The association between the risk perceptions of COVID-19, trust in the government, political ideologies, and socio-demographic factors: A year-long cross-sectional study in South Korea.

Risk perception research, targeting the general public, necessitates the study of the multi-faceted aspects of perceived risk through a holistic approach. This study aimed to investigate the association between the two dimensions of risk perception of COVID-19, i.e., risk as a feeling and analysis, trust in the current government, political ideologies, and socio-demographic factors in South Korea. This study used a year-long repeated cross-sectional design, in which a national sample (n = 23,018) participated in 23 consecutive telephone surveys from February 2020 to February 2021. Most factors differed in the magnitude and direction of their relationships with the two dimensions of risk perception. However, trust in the current government, alone, delineated an association in the same direction for both dimensions, i.e., those with a lower level of trust exhibited higher levels of cognitive and affective risk perception. Although these results did not change significantly during the one-year observation period, they are related to the political interpretation of risk. This study revealed that affective and cognitive risk perceptions addressed different dimensions of risk perception. These findings could help governments and health authorities better understand the nature and mechanisms of public risk perception when implementing countermeasures and policies in response to the COVID-19 pandemic and other public health emergencies.

Development of a quantitative evaluation tool for Seoul's community-based participatory health program 'building healthy communities'.

Community-based participatory health (CBPH) programs are important for addressing health disparities; however, the limited development of validated scales to measure outcomes may hinder the utilization and upscaling of such programs. Thus, this study aimed to develop a culturally appropriate and valid tool for the quantitative evaluation of a CBPH program and to test theory-driven pathways of associations among participation, social capital, empowerment and health outcomes. This study used a participatory and mixed methods approach. Formative research, including a literature review, survey results over the past 2 years, focus group interviews and participatory evaluation committee meetings, was conducted. Four program components-participation, social capital, empowerment and quality of life (QoL)-were identified and used to construct a validated evaluation tool. A total of 317 participants (89.9% women, mean age = 57.7 ± 11.5 years) responded to the survey. The data were analyzed for internal consistency and factor structure. Structural equation modeling (SEM) was used to test the theoretical pathways of health promotion through the CBPH program. The SEM results showed two significant mediation pathways such that participation in interventions was associated with higher QoL via social capital accumulation and improved empowerment. Our results exemplify a validated scale that can be used to evaluate the intermediate- and long-term outcomes of a CBPH program.

This study aimed to develop a reliable and valid tool for the evaluation of community-based participatory health (CBPH) programs and to test a pathway to explain how participation may be associated with better health. The study used mixed methods, including focus group interviews, analysis of survey data from the past 2 years, participatory evaluation committee meetings and a main survey. Four core program components were identified: participation, social capital, empowerment and quality of life. In total, 317 participants responded to the survey. The results also showed that program participation was associated with a higher quality of life through increased social capital and empowerment. In conclusion, the developed evaluation tool can be used to evaluate the intermediate-and long-term outcomes of a CBPH program.

Investigating similarities and differences in health needs according to disability type using the International Classification of Functioning, Disability and Health.

PURPOSE: This study aimed to investigate the health needs of adults with disabilities in South Korea according to disability type using the International Classification of Functioning, Disability and Health (ICF). MATERIALS AND METHODS: An exploratory, qualitative approach using content analysis was employed. Five focus groups consisted of six to seven participants with visual impairment (PVI), hearing impairment (PHI), physical impairment (PPI), brain disorder (PBD), and intellectual disability (PID). Linking rules were used to identify how the health needs related to the ICF components of Body Functions, Activity & Participation, and Environmental Factors. RESULTS: The health needs related to the Environmental Factors were the most mentioned and were frequently perceived as causes of poor health conditions related to Activities & Participation and Body Function. According to what participants perceived as main health issues in the Environmental Factors, the five groups were classified into (1) Services, systems, and policies mainly affecting type (PVI and PPI); (2) Support and relationships mainly affecting type (PHI); and (3) Attitude mainly affecting type (PBD and PID). CONCLUSIONS: Government officials and health professionals must tailor development and provision of healthcare for people with disabilities based on health need type.IMPLICATIONS FOR REHABILITATIONFew studies have investigated the health needs of people with disabilities, although many health indicators suggest that they are facing health inequalities in South Korea.The health issues related to the Environmental Factors were often perceived in this study as causes of poor health conditions related to the Activities & Participation and Body Function, indicating the need to preferentially solve the health issues related to the Environmental Factor.According to what people with each of the five types of disabilities perceived as main health issues and what kinds of actions they expected in the Environmental Factors, they could be classified into three health need types.It is recommended that government officials and health professionals develop and provide appropriate supply-side measures of healthcare considering these different demand-side health needs according to disability type.

