Journal of Preventive Medicine and Public Health最新文献

Objectives: Family caregivers play a crucial role in the care of children with human immunodeficiency virus (HIV); however, they frequently face limitations in knowledge, attitudes, and skills. Mobile application (app)-based training may offer an effective solution to enhance caregiver competence. This study aimed to assess the effectiveness of mobile app-based care management training in improving the knowledge, attitudes, and skills of family caregivers caring for children with HIV.

Methods: A quasi-experimental design, including pretest, posttest, and follow-up assessments, was conducted at a national referral hospital for infectious diseases in Jakarta, Indonesia. The study involved 44 respondents, divided equally into intervention and control groups (22 per group). The intervention group received mobile app-based training, while the control group received conventional caregiver education. Questionnaires assessing caregivers' knowledge, attitudes, and skills in managing children with HIV were utilized. Data were analyzed using independent sample t-tests and repeated measures analysis of variance (ANOVA).

Results: Repeated measures ANOVA revealed that the intervention group experienced significant improvements in knowledge, attitudes, and skills from pretest to posttest, which were maintained at the 1-month follow-up (p<0.001). In contrast, the control group did not exhibit significant changes in any of these variables (knowledge, attitudes, and skills) throughout the study period.

Conclusions: Mobile app-based care management training significantly enhances caregiving competencies among family caregivers of children with HIV. These findings underscore the potential of digital technology as an innovative and sustainable approach for caregiver training in various healthcare settings, supporting the long-term effectiveness of educational interventions.

Objectives: The association between sleep disturbances and hypertension has been reported in numerous studies. However, prospective cohort data on the role of sleep disturbances in the development of preeclampsia remain limited.

Methods: This prospective cohort study was conducted on pregnant women with a in Iran. Sleep quality was assessed at the first prenatal visit (gestational age ≤14 weeks) using the Pittsburgh Sleep Quality Index (PSQI) questionnaire. Multivariate logistic regression was run to investigate the independent role of sleep abnormalities in the development of preeclampsia.

Results: The final analysis was performed on 576 participants, of whom 3.5% developed preeclampsia. In the univariate analysis, short sleep duration (< 6 hours) and prolonged sleep latency was associated with a 5.5 times and 3.5 times higher risk of developing preeclampsia (95% confidence interval [CI], 1.5 to 20.9; p=0.011, and 95% CI, 1.2 to 10.1; p=0.019, respectively). Considering the total PSQI score, fairly bad or very bad sleep quality was a risk factor for developing preeclampsia, with a relative risk of 4.9 in the univariate analysis (95% CI, 1.4 to 17.8; p=0.014). In the fully adjusted model, short sleep duration and prolonged sleep latency were associated with 7.2 times and 4.5 times higher risk of preeclampsia, respectivey (95% CI, 1.6 to 33.1; p=0.011 and 95% CI, 1.4 to 14.6; p=0.012, respectively). In this model, pregnant women with fairly bