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Plan and operations of the 10th Korea National Health and Nutrition Examination Survey (2025–2027)
Sun-Ja Kim, Sihyun Park, Sunja Kim, Suyeon Park, Yoonjung Kim, Yunjung Choi, Sungha Yun, Kyungwon Oh
Epidemiol Health. 2026;48:e2026001.   Published online January 2, 2026
DOI: https://doi.org/10.4178/epih.e2026001
  • 5,007 View
  • 105 Download
AbstractAbstract AbstractSummary PDFSupplementary Material
Abstract
The Korea National Health and Nutrition Examination Survey (KNHANES) is a national health survey mandated by Article 16 of the National Health Promotion Act to assess the health and nutritional status of the Korean population. Over the past 2 decades, the survey has continuously introduced timely survey components while strengthening its survey methodology and operational systems to enhance both the policy relevance and scientific utility of its findings. The 10th KNHANES (2025–2027) preserves the statistical representativeness of its sampling design while expanding the use of web-based self-administered questionnaires to improve participant convenience. In response to Korea’s transition into a super-aged society, the 10th KNHANES incorporates enhanced older-adult health surveys, including osteoporosis assessment and older adults’ life functioning, and newly introduces items addressing social support as part of the social determinants of health. In addition, a longitudinal follow-up survey system has been established to monitor long-term changes in population health. Collectively, these changes are expected to improve understanding of aging-related health issues, support evidence-based national health policy development, and expand the applicability of KNHANES data for academic research.
Summary
Korean summary
국민건강영양조사는 국민건강증진법 제16조에 근거하여 1998년부터 우리 국민의 건강 및 영양 수준을 파악해 온 국가 단위 건강조사이다. 제10기(2025–2027) 국민건강영양조사는 통계적 대표성을 유지하면서 온라인 조사로의 지속적인 개선·확대, 초고령 사회 등 사회·보건환경 변화에 대응한 신규 조사항목 도입, 추적조사 체계 구축을 통해 국가 건강정책 및 만성질환 예방·관리 전략 수립을 위한 근거 생산을 강화하고자 한다.
Key Message
The Korea National Health and Nutrition Examination Survey (KNHANES) is a national health survey mandated by Article 16 of the National Health Promotion Act that has assessed the health and nutritional status of the Korean population since 1998. The 10th KNHANES (2025–2027) maintains statistical representativeness while further improving and expanding web-based self-administered surveys, incorporating new survey components in response to social and public health changes such as the transition to a super-aged society, and establishing a longitudinal follow-up system to strengthen the evidence base for national health policy development and chronic disease prevention and management.
Original Articles
The prevention and response to infectious diseases in long-term care facilities in Korea: a nationwide survey
Sun Hee Na, Joong Sik Eom, Sun Bean Kim, Hyung Jin Yoon, So Yeon Yoo, Kyeong Sook Cha, Jong Rim Choi, Ji Youn Choi, Si Hyeon Han, Jin Ju Park, Tark Kim, Jacob Lee
Epidemiol Health. 2024;46:e2024084.   Published online October 17, 2024
DOI: https://doi.org/10.4178/epih.e2024084
  • 16,641 View
  • 184 Download
  • 2 Crossref
AbstractAbstract AbstractSummary PDFSupplementary Material
Abstract
OBJECTIVES
Long-term care facilities (LTCFs) are communal environments for patients with chronic diseases or older adults, making them particularly susceptible to significant harm during infectious disease outbreaks. Nonetheless, LTCFs have historically been subject to less stringent infection prevention and control (IPC) mandates. This study aimed to assess the current state of LTCFs and to develop an IPC system tailored for these facilities following the coronavirus disease 2019 (COVID-19) pandemic.
METHODS
We conducted an online survey of 11,366 LTCFs in Korea from December 30, 2022 to January 20, 2023, to evaluate the components of IPC in LTCFs. The infectious diseases targeted for IPC included COVID-19, influenza, and scabies. Additionally, we compared institution-based and home-based long-term care insurance facilities.
RESULTS
Overall, 3,537 (31.1%) LTCFs responded to the survey, comprising 1,819 (51.4%) institution-based and 1,718 (48.6%) home-based facilities. A majority (87.4%, 2,376/2,720) of these facilities experienced COVID-19 outbreaks. However, only 42.2% of home-based facilities, in contrast to 90.6% of institution-based facilities, were equipped to manage concurrent COVID-19 cases. Similarly, while 92.1% of institution-based facilities were capable of managing influenza, only 50.5% of home-based facilities could do the same. The incidence of scabies was significantly higher in institution-based facilities than in home-based ones (26.1 vs. 4.3%). Additionally, 88.7% of institution-based facilities managed scabies cases effectively, compared to only 42.1% of home-based facilities.
CONCLUSIONS
Approximately half of the LTCFs had a basic capacity to respond to infectious diseases. However, there were differences in response capabilities between institution-based facilities and home-based facilities.
Summary
Korean summary
장기요양기관을 대상으로 실태조사가 시행되었습니다. 50% 기관에서 감염병에 대한 기본 대응능력을 가지고 있었지만 시설급여기관과 재가급여기관 사이 대응능력에 차이가 있었습니다.
Key Message
A survey of long-term care facilities (LTCFs) was conducted. Fifty per cent of LTCFs had a basic capacity to respond to infectious diseases. However, there were differences in response capacity between institution-based and home-based facilities.

Citations

Citations to this article as recorded by  
  • 2025년 서산시 노인요양시설 환기 실태 및 SARS-CoV-2 공기전파 위험도 평가
    대희 한, 지애 임, 상욱 우, 혜진 강, 수진 김, 유호 최, 보람 김, 동권 최, 오현 조
    Public Health Weekly Report.2026; 19(8): 377.     CrossRef
  • COVID-19 Pandemic and Next Pandemic Preparedness of Long-term Care Hospitals and Facilities
    Kyujin Chang
    Korean Journal of Healthcare-Associated Infection Control and Prevention.2025; 30(2): 105.     CrossRef
Development and validation of the Health Literacy Index for the Community for the Korean National Health and Nutrition and Examination Survey
Junghee Yoon, Soo Jin Kang, Mangyeong Lee, Juhee Cho
Epidemiol Health. 2024;46:e2024061.   Published online July 10, 2024
DOI: https://doi.org/10.4178/epih.e2024061
  • 22,217 View
  • 291 Download
  • 15 Crossref
AbstractAbstract AbstractSummary PDFSupplementary Material
Abstract
OBJECTIVES
We developed and validated the Health Literacy Index for the Community (HLIC) to assess the health literacy of the Korean population within the framework of the Korean National Health and Nutrition and Examination Survey.
METHODS
The HLIC was developed through (1) defining the conceptual framework and generating the item pool and (2) finalizing the items and identifying the cut-off value. Interviews were conducted to examine items’ face validity, and a cross-sectional survey was performed to analyze the item-response theory and Rasch models to investigate the instrument’s psychometric properties.
RESULTS
In this study of 1,041 participants, most had no difficulty understanding health information; however, 67.9% struggled to assess the reliability of health information from the Internet or media. A 4-factor structure was identified through factor analysis, leading to the exclusion of some items. This resulted in 10 items across 4 domains: (1) disease prevention, (2) health promotion, (3) health care, and (4) technology and resources. The HLIC demonstrated good internal consistency, with a Cronbach’s α of 0.87. It also showed high test-retest reliability and correlations with other health literacy instruments. A socio-demographic analysis of the HLIC revealed disparities in health literacy across various age groups, education levels, and income brackets.
CONCLUSIONS
The HLIC was developed to systematically measure health literacy in Korea’s general population. Its simplicity and conciseness ensure reliability and validity and improve its accessibility, making it particularly suitable for the broader Korean population, including those with lower literacy levels.
Summary
Korean summary
본 연구는 한국인의 건강 문해력을 평가하기 위해 지역사회 건강정보 이해능력 측정도구(Health Literacy Index for the Community, HLIC)를 개발하고 검증하였다. 그 결과, 많은 사람들이 인터 넷이나 미디어에서 얻은 정보의 신뢰성을 평가하는 데 어려움을 겪고 있으며, 연령, 교육 수준, 소 득에 따라 건강정보 이해능력 격차가 존재함을 확인하였다. 특히 본 도구는 높은 신뢰도와 타당성 을 입증하였으며, 이를 통해 한국인의 격차를 파악하고 맞춤형 개입을 위한 중요한 정보를 제공하 는 도구로서의 유용성을 확인하였다.
Key Message
This study developed and validated the Health Literacy Index for the Community (HLIC) to assess the health literacy of Koreans, finding that many had difficulties to assess its reliability from Internet or media sources, and disparities in health literacy were observed across age, education level, and income. The HLIC demonstrated strong reliability and validity, highlighting its utility for identifying health literacy gaps and informing targeted interventions in Korea.

