Health communication issues related to latent tuberculosis infection treatment support for the foreign-born in Japan / 国際保健医療

Objective  To identify issues in health communication regarding treatment support for foreign-born who are diagnosed as latent tuberculosis infection (LTBI) in Japan, from the perspective of public health centers (PHCs).Methods  A self-administered survey was sent to 469 PHC, between June and July 2020. The survey asked closed and open-ended questions to tuberculosis (TB) program personnel on (1) their experiences of foreign-born patients who were eligible for LTBI treatment but did not start their treatment, and who started treatment but were lost to follow-up, and (2) health communication issues with foreign-born patients. Responses were summarized descriptively for close-ended questions, and analyzed qualitatively for open-ended question.Results  We obtained response from 307 PHCs, regarding 315 foreign-born patients. Twenty-five patients did not initiate, and 52 were lost to follow-up after initiating LTBI treatment. Of the 77 patients who either did not start treatment or were lost to follow-up, 45 apparently could hold everyday conversation in Japanese but had difficulties understanding technical terms, and 19 could not even exchange basic conversation, with PHC staff. Barriers to LTBI treatment initiation and completement, as perceived by PHC staff, included “lack of correct knowledge about TB and LTBI”, “different attitudes to health” and “economic difficulties”. Conclusion  Issues in health communication between PHC staff and foreign-born patients included not only a language barrier, but also the unconscious mind among PHC staff, which sought reasons for refusal or termination of LTBI treatment in patients. We argue that this mind is based on positivism, whereby health personnel consider themselves as the provider of “scientific knowledge” and that “lay persons” can act rationally once enlightened. However, PHC staff may need to reflect upon such position as the provider of scientific knowledge, but instead, learn from foreign-born patients about how they perceive health, TB or LTBI, to conduct better communication.

Association between meat, fish, and fatty acid intake and incidence of acute myeloid leukemia and myelodysplastic syndrome: the Japan Public Health Center-based Prospective Study

BACKGROUND@#The association between meat, fish, or fatty acid intake and acute myeloid leukemia (AML) and myelodysplastic syndrome (MDS) has been investigated in a few studies, and the results were inconsistent. In addition, most studies are mainly based on the United States and European countries, in which the dietary patterns differ from that in Asia. Therefore, the risk of AML/MDS from meat, fish, or fatty acid intake in Asia requires further exploration. The aim of this study was to investigate the association between AML/MDS incidence and meat, fish, or fatty acid intake using the Japan Public Health Center-based prospective study.@*METHODS@#The present study included 93,366 participants who were eligible for analysis and followed up from the 5-year survey date until December 2012. We estimated the impact of their intake on AML/MDS incidence using a Cox proportional hazards model.@*RESULTS@#The study participants were followed up for 1,345,002 person-years. During the follow-up period, we identified 67 AML and 49 MDS cases. An increased intake of processed red meat was significantly associated with the incidence of AML/MDS, with a hazard ratio of 1.63 (95% confidence interval, 1.03-2.57) for the highest versus lowest tertile and a Ptrend of 0.04. Meanwhile, the intake of other foods and fatty acids was not associated with AML/MDS.@*CONCLUSION@#In this Japanese population, processed red meat was associated with an increased incidence of AML/MDS.

Infection control measures promoted by the public health center for “housing for the elderly” facilities during norovirus cluster outbreaks / Journal of Rural Medicine

