Factors associated with COVID-19 vaccination hesitancy in South Korea: A cross-sectional study.

Vaccination against COVID-19 has been promoted as a way to protect oneself and others from infection. To ensure the comprehensive acceptance of COVID-19 vaccines, the factors that affect COVID-19 vaccination hesitancy should be examined. This study aimed to identify the factors that affect COVID-19 vaccination hesitancy among Korean adults, focusing on COVID-19 knowledge and attitudes toward vaccination. This was a cross-sectional study conducted with 2286 Korean adults aged 20-64 years. Demographic characteristics, knowledge regarding COVID-19, and attitudes toward vaccination were assessed. A generalized linear model with Poisson regression was used to identify factors associated with COVID-19 vaccination hesitancy. Approximately 67% of the COVID-19 knowledge-related questions were correctly answered. A neutral attitude toward vaccination and relatively low vaccination hesitancy were found. COVID-19 vaccination hesitancy was affected by individuals' attitudes toward vaccination, as well as their gender and age, but not by their knowledge. Interventions or policies considering gender and age could be helpful in reducing COVID-19 vaccination hesitancy. Strategies to disseminate more accurate and novel information related to the COVID-19 vaccines should be implemented.

Effect of Physical Activity on Adolescent Obesity Status over Time: A Latent Growth Modeling Approach.

This study aims to examine the longitudinal influence of physical activity (PA) on obesity among normal-weight adolescents in South Korea. A total of 1347 data samples from the Korean Children and Youth Panel Survey from 2011 to 2014 were used. Latent growth modeling was applied. PA was assessed by the hours spent on PA during physical education (PE) classes in the last week. Body mass index for age was considered to determine obesity status. PA during PE positively predicted the intercept of obesity status, but it was not associated with the slope of obesity status. Although a longitudinal effect of PA was not identified, PA could influence the initial status of obesity. Because obesity in early years could steadily influence future obesity status, early detection and intervention for adolescent obesity are necessary. Moreover, more studies examining the effect of PA during PE on obesity status among adolescents should be conducted to identify the association between PA during PE and obesity status over time.

Clustering of South Korean Adolescents' Health-Related Behaviors by Gender: Using a Latent Class Analysis.

BACKGROUND: Health-related behaviors during adolescence could influence adolescents' health outcomes, leading to either advantageous or deteriorative conditions. Clustering of adolescents' health-related behaviors by gender identifies the target groups for intervention and informs the strategies to be implemented for behavioral changes. METHODS: Data from 1807 adolescents in grades 7 and 10 in a city in South Korea were used. Health-related behaviors including eating habits, physical activity, hand washing, brushing teeth, drinking alcohol, smoking, and Internet use were examined. Latent class analysis (LCA) was used to identify subgroups of adolescents with regard to their health-related behaviors. RESULTS: A four-class model was the most adequate grouping classification across genders: adolescents with (1) healthy behaviors, (2) neither health-promoting nor health-risk behaviors, (3) good hygiene behaviors, and (4) unhealthy behaviors. The majority of both male and female adolescents were classified into the healthy group. Male adolescents belonging to the healthy group were more likely to engage in vigorous physical activities, while vigorous physical activity was not important for female adolescents. The smallest group was the unhealthy group, regardless of gender; however, the proportion of boys in the unhealthy group was almost twice that of girls. Only female adolescents engaged in excessive Internet use, especially the group with neither health-promoting nor health-risk behaviors. CONCLUSION: To improve adolescents' health-related behaviors, it would be more effective to develop tailored interventions considering the behavioral profiles of the target groups.

Diet and Physical Activity of Korean Female Adolescents in Their Peer Networks.

PURPOSE: The purpose of this study was to examine and compare the diet and physical activity behaviors of female adolescents and their friends within classroom-based peer networks in Korea. DESIGN: Complete social network analysis was used to examine the influence of classroom-based peers on adolescents' diets and physical activity. Data were collected by self-report from 99 female adolescents in three classrooms. METHODS: Diet and physical activity behaviors were measured using the Adolescent Food Habit Checklist, food frequency questions, and the International Physical Activity Questionnaire. Female adolescents were asked to nominate close friends within their classroom. Descriptive statistics for diet and physical activity were generated; social network data were analyzed using social network analysis. FINDINGS: Most participants were normal-weight, 18-year-old adolescents. Across three classrooms, adolescents' dietary behaviors were connected with those of their classroom-based peer networks; however, similar outcomes were not identified for physical activity. CONCLUSIONS: Clusters of diet behaviors for Korean female adolescents were identified in classroom-based peer networks. Developing interventions based on these shared behaviors could be effective in improving these behaviors. Additional studies should explore potential barriers to physical activity for Korean female adolescents and their classroom-based peers. CLINICAL RELEVANCE: The current study found that Korean female adolescents' dietary behaviors were associated with their peers'. Healthcare providers should consider involving peers when developing interventions to improve the diet of Korean female adolescents.

Parent, school, and peer factors related to U.S. adolescents' diet and exercise.