Citations

Citations to this article as recorded by  
  • Health literacy mediates the association of education levels with engagement in leisure-time physical activity and muscle-strengthening exercise: a population-based study of Korea
    Seong-Uk Baek, Jin-Ha Yoon
    Postgraduate Medical Journal.2026; 102(1204): 140.     CrossRef
  • Validation of health literacy competencies for healthcare professionals in Korea: a psychometric evaluation study
    Soo Jin Kang, Won Ju Hwang, Chanho Park, Hae-Ra Han
    BMC Medical Education.2026;[Epub]     CrossRef
  • Health literacy and the continuum of suicidal behaviors among adults: A national survey from South Korea, 2023
    Seong-Uk Baek, Jin-Ha Yoon
    Asian Journal of Psychiatry.2026; 117: 104884.     CrossRef
  • Associations among health literacy, anxiety symptoms, and health-related quality of life in Korean adults: A cross-sectional study with age-stratified analyses
    Gyuri Seol, Young Hwangbo, Yongbae Kim, Youngs Chang, Mee-Ri Lee, Muhammad Shahzad Aslam
    PLOS One.2026; 21(2): e0342239.     CrossRef
  • Association Between Health Literacy and Prehypertension in South Korean Adults: Cross-Sectional Study Using the 2023 Korea National Health and Nutrition Examination Survey
    Jiyeon Chun, Dan Bi Kim, Suk-Yong Jang, Eun-Cheol Park
    JMIR Public Health and Surveillance.2026; 12: e82684.     CrossRef
  • Health literacy domains and socioeconomic inequalities in leisure-time physical activity among Korean adults
    Myong-Won Seo
    Frontiers in Public Health.2026;[Epub]     CrossRef
  • Association between health literacy and seat belt use among Korean adults
    Young Ko, Soo Jung Choi, In Cheol Hwang, Hong Yup Ahn
    Journal of Medicine and Life Science.2026; 23(2): 105.     CrossRef
  • Analysis of Parental Literacy in Healthy Nutrition
    K. Yu. Miropolskaya, M. G. Vershinina, A. V. Kochubey
    M.Ya. Studenikin Russian Pediatric Journal.2026; 1(2): 97.     CrossRef
  • Health literacy by occupation in Korea
    In Cheol Hwang, Hong-Yup Ahn
    Journal of Epidemiology and Community Health.2025; 79(12): 963.     CrossRef
  • Health literacy and its relationship with mental health: A nationwide Korean survey
    Yoo Jeong Lee, Ki Dong Ko, In Cheol Hwang, Hong Yup Ahn
    Asian Journal of Psychiatry.2025; 111: 104628.     CrossRef
  • Digital Health Literacy in the General Population: National Cross-Sectional Survey Study
    Junghee Yoon, Seongwoo Yang, Soo Jin Kang, Mangyeong Lee, Dokyoon Kim, Joungwon Park, Su Jin Kim, Jiyoon Han, Jungin Joo, Juhee Cho
    Journal of Medical Internet Research.2025; 27: e67780.     CrossRef
  • Cross-sectional analysis of sociodemographic factors associated with self-reported and knowledge-based health literacy in Korea using data from KNHANES 2023
    Ki Young Huh, Ildae Song
    Scientific Reports.2025;[Epub]     CrossRef
  • Health literacy in Korea: findings from the 2023 Korea National Health and Nutrition Examination Survey
    Sunhye Choi, Yukyeong Kang, Hyejin Kim, Kyungwon Oh
    Epidemiology and Health.2025; 47: e2025037.     CrossRef
  • Impact of Sleep, Mental Health, and Health Literacy on Health-Related Quality of Life in Patients with Allergic Rhinitis: A Secondary Analysis of the 2023 Korea National Health and Nutrition Examination Survey
    Gaeun Kim, Moonhee Gang
    Journal of Korean Academy of Fundamentals of Nursing.2025; 32(3): 389.     CrossRef
  • Psychometric of the Ferrer-Urbina multidimensional scale of sexual self concept (MSSSC) in the Iranian population
    Yeganeh Dadashzadeh Sangary, Mohammad Hassan Asayesh, Ali Asgharzadeh, Zahra Naghsh
    BMC Psychology.2025;[Epub]     CrossRef
Determinants of unhealthy living by gender, age group, and chronic health conditions across districts in Korea using the 2010-2017 Community Health Surveys
Thi Tra Bui, Thi Huyen Trang Nguyen, Jinhee Lee, Sun Young Kim, Jin-Kyoung Oh
Epidemiol Health. 2024;46:e2024014.   Published online January 4, 2024
DOI: https://doi.org/10.4178/epih.e2024014
  • 17,740 View
  • 142 Download
  • 2 Web of Science
  • 3 Crossref
AbstractAbstract AbstractSummary PDFSupplementary Material
Abstract
OBJECTIVES
We investigated the prevalence and determinants of unhealthy living by gender, age, and comorbidities across Korean districts.
METHODS
For 806,246 men and 923,260 women from 245 districts who participated in the 2010-2017 Korean Community Health Surveys, risk scores were calculated based on obesity, physical inactivity, smoking, and high-risk alcohol consumption, each scored from 0 (lowest risk) to 2 (highest risk). A risk score ≥4 was defined as indicating unhealthy living, and weighted proportions were calculated for each district. Using multivariate regression, an ecological model including community socioeconomic, interpersonal, and neighborhood factors was examined by gender, age, and comorbidities.
RESULTS
The mean age-standardized rate of unhealthy living was 24.05% for men and 4.91% for women (coefficients of variation, 13.94% and 29.51%, respectively). Individuals with chronic diseases more frequently exhibited unhealthy lifestyles. Unhealthy lifestyles were associated with educational attainment (β-coefficients: men, -0.21; women, -0.15), high household income (β=0.08 and 0.03, respectively), pub density (β=0.52 and 0.22, respectively), and fast-food outlet density (β=2.81 and 1.63, respectively). Negative associations were observed with manual labor, social activity participation, and hospital bed density. Unhealthy living was positively associated with living alone among women and with being unemployed among middle-aged men. Access to parks was negatively associated with unhealthy living among young men and women. The ecological model explained 32% of regional variation in men and 41% in women.
CONCLUSIONS
Improving the neighborhood built and socioeconomic environment may reduce regional disparities in lifestyle behaviors; however, the impacts may vary according to socio-demographic traits and comorbidities.
Summary
Korean summary
- 시군구 지역단위의 불건강생활(흡연, 음주, 비만, 신체활동 부족 각 0-2점, 합 4점 이상 불건강) 유병률은 여자보다 남자에서 높고, 연령이 높아지면서 감소한다. - 지역사회 환경개선(술집 개수, 패스트푸드점 밀도, 공원 면적, 병상밀도)과 사회경제적 수준 강화(교육수준, 가구소득, 고용)를 통해 생활습관적 건강행태의 지역 격차를 줄일 수 있다. - 이러한 향상 노력의 효과는 지역의 건강상태 수준이나 사회인구학적 특성에 따라 다를 수 있다.
Key Message
• District prevalence rates of unhealthy living were higher among men than women and decreased with advancing age. • Efforts to reduce regional disparities in lifestyle behaviors could benefit from enhancements to the neighborhood environment and the socioeconomic status of the area. • The effectiveness of such improvements may vary based on socio-demographic characteristics and health conditions.

