Although periodic health examination has been one of the most common practices of preventive medicine, its effect on modification of risk behavior has been seldom assessed. Thus, this study attempted to demonstrate the influence of a health examination on modification of cardiovascular disease related health risk behaviors such as smoking, physical inactivity, and obesity. Data of 893 adults were derived from two types of a popular and highly acclaimed health examination program. With a conceptual model constructed using Persuasive Communication variables, McNemar tests examined Source-Outcome association, hypothesizing that different health examination programs would yield different levels of behavior change in smoking, physical inactivity, and obesity. No significant behavior change was found in any of the two health examination programs. Instead, previously established Receiver-Outcome relationship was reconfirmed by logistic regression modeling where gender was the most prominent predictor of all three behaviors. Men were more likely to be current smokers (OR=0.029), exercisers (OR=2.629), and obese (OR=0.237). The importance of followups after health examination is highly stressed as well as that of gender-specific health education strategies. This study recommends applying the social-ecological approaches in health examination, which emphasizes the support and collaboration at individual, family, organizations, community, and policy level to improve health. Long term and qualitative evaluation of health examination may provide more foundation for increasing the effectiveness of health education and communication in health examinations.
Tak, Young-Ran;An, Ji-Yeon;Kim, Young-A;Woo, Hae-Young
Journal of Korean Academy of Nursing
/
v.37
no.6
/
pp.902-913
/
2007
Purpose: The purpose of this study was to identify the effects of a physical activity-behavior modification combined intervention(PABM-intervention) on metabolic risk factors in overweight and obese elementary school children. Methods: Thirty-two participants ($BMI\geq85$ percentile or relative $obesity\geq10$) were allocated to the PABM-intervention group and behavior modification only intervention group. The PABM -intervention was composed of exercise intervention consisting of 50 minutes of physical activity(Hip-hop dance & gym-based exercises) twice a week and the behavior modification intervention consisted of 50 minutes of instruction for modifying lifestyle habits(diet & exercise) once a week. Effectiveness of intervention was based on waist circumference, BP, HDL-cholesterol, TG, and fasting glucose before and after the intervention. Results: The proportion of subjects with 1, 2, 3 or more metabolic risk factors were 28.1, 43.8, and 15.6%, respectively. After the 8-week intervention, waist circumference, systolic BP, diastolic BP, and HDL-cholesterol changed significantly(p<.01) in the PABM group. Conclusion: This provides evidence that a PABM-intervention is effective in changing metabolic risk factors such as waist circumference, systolic BP, diastolic BP, and HDL-cholesterol in overweight and obese elementary school children.
The purpose of this study was to find out the effects of a 12-week aerobic exercise plus lifestyle modification on obese-induced metabolic syndrome in obese adolescent girls. A total of 52 obese adolescent girls (13-14 years old; body mass index (BMI) ${\geq}$95th percentiles for age and sex) purposely assigned to aerobic exercise group (AEG, n=15), aerobic exercise plus lifestyle modification group (ALG, n=18), or control group (CG, n=19). The AEG completed 12 weeks of walking exercise (30-60 min/day, 65-75% HRmax, 6 days/week), the ALG completed 12 weeks of walking exercise (30-60 min/day, 65-75% HRmax, 6 days/week) and behavior modification (60 min/day, 1 day/week), and the CG continued their normal life. The presence of the metabolic syndrome and component risk factors were determined before and after 12-week programs. The total prevalence of the metabolic syndrome was 48.1% in this sample (25/52) of participants at baseline. After the programs the prevalence of the metabolic syndrome was improved in the AEG and ALG 33.3, 27.8%, respectively. Group analyses showed significant difference in risk factors of the metabolic syndrome such that the AEG and ALG had significantly greater improvements in waist circumference, triglycerides, blood glucose and systolic blood pressure than the CG, while there were no significant difference in HDL cholesterol and diastolic blood pressure. Also there was no group difference between AEG and ALG in all measured metabolic risk factors after the programs. These results indicate that the positive changes of the ALG were not associated with lifestyle modification (behavior modification) but associated with aerobic exercise. However, long-term follow up studies are necessary to clarify the additive effect of the behavior modification on the metabolic syndrome.