Objective: “Housing for the elderly” is a type of facility where a few healthcare staff and care workers provide long-term care to residents. This study aimed to explore the infection control measures promoted by the public health centers (PHC) when a cluster of norovirus cases occurred in this type of facility.Materials and Methods: This study involved a prefectural office in Japan and collected the records of PHC surveys/instructions of norovirus cluster cases that occurred in “housing for the elderly” facilities between 2017 and 2019. The records provided information about the case characteristics (cluster periods and number of infected individuals) and instructions for infection control by the PHC. We tabulated the case characteristics and performed a descriptive qualitative analysis to extract the instructions from the PHC.Results: Twelve clusters of cases were included in the study. Approximately 16% of the residents and care workers in each facility were infected, and it took an average of 23 days from the start of the outbreak to the end. Nine categories of PHC instructions emerged after the data analysis. “Collaboration with community healthcare workers” included instructions by the PHC to share information with external physicians and home-visiting nurses. In “precautions when caring for elderly residents with functional decline”, the procedure for changing diapers and infection control measures considering the behavior of residents with dementia were advised. If the contents of the infection control manuals were deemed to be inadequate, an “improvement of the infection control manuals” was instructed.Conclusion: To implement effective infection control by care workers at “housing for the elderly” facilities, the PHC should promote the involvement of community physicians and nurses and advise on clear procedures based on residents’ functional decline.

Public Health Center Capacity in Managing The Risk of Climate Change. A Case Study in The City of Padang, Indonesia

@#Introduction: Indonesia already has a regulation regarding capacity of public health sector to deal with climate change issue to overcome the adverse effects on health. This regulation is based on Indonesia's vulnerability to climate change and extreme weather. Despite having commitments and regulations about this issue, implementation of this policy is still not maximal in line with government expectations. Thus, the purpose of this study is to identify capacity of the health sector to be actively involved in minimizing the risks of climate change in Public Health Center (PHC) as the first level of health service for community. Method: This research is carried out to nine informants at three PHCs in the city of Padang. The study is conducted with a qualitative approach by reviewing the capacity of PHCs which regards to perception of climate change, health services provision for climate-based diseases, institution management, surveillance and early warning systems, and intersectoral coordination in managing climate change. Results: The results show that almost all informants in PHCs do not understand climate change issues correctly and do not have specific planning documents about climate change. Almost all PHCs do not utilize climate data that available from relevant stakeholders to predict climate-based diseases. Conclusion: The government is expected to apply existing climate change regulations in regional level so that PHCs can work through promotive and preventive approaches to address health problems caused by climate change.

Performance assessment of public health center in pare-pare, South Sulawesi

Background: Customer (patient) satisfaction in health services is very important to note because it can describe the quality of services in the health service. This study aims to determine the level of performance assesment of public health centers relating to the quality of public health centers service, management of public health centers and health services based on patient satisfaction in the public health center in Parepare, South Sulawesi.Methods: The research method is quantitative with survey research to determine the level of reseach results on public health centers about patient satisfaction.Results: The results of the study indicate that performance assessment is in the form of the quality of service possessed by the public health center obtained an average performance value of 8.8 with a good performance category. Management of the public health center obtained an average performance value of 8.9 with a good performance category. Health services obtained an average performance value of 90.7% with sufficient performance categories. Customer satisfaction obtained an average value of 71.1% in the good category.Conclusions: Service quality of public health center has a good performance, health center management has good performance, health services have sufficient performance, customer satisfaction has a good category. So that the average performance of the public health center has results comparable to the results of customer satisfaction, which is a good category.

Evaluation of the Effectiveness and the Level of Self-Management Support on the Metabolic Syndrome Management Program at Public Health Centers in Seoul Metropolitan City / 보건행정학회지

BACKGROUND: The purpose of this study was to evaluate the effectiveness and the level of self-management support on the Metabolic Syndrome Management Program at public health centers in Seoul metropolitan city. METHODS: The effectiveness on the Metabolic Syndrome Management Program were analyzed using secondary data from 1,312 community residents who were receiving program. The level of self-management support on Metabolic Syndrome Management Program was evaluated using an ‘Assessment of Primary Care Resources and Supports for Chronic Disease Self-Management’ from four public health centers. RESULTS: The effectiveness on the Metabolic Syndrome Management Program was showed that decreased smoking (p=0.044) and drinking (p<0.001), and increased healthy dietary habit (p<0.001) in health behaviors. It was showed that decreased triglyceride (p=0.002) and increased high-density lipoprotein cholesterol (p<0.001) in clinical indicators. The level of self-management support on Metabolic Syndrome Management Program was 98.1 points and it meaned that implementation is done in an organized and consistent manner using a team approach. There was difference in the level of self-management support by public health centers (p=0.003). CONCLUSION: The Metabolic Syndrome Management Program in public health centers was effective, and level of self-management support was done as organizational level, but patient input and mental health were insufficient.