A stakeholder analysis of community-led collaboration to reduce health inequity in a deprived neighbourhood in South Korea.

Intersectoral collaboration amongst health and other sectors, as well as between government and non-governmental organisations, has been highlighted as a way to improve health equity. We used a mixed-methods approach to assess collaborative relationships between multiple government sectors and civil society and to suggest possible health promotion interventions and policy alternatives for the urban poor in deprived neighborhoods. A total of 18 participants involved in health promotion interventions and policy processes related to the inner-city area of Seoul were recruited using purposive sampling methods. Participants included stakeholders working for or engaging in governments (3), public health care institutions (5), social service providers (3), community-based organisations (CBOs) (4) and faith-based organisations (3). We conducted semi-structured, one-on-one interviews and then collected survey data. Quantitative data were analysed using social network analysis, and qualitative data were analysed through iterative and consensus processes. The social network analysis indicated that a CBO plays the most substantial role in sharing and controlling informational resources to promote health. A stakeholder analysis showed that the CBO neutrally and negatively viewed the possibility of collaboration with other stakeholders. Three themes related to challenges to intersectoral collaboration emerged: (1) lack of trust and communication, (2) need of a coalition with a committed leading actor for future collaboration and (3) organisational and political silos within and across public sectors. Increased understanding of the current status of and challenges to collaboration can inform the planning and implementation of complex intervening strategies and policies tailored to vulnerable people in deprived neighborhoods. Community-led collaborative actions empower people in marginalised communities to envision a healthier community.

Patient-centered evaluation of home-based rehabilitation developed using community-based participatory research approach for people with disabilities: a case series.

PURPOSE: The purpose of this study was to evaluate the effectiveness of the locally tailored and individualized home-based rehabilitation (HBR) program developed using the community-based participatory research (CBPR) approach, in terms of perceived health in patients with different levels of social engagement, and to explore the perceived facilitators and barriers to rehabilitation. METHOD: A concurrent mixed-method design was employed. Four patients participated in the combined therapist- and self-delivered HBR program for 5 months. The perceived health outcomes were quantitatively assessed at baseline, after the therapist-delivered intervention period, and at 1 and 3 months after the self-delivered intervention period. Then, in-depth individual interviews were conducted to explore the facilitators and barriers to rehabilitation. RESULTS: The perceived health of patients who were fully or partially engaged in society was increased during the therapist-delivered intervention period, and maintained the increased level during the self-delivered intervention period, whereas that of patients who were rarely or not engaged dropped again to lower than the baseline. These results were caused by differentiated facilitators and barriers to rehabilitation depending on the level of social engagement. CONCLUSIONS: Applying tailored strategies to patients with differing levels of social engagement is recommended to further optimize the local relevance of the HBR program. Implications for rehabilitation A community-based participatory research approach can provide an opportunity to enhance local relevance through community-academic partnerships, in developing a home-based rehabilitation (HBR) program for the people with disabilities. For community therapists, enhancing the local relevance of the HBR program, applying tailored strategies to patients with differing levels of social engagement is recommended because the perceived health of the HBR program can be different owing to differing perceived facilitators and barriers to rehabilitation, depending on the level of social engagement. For patients with rare or no engagement in society, satisfying their need for interaction with the therapists and helping them cope with their wrong belief about the possibility of their recovery is important to encourage behavioral change and perceived physical improvements.