Objectives: The aim of this study was to evaluate the effects of a lifestyle modification program for Korean adults with cardiovascular disease risk factors on their health behaviors and health status. Methods: A total of 448 adults with abdominal obesity and additional cardiovascular disease risk factors(high blood pressure, low HDL-cholesterol, high triglyceride or high blood glucose) were randomly assigned to either an intensive intervention group (IIG, n=216) or a minimal intervention group(MIG, n=232). Participants in the IIG received lifestyle modification program which consisted of health counseling with nutrition assessment, health booklet and health diary, while those in MIG received minimal information. Results: The participants in the IIG significantly improved dietary habits(p<.05), retrained eating(p<.001), external eating(p<.01) behaviors, leisure time physical activity(p<.05), dietary self-efficacy(p<.01), exercise self-efficacy(p<.01) and MetS score(p<.001) after 3 months. In addition, the participants in the IIG showed more improvement in dietary habits(p<.05) compared with those in the MIG. Conclusion: The lifestyle modification program was effective in improving some health behaviors, behavioral determinants and cardiovascular risk factors for a short term.
Objectives: This paper aims to identify the health related behaviors patterns and its associated factors among marriage immigrant women in Korea, and discusses their application to health promotion strategies. Methods: The study participants were 7,591 immigrant wives in Gyeonggi province who participated in health examinations conducted by the Korea Association of Health Promotion in 2011-2013. The participants completed self-administered questionnaires on sociodemographics, psychological characteristics, health status and health care factors, and health related behaviors. Results: A 3-latent-class model of health behaviors was identified related to 'lack of physical activity', 'abnormal diet', and 'not experienced medical check-up': 'high risk class', 'middle risk class', and 'low risk class'. Most of the participants belong to 'middle risk class'. Country of origin, age, length of stay, number of children, work status, health insurance status, and unmet health care needs were associated with problematic health behaviors in middle risk health behavior class. Conclusions: Health promotion and intervention programs for marriage immigrant women and their family members need to consider the health behavior patterns of physical inactivity, abnormal diet and no medical check-up and develop multiple behavior intervention with pre-existing program modification.
Purpose: The purpose of this study was to survey the college students' perception of cancer risks, cancer related health behavior, and perception of cancer occurrence possibility before and after age 40. Methods: The subjects were 771 college students who were conveniently selected from two colleges in the Gyeonggi Province. Data were analyzed using SPSS WIN 12.0. Results: The mean score of cancer risk perception was 3.8. The highest score item was 'smoking may cause cancer'. The mean score of cancer related health behavior was 3.0. The highest score item was 'take bath or shower'. Student felt that possibility of developing cancer before age 40 was 20.1% and that after age 40 was 36.2%. The perception of cancer risks was significantly different between male and female, and the health behavior was significantly different between age groups. There were weak relationships between the perception of cancer risks and cancer related health behavior. Conclusion: College students' perception of cancer risks was mostly good, but their behavior to reduce the risks did not match the degree of perception. Students recognized that after age 40 has a higher risk of developing cancer, therefore, intervention on behavioral modification to reduce cancer risks would be beneficial.
This study was conducted to investigate the effect of a 3 week low calorie diet (LCD) and a 9 week of behavior modification (BM) program on the weight loss, mineral and vitamin status in 22 obese women. The subject were healthy, obese (PIBW> $120\%$) women aged 20 - 50 Yr and not taking any medications known to influence body composition, mineral or vitamin metabolism During the LCD program, subjects were provided commercial liquid formulas with 125 kcal per pack and were instructed to have a formula for replacement of one meal and at least one regular meal per day within the range of daily 800 - 1200 kcal intake. During the BM program the subjects weekly attended the group nutrition counseling session to encourage themselves to modify their eating behavior and spontaneously restrict their energy intakes. The BM program focused on stimulus control, control of portion sizes and modification of binge eating and other adverse habits. The initial mean energy intake of subjects was 2016.9 $\pm$ 129.8 kcal ($100.8\%$ of RDA) and dropped to 1276.5 $\pm$ 435.7 kcal at the end of a 3 week of LCD program and elevated to 1762 $\pm$ 329.3 kcal at the end of a 9 week of BM program. Carbohydrate, protein and fat intakes were significantly decreased at the end of the LCD but carbohydrate was the only macro nutrient that showed significant decrease (p < 0.05) at the end of the BM program compared to baseline. Calcium and iron intakes decreased