Implementing Expanded Rapid Human Immunodeficiency Virus Testing in Public Health Centers in Seoul, 2015 / 감염과화학요법

In 2015, rapid human immunodeficiency virus (HIV) testing was implemented in all 25 public health centers in Seoul. During March and December 2015, 20,987 rapid HIV tests were performed, of which 116 (0.5%) were positive. Compared to those of the period before application of the rapid HIV test in place of conventional enzyme immunoassay method, the number of HIV tests performed and the number of positive results increased by sevenfold and twofold, respectively. In conclusion, expansion of the provision of rapid HIV tests in public health centers increased the number of voluntary HIV tests.

Status and Issues on Disaster Preparation Programs in Public Health Center / 農村醫學 地域保健

OBJECTIVES: The purpose of this study was to review the disaster preparation and response programs and the status of disaster preparation in public health center. METHODS: In depth interview was performed in September 2017 using 5 open questions to the persons who are in charge of disaster response services in 5 public health centers of different levels in Korea. The questions included general characteristics of public health center, disaster programs and future issues. The research hired a quality method. RESULTS: In general, the persons in charge recognized the cooperative agency of local government in disaster management. There were no disaster preparation programs developed by the public health centers. Most of the preparation were passive activities such as emergency support, crisis management on communicable disease and quarantine, participation in biological disaster response training, and education etc. The persons in charge emphasized necessity of disaster preparation programs. CONCLUSIONS: Disaster preparation and responsiveness is an evolving issue in public health centers in Korea. Medical support system and communicable disease management system are being set up in the national level. A comprehensive system covering health management, nutritional support, mental health, environment management of shelter, and volunteers supports on public health center level needs to be developed along with a easy-to-follow manual.

Comparison of Perceptions of Local Residents and Public Health Center Staffs on the Performance of Medical Service Improvement Plan in Rural Areas / 農村醫學 地域保健

OBJECTIVES: The purpose of this study is to compare the perceptions of the rural healthcare service improvement project' performance and reorganization of public health centers between project staffs and local residents. METHODS: Data collection from this study was performed in 141 project areas using structured questionnaires. Data analysis was used in SPSS 22.0 version. RESULTS: The public health center staffs were more positive about the items for improving health facilities than the local residents. Residents in the Si area generally perceived performance as more positive than residents in the Gun area, while public health center staffs in the Gun area perceived performance as more positive than public health center staffs in the Si area. Local residents expressed negative opinions about the reduction in the number of branches of public health clinics and health medical clinics. CONCLUSIONS: In conclusion, careful improvement projects for rural health care and the establishment of health care systems will be necessary, reflecting the opinions of local residents, along with a variety of regional characteristics.

Implementing Expanded Rapid Human Immunodeficiency Virus Testing in Public Health Centers in Seoul, 2015 / 감염과화학요법

In 2015, rapid human immunodeficiency virus (HIV) testing was implemented in all 25 public health centers in Seoul. During March and December 2015, 20,987 rapid HIV tests were performed, of which 116 (0.5%) were positive. Compared to those of the period before application of the rapid HIV test in place of conventional enzyme immunoassay method, the number of HIV tests performed and the number of positive results increased by sevenfold and twofold, respectively. In conclusion, expansion of the provision of rapid HIV tests in public health centers increased the number of voluntary HIV tests.