Citations

Citations to this article as recorded by  
  • Interactive Digital Visualization Counseling for Lifestyle Change in Patients at Risk of Cardiovascular Diseases: Randomized Controlled Trial
    Adrijana Svenšek, Mateja Lorber, Zalika Klemenc-Ketiš, Lucija Gosak, Dominika Muršec, Gregor Štiglic
    JMIR Public Health and Surveillance.2026; 12: e83488.     CrossRef
  • A Community-Based, Lifestyle Behavioral Intervention Based on the Extended Theory of Planned Behavior for Postmenopausal Women at Cardiometabolic Risk: A Randomized Controlled Trial
    Sooyeon Park, Jina Choo
    Western Journal of Nursing Research.2025; 47(7): 573.     CrossRef
  • Feasibility of Using the EuroQol-5 Dimensions to Identify Masticatory Discomfort in Community-Dwelling Older Adults
    Han-Nah Kim, Nam-Hee Kim
    Journal of Dental Hygiene Science.2025; 25(3): 237.     CrossRef
Associations of breastfeeding duration and the total number of children breastfed with self-reported osteoarthritis in Korea women 50 years and older: a cross-sectional study
Dajeong Ham, Sanghyuk Bae
Epidemiol Health. 2023;45:e2023044.   Published online April 13, 2023
DOI: https://doi.org/10.4178/epih.e2023044
  • 18,861 View
  • 123 Download
  • 3 Web of Science
  • 5 Crossref
AbstractAbstract AbstractSummary PDFSupplementary Material
Abstract
OBJECTIVES
Osteoarthritis is the most common joint disease, with a higher prevalence among women than men. The present study aimed to examine the associations of breastfeeding duration and the total number of children breastfed with osteoarthritis in Korean women aged 50 years and older.
METHODS
In this cross-sectional study, we used representative data from the Korea National Health and Nutrition Examination Survey, phases 5 through 7 (2010-2018). Our analysis included 10,102 women aged ≥50 years. Osteoarthritis experience was defined as whether a physician had ever diagnosed osteoarthritis. Breastfeeding duration was categorized as 1-6 months, 7-24 months, and ≥25 months. The total number of children breastfed was categorized as 1-2, 3-4, and ≥5. The covariates were health behavior characteristics and risks of diseases (smoking, drinking, physical activity, body mass index, diabetes, hypertension, oral contraceptive use, and menopause) as well as socioeconomic characteristics (income, educational level, and occupation). A multiple logistic regression model was used to investigate associations between osteoarthritis and aspects of breastfeeding experience.
RESULTS
Compared to the non-breastfeeding group, the breastfeeding group had an odds ratio (OR) of 1.55 (95% confidence interval [CI], 1.18 to 2.03) for osteoarthritis. Those who reported breastfeeding for >25 months had an OR of 1.56 (95% CI, 1.19 to 2.06).
CONCLUSIONS
The advantages of breastfeeding are already well known, but the present study suggests that women who breastfeed children for a longer time may have a higher risk of osteoarthritis after middle age.
Summary
Korean summary
골관절염은 가장 흔한 관절 질환이며 유병률은 여성에서 더 높다. 본 연구는 국민건강영양조사의 50세 이상 여성 10,130명을 대상으로 모유수유경험과 골관절염의 유병율 사이의 연관성을 분석하였다. 모유 수유의 이점은 이미 잘 알려져 있지만, 모유 수유 기간이 길수록 골관절염에 걸릴 가능성이 더 높음을 관찰하였다.
Key Message
Osteoarthritis is one of the most common disorders in elderly women and identifying risk factors may contribute to screening and early treatment. In the present article, we analyzed the association of breastfeeding and related factors with prevalent osteoarthritis in Korea National Health and Nutrition Examination Survey. The advantages of breastfeeding are already well known, but we observed that the longer the breastfeeding duration was the more likely the woman has osteoarthritis.

Citations

Citations to this article as recorded by  
  • Osteoarthritis from a female perspective
    Maritza Vidal, Nancy E Lane
    Exploration of Endocrine and Metabolic Diseases.2026;[Epub]     CrossRef
  • Comparative Analysis of Breastfeeding and Infant Formulas: Short‐ and Long‐Term Impacts on Infant Nutrition and Health
    Kalmee Pramoda Kariyawasam, Geeshani Somaratne, Sumali Dilrukshi Dillimuni, Umani Walallawita
    Food Science & Nutrition.2025;[Epub]     CrossRef
  • Joint Tissues: Convergence and Divergence of the Pathogenetic Mechanisms of Rheumatoid Arthritis and Osteoarthritis
    Marina O. Korovina, Anna R. Valeeva, Ildar F. Akhtyamov, Wesley Brooks, Yves Renaudineau, Gayane Manukyan, Marina I. Arleevskaya
    International Journal of Molecular Sciences.2025; 26(17): 8742.     CrossRef
  • Association of Reproductive Factors with Osteoarthritis and the Mediating Effect of Body Mass Index Among Postmenopausal Women
    Renyang Liu, Yang Hu, Ximing Zhang, Jun Li
    Journal of Women's Health.2025; 34(11): 1399.     CrossRef
  • Designing a Knee Self-care Checklist for Menopause Women with Knee Osteoarthritis
    Masoomeh Dashtian, Sedighe Sadat Tavafian, Kambiz Karimzade Shirazi, Parviz Yazdanpanah
    Journal of Education and Community Health.2024; 11(1): 25.     CrossRef
COVID-19: Special Article
Changes in mental health of Korean adolescents before and during the COVID-19 pandemic: a special report using the Korea Youth Risk Behavior Survey
Bomi Park, Jihee Kim, Jieun Yang, Sunhye Choi, Kyungwon Oh
Epidemiol Health. 2023;45:e2023019.   Published online February 14, 2023
DOI: https://doi.org/10.4178/epih.e2023019
  • 26,717 View
  • 406 Download
  • 7 Web of Science
  • 7 Crossref
AbstractAbstract AbstractSummary PDFSupplementary Material
Abstract
OBJECTIVES
We aimed to study the effects of the coronavirus disease 2019 (COVID-19) pandemic on adolescents’ mental health in Korea.
METHODS
We used data from the Korea Youth Risk Behavior Survey 2018-2021 with 227,139 students aged 12-18 years. We estimated the differences in depressive symptoms, suicidal ideation, and stress perception before (2018-2019) and during (2020-2021) the pandemic, as well as before (2019), the first year (2020) of, and the second year (2021) of the pandemic. We also examined whether COVID-19 is statistically associated with mental health.
RESULTS
In both male and female adolescents, the prevalence of depressive symptoms, suicidal ideation, and stress perception was higher in the “not living with family,” “low household economic status,” and “self-rated unhealthy status” subgroups. The prevalence of depressive symptoms and stress perception was higher in middle school students. Adolescents were less likely to experience depressive symptoms (adjusted odds ratio [aOR], 0.86; 95% confidence interval [CI], 0.83 to 0.89), suicidal ideation (aOR, 0.80; 95% CI, 0.76 to 0.83), and stress perception (aOR, 0.76; 95% CI, 0.74 to 0.79) in 2020 than in 2019. However, there were more depressive symptoms (aOR, 1.06; 95% CI, 1.02 to 1.09), suicidal ideation (aOR, 1.15; 95% CI, 1.10 to 1.21), and stress perception (aOR, 1.19; 95% CI, 1.16 to 1.23) in 2021 than in 2020.
CONCLUSIONS
The COVID-19 pandemic had positive impacts on mental health of adolescents in its early stages but has had negative impacts as the pandemic continues. Attention should be paid to adolescents who are particularly vulnerable to the mental health effects of the pandemic.
Summary
Korean summary
The results from a nationally representative data showed that mental health in adolescents was improved in the first year of the COVID-19 pandemic compared to before the COVID-19 pandemic, but it was deteriorated in the second year of the pandemic compared to the first year.
Key Message
본 연구에서는 대규모 건강조사를 이용하여 코로나19가 장기화됨에 따른 영향을 평가하고자 하였다. 2018년-2021년 청소년건강행태조사에 참여한 만 12-18세 청소년 227,139 명을 대상으로 분석한 결과, 코로나19 유행 첫번째 해(2020년)에는 코로나19 유행 이전에 비해 정신건강이 개선되었으나, 코로나19 유행 두 번째 해(2021년)에는 코로나19 유행 첫 번째 해에 비해 청소년 정신건강이 나빠졌다. 또한 가족과 함께 거주하지 않는 경우, 가정 경제 수준이 낮은 경우, 본인이 건강하지 않다고 인지하는 경우에 더 취약하였다.

Citations

Citations to this article as recorded by  
  • Association Between Smartphone Screen Time and Mental Health Among Korean Adolescents: A National Representative Study
    Su Hee Kim, Jiyoung Hwang, Kyeongeun Kim, YeoJin Im, Dong Keon Yon
    Psychiatry Investigation.2026; 23(3): 384.     CrossRef
  • Temporal Patterns and Predictive Factors of Childhood Depressive Disorders Across Asia
    Kexin Zhang, Chengxia Kan, Yujie Ma, Zhenghui Tian, Fang Han, Xiaodong Sun, Raffaella Bosurgi
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    Yeonjae Kim, Hyewon Park, YooWha Bhan, Donghwan Lee, Chang-Mo Oh, Weon Young Lee, Bomi Park
    Journal of Adolescent Health.2025; 76(1): 72.     CrossRef
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    Danilo Bastos Bispo Ferreira, Renata Maria Silva Santos, Maria Carolina Lobato Machado, Victhor Hugo Martins Rezende, Patrícia Gazire de Marco, Marco Aurélio Romano-Silva, Débora Marques de Miranda
    Frontiers in Psychiatry.2025;[Epub]     CrossRef
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    Changwoo Han, Juho Choi, Hoyeon Jang, Hwa-Young Lee, Tarik Benmarhnia, Juhwan Oh
    BMC Psychiatry.2024;[Epub]     CrossRef
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    Changwoo Han, Hoyeon Jang, Juhwan Oh
    BMC Public Health.2023;[Epub]     CrossRef
  • A Comparison of Changes in Health Behavior, Obesity, and Mental Health of Korean Adolescents Before and During the COVID-19 Pandemic: Online Cross-Sectional Study
    Mi-Sun Lee, Hooyeon Lee
    Psychiatry Investigation.2023; 20(11): 1086.     CrossRef
COVID-19: Special Article
Changes in health behaviors and obesity of Korean adolescents before and during the COVID-19 pandemic: a special report using the Korea Youth Risk Behavior Survey
Chang-Mo Oh, Yangha Kim, Jieun Yang, Sunhye Choi, Kyungwon Oh
Epidemiol Health. 2023;45:e2023018.   Published online February 14, 2023
DOI: https://doi.org/10.4178/epih.e2023018
  • 30,865 View
  • 395 Download
  • 10 Web of Science
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AbstractAbstract AbstractSummary PDFSupplementary Material
Abstract
OBJECTIVES
This study aimed to investigate changes in health behaviors, including cigarette smoking, alcohol drinking, physical activity, dietary behaviors, and obesity, before and during the coronavirus disease 2019 (COVID-19) pandemic using the Korea Youth Risk Behavior Survey (KYRBS) database.
METHODS
KYRBS data from 2015 to 2021 were used in this study. Differences in health behaviors between before (pre-pandemic period: 2018-2019) and during (pandemic period: 2020-2021) the pandemic were examined. Differences were compared using linear regression and the chi-square test considering the complex survey design after adjusting for grade level.
RESULTS
The prevalence of current cigarette smoking and current alcohol drinking significantly decreased in both male and female students during the pandemic compared to the pre-pandemic period. However, the prevalence of obesity significantly increased in both male and female students during the same period. When examining physical activity and dietary behaviors closely related to obesity, fast food consumption increased and fruit consumption decreased during the pandemic in both male and female students, whereas no significant changes in physical activity were observed in either male or female students.
CONCLUSIONS
The deterioration of adolescent dietary behaviors and an increase in the prevalence of obesity can increase the future disease burden, and concerted efforts at the individual and national levels are needed to reduce obesity and promote healthy dietary behaviors.
Summary
Korean summary
이 연구는 한국 청소년건강행태조사자료(KYRBS)를 사용하여 코로나19 유행 전후의 우리나라 청소년들의 흡연, 음주, 신체활동, 식습관, 비만 등의 건강행태의 변화에 대하여 살펴보고자 하였다. 이 연구에서는 2015년부터 2021년까지의 청소년건강행태조사자료를 사용하여, 코로나19 유행 이전 (2018-2019년)과 코로나 유행 이후 (2020-2021년) 기간의 건강행태의 변화에 대하여 조사하였다. 학년레벨을 보정한 후, 복합표본설계를 고려하여 로지스틱 회귀분석과 카이제곱검정을 이용하여 코로나19 유행 이전 (2018-2019년)과 비교하여, 코로나 유행 이후 (2020-2021년) 기간의 건강행태의 변화가 있었는지에 대하여 확인하였다. 그 결과, 코로나19 유행 이전 (2018-2019년)과 비교하여, 코로나19 유행 기간(2020-2021년) 동안에 현재흡연율과 현재음주율이 유의하게 감소하였다. 그러나 동일한 기간 동안에 남학생과 여학생 모두에서 비만율이 유의하게 증가하였는데, 비만율과 관련된 신체활동 및 식습관에 대하여 살펴보았을 때, 신체활동에서는 유의한 변화가 없었던 반면, 남학생과 여학생 모두에서 패스트푸드 섭취는 증가하고 과일섭취가 감소한 것으로 나타났다. 따라서 코로나19 유행기간 동안 흡연율 및 음주율 등의 청소년 건강에 유익한 변화도 있었으나, 비만율도 같이 증가한 것을 확인할 수 있었다. 청소년기의 식습관의 악화 및 비만율의 증가는 미래 우리나라의 질병부담을 증가시킬 수 있기 때문에, 청소년의 비만율을 낮추고 건강한 식습관을 증진시키기 위한 개인 및 사회 차원의 노력이 필요하다.
Key Message
-The current cigarette smoking and current alcohol drinking rates significantly decreased among Korean adolescents during the pandemic period compared to the pre-pandemic period. -On the other hand, the obesity rate increased significantly especially among Korean male adolescents, which is accompanied by changes in dietary habits such as an increase in fast food intake and a decrease in fruit intake.

