• Health Policy and Management
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• v.16 no.1
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• pp.54-72
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• 2006

This study was conducted as the primary work to develop a customer relationship management (CRM) system to improve the performance of health screening programs. The specific aims of the study was to identify and classify the characteristics of the people who did not receive their health screening using decision trees and to propose management strategies according to their characteristics identified. The data on a total of 5,102,761 subjects of health screening provided by the National Health Insurance Program in the year of 2002 were used. The target variable was whether they underwent their health screening. The input variables included a total of 27. The SAS 9.1 version was used for data preprocessing and statistical analyses. SAS Enterprise Miner was used to develop the decision trees model. The decision trees identified the factors greatly affecting the health screening. In the non-disease group, the highest rate of non-examinees was characterized by: no experience of receiving a health screen, household's age, non-insured episode for the last one year, and patients' age. In the disease group, the one showing the highest rate of non-examinees was characterized by: no experience of receiving a health screening, no experience of going to public health center or midwife clinic for the last one year, and examinees' age. Developing CRM systems for health screening management taking into account the individual characteristics would be considerably helpful to increase the rate of receiving health screening.

• Asian Pacific Journal of Cancer Prevention
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• v.13 no.2
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• pp.671-676
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• 2012

Objectives: Screening for second primary cancer (SPC) is one of the key components of cancer survivorship care. The aim of the present study was to explore oncologists' experience with promoting second primary cancer screening. Methods: Two focus group interviews were conducted with 12 oncologists of diverse backgrounds. Recurrent issues were identified and placed into thematic categories. Results: Most of the oncologists did not consider SPC screening promotion as their responsibility and did not cover it in routine care. All of the study participants had experience with unexpected SPC cases, and they were under emotional tress. There was no systematic manner of providing SPC screening. Oncologists usually prescribe SPC screening in response to patients' requests, and there was no active promotion of SPC screening. Short consultation time, limited knowledge about cancer screening, no established guideline for SPC screening, and disagreement with patients about oncologists' roles were major barriers to its promotion. An institution-based shared care model was suggested as a potential solution for promoting SPC screening given current oncology practices in Korea. Conclusion: Oncologists could not effectively deal with the occurrence of SPC, and they were not actively promoting SPC screening. Lack of knowledge, limited health care resources, and no established guidelines were major barriers for promoting SPC screening to cancer survivors. More active involvement of oncologists and a systematic approach such as shared-care models would be necessary for promoting SPC screening considering increasing number of cancer survivors who are vulnerable.

• Asian Pacific Journal of Cancer Prevention
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• v.13 no.8
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• pp.3773-3779
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• 2012

Objective: Despite government efforts to increase participation in gastric cancer screening, the rate is still suboptimal in Korea. Therefore, we explored barriers to and predictors of gastric cancer screening participation among a nationally representative sample. Methods: We used the Health Interview Survey sub-dataset derived from the Fourth Korean National Health and Nutrition Examination Survey 2008 (KNHANES IV) to evaluate participation in gastric cancer screening and factors associated with attendance in individuals age ${\geq}40$ years. We enrolled 4,464 subjects who completed the questionnaire and were not previously diagnosed with gastric cancer. Four groups of factors were considered potential predictors of gastric cancer screening in a multivariate analysis: sociodemographic, health behavior, psychological and cognitive, and dietary factors. Results: Overall, 41.3% complied with the gastric cancer screening recommendations. Younger age, lower education level, living without a spouse, frequent binge drinker, and current smoker were significantly associated with less participation in gastric cancer screening. Conclusions: To improve participation in gastric cancer screening, more focused interventions should be directed to vulnerable populations, such as groups with low socioeconomic status or unhealthy behavior. In addition, there should be new promotional campaigns and health education to provide information targeting these vulnerable populations.

