Regional differences in the effects of healthy aging on depressive symptoms: a Korean longitudinal study of aging (2006-2020).

Background: Depression is a widely prevalent, often recurrent condition. To analyze the regional differences in depressive symptoms over time, we investigated urban-rural differences in change in depression over time in South Korea and the association between healthy aging and depressive symptoms among middle-aged and older adults. Methods: Data collected in the Korean Longitudinal Study of Aging, from 2006 to 2020, of adult participants aged ≥45 years without depressive symptoms were analyzed. Healthy aging was defined under five principal components: absence of chronic disease, good physical function, normal cognitive function, active social engagement, and good psychological adaptation. Depressive symptoms were measured using the short version of the Center for Epidemiologic Studies Depression Scale. Using the Andersen-Gill model for recurrent time-to-event, we examined the effect of healthy aging on depressive symptoms, with a subgroup analysis based on the residential area. Results: Of the 7,708 participants, 78.2% lived in urban areas and 39.4% achieved healthy aging. In 2008, rural residents had a higher incidence of depressive symptoms (rural 11.8%; urban 8.9%); however, after 2016, the depressive symptoms of urban residents gradually increased (rural 6.4%; urban 12.1%). Unhealthy aging (adjusted hazard ratio = 3.04, 95% confidence interval: 2.72-3.39) and urban residence (adjusted hazard ratio = 1.15, 95% confidence interval: 1.06-1.24) were risk factors for depressive symptoms. The subgroup analysis revealed that individuals who did not achieve healthy aging had an increased risk of depressive symptoms, regardless of their residential area (hazard ratio [95% confidence interval]: urban, 3.13 [2.75-3.55]; rural 2.59 [2.05-3.28]). Conclusion: As urbanization accelerates, urban residents have a higher risk of depressive symptoms than rural residents. Healthy aging is an essential factor in reducing depressive symptoms. To achieve healthy aging, appropriate interventions and policies that target the middle-aged adults and gradually extend to older adults are needed, considering individual and regional factors.

Individual and Neighborhood Environmental Factors Affecting Healthy Eating Among Korean Rural Adults.

Background: Although it is recognized that social and environmental factors influence healthy eating behaviors, few studies have investigated the association between environmental factors and healthy eating among rural adults in Korea. We aimed to identify individual and neighborhood environmental factors influencing adherence to fruit and vegetable intake among adults living in rural areas using an ecological approach. Methods: The study sample comprised 1,582 adults from 38 rural areas from Chungbuk Province, South Korea in 2017 who provided individual- and neighborhood-level data. Neighborhood-level data were obtained by aggregating individual-level responses measured for each residential town resulting in an average value for each neighborhood-level variable for the 38 rural areas. The data were merged and used for a series of multilevel logistic regression analyses. Results: Among the individual-level factors, age, alcohol drinking, physical activity, self-efficacy for healthy eating, and social support for healthy eating were significantly associated with adherence to fruit and vegetable intake. Among the neighborhood-level factors, social cohesion and perceived neighborhood safety were significantly associated with adherence to fruit and vegetable intake. Conclusion: Multifaceted intervention strategies to increase consumption of fruits and vegetables should include behavioral modification, social support, and improvement of neighborhood environments.

Individual and environmental factors associated with successful aging among Korean older adults: Multilevel analysis of cross-sectional nationwide survey data.

