Journal of Preventive Medicine and Public Health最新文献

Objective: Excessive sedentary behavior in youth is a major global issue, contributing to the rise in childhood obesity and metabolic diseases. International public health authorities have issued guidelines recommending that children and adolescents limit their daily sedentary time, including screen time. However, to date, no studies have explored the relationship between sedentary behavior as an exposure factor and skeletal muscle strength and mass as outcomes in this population. The present study investigated the association of sedentary behavior with handgrip strength (HGS) and appendicular lean mass (ALM) among US adolescents.

Methods: A total of 1,449 adolescent participants from the National Health and Nutrition Examination Survey (2011-2014) were included. Information on sedentary behavior, specifically daily sedentary time, was obtained through a self-reported questionnaire. Muscular parameters, including HGS and ALM, were measured. To adjust for differences in body size, these parameters were divided by body mass index (BMI) and weight. Linear regression analyses were performed to evaluate the associations between daily sedentary time and each muscular parameter, adjusting for age, sex, ethnicity, annual family income, and moderate-to-vigorous physical activity (MVPA).

Results: The linear regression analyses revealed negative associations between daily sedentary time and all muscular parameters, apart from absolute ALM. These included HGS (β=-0.2652, standard error [SE]=0.0740; p=0.0011), HGS/BMI (β=-0.0215, SE=0.0044; p<0.0001), HGS/weight (β=-0.0079, SE=0.0016; p<0.0001), ALM/BMI (β=-0.0083, SE=0.0030; p=0.01), and ALM/weight (β=-0.0030, SE=0.0010; p=0.0047).

Conclusions: After adjusting for MVPA, daily sedentary time was inversely associated with HGS, HGS/BMI, HGS/weight, ALM/BMI, and ALM/weight in US adolescents.

Objective: Immunization has been identified as a specific nutrition-related intervention to address the direct causes of stunting. This study examines the association between basic immunization status and stunting among toddlers in Indonesia.

Methods: We conducted a cross-sectional analysis using data from the 2021 Study of Indonesia's Nutritional Status. A total of 70,267 toddlers, aged 12 to 59 months, were examined. Cox regression was employed to calculate prevalence ratios (PRs) with their 95% confidence intervals (CIs).

Results: The prevalence of stunting among children aged 12 to 59 months in Indonesia was 23.1%, while 74.92% of children under 5 years old had complete basic immunization status. Multivariable analysis revealed a statistically significant association between basic immunization status and the incidence of stunting. Relative to toddlers with complete basic immunization, those with incomplete (partial) immunization were at a 1.18 times higher risk of stunting (adjusted PR, 1.18; 95% CI, 1.15 to 1.22). Furthermore, toddlers who had not been immunized at all faced an even greater stunting risk (adjusted PR, 1.27; 95% CI, 1.17 to 1.37). This association persisted after adjusting for variables such as maternal education, economic status, and the child's birth weight.

Conclusions: Basic immunization status influences the incidence of stunting in toddlers aged 12 to 59 months. Thus, parents must ensure that their children's immunizations are completed according to the recommended schedule. Additionally, it is crucial to increase parental awareness regarding health service utilization, disease prevention, and the nutritional needs of toddlers.

Objective: Extensive research has been conducted on digital addiction, particularly concerning internet, gaming, and smartphone use among adolescents and young adults. However, there is limited information about digital addiction in adults, especially in relation to physical activity. This study investigated the prevalence of digital addiction among Korean adults and explored its association with physical activity across various age groups.

Methods: Using data from the 2023 Community Health Survey (n=231,752), this study estimated the prevalence of digital addiction, defined as experiencing impaired daily functioning due to excessive internet, gaming, or smartphone use. Physical activity was defined as exercise and regular walking. Multiple logistic regression was conducted to examine the association between physical activity and digital addiction in the full sample and by age group (under 40, 40-59, and 60+ years).

Results: In 2023, the prevalence of digital addiction among adults was estimated to be 12.0%. Significantly higher odds of digital addiction were observed in younger age groups. Individuals who reported perceived stress or depression were at an increased risk for digital addiction. Conversely, physical activity was linked to a reduced risk of digital addiction, with odds ratios of 0.96 (p<0.05) for exercise and 0.93 (p<0.001) for regular walking. Notably, regular walking was associated with a reduced risk of digital addiction only in the 40-59 age group.

Conclusions: Physical activity, particularly regular walking, is linked to a lower risk of digital addiction in Korean adults. Encouraging regular walking may help reduce digital addiction among middle-aged adults.

Objective: Adhering to management guidelines, including routine follow-up and education, is crucial for the effective management of chronic diseases such as diabetes. Uncontrolled diabetes is linked to poor sleep quality. We used nationally representative data from community-dwelling Koreans to investigate potential associations between non-adherence to diabetes management and poor sleep quality.