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.7
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• pp.3279-3286
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• 2014

Background: Cancer is one of the leading causes of death in Korea. To reduce cancer incidence, the Korean National Cancer Center (KNCC) has been expanding its organized cancer screening program. In addition, there are opportunistic screening programs that can be chosen by individuals or their healthcare providers. The purpose of this study was to investigate factors associated with participation in organized and opportunistic cancer screening programs, with a particular focus on socioeconomic factors. Materials and Methods: We used data from the Korea National Health and Nutrition Examination Survey (KNHANES), a cross-sectional nationwide study conducted by the Korean Ministry of Health and Welfare from 2007 to 2011. The study included information from 9,708 men and 12,739 women aged 19 years or over. Multinomial logistic regression analysis was conducted, adjusting for age, year of data collection, residential region, current smoking status, current alcohol consumption status, exercise, marriage status, job status, perceived health status, stress level, BMI, limitation of activities, cancer history, health insurance type, and private insurance status, to investigate the association between education level, economic status, and cancer screening participation. Results: In terms of education level, disparities in attendance were observed only for the opportunistic screening program. In contrast, there was no association between education level and participation in organized screening. In terms of economic status, disparities in opportunistic screening participation were observed at all income levels, but disparities in organized screening participation were observed only at the highest income level. Conclusions: Our findings reveal that socioeconomic factors, including educational level and economic status, were not significantly associated with participation in organized cancer screening, except at the highest level of income.

• The Journal of Korean Society for School & Community Health Education
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• v.20 no.2
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• pp.25-36
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• 2019

Purpose: The purpose of this study was to examine the factors affecting of health screening among persons with disabilities. Method: The study examines the factors affecting of health screening using over 20 years of age who participated in the 2017 National survey of the disabled data. Subjects were 6,332 person with disabilities over 20 years of age. Data were analyzed using descriptive statistics, X2-test, multiple logistic regression with the SPSS win 21.0 program. Results: Health screening among persons with disabilities is differentiated with education level, marital status, Subjective House economic status, Health insurance, Economic activity, Type of disability, Grade of disability, Stress recognition, Depressive symptom, Suicidal thinking, Suicidal attempt, and grade of disability. The significant predictors of the health screening were age, Subjective House economic status, Economic activity, and Grade of disability. Conclusion: We should consider age, disability level, and economic level when developing a screening program for people with disabilities. Especially, the development and promotion of the health screening program for persons with disabilities and related education are required.

• Korean Journal of Health Education and Promotion
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• v.24 no.1
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• pp.127-138
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• 2007

Objectives: This study aims to examine if the follow-up management service by National Health Insurance (NHI) for person at health risk leads to significant modification of the lifestyle and change of health status. Methods: Of persons who underwent health screening and were classified as having health risks after periodic health screening by NHI in 2003, persons who took the follow-up management service were selected as case group and persons who took no service were selected as control group. The DW database of NHI was used to explore the effect of the follow-up management service on the modification of health status and lifestyle. Chi-square tests were conducted with SAS 9.1 to examine the differences of health promotion effect between case vs. control group. Results: It was shown that of lifestyle behaviors, only exercise was significantly improved for case group compared with control group as the effect of the follow-up management service by NHI (2.98%p) (p<.0001). Further, morbidity rate for control group was 2% higher than that of case group (p <.0001), which indicates that persons who received the follow-up management service better maintained their health significantly than persons who did not. Conclusions: The present study shows that the appropriate follow-up management services need to be provided for maximizing potential effect of periodic health screening by NHI.

• Journal of Korean Public Health Nursing
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• v.19 no.2
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• pp.229-240
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• 2005

Purpose: To evaluate every step of the cancer screening program. Method: 146 of 233 health centers participated in this study. Data were collected by mailing questionnaires between December 2002 and January 2003. The response rate was 65.5%. Result: The government cancer screening program was directed by a variety of departments of the health centers. 41.1% of persons in charges were nurses. 41.3% of the health centers received a list of the appropriate person from the National Health Insurance Cooperation within one or two months. 26.1% of health centers received ??? after five month from when the program started. All the health centers advertised their services, and most of them used mail and mass media 56.4%, used other institute's materials, and 72.2% of them used the government's materials. 76.7% of the heath centers recommended secondary health screening to the persons who had positive results at the first screening. 71.6% of the health centers ascertained the patients with cancer who were diagnosed at secondary screenings. 67.9% of the health centers had registered home-based cancer patients at the health center. 137 out of 146 health centers had a local institute for cancer screening; an average of 4.9 institutes had cancer screening. 80.1% of the persons in charge of the programs felt they needed this program, but 80.8% of them thought the program should be modified. Conclusion: Organized and standardized programs are needed to promote the efficiency of National Cancer Screening Program.