The Effects of Service Orientation on the Organizational Commitment and Management Performance of Public Health Center Workers / 한국직업건강간호학회지

PURPOSE: The purpose of this study was to identify the effects of service orientation on the organizational commitment and management performance of public health center workers. METHODS: A cross-sectional survey design was used. A convenience sample of 280 workers was recruited from six public health centers in J province, South Korea. Data were collected by self-report questionnaires, including general characteristics, service orientation, organizational commitment, and management performance. Data were analyzed with descriptive statistics, Pearson correlation coefficients, independent t-test, one-way ANOVA, and hierarchical regression using the SPSS 22.0 program. RESULTS: The service orientations explained 34.1%of the variance in organizational commitment and explained 31.4% of the variance in management performance. The service orientation was a significant predictor of organizational commitment and management performance. CONCLUSION: The results of this study suggest that better strategies for service orientations will be helpful to enhance organizational commitment and management performance in the public health center.

Implementing the Use of Rapid HIV Tests in Public Health Centers in Seoul: Results of a Pilot Project, 2014

To determine whether rapid HIV tests in public health centers might encourage voluntary HIV testing, a pilot project was conducted in four selected public health centers in Seoul, 2014. During the period April 10 to November 28 of pilot project, 3,356 rapid tests were performed, and 38 were confirmed as positive. The monthly average numbers of voluntary HIV tests and HIV-positive cases were up to nine-fold and six-fold larger, respectively, than those of the period before application of the rapid HIV test. Among 2,051 examinees that completed questionnaires, 90.3% were satisfied. In conclusion, the use of rapid HIV tests in public health centers promoted voluntary HIV testing and was satisfactory for examinees.

A Study on Disaster Preparedness Competency in Public Health Center Workers / 한국간호교육학회지

PURPOSE: The purpose of this study was to explore the levels of disaster preparedness competency in public health workers and identify influential factors on disaster preparedness competency. METHODS: The data was collected through self-report questionnaires from a convenience sample of 281 public health workers in 2014 in Korea. The data was analyzed using descriptive statistics, t-test, ANOVA, and multiple regression. RESULTS: The mean disaster preparedness competency score was 2.77 and the mean disaster educational needs score was 4.01. Disaster preparedness competency had a statistically significant difference by gender, position, experience of disaster education in workplace, and experience of BLS education. As a result of the multiple regression analysis, disaster preparedness competency accounted for 11.6% of the variance by gender, experience of disaster education in workplace, and experience of BLS education. CONCLUSION: The results of this study reveal that gender, strengthening education of disasters in the workplace, and education of BLS should be taken into consideration and integrated when developing an effective educational program in order to enhance disaster preparedness competency in public health workers.

A Study on Dietary Behaviors, Health-Related Lifestyle of Adult Visitors at Public Health Centers in Gyeonggi Urban Area / 대한지역사회영양학회지

The purpose of this study was to investigate dietary behaviors and health-related lifestyles of adult visitors at a public health center in Gyeonggi urban area. A survey using questionnaire was conducted with 949 visitors at Seongnam public health centers from June to August, 2012. The data from 905 respondents were analyzed by gender, consisting of 322 males and 583 females, and age group, consisting of 243 low-age group (LA), 312 middle-age group (MA), 350 high-age group (HA), aged 20 to 30 years, 31 to 50 years, and 51 to 69 years, respectively. Average Body Mass Index was 23.0, which increased with age, and education level was high in LA. 59.0 percent of the subjects had various diseases, and the incidence of hypertension was the highest, followed by allergy, hyperlipidemia, diabetes mellitus, joint rheumatism. Incidence rates of chronic disease increased with age, which were lower than those from 2011 Korea National Health and Nutrition Examination Survey (KNHANES). Weekly drinking frequency rate and smoking rate decreased with age, and exercise performing rate was high at male and HA, which showed the same tendency as KNHANES. Female and HA showed more healthy dietary behaviors such as restricting salt, sugar, oily foods, foods containing food additives, calorie, caring for balanced diet, and referring to nutrition label. Subjects chose stress as the first factor, followed by diet, exercise, etc., among 13 suggested factors which strongly influence on human's life-span. In general, public health center visitors, especially female and HA, showed better dietary behaviors and health-related lifestyles compared with KNHANES.