Methods: Of the 228,340 participants in the 2018 Korea Community Health Survey, we analyzed data from 68,246 participants aged 65 years and older. Based on their diabetes status and adherence to diabetes-related tests (glycated hemoglobin, fundus examination, and urine microalbuminuria) and management education, study participants were divided into 3 groups: no diabetes, adherence, and non-adherence. Outcome variables included poor overall sleep quality and sleep disturbances, as measured by the Pittsburgh Sleep Quality Index.

Results: The study included 934 participants in the adherence group (2.0%) and 13,420 in the non-adherence group (20.2%). Participants displaying non-adherence were significantly more likely to report poor overall sleep quality (adjusted odds ratio [aOR], 1.09; 95% confidence interval [CI], 1.04 to 1.13) and to experience sleep fragmentation, nocturia, pain during sleep, and difficulty falling asleep compared to participants without diabetes. Even in the earlier stage of diabetes, non-adherent participants were more likely to report poor sleep quality (aOR, 1.06; 95% CI, 1.001 to 1.18).

Conclusions: Patients with diabetes who do not follow management guidelines are more likely to experience poor sleep quality than those without diabetes. Emphasizing diabetes management and increasing awareness of management strategies may improve sleep quality among patients with this disease.

Objective: This study was performed to investigate the prevalence of falls, mental health issues, and health behaviors among older adults, as well as to analyze the association between multiple falls and mental health status in this population.

Methods: We utilized data from the 2017, 2019, and 2021 Korean Community Health Survey, a nationwide survey organized by region and conducted by the Korea Disease Control and Prevention Agency. Participants were categorized into no-fall, single-fall, and multiple-fall groups based on responses to an index question regarding fall experiences and the number of such incidents reported in the survey. The chi-square test was applied to understand the characteristics of the elderly population in the community. Subsequently, multinomial logistic regression analysis was conducted to clarify the association between falls and mental health.

Results: Integrated data analysis revealed that 11.3% of participants experienced a single fall, while 5.7% reported multiple falls. Participants from low-education and low-income backgrounds exhibited relatively high rates of falls. Additionally, non-drinkers and non-smokers reported falls more frequently than their counterparts who consumed alcohol and smoked. Multinomial logistic regression revealed significant associations between multiple falls and mental health factors. In particular, the severity of depression was directly proportional to the likelihood of experiencing multiple falls, with an odds ratio of 2.953 (95% confidence interval, 2.493 to 3.497).

Conclusions: We identified associations between various mental health-related factors-including sleep duration, subjective stress, the presence of depression, and Patient Health Questionnaire-9 score-and the occurrence of multiple falls.

Objective: Depression affects 23.3% of Thai and 15.2% of Vietnamese health science students, rates that exceed the global average of 4.4%. This study compared the causal models of mental health literacy and helping behavior toward individuals at risk of depression between these 2 groups.

Methods: This cross-sectional study was conducted from April to October 2023 and included 422 students from Thailand and Vietnam, who were studying medicine, nursing, psychology, and physical therapy. Stratified random sampling was used to select 211 students from each country. Data collection was performed using a Likert scale, which showed total-item correlations ranging from 0.24 to 0.83 and Cronbach's alpha values between 0.74 and 0.86. The data were analyzed using a structural equation model.

Results: The causal models were consistent with the empirical data. The helping behavior of students toward peers at risk of depression was significantly influenced by their mental health literacy (effect size [ES]=0.91). This influence was also mediated indirectly by self-efficacy (ES=0.18), positive attitudes (ES=0.29), and social support (ES=0.77). Collectively, these factors accounted for 83% of the variance in helping behavior. Social support had a more pronounced effect on mental health literacy among Vietnamese students than among their Thai counterparts (ES=0.46 vs. 0.27, p<0.05). Conversely, positive attitudes had a stronger influence among Thai students than among Vietnamese students (ES=0.17 vs. 0.01, p<0.05).

Conclusions: The causal models of helping behavior among Thai and Vietnamese health science students exhibited no significant differences. However, improving mental health literacy is crucial, as it significantly impacts helping behavior.

Objectives: Physical and mind-body exercises represent distinct intervention strategies that may improve sleep quality by influencing physiological and psychological factors. Nevertheless, their effectiveness in individuals with diabetes is not well-established. This systematic review and meta-analysis aimed to examine the impacts of physical and mind-body exercise interventions on sleep quality in patients with diabetes mellitus.

Methods: Six randomized controlled trials (RCTs) that met the inclusion criteria were identified from PubMed, CINAHL, Embase, Scopus, Web of Science, Cochrane, and Ovid-Medline Library. The effect size for sleep quality was calculated using the standardized mean difference (SMD) with a 95% confidence interval (CI), employing a random-effects model. Heterogeneity and publication bias were also examined, and subgroup, meta-regression, and sensitivity analyses were performed.