PURPOSE: The importance of environmental influences on successful aging has recently been emphasized. However, existing studies that investigated environmental factors related to successful aging in older adults did not apply multi-level analysis while simultaneously examining individual and environmental factors related to successful aging. Therefore, this study aimed to determine the level of successful aging in older adults and the individual and environmental factors related to successful aging. MATERIALS AND METHODS: Data from a nationwide survey were used. The study comprised a cross-sectional sample of 73,942 community-dwelling adults aged ≥65 years with individual-level data drawn from the 2019 Korea Community Health Survey. Community-level data of 255 local administrative districts (cities or counties) were extracted from the Community Health Determinant Database from 2017 to 2019. These data were merged and used in multi-level logistic regression analyses. RESULTS: Generally, 27.1% of the participants achieved successful aging. Individual factors including sex, age, marital status, education level, job, monthly household income, smoking, physical activity, and body mass index were significantly associated with successful aging. Four environmental factors, urban residential area, social network, satisfaction with living environment, and air quality, were positively associated with successful aging at the community level; among them, high satisfaction with living environment (OR = 6.06, 95% CI: 2.43-15.12) was the most strongly associated factor with successful aging. CONCLUSIONS: The findings suggest that environmental factors are essential for successful aging among older adults in addition to individual factors. Therefore, multiple strategies considering individual and environmental factors are needed to improve successful aging.

Factors associated with self-rated health among immigrant workers in South Korea: Analyzing the results of the 2020 survey on immigrants' living conditions and labor force.

Immigrants' health is an emerging public health issue worldwide. This study aimed to measure immigrant workers' self-rated health and identify the factors affecting it. Data were obtained from the nationwide 2020 Survey on Immigrants' Living Conditions and Labor Force in Korea. The data from 14,277 economically active immigrants who participated in the study were analyzed. Self-rated health was measured using one question and divided into dichotomized categories (good and poor). Multivariate logistic regression with a weighted sampling method was used to investigate associated factors, namely, individual, social, and living and working environment variables, and to evaluate the interaction effects with gender. Overall, 23.0% of the participants showed poor self-rated health. The odds ratios for poor self-rated health were high in participants who reported unmet healthcare needs (OR = 3.07, 95% confidence interval: 3.00-3.13) compared to those who reported other factors, followed by moderate job satisfaction (OR = 2.23, 95% confidence interval: 2.20-2.26) and unsatisfied residential environment satisfaction (OR = 1.80, 95% confidence interval: 1.74-1.86). Significant associations were found between self-rated health and most variables, including the interaction test (gender × residential environment satisfaction, education level, working hours, and length of residence). To enhance immigrants' health status, the Korean government must develop strategies to increase their access to healthcare services and minimize unmet healthcare needs. In addition, working conditions must be improved, specifically regarding long working hours and discrimination; furthermore, immigrants' living environments should be considered.

Effects of Life Skill Training on the School Violence Attitudes and Behavior Among Elementary School Children.

This study evaluated a life skill training program on school violence given to elementary school children. A quasi-experimental study was conducted, and a 12-week intervention was implemented targeting 70 students aged between 10 and 11 years. The instruments included peer competency, attitudes toward school violence, experience of school violence, and the Self-Control Rating Scale. The data were analyzed using repeated measure analysis of variance. A significant difference was observed between the groups over time on peer competency (F = 4.17, p = .020), attitudes toward school violence (F = 6.02, p = .004), and violence experience as a victim (F = 3.49, p = .036) and as a perpetrator (F = 3.87, p = .026). In the experimental group, the mean scores for peer competency increased compared to the control group, whereas school violence experience decreased at the posttests. A 12-week program of life skill training offered to children was effective in promoting peer competency and attitudes toward school violence, while decreasing the experience of school violence.

Development and validation of a tool to assess the rural neighborhood environment for obesity in Korean adults.

OBJECTIVES: This study aimed to develop and validate a tool that assesses the perceived neighborhood environments influencing obesity development among rural adults in Korea. DESIGN AND SAMPLES: Qualitative and quantitative methods were used. Twenty-one adults participated in focus group interviews. Subsequently, two independent surveys were conducted with rural adults aged 19-65. MEASUREMENTS: Literature review and focus group interviews were used to generate initial items. An expert's panel evaluation established content validity for these items and pilot testing of the draft tool was performed. Explanatory (n = 328) and confirmatory factor analyses (n = 1,070) were used to establish construct validity, and internal consistency and test-retest reliability were calculated (n = 88). RESULTS: The new tool consisting of 37 items was developed and validated. Confirmatory factor analysis revealed an eight-subscale structure (χ2  = 3,738.1, GFI = 0.831, SRMR = 0.060, RMSEA = 0.070). The tool showed moderate test-retest reliability (ICC = 0.519-0.775) and good internal consistency except for Social Influence on Healthy Eating (Cronbach's α = 0.612). CONCLUSIONS: The Rural Neighborhood Environment Assessment for Obesity tool might be a valid and reliable instrument for public health practitioners to assess complex social and physical environmental factors related to obesity.