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Original Articles
Trends in breast cancer screening rates among Korean women: results from the Korean National Cancer Screening Survey, 2005-2020
Soo Yeon Song, Yun Yeong Lee, Hye Young Shin, Bomi Park, Mina Suh, Kui Son Choi, Jae Kwan Jun
Epidemiol Health. 2022;44:e2022111.   Published online November 24, 2022
DOI: https://doi.org/10.4178/epih.e2022111
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AbstractAbstract AbstractSummary PDFSupplementary Material
Abstract
OBJECTIVES
Since 2002, the Korean government has provided breast cancer screening as part of the National Cancer Screening Program. This study reported trends in the screening rate among Korean women from 2005 to 2020, including organized and opportunistic screening for breast cancer.
METHODS
Data from the Korean National Cancer Screening Survey, an annual cross-sectional nationwide survey, were collected using a structured questionnaire between 2005 and 2020. The study population included 23,702 women aged 40-74 years with no history of cancer. We estimated the screening rate based on the current recommendation of biennial mammographic screening for breast cancer. In addition, a joinpoint trend analysis was performed for breast cancer screening rates among various subgroups.
RESULTS
In 2020, the breast cancer screening rate was 63.5%, reflecting an annual increase of 7.72% (95% confidence interval 5.53 to 9.95) between 2005 and 2012, followed by non-significant trends thereafter. In particular, a significant decrease in the breast cancer screening rate was observed in the subgroups aged 50-59 years old, with 12-15 years of education, and living in rural areas.
CONCLUSIONS
Although there has been substantial improvement in breast cancer screening rates in Korean women, the trend has flattened in recent years. Therefore, continual efforts are required to identify subgroups with unmet needs and solve barriers to the uptake of breast cancer screening.
Summary
Korean summary
본 연구는 2005년에서 2020년까지 암검진수검행태조사 자료를 이용하여 40세 이상의 우리나라 여성의 유방암 검진 수검률이 추이에 대해 분석하였다. 우리나라 유방암 검진 수검률은 2020년 현재 63.5%이다. 하지만 지속적으로 증가하던 유방암 검진 수검률의 추이는 2012년 이후 정체되어 있으며 일부 사회경제적 계층에서는 감소하는 경향을 보였다.
Key Message
In Korea, despite of the high level of breast cancer screening rate, decreasing trends in some socioeconomic classes after 2012. Continual efforts are required to identify subgroup with unmet needs and barriers to the uptake of breast cancer screening.

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Smokeless tobacco consumption and its association with tobacco control factors in the Western Pacific Region: results from the Global Youth Tobacco Survey 2015-2019
Chandrashekhar T. Sreeramareddy, Anusha Manoharan
Epidemiol Health. 2022;44:e2022103.   Published online November 8, 2022
DOI: https://doi.org/10.4178/epih.e2022103
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AbstractAbstract AbstractSummary PDFSupplementary Material
Abstract
OBJECTIVES
We estimated the prevalence of smokeless tobacco (ST) consumption and its associations with tobacco control factors among school-going youth in 18 Western Pacific Region (WPR) countries.
METHODS
We analyzed school-based Global Youth Tobacco Survey (2014-2019) microdata from 18 WPR countries and estimated weighted prevalence rates of ST consumption, cigarette smoking, and dual use. We used multilevel binary logistic regression to examine the associations of ST consumption and dual use with demographic variables, exposure to pro-tobacco and anti-tobacco factors, national income, and MPOWER indicators.
RESULTS
Data from 58,263 school-going youth were analyzed. The prevalence of past 30-day ST consumption was highest in Kiribati (42.1%), the Marshall Islands (26.1%), Micronesia (21.3%), Palau (16.0%), and Papua New Guinea (15.2%). In adjusted multilevel models, ST consumption and dual use were significantly associated with sex, age, parental smoking, pro-tobacco factors, national income, and MPOWER score. For each unit increase in score for cessation programs, we observed approximately 1.4-fold increases in the odds of youth ST consumption (adjusted odds ratio [aOR], 1.38; 95% confidence interval [CI], 1.15 to 1.66) and dual use (aOR, 1.47; 95% CI, 1.16 to 1.86). Similarly, for each unit increase in score for health-related warnings, the odds of both ST consumption (aOR, 0.47; 95% CI, 0.42 to 0.53) and dual use (aOR, 0.35; 95% CI, 0.30 to 0.42) decreased by approximately 60%.
CONCLUSIONS
The prevalence of youth ST consumption was substantial in the Pacific Islands, exceeding that of cigarette smoking in some countries. Implementing MPOWER measures for ST products could help reduce ST consumption.
Summary
Key Message
The prevalence of smokeless tobacco consumption, and cigarette smoking is considerably high among the school going youth in five pacific island nations of Western Pacific Region. Exposure to pro-tobacco factors and parental smoking were positively associated with youth smokeless tobacco consumption as well as dual use (both smokeless tobacco and cigarettes smoking) Closer monitoring and strict tobacco control policies are needed to prevent further escalation of smokeless tobacco consumption.

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Socio-demographic inequalities in the uptake of Papanicolaou tests in Peru: analysis of the 2015-2017 Demographic and Family Health Survey
Antonio Barrenechea-Pulache, Emmanuel Avila-Jove, Akram Hernández-Vásquez, Fernando M. Runzer-Colmenares
Epidemiol Health. 2020;42:e2020043.   Published online June 18, 2020
DOI: https://doi.org/10.4178/epih.e2020043
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AbstractAbstract PDF
Abstract
OBJECTIVES
This study was conducted to analyze the inequalities in Papanicolaou test (also referred to as the Pap smear) uptake according to the socio-demographic characteristics of Peruvian women 30 years to 59 years of age using information from the 2015-2017 Demographic and Family Health Survey (ENDES, acronym in Spanish).
METHODS
This is an analytical, cross-sectional study based on information acquired from the 2015-2017 ENDES surveys. Socio-demographic characteristics were reported using absolute frequencies and weighted proportions with 95% confidence intervals, considering results with a p-value <0.05 as statistically significant. Concentration curves (CCs) and concentration indices (IndCs) were created based on the interaction of the wealth index and uptake of Pap smears, taking into account the different characteristics of the population studied for the measure of inequalities.
RESULTS
All the CCs were distributed below the line of equality. Similarly, all the IndCs were higher than zero, indicating inequality in the uptake of Pap smears, favoring those with a higher wealth index. The highest IndC values were obtained from women aged 50-59 (IndC, 0.293), those who lived in the jungle (IndC, 0.230), and those without health insurance (IndC, 0.173).
CONCLUSIONS
We found socio-demographic inequalities in the uptake of Pap smears in Peru, favoring women with a higher wealth index. More funding is needed to promote cervical cancer screening programs and to create systems that ensure equal access to healthcare in Peru.
Summary

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  • Desigualdades en el acceso a la atención oncológica en las ciudades del sur del Perú: Una realidad urgente
    Richard Ponce-Cusi, María del Pilar Urday-Huarilloclla, Edwin Germán Lázaro-Valdivia, Grovert Quino-Villanueva
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Determinants of early initiation of breastfeeding in Peru: analysis of the 2018 Demographic and Family Health Survey
Akram Hernández-Vásquez, Horacio Chacón-Torrico
Epidemiol Health. 2019;41:e2019051.   Published online December 25, 2019
DOI: https://doi.org/10.4178/epih.e2019051
  • 29,803 View
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AbstractAbstract PDF
Abstract
OBJECTIVES
Early initiation of breastfeeding (EIBF) is one of the most cost-effective strategies to reduce neonatal mortality. We sought to determine the prevalence and determinants of EIBF in Peru.
METHODS
We performed a cross-sectional analytical study of the 2018 Peruvian Demographic and Family Health Survey as a secondary data source. In total, 19,595 children born during the 5 years prior to the survey were included in the study. The dependent variable (EIBF status), socio-demographic variables, and pregnancy-related variables were analyzed using a multivariate logistic regression model to identify the determinants of EIBF.
RESULTS
The prevalence of EIBF in the study population was 49.7%. Cesarean deliveries were associated with a lower likelihood of EIBF (adjusted odds ratio [aOR], 0.06; 95% confidence interval [CI], 0.05 to 0.07) than were vaginal deliveries. Newborns born at public health centers (aOR, 1.37; 95% CI, 1.15 to 1.65) had a higher rate of EIBF than those not born at public or private health centers. Women from the jungle region (aOR, 2.51; 95% CI, 2.17 to 2.89) had higher odds of providing EIBF than those from the coast. Mothers with more than a secondary education (aOR, 0.65; 95% CI, 0.55 to 0.76) were less likely to breastfeed during the first hour of the newborn’s life than women with primary or no education.
CONCLUSIONS
More than half of Peruvian children do not breastfeed during the first hour after birth. The major determinants of EIBF status were the delivery mode and the region of maternal residence. Strategies are needed to promote early breastfeeding practices.
Summary