Results: Physical and mind-body exercise interventions significantly improved sleep quality, with an SMD of -1.040 (95% CI, -1.686 to -0.394). Subgroup analysis revealed significant differences with respect to the type of intervention (p=0.047), or its duration (p=0.282). Meta-regression analysis indicated that mean hemoglobin A1c level was the only factor to be significantly related to the effect size for sleep quality, demonstrating a negative association (p=0.033). The assessment of publication bias and the sensitivity analysis suggested that the findings were reliable and robust.

Conclusions: Physical and mind-body exercises may serve as effective interventions for patients with diabetes mellitus who experience poor sleep quality. However, to substantiate these findings, additional rigorous RCTs with larger sample sizes, longer follow-up periods, and standardized interventions are required.

Objectives: The purpose of this study is to examine the impact of subjective socioeconomic status and social capital on self-rated health and quality of life among a minority group in Iran.

Methods: This cross-sectional study involved 800 individuals from a minority group in Iran. The sampling method was clustering, and data collection was conducted using a questionnaire. Data analysis was performed using SPSS version 18 and Stata version 8.

Results: The results of logistic regression analysis revealed that subjective socioeconomic status (odds ratio [OR], 1.47; 95% confidence interval [CI], 1.34 to 1.61), belonging and empathy (OR, 1.09; 95% CI, 1.03 to 1.15), and trust (OR, 1.06; 95% CI, 1.00 to 1.13) significantly impacted the quality of life. Additionally, the logistic regression analysis for factors influencing self-rated health demonstrated significant effects for the age group of 31-50 years (OR, 0.59; 95% CI, 0.38 to 0.91), gender (OR, 0.65; 95% CI, 0.46 to 0.92), academic education (OR, 2.00; 95% CI, 1.22 to 3.26), subjective socioeconomic status (OR, 1.27; 95% CI, 1.16 to 1.38), chronic disease (OR, 4.52; 95% CI, 2.49 to 8.19), belonging and empathy (OR, 1.06; 95% CI, 1.01 to 1.11), and participation (OR, 1.12; 95% CI, 1.00 to 1.24).

Conclusions: The findings indicate that bonding social capital significantly influences health levels and quality of life. Focusing on delegating local responsibilities to community members and striving to promote participation in health programs, along with increasing the socioeconomic status of minority groups, can effectively improve their health and quality of life.

Objectives: This cross-sectional study investigated the association between the utilization of 8 antenatal care (ANC) visits and delivery in a healthcare institution in the Philippines, using data from the 2022 National Demographic and Health Survey.

Methods: A sample of women who had given birth within the past 3 years was selected for analysis (n=4452). The association between ANC utilization and institutional delivery was assessed using logistic regression models, covariates by relevant socio-demographic factors, and childbirth history.

Results: We found that 97.2% of respondents who completed ANC opted for institutional delivery. A higher proportion of rural residents did not undergo institutional delivery than urban residents (12.9 vs. 6.9%). The group aged 20-24 years had the highest coverage (92.8%), and the group aged 40-44 years had the lowest. Higher education levels, employment, and greater wealth were associated with higher institutional delivery rates. Divorced or widowed mothers (85.1%) and grand multiparous mothers had lower rates than other groups. Multivariable logistic regression analysis showed a significant positive association between ANC utilization and institutional deliveries after adjusting for covariates (adjusted odds ratio, 2.486; 95% confidence interval, 2.485 to 2.487; p<0.001).

Conclusions: ANC visits were associated with deliveries in institutions in the Philippines. Policymakers should promote ANC by ensuring 8 World Health Organization-recommended visits, strengthening programs, conducting community outreach, addressing access barriers, and integrating maternal health services to increase institutional births and improve maternal and infant health.

Objectives: This study examined the association between oral health-related quality of life (OHRQoL), as assessed by the Geriatric Oral Health Assessment Index (GOHAI), and cardiovascular disease (CVD) outcomes among Korean older adults.

Methods: Data from 5413 participants in the Korean Longitudinal Study of Aging were analyzed. GOHAI scores were categorized as either "poor" (<40) or "not poor" (≥40). Generalized estimating equation models were used to assess the relationship between GOHAI scores and CVD prevalence, with analyses stratified by sex.

Results: Poor GOHAI score was significantly associated with elevated odds of CVD (odds ratio [OR], 1.13; 95% confidence interval [CI], 1.07 to 1.19; p<0.001). This association was stronger in female (OR, 1.36) compared to male (OR, 1.12). Poor oral health is indicative of systemic inflammation and age-related vulnerabilities, underscoring the utility of the GOHAI as an instrument for early identification of CVD risk.

Conclusions: Poor oral health, as measured by the GOHAI, is associated with an increased risk of CVD among older adults, especially female. These findings support the use of the GOHAI as a cost-effective screening tool for the early assessment of CVD risk. Further research is warranted to explore inflammatory biomarkers and sex-specific mechanisms that could inform targeted interventions.