Disparities in Potentially Preventable Hospitalizations for Chronic Conditions Among Korean Americans, Hawaii, 2010-2012.

INTRODUCTION: Korean Americans are a growing but understudied population group in the United States. High rates of potentially preventable hospitalizations suggest that primary care is underutilized. We compared preventable hospitalizations for chronic conditions in aggregate and for congestive heart failure (CHF) for Korean Americans and whites in Hawaii. METHODS: Discharge data from 2010 to 2012 for all hospitalizations of adults in Hawaii for preventable hospitalizations in aggregate and for CHF included 4,345 among Korean Americans and 81,570 among whites. Preventable hospitalization rates for chronic conditions and CHF were calculated for Korean Americans and whites by sex and age group (18-64 y vs ≥65 y). Unadjusted rate ratios for Korean Americans were calculated relative to whites. Multivariate models, controlling for insurance type and comorbidity, provided adjusted rate ratios (aRRs). RESULTS: Korean American women and men aged 65 or older were at greater risk of preventable hospitalization overall than white women (aRR, 2.48; P = .003) and white men (aRR, 1.82; P = .049). Korean American men aged 65 or older also were at greater risk of hospitalization for CHF relative to white men (aRR, 1.87; P = .04) and for older Korean American women (aRR, 1.75; P = .07). Younger age groups did not differ significantly. CONCLUSION: Older Korean American patients may have significant disparities in preventable hospitalizations, which suggests poor access to or poor quality of primary health care. Improving primary care for Korean Americans may prevent unnecessary hospitalizations, improve quality of life for Korean Americans with chronic illness, and reduce health care costs.

Culturally tailored interventions of chronic disease targeting Korean Americans: a systematic review.

OBJECTIVE: Because little is known about promising interventions to prevent and control chronic disease in Korean Americans, we conducted a systematic literature review to investigate: (1) theoretical frameworks and strategies employed by interventions targeting Korean Americans; (2) cultural factors considered by these interventions; and (3) the extent of their success in engaging Korean participants and improving their health. DESIGN: Following the PRISMA guidelines, PubMed, PsycInfo, and Web of Science were searched to identify primary research articles evaluating interventions to prevent or control chronic disease, tailored to Korean Americans, and published from 1980 through 2011. Of 238 articles identified, 21 articles describing16 unique intervention tests met inclusion criteria. These interventions targeted cancer (10), hypertension (2), diabetes (1), mental health (1), tobacco cessation (1), and general health (1). RESULTS: All included studies were published since 2000, reflecting the relatively recent establishment of intervention research with Korean Americans. All 16 programs delivered linguistically appropriate messages and education. The 11 programs that realized significant intervention effects also provided or coordinated social support from culturally relevant and well-trained lay health workers, nurses, or family members during an intervention and/or follow-up period. CONCLUSIONS: Culturally matched and linguistically appropriate messages and education may not be enough to prevent or control chronic disease among immigrant Korean Americans. Culturally sensitive and committed social support should be provided to catalyze behavioral changes and sustain the effect of the interventions.

Health literacy, health communication challenges, and cancer screening among rural native Hawaiian and Filipino women.

Native Hawaiians and Filipinos are disproportionately impacted by cancer and are less likely to participate in cancer screening than whites. Limited information exists about health information pathways and health communication challenges as they relate to cancer screening in these groups. Six focus groups (n=77) of Native Hawaiian and Filipino women age 40+years were conducted to investigate these research gaps. Participants noted many health information challenges. Challenges were both practical and interpersonal and included both written and oral health communication. Practical challenges included "big" words, complexity of terms, and lack of plain English. Interpersonal issues included doctors rushing, doctors not assessing comprehension, and doctors treating respondents as patients not people. Women noted that they would often not ask questions even when they knew they did not understand because they did not want the provider to think negatively of them. Overarching themes to improve cancer communication gaps included: (1) the importance of family and community in health information dissemination, (2) the key role women play in interpreting health information for others, (3) the importance of personal experience and relationships to the salience of health information, and (4) the desire for local cultural relevance in health communication. Findings are discussed in light of the 2010 National Action Plan for Health Literacy.