• The Korean Journal of Pain
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• v.30 no.1
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• pp.34-43
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• 2017

Background: We sought to determine the association between chronic pain and participating in routine health screening in a low socioeconomic-status (SES) rental-flat community in Singapore. In Singapore, ${\geq}85%$ own homes; public rental flats are reserved for those with low-income. Methods: Chronic pain was defined as pain ${\geq}3$ months. From 2009-2014, residents aged 40-60 years in five public rental-flat enclaves were surveyed for chronic pain; participation in health screening was also measured. We compared them to residents staying in adjacent owner-occupied public housing. We also conducted a qualitative study to better understand the relationship between chronic pain and health screening participation amongst residents in these low-SES enclaves. Results: In the rental-flat population, chronic pain was associated with higher participation in screening for diabetes (aOR = 2.11, CI = 1.36-3.27, P < 0.001), dyslipidemia (aOR = 2.06, CI = 1.25-3.39, P = 0.005), colorectal cancer (aOR = 2.28, CI = 1.18-4.40, P = 0.014), cervical cancer (aOR = 2.65, CI = 1.34-5.23, P = 0.005) and breast cancer (aOR = 3.52, CI = 1.94-6.41, P < 0.001); this association was not present in the owner-occupied population. Three main themes emerged from our qualitative analysis of the link between chronic pain and screening participation: pain as an association of "major illness"; screening as a search for answers to pain; and labelling pain as an end in itself. Conclusions: Chronic pain was associated with higher cardiovascular and cancer screening participation in the low-SES population. In low-SES populations with limited access to pain management services, chronic pain issues may surface during routine health screening.

• Journal of Korea Association of Health Promotion
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• v.3 no.2
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• pp.280-287
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• 2005

The Government bean implementing the National Cancer Screening Program(NCSP) in 1999 and expanded its target population and target cancers. The target cancers of NCSP since 2004 are the five most common cancers in Korea: stomachm liver colorectal, breast, cervical cancer. One goal of the NCSP in 2005 is to include in its target population up to lower 50% of premiu of National Health Insurance. The Government and National Cancer Center have bee developing the protocol for the NCSP with associated related academic societies Health Centers operate the NCSP with National Health Insurance Cooperation. The Particioants of NCSP in 2004 are 1.34million, 14% of target population and the detection rate 2004 is 0.07%. NCSP has three challenges. Firstly, NCSP improves the participant rate through educating cancer screening increasing the access of screening(e.g. mobile screening unit), and increasing reimbursement fee Secondly NCSP assesses the quality of screening with related academic societies and implement the intervention for quality improvement. Thirdly, NCSP continues to increase the cost-effectiveness through modification of target population, screening interval, method, and information system.

• Korea Journal of Hospital Management
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• v.26 no.3
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• pp.43-55
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• 2021

Purposes: The purpose of this study is to confirm the effect of mother's nationality on screening rates for infants and children health screening. We intend to find out if there is a difference in health level between infants of multicultural families and infants of domestic families, and contribute to policies to enhance future national health levels by providing information on them. Methodology: Data for those who received the first infant and children health screening between 2012 and 2018 were obtained from the National Health Insurance Service(NHIS) DB. Frequency analysis, chi-square test and logistic regression analysis were performed with the SAS 9.4 program, and the case where all the 1st to 3rd checkups were completed was defined as type I, and the case of all the 1st to 7th checkups completed, type II. Findings: Complete screening rates for type I and type II were 45.8% and 20.0%, respectively. Especially, complete screening rate of infants whose mothers nationality is foreign is only 3-4th of that of domestic mothers, and it also differed according to nationality. Practical Implications: The difference in the screening rate according to the mother's nationality is likely to lead to a health gap between multicultural families and domestic families. It is necessary to promote and encourage proper monitoring and health management through continuous health screening for infants and children.