Organizational Personality Type and Citizenship Behaviors Perceived by Public Health Center Workers in Chonnam Province, Korea / 農村醫學 地域保健

OBJECTIVES: The purpose of this study was to assess organizational citizenship behaviors (OCBs) and organizational personality types (OPT) perceived by public health center workers and to analyze differences in perceptions according to organizational characteristics. METHODS: The subjects of this study were workers at 12 of the 22 public health centers in Chonnam Province, South Korea. To measure organizational characteristics, we employed the OPT Index and OCBs Index. Data were collected for one month, from 15 September to 14 October 2009. Data for 422 workers were used in the final analysis. Descriptive statistics and t tests were performed as appropriate, utilizing SPSS/WIN 14. RESULTS: Among 16 types of OPT, ESTJ, ISTJ and ESTP were the most prevalent for the 12 public health centers. The average weight of OCBs was 4.77, and courtesy and civic virtue held the first and the second ranks among OCBs, respectively. Statistically significant differences between types of OPT were detected, in that T type was gender (p=.007) while J type was age (p=.010), education (p=.043) and career (p=.000). Statistically significant differences between OCBs were found in age, education and career. CONCLUSION: Public health centers should have programs to innovate OPT and to improve OCB. The development of such programs should consider characteristics of public health center workers such as age, gender, education and career.

Factors Associated with Active Participation in Health Promotion Programs at a Public Health Center / 農村醫學 地域保健

OBJECTIVES: We identified factors associated with any participation and with "good participation" (as assessed by frequency of attendance) in health promotion programs at a public health center in Korea. METHODS: The subjects included 199 women who attended a baseline examination of health promotion programs during the first half of 2009. We collected data by structured interviews and physical examinations. Participation status was quantified by the frequency of attendance to the program. We classified the subjects as non-participants (0) and participants (1+ times), and as poor participants (0-29 times) and good participants (30+ times). RESULTS: Of the 199 subjects, there were 57 (28.6%) non-participants, while 56 (28.1%) were classified as good participants. The factors that significantly affected participation status, as identified by univariate analysis, were personal factors (age, educational level, marital status, religion, living with someone, monthly income), environmental factors (method of access, accessibility of other facilities), body mass index, hypertension, perceived barriers to health, emotional salience, affectionate domain of social support, and depression. Multiple logistic regression analyses indicated that method of access was the most significant factor affecting participation in the health promotion program, and that the factors most highly associated with good participation were emotional salience, hypertension and body mass index. CONCLUSIONS: Our findings suggest that specific factors determine and enhance participation in health promotion programs offered by public health centers. These factors should be considered during the design and evaluation of health promotion programs that are offered by public health centers.

Agreement between Self-Report on Smoking Cessation and Urinary Cotinine Test / 대한정신약물학회지

OBJECTIVE: Self-report is being used in most of studies investigating the therapeutic effect of smoking cessation clinics of public health centers in Korea instead of cotinine or other chemical markers of nicotine exposure. This study was conducted to evaluate the agreement between self-report and urinary cotinine test after smoking cessation program. METHODS: The study subjects were 333 adult male who visited public health center and participated in 12-week scheduled smoking cessation program. Questionnaires including demographic data and information about cigarette use, blood test, and urinary cotinine test were performed to all subjects during initial evaluation. At the end of the program, smoking status of subjects was assessed by an oral self-report and additional blood and urinary cotinine tests were done to the subjects who agreed. RESULTS: 52 participants who gave both self-report on smoking status and urine sample were included in the final analysis. The overall percentage agreement was 67.3%, and the overall Kappa index was 0.367. The sensitivity, specificity, positive predictive value, and negative predictive value of self-report in detecting smoking state were 46.43%, 91.67%, 86.67%, and 59.46%, respectively. CONCLUSION: The agreement between self-report and urinary cotinine test in detecting smoking status after smoking cessation program was relatively low on account of participants who failed to quit smoking but reported their smoking status incorrectly. Therefore, the use of objective measures such as urine cotinine should be considered in evaluation of successful smoking cessation.