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    Tam Thi Thanh Nguyen, Kimihiro Nishino, Lan Thi Huong Le, Souphalak Inthaphatha, Eiko Yamamoto
    Nutrients.2023; 15(21): 4501.     CrossRef
  • Effects of maternal education on early initiation and exclusive breastfeeding practices in sub-Saharan Africa: a secondary analysis of Demographic and Health Surveys from 2015 to 2019
    Wako Golicha Wako, Zelalem Wayessa, Anteneh Fikrie
    BMJ Open.2022; 12(3): e054302.     CrossRef
  • Timing of Breastfeeding Initiation Mediates the Association between Delivery Mode, Source of Breastfeeding Education, and Postpartum Depression Symptoms
    Xinran Shen, Shunna Lin, Hui Li, Nubiya Amaerjiang, Wen Shu, Menglong Li, Huidi Xiao, Sofia Segura-Pérez, Rafael Pérez-Escamilla, Xin Fan, Yifei Hu
    Nutrients.2022; 14(14): 2959.     CrossRef
  • Determinants of early initiation of breast feeding among mothers of children aged less than 24 months in Ethiopia: A community-based cross-sectional study
    Sewunet Sako, Girma Gilano, Be'emnet Tekabe, Sintayehu Abebe
    BMJ Open.2022; 12(10): e062905.     CrossRef
  • Socioeconomic determinants and inequalities in exclusive breastfeeding among children in Peru
    Akram Hernández-Vásquez, Rodrigo Vargas-Fernández
    Frontiers in Nutrition.2022;[Epub]     CrossRef
Development and validation of a sunlight exposure questionnaire for urban adult Filipinos
Marc Gregory Yu, Nina Castillo-Carandang, Maria Elinor Grace Sison, Angelique Bea Uy, Katrina Lenora Villarante, Patricia Maningat, Elizabeth Paz-Pacheco, Eileen Abesamis-Cubillan
Epidemiol Health. 2018;40:e2018050.   Published online October 11, 2018
DOI: https://doi.org/10.4178/epih.e2018050
  • 32,453 View
  • 274 Download
  • 5 Web of Science
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AbstractAbstract PDF
Abstract
OBJECTIVES
To develop and validate a self-reported sunlight exposure questionnaire (SEQ) for urban adult Filipinos.
METHODS
The study included adults (19-76 years old) in Metro Manila, Philippines, well-versed in the Filipino (Tagalog) language and had resided in Metro Manila for at least 1 year. Exclusion criteria included pregnancy, active skin disorders, and immunocompromised states. An expert panel created a questionnaire in Likert-scale format based on a conceptual framework and 4 existing instruments. The study proceeded in 4 phases: questionnaire item development, translation and back-translation, pretesting, and construct validity and reliability testing using factor analysis, the Cronbach alpha coefficient, and the paired t-test.
RESULTS
A 25-item, self-administered, Filipino (Tagalog) SEQ answerable using a 4-point Likert scale was created. The questionnaire was administered to 260 adult participants twice at a 2-week interval, with all participants completing both the first and second rounds of testing. All questionnaire items possessed adequate content validity indices of at least 0.86. After factor analysis, 3 questionnaire domains were identified: intensity of sunlight exposure, factors affecting sunlight exposure, and sun protection practices. Internal consistency was satisfactory for both the overall questionnaire (Cronbach alpha, 0.80) and for each of the domains (Cronbach alpha, 0.74, 0.71, and 0.72, respectively). No statistically significant differences were observed in the responses between the first and second rounds of testing, indicating good test-retest reliability.
CONCLUSIONS
We developed a culturally-appropriate SEQ with sufficient content validity, construct validity, and reliability to assess sunlight exposure among urban adult Filipinos in Metro Manila, Philippines.
Summary

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  • Reliability and validity of the Chinese version of the sunlight exposure questionnaire
    Xiaoxia Wang, Qin Wang, Zhe Li, Mengjie Chen, Maoting Guo, Laixi Kong, Liyuan Chen, Xiaolong Li, Junjun Li, Qieyan Cao, Zhenhua Luo, Zhenzhen Xiong, Dan Zhao
    Frontiers in Public Health.2024;[Epub]     CrossRef
  • Development and Validation of Vitamin D- Food Frequency Questionnaire for Moroccan Women of Reproductive Age: Use of the Sun Exposure Score and the Method of Triad’s Model
    Noura Zouine, Ilham Lhilali, Aziza Menouni, Lode Godderis, Adil El Midaoui, Samir El Jaafari, Younes Zegzouti Filali
    Nutrients.2023; 15(4): 796.     CrossRef
  • Sun Exposure Score and Vitamin D Levels in Moroccan Women of Childbearing Age
    Ilham Lhilali, Noura Zouine, Aziza Menouni, Lode Godderis, Marie-Paule Kestemont, Adil El Midaoui, Samir El Jaafari, Younes Filali-Zegzouti
    Nutrients.2023; 15(3): 688.     CrossRef
  • Vitamin D Deficiency and Diseases
    Yasir Mahmood, Nazish Waris, Asher Fawwad, Abdul Basit
    Journal of Diabetology.2021; 12(4): 391.     CrossRef
  • Association of sunlight exposure with 25-hydroxyvitamin D levels among working urban adult Filipinos
    Noemie Marie M. Mansibang, Marc Gregory Y. Yu, Cecilia A. Jimeno, Frances Lina Lantion-Ang
    Osteoporosis and Sarcopenia.2020; 6(3): 133.     CrossRef
Physician’s awareness of lung cancer screening and its related medical radiation exposure in Korea
Seri Hong, Suyeon Kim, Mina Suh, Boyoung Park, Kui Son Choi, Jae Kwan Jun
Epidemiol Health. 2018;40:e2018002.   Published online January 20, 2018
DOI: https://doi.org/10.4178/epih.e2018002
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AbstractAbstract AbstractSummary PDFSupplementary Material
Abstract
OBJECTIVES
Through a survey on perception of lung cancer screening and accompanying medical radiation exposure in Korea, the present study was to investigate its current situations and evaluate various perception of physicians regarding it in order to propose measures for improvements.
METHODS
Medical specialists in national cancer screening institutions selected through stratified random sampling were subjected to face-to-face interview using a structured questionnaire. We investigated physicians’ perception on effectiveness of lung cancer screening depending on screening modality, selection criteria for subjects of screening, types of equipment used to screen, and perception for seriousness of adverse effects following the test. In addition, odds ratios to underestimate risk of radiation exposure from screening were calculated through logistic regression analysis.
RESULTS
Each response that chest X-ray is effective for lung cancer screening and that smoking history is not considered prior to screening recommendation accounted for more than 60% of respondents, suggesting the chance of unnecessary screening tests. Regarding adverse effects of lung cancer screening, about 85% of respondents replied that false positive, radiation exposure, and overdiagnosis could be ignored. About 70% of respondents underestimated radiation dose from lung cancer screening, and a low proportion of physicians informed patients of radiation exposure risk.
CONCLUSIONS
It was found that most physicians underestimated harms of lung cancer screening including radiation exposure and were lack of awareness regarding lung cancer screening. It should be noted that physicians need to have proper perceptions about screening recommendation and accompanying possible harms, for successful implementation of the screening program.
Summary
Korean summary
전국 100여개 국가암검진 기관을 대상으로 폐암검진 관련 설문을 수행한 결과, 효과적인 폐암검진의 수단이나 방법에 대한 이해 및 검사에 수반되는 각종 부작용에 대한 의사들의 인식이 확연히 부족한 것으로 조사되었다. 그 중에서도 특히 의료방사선 노출에 대한 낮은 인지도는, 촬영 시 피폭량에 대한 전반적인 과소평가 및 방사선 노출 위험과 관련한 환자 교육의 부재를 통해 확인할 수 있었다. 인구집단 대상 선별검사의 도입에 따른 잠재적인 위해 가능성과 그 결과에 대한 고민은 반드시 필요하며, 이와 관련된 의료제공자들의 인식 개선을 촉구하는 본 연구는 정책 도입에 앞서 선결되어야 할 과제로서 공중보건학적 측면에서 중요한 의의를 지닌다.