significantly (p < 0.01, respectively) with no significant changes in other micronutrients at the end of the LCD. The mean weight of the subjects decreased from 73.8 $\pm$ 8.0 kg to 69.2 $\pm$ 7.7 kg with LCD and ended up with 67.7 $\pm$ 7.1 kg after 9 weeks of BM. The 3 weeks of LCD reduced most of the anthropometric indices such as BMI, PIBW, fat weight, wast-to-hip ratio and subscapular and suprailiac skinfold thickness. The 9 weeks of behavior modification showed slight change or maintenance of each anthropometric measurements. Weight loss and decreased WHR with the diet program induced significantly decreased systolic blood pressure. SGOT, SGPT and serum insulin levels with improved serum lipid profiles. Biochemical parameters related to iron status such as hemoglobin, hematocrit were significantly decreased (p < 0.01) at the end of the LCD. But their mean values were within normal range. The mean serum 25 (OH) vitamin $D_3$ level significantly increased after whole diet program. Serum folate level significantly decreased after 12 weeks of diet program. In conclusion 3 weeks of LCD brought 4.6 kg reduction in body weight without risk of iron, zinc or vitamin D deficiency and 9 weeks of the BM was effective to maintain nutritional status with slightly more weight reduction (1.5 kg). However calcium intake and serum folate should be monitored during the LCD and BM because of increased risk of deficiencies.
Objectives: Life style modification leads to decrease health risk and change of health status for person at health risk. This study aimed to suggest essential components and effective strategies for customized health management service to provide individual and risk group in public and private health care organizations. Methods: To systematic review the essential component of health management service, I performed to collect political legislation, research papers, reports, publication and public release for heath management service from 2008 to 2016. Essential components of heath management service were service scope, service design, organizations and applied technology. Results: Service cope was composed of health risk factors, such as smoking, drinking, nutrition, physical activity and weight control. Main strategies were customized health management services, personalized behavior modification programs, evidence-based service protocol, utilization of information and communications technology (ICT), multi-dimension and multi-level approach, and public and private organizations partnership through health policies and health care system. Conclusions: To make the most of the limited resources, it should require a systematic approach that focuses on continuous monitoring and partnership of health management service.
The study was done to identify factors influencing the health risk behavior of the chronic mental illness in the community. A cross-sectional study design was used in this study. The sample was 255 chronic mentally ill persons from D city and C province and who agreed to participate in the study. Data were collected on August-september, 2011 and analyzed using the SPSS/WIN 20. Stress event, insight and depression had significant correlations with health risk behavior. Hierarchial regression analysis showed gender (men), diagnosis (schizophrenia), stress event, insight and depression together explained 24% of variance in health risk behavior. Findings of this study allow a comprehensive understanding of health risk behavior of the chronic mentally ill persons in community. It is necessary to integrated health promotion programs designed for this population should focus on these factors for effective behavioral modification.
A quasi-experimental study was conducted to develop a health education modification program based on self-efficacy and motivation regarding liver flukes and cholangiocarcinoma development in Keang Sanam Nang district, Nakhon Ratchasima province, Thailand. A total of 36 individuals were invited to participate in the program and were screened for population at risk of liver fluke infection and cholangiocarcinoma using SUT-OV-001 and SUT-CCA-001. Development of health education modification program regarding liver fluke and cholangiocarcinoma prevention included 3 steps: (1) preparation, (2) health education program, and (3) follow-up and evaluation. The study was implemented for 10 weeks. Pre-and-post-test knowledge was measured with questionnaires, Kuder-Richardson-20: KR-20 = 0.718,and Cronbach's Alpha Coefficient = 0.724 and 0.716 for percection and outcome expectation questionnaires. Paired and independent t-tests were applied for data analysis. The majority of the participants were female (55.6%), aged between ${\leq}50$ and 60 years old (36.1%), married (86.1%), education level of primary school (63.9%), agricultural occupation (80.6%), and income <4,000 Baht (44.4%). The results revealed that after the health education program, the experimental group had a mean score of knowledge, perception, and outcome expectation regarding liver fluke and cholangiocarcinoma prevention significantly higher than before participation and in the control group. In conclusion, this successful health education modification program for liver fluke and cholangiocarcinoma, therefore may useful for further work behavior modification in other epidemic areas.
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