Difference of Body Compositional Changes According to the Presence of Weight Cycling in a Community-based Weight Control Program

Many obese people who try to control body weight experience weight cycling (WC). The present study evaluated the importance of WC in a community-based obesity intervention program. We analyzed the data of 109 Korean participants (86% women) among 177 subjects who had completed a 12-week intervention program at two public health centers in Korea from April to December, 2007. Completion of a self-administrated questionnaire at baseline was used to obtain anthropometric measurements, and laboratory testing was done before and after the program. Differences in body composition change and obesity-related life style between the two groups were compared with respect to WC and non-weight cycling (NWC). After 12 weeks, both groups showed reductions in weight, waist circumference, and body mass index. The group differences were not significant. However, significant differences were evident for the WC group compared to the NWC group in fat percent mass (WC vs. NWC, -3.49+/-2.31% vs. -4.65+/-2.59%, P=0.01), fat free mass (WC vs. NWC, -0.95+/-1.37 kg vs. -0.38+/-1.05 kg, P=0.01), and total cholesterol (WC vs. NWC, -3.32+/-14.63 vs. -16.54+/-32.39, P=0.005). In conducting a community-based weight control program that predominantly targets women, changes of body composition and total cholesterol may be less effective in weight cyclers than in non-weight cyclers.

An Economic Evaluation of the Home Nursing Care Services: Public Health Center Versus Private Hospital / 간호행정학회지

PURPOSE: The purpose of this study was to compare the costs and benefits of home nursing care services between public health centers (PHC) and private hospitals. METHOD: Participants were 105 patients who had received home nursing care services from a private hospital or public health center. From a societal perspective, the researcher identified the costs and benefits of the services using performance data and calculated the net benefit and benefit/cost ratio. RESULT: The net benefit of the home nursing care service based in the PHC was 165.9 million won and benefit/cost ratio was 2.0, while the net benefit of the home nursing care services by the private hospital was 141.1 million won and benefit/cost ratio was 1.7. Both types of programs were economically validated. CONCLUSION: Home nursing care services were basically efficient as the results showed a positive net benefit. A cost-benefit analysis indicated that the PHC-based home nursing care services were more efficient than that of the private hospital. With limited human resources and management standards in public health centers, results suggest the need for a more systematic management of the home nursing care service to improve the health of this vulnerable community population.

Effect of Nutrition Education Program Developed by a Public Health Center on Preschool Children's Nutrition Knowledge and Dietary Habits and the Parent's Dietary Attitudes / 대한지역사회영양학회지

This study was carried out to examine the effects of nutrition education program developed by Jincheon Public Health Center on preschool children's nutrition knowledge and dietary habits and the parents' dietary attitudes. The subjects of this study were five- and six-year-old children as well as their parents. A 5-week nutrition education program was implemented to 104 children in five day care centers, and 107 children in three day care centers were investigated as a control group. Activity tools designed for each lesson such as puzzles, food magnets, story, songs, Pierrot costume, and balls were used. Nutrition knowledge and dietary habits of children and dietary attitudes of parents were evaluated before and after education. Mean nutrition knowledge score in the education group was significantly higher than that in the control group after education (p < 0.001). Mean dietary habit score of three questions (three meals a day, eating at fixed time, eating breakfast) in the education group was also significantly higher than that in the control group after education (p < 0.01). In addition, parents in the education group showed significantly higher mean dietary attitude score than those in the control group even though they did not receive education (p < 0.001). Our nutrition education program was found to be effective in improving nutrition knowledge and dietary habits in preschool children as well as improving dietary attitudes in their parents.