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  • Assessment of radiation knowledge and awareness among radiology staff in tertiary hospitals: a study in Wuxi, China
    J. Yuan, D. Liu, J. Ni
    Radioprotection.2024; 59(3): 184.     CrossRef
  • Why is the screening rate in lung cancer still low? A seven-country analysis of the factors affecting adoption
    Charlotte Poon, Tim Wilsdon, Iqra Sarwar, Alexander Roediger, Megan Yuan
    Frontiers in Public Health.2023;[Epub]     CrossRef
  • Why clinicians overtest: development of a thematic framework
    Justin H. Lam, Kristen Pickles, Fiona F. Stanaway, Katy J. L. Bell
    BMC Health Services Research.2020;[Epub]     CrossRef
Data Profile
The current status of health data on Korean children and adolescents
Eunyoung Lee, Dahye Baik, Yoon Park, Moran Ki
Epidemiol Health. 2017;39:e2017059.   Published online December 26, 2017
DOI: https://doi.org/10.4178/epih.e2017059
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AbstractAbstract AbstractSummary PDFSupplementary Material
Abstract
Childhood and adolescence are critical periods that affect adults’ health status. Therefore, the factors influencing the health of children and adolescents should be analyzed. In Korea, a wide range of youth-related health data has been obtained, both on the regional level and on the national level. This report summarizes the current status of studies related to the health of Korean children and adolescents. Data for which open access is offered include the Korea Youth Risk Behavior Web-based Study, the Panel Study on Korean Children, the Korean Youth Panel Survey, the Korean Children and Youth Panel Survey, and the Student Health Examination. In addition, the Health Examination of Korean Youth Outside of School, the Korean Children and Adolescents Obesity Cohort Study, the Korean Children’s Environmental Health Study, the Korea Youth Media Use and Harmful Environment Survey, the Comprehensive Survey of Korean Youth, and the Multicultural Adolescents Panel Study are summarized.
Summary
Korean summary
청소년시기는 성인의 건강상태에 영향을 미치는 중요한 시기이다. 따라서 청소년의 건강에 영향을 미치는 여러 가지 요소들에 대한 분석이 필요하다. 한국에서 청소년건강과 관련한 데이터는 지역 단위에서뿐 아니라 국가 단위에서도 수집되고 있다. 해당 데이터가 공개되고 있는 것으로는 청소년건강행태온라인조사, 한국아동패널, 한국청소년패널조사, 한국아동ㆍ청소년패널조사, 학교건강검사가 있다. 이외에도 학교 밖 청소년 건강검진조사, 소아비만 및 대사질환 코호트, 어린이 환경 보건 출생코호트, 청소년 매체이용 및 유해환경 실태조사, 청소년 종합실태조사, 다문화청소년패널조사를 요약하였다.

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  • Relevance of self-rated health level and mental health in Korean adolescents
    Yunjeong Kim, Joohee Shim
    Frontiers in Public Health.2025;[Epub]     CrossRef
  • Dietary intake and nutritional status of Korean children and adolescents: a review of national survey data
    Minji Kang, So Yoon Choi, Minyoung Jung
    Clinical and Experimental Pediatrics.2021; 64(9): 443.     CrossRef
  • Benefits of cooperation among large-scale cohort studies and human biomonitoring projects in environmental health research: An exercise in blood lead analysis of the Environment and Child Health International Birth Cohort Group
    Shoji F. Nakayama, Carolina Espina, Michihiro Kamijima, Per Magnus, Marie-Aline Charles, Jun Zhang, Birgit Wolz, André Conrad, Aline Murawski, Miyuki Iwai-Shimada, Cécile Zaros, Ida Henriette Caspersen, Marike Kolossa-Gehring, Helle Margrete Meltzer, Sjur
    International Journal of Hygiene and Environmental Health.2019; 222(8): 1059.     CrossRef
Perspective
The direction of restructuring of a Korea field epidemiology training program through questionnaire survey among communicable disease response staff in Korea
Moo Sik Lee, Kwan Lee, Jee-Hyuk Park, Jee-Young Hong, Min-Young Jang, Byoung-Hak Jeon, Sang-Yun Cho, Sun-Ja Choi, JeongIk Hong
Epidemiol Health. 2017;39:e2017032.   Published online July 24, 2017
DOI: https://doi.org/10.4178/epih.e2017032
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AbstractAbstract AbstractSummary PDFSupplementary Material
Abstract
We used a survey about the need for an educational training of infectious disease response staff in Korea Centers for Disease Control and Prevention (KCDC) and officer in metropolitan cities and provincial government to conduct field epidemiological investigation. The survey was conducted from January 25 to March 15, 2016. A total of 173 participants were selected from four different groups as follows: 27 clinical specialists, 22 Epidemic Intelligence Service (EIS) officers, 82 KCDC staff, and 42 local health department officials. Results revealed that 83% of KCDC staff and 95% of local health department officials agreed on the need for educational training to strengthen capability of personnel to conduct epidemic research and investigation. The level of their need for training was relatively high, while self-confidence levels of individuals to conduct epidemic research and investigation was low. It was concluded that there was a need to develop training programs to enhance the ability of public health officials, EIS officers, KCDC staff, and local health department personnel to conduct epidemic research and investigation.
Summary
Korean summary
2015년 한국의 메르스 유행후 한국의 감염병 대응인력을 대상으로 한 조사분석을 통하여 역학조사관 교육 개편의 필요성을 확인하고, 세부 교육과정, 방법 및 내용 등 포괄적인 교육강화 및 개선방안을 모색하여 향후 역학조사관 신규 교육프로그램의 개발과 역량강화 방안을 제시하였다.