PURPOSE: Adolescent obesity is a significant public health problem in the United States. Developing interventions to prevent or improve adolescent obesity may positively affect physical and mental health across the lifespan. However, to ensure that interventions are effective, influential factors must first be identified. The purpose of this study was to examine associations among parent-, school-, and peer-related factors and diet and physical activity of the adolescents in the United States. DESIGN AND METHODS: Using logistic regression analyses, cross-sectional data of 5,248 adolescents in grades 5-10 from 184 schools from the World Health Organization's 2009/2010 survey of Health Behavior in School-Aged Children (HBSC) for the United States were analyzed, including variables for parent, peer, and school factors. RESULTS: Parent- and peer-related factors were associated with adolescents' diet and physical activity (PA). Peer factors were associated with time spent on PA, but not a parent or school factors. The type of school lunch program was the only school factor associated with diet; no school factors were associated with exercise. PRACTICE IMPLICATIONS: Results of this secondary analysis extend prior work, which identified associations between parent- and peer factors and adolescents' diet and exercise. Findings will help identify targets for improving adolescents' diet and exercise behaviors.

The Influence of Peers on Diet and Exercise Among Adolescents: A Systematic Review.

Adolescents' diet and exercise are modifiable factors contributing to high rates of adolescent obesity. Diverse contextual factors, including family, social environment, and peers, affect adolescents' diet and exercise behaviors. Because peer influence increases during adolescence, peers' contributions to adolescents' diet and exercise behaviors should be examined as potential targets for intervention to reduce the prevalence of adolescent obesity. The purpose of this systematic review is to identify research examining the contribution of peers to diet and exercise of adolescents. The electronic databases PubMed, CINAHL, Web of Science, and SCOPUS were searched. A total of 24 unique articles were included: seven examined diet only, fourteen studied exercise only, and three explored diet and exercise. This review provided evidence that diet and exercise of adolescents were significantly associated with those of their peers. However, these associations differed depending on gender, the type of diet and exercise, and closeness of friends. Findings from this review suggest that peers could be possible targets for interventions to promote healthier diet and exercise among adolescents; however, more studies are needed to identify specific peer influences and develop tailored interventions.

Implementation of collaborative goal setting for diabetes in community primary care.

Collaborative goal setting (CGS) is a cornerstone of diabetes self-management support, but little is known about its feasibility and effectiveness during routine care. The aim of this study was to evaluate the implementation of an existing CGS intervention when integrated by primary care staff. Using a mixed-methods approach guided by the RE-AIM framework, intervention adoption, implementation, reach, and effectiveness were evaluated over 12 months. Three of four sites adopted the CGS intervention, in which 521 patients with type 2 diabetes (9-29 % of those targeted) received CGS. For those with suboptimal glycemic control (A1C ≥ 7.5 %), %A1C decreased by 1.1 for those receiving CGS (n = 204, p < 0.001) compared to 0.4 for a group who did not (n = 41, p = 0.23). Practice characteristics influenced adoption and implementation, while isolation of CGS from the remainder of clinical care likely influenced reach and effectiveness. CGS may benefit patients with diabetes, but a lack of integration by practice staff is a key barrier to overcome during implementation.

Readiness for Hospital Discharge, Health Literacy, and Social Living Status.

Patient characteristics and lack of preparedness are associated with poor outcomes after hospital discharge. Our purpose was to explore the association between patient characteristics and patient- and nurse-completed Readiness for Hospital Discharge Scale (RHDS). We conducted a prospective study of 70 Veterans being discharged from medical and surgical units. Differences in RHDS knowledge subscale scores were found among literacy levels, with lower perceived knowledge reported for those with marginal or inadequate literacy (p = .03). Differences in RHDS expected support subscale scores were also found, with those who were unmarried and/or living alone (p < .001) anticipating less support upon discharge. No other differences were found. Similar differences were found for the RHDS completed by nurses. These findings suggest that the RHDS appears responsive to differences in health literacy and social environment, adding to evidence of its utility as a tool to identify, and plan interventions for, those at risk for readmission.

Parenting Efficacy and Health-promoting Behaviors for Children of Mothers from Native and Multicultural Families in Korea.

PURPOSE: The aim of this study was to examine the levels of parenting efficacy and health-promoting behaviors for children of mothers, and to explore the relationships between parenting efficacy and the behaviors of mothers from native and multicultural families in South Korea. METHODS: Data was collected by a self-report questionnaire completed by 258 mothers who had 6-month to 36-month-old children attending kindergartens or multicultural family support centers located in Seoul and in Gyeounggi Province, South Korea. RESULTS: No significant difference in parenting efficacy was found, depending on the maternal country of origin. However, Chinese mothers performed health-promoting behaviors more frequently for their children than Korean and Vietnamese mothers did (F = 6.87, p < .001). The significant positive correlations between parenting efficacy and maternal health-promoting behaviors for children were found, regardless of maternal country of origin (r = .57, p < .001 for Korean, r = .42, p < .001 for Chinese, and r= .40, p < .001 for Vietnamese mothers). CONCLUSIONS: Since maternal health-promoting behaviors were different depending on the native country of the mothers, maternal country of origin should be considered in designing programs for improving maternal health-promoting behaviors for their children. In addition, increasing the level of parenting efficacy can be an effective way for improvement of maternal health-promoting behaviors.