their weight with eating behaviours such as 'eat small portion', 'avoid snacking' and 'avoid soft drinks' rather than doing regular exercise. The study did not include a control group, and was foreshortened due to technical difficulties so it may be necessary to repeat the study while considering these two points.

Comparison of Weight Control Behavior and Self-esteem between Healthy Weight and Obese Children / 대한지역사회영양학회지

The study compared eating and physical activity related behaviors and self-esteem between healthy weight and obese children by presenting 175 primary school students in Busan City and Gyeongsang province with a self-reported questionnaire and Coopersmith's self-esteem inventory. The questionnaire was composed of 25 items, weighted primarily by a Likert scale. The self-esteem inventory presented to the students comprised 25 "Yes" or "No" response questions to different statements. The study found obese children were more likely to think they always had to control their weight (p = 0.000), reportedly measuring their weights significantly more than the healthy weight children. Also the study found that obese children are significantly more likely than healthy weight children to go on a diet, however neither group were successful in losing weight as the duration of the diet in 79.5% of the total sample lasted no longer than one week. In comparison to healthy weight children, obese children reported that they consumed fewer snacks during the day, avoided snacking subsequent to an evening meal and exercised more frequently for as long as physically possible. Interestingly, we found no difference of reported self-esteem between groups, though the obese group were more likely to answer that their parents did not understand them (p = 0.055). Based on these findings, we concluded that the obese children who participated in the study were more aware of their body weights than the healthy weights children. It may be necessary to investigate further the relationship between self-esteem and participants' weights while considering other variables such as personality and body image.