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  • Perceived sources of occupational burn-out and embitterment among front-line health workers for COVID-19 control in Gyeonggi province, South Korea: a qualitative study
    Bee-Ah Kang, Sijoung Kwon, Myoungsoon You, Heeyoung Lee
    Occupational and Environmental Medicine.2022; 79(4): 245.     CrossRef
Method
Assessing measurement error in surveys using latent class analysis: application to self-reported illicit drug use in data from the Iranian Mental Health Survey
Kazem Khalagi, Mohammad Ali Mansournia, Afarin Rahimi-Movaghar, Keramat Nourijelyani, Masoumeh Amin-Esmaeili, Ahmad Hajebi, Vandad Sharif, Reza Radgoodarzi, Mitra Hefazi, Abbas Motevalian
Epidemiol Health. 2016;38:e2016013.   Published online April 10, 2016
DOI: https://doi.org/10.4178/epih.e2016013
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AbstractAbstract PDF
Abstract
Latent class analysis (LCA) is a method of assessing and correcting measurement error in surveys. The local independence assumption in LCA assumes that indicators are independent from each other condition on the latent variable. Violation of this assumption leads to unreliable results. We explored this issue by using LCA to estimate the prevalence of illicit drug use in the Iranian Mental Health Survey. The following three indicators were included in the LCA models: five or more instances of using any illicit drug in the past 12 months (indicator A), any use of any illicit drug in the past 12 months (indicator B), and the self-perceived need of treatment services or having received treatment for a substance use disorder in the past 12 months (indicator C). Gender was also used in all LCA models as a grouping variable. One LCA model using indicators A and B, as well as 10 different LCA models using indicators A, B, and C, were fitted to the data. The three models that had the best fit to the data included the following correlations between indicators: (AC and AB), (AC), and (AC, BC, and AB). The estimated prevalence of illicit drug use based on these three models was 28.9%, 6.2% and 42.2%, respectively. None of these models completely controlled for violation of the local independence assumption. In order to perform unbiased estimations using the LCA approach, the factors violating the local independence assumption (behaviorally correlated error, bivocality, and latent heterogeneity) should be completely taken into account in all models using well-known methods.
Summary
Original Articles
Community mental health status six months after the Sewol ferry disaster in Ansan, Korea
Hee Jung Yang, Hae Kwan Cheong, Bo Youl Choi, Min-Ho Shin, Hyeon Woo Yim, Dong-Hyun Kim, Gawon Kim, Soon Young Lee
Epidemiol Health. 2015;37:e2015046.   Published online October 23, 2015
DOI: https://doi.org/10.4178/epih/e2015046
  • 34,903 View
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AbstractAbstract AbstractSummary PDFSupplementary Material
Abstract
OBJECTIVES
The disaster of the Sewol ferry that sank at sea off Korea’s southern coast of the Yellow Sea on April 16, 2014 was a tragedy that brought grief and despair to the whole country. The aim of this study was to evaluate the mental health effects of this disaster on the community of Ansan, where most victims and survivors resided.
METHODS
The self-administered questionnaire survey was conducted 4 to 6 months after the accident using the Korean Community Health Survey system, an annual nationwide cross-sectional survey. Subjects were 7,076 adults (≥19 years) living in two victimized communities in Ansan, four control communities from Gyeonggi-do, Jindo and Haenam near the accident site. Depression, stress, somatic symptoms, anxiety, and suicidal ideation were measured using the Center for Epidemiologic Studies-Depression Scale, Brief Encounter Psychosocial Instrument, Patient Health Questionnaire-15, and Generalized Anxiety Disorder 7-Item Scale, respectively.
RESULTS
The depression rate among the respondents from Ansan was 11.8%, and 18.4% reported suicidal ideation. Prevalence of other psychiatric disturbances was also higher compared with the other areas. A multiple logistic regression analysis revealed significantly higher odds ratios (ORs) in depression (1.66; 95% confidence interval [CI], 1.36 to 2.04), stress (1.37; 95% CI, 1.10 to 1.71), somatic symptoms (1.31; 95% CI, 1.08 to 1.58), anxiety (1.82; 95% CI, 1.39 to 2.39), and suicidal ideation (1.33; 95% CI, 1.13 to 1.56) compared with Gyeonggi-do. In contrast, the accident areas of Jindo and Haenam showed the lowest prevalence and ORs.
CONCLUSIONS
Residents in the victimized area of Ansan had a significantly higher prevalence of psychiatric disturbances than in the control communities.
Summary
Korean summary
본 연구는 2014년 4월 16일 발생한 세월호 침몰 사고가 지역사회의 정신건강 수준에 미친 영향을 평가하기 위해 실시하였다. 2014년 지역사회건강조사를 활용, 사고 후 6개월 시점에 조사를 시행하였다. 대부분의 희생자가 발생한 안산시 대상자의 11.8%가 우울군으로 분류되었으며, 18.4%가 자살생각을 호소하였고, 그 밖의 유병률도 대조 지역에 비해 높았다.

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Test-retest reliability of health behavior items in the Community Health Survey in South Korea
Soo Jeong Kim, Jin A Han, Young Hwa Kim, Bo Youl Choi, Su Young Kim, Hun Je Lee, In Hwan Oh, Sung-il Cho, Jakyoung Lee, Soon Young Lee
Epidemiol Health. 2015;37:e2015045.   Published online October 20, 2015
DOI: https://doi.org/10.4178/epih/e2015045
  • 33,260 View
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  • 11 Web of Science
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AbstractAbstract AbstractSummary PDF
Abstract
OBJECTIVES
Responses to health-related items on the Community Health Survey (CHS) provide evidence that is used to develop community-based health policy. This study aimed to assess the test-retest reliability of selected health behavioral items on the CHS according to item category, response period, and response scale.
METHODS
A sample of 159 men and women 20 to 69 years of age participated in a test-retest with an interval of 14 to 21 days. A total of 28 items relating to smoking, alcohol consumption, diet and weight control, and mental health were selected. We evaluated the test-retest reliability of the items using kappa statistics.
RESULTS
Kappa values ranged from 0.44 to 0.93. Items concerning habits had higher kappa values (mean, 0.7; standard error, 0.05) than items concerning awareness or attitudes (p=0.012). The kappa value of items with two- to four-point scales was 0.63, which was higher than the value of 0.59 for items with scales involving five or more points, although this difference was not statistically significant. Different kappa values were observed for each reference period, but no statistically significant differences were noted.
CONCLUSIONS
The test-retest reliability of the CHS items that we studied was associated with item category. Further study of the relationship between item category and reliability in domains other than health behaviors is required.
Summary
Korean summary
이 연구는 지역사회건강조사의 건강행태 문항 중 28개 문항에 대하여 문항의 특성, 준거기간, 보기의 척도에 따라 조사-재조사 신뢰도의 차이를 분석하였다. 전체 문항의 카파값의 범위는 0.44-0.93이었다. 문항의 특성별로는 인지 또는 태도에 비해 습관에 관한 문항의 신뢰도가 높았으며, 보기의 척도가 5점 척도 이상에 비해 2-4점 척도의 신뢰도가 높음을 확인하였다.

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Using Formative Research to Design an Epidemiologic Survey: The North Carolina Study of Home Care and Hospice Nurses
Jack K. Leiss, Jennifer T. Lyden, Cynthia Klein
Epidemiol Health. 2011;33:e2011008.   Published online September 7, 2011
DOI: https://doi.org/10.4178/epih/e2011008
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AbstractAbstract PDF
Abstract
<sec><title>OBJECTIVES</title><p>Formative research can serve as a means of obtaining important information for designing an epidemiologic study, but descriptions of this approach in the epidemiologic literature are lacking. The objective of this paper is to describe the use of three formative research techniques in designing a survey of home care and hospice nurses.</p></sec><sec><title>METHODS</title><p>We conducted two focus groups, seven key informant interviews, and approximately fifteen hours of direct observation among home care and hospice nurses recruited by word of mouth in North Carolina in 2006.</p></sec><sec><title>RESULTS</title><p>We used information obtained from the formative research to decide which survey design would likely be most successful with this population (mail survey, as opposed to Internet survey or in-person interviews), which measure to use for the denominator of the blood exposure incidence rates (number of visits, as opposed to patient-time), and which items and response options to include in the questionnaire, as well as to identify specific survey techniques that would likely increase the response rate (emphasizing the regional focus of the study; sending the questionnaire to the home address).</p></sec><sec><title>CONCLUSION</title><p>When particular information for planning a study is unavailable from the literature or the investigator's experience, formative research can be an effective means of obtaining that information.</p></sec>
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