Corrigendum to "Associations between Social and Physical Environments, and Physical Activity in Adults from Urban and Rural Regions"[Osong Public Health Res Perspect 2018;9(1):16-24].

[This corrects the article on p. 16 in vol. 9, PMID: 29503801.].

Associations between Social and Physical Environments, and Physical Activity in Adults from Urban and Rural Regions.

OBJECTIVES: This study investigates investigated the relationship between social and physical environments, and moderate to vigorous physical activity (MVPA) amongst adults in both rural and urban areas within Korea. METHODS: A sample of 128,735 adults from the 2013 Community Health Survey (CHS) was analyzed using a multilevel logistic analysis. RESULTS: Urban residents with higher satisfaction in public transportation satisfaction and rural residents with more access to sports parks, hiking trails, and bike cycle paths were more likely to be active. The MVPA of adults from rural areas correlated urban adults was uncorrelatedwith neighborhood factors, but that of rural adults was whereas no correlations were observed in adults from urban areas. CONCLUSION: These differences should be considered when developing interventions strategies to enhance adult physical activity in different communities.

Psychometric Properties of the Korean Version of the "Patient Activation Measure 13" (PAM13-K) in Patients With Osteoarthritis.

This study investigated the psychometric properties of the Korean version of the Patient Activation Measure 13 (PAM13) using Rasch analysis. The sample consisted of 270 Korean patients with osteoarthritis. The PAM13 was translated into Korean using a standardized forward-backward translation approach. In this study, the Cronbach's α coefficient was .88, the average interitem correlation was .34, and the average item-rest correlation was .55. The difficulty ranking of the item in this study differed from that in the original version. We did not need to collapse response categories. A total of 57.5% of the variance was explained by the residuals, indicating unidimensionality. The results suggest that the PAM13-K is a reliable and valid measure of activation. Further research is needed to validate item responsiveness and intervention effects.

Correlates of depressive symptoms in married immigrant women in Korea.

PURPOSE: The purpose of this study was to identify the correlates of depressive symptoms among women who have immigrated to Korea for marriage. DESIGN: Cross-sectional data reflecting Korean language fluency, acculturation, acculturative stress, general stress, and marital satisfaction were collected from 223 married immigrant women. FINDINGS: There was a significant negative correlation between depressive symptoms and Korean language fluency as well as between depressive symptoms and Korean acculturation. Multiple linear regression revealed that depressive symptoms among married immigrant women were predicted by levels of acculturative stress, general stress, marital satisfaction, and type of household. The model including each of these variables accounted for 41.9% of the variance in depressive symptoms in these women. CONCLUSIONS: Prevention programs for the management of depression in immigrant women should include an evaluation of acculturative conflict and stress and should consider marital and family conditions.

Ecological risk factors of childhood obesity in Korean elementary school students.

The purpose of this study was to examine ecological correlates of obesity among Korean children. Cross-sectional data, including measurements of height and weight, were collected by questionnaire from 1,644 children in the fifth and sixth grades. A multiple logistic regression model incorporating individual- and school-level variables determined factors of childhood obesity. Intrapersonal factors associated with obesity included gender, computer use, and dissatisfaction with body image; significant interpersonal factors included low level of the father's education and encouragement to engage in physical activity. School-level factors that were significant predictors included location in Gyeonggi province, having two or more school exercise facilities, physical-education classes of 2 hr per week, higher fat content of school lunch, and higher number of classes in the school. The findings indicate that multifaceted, multilevel prevention strategies to manage and prevent childhood obesity should include behavioral modification, familial support, and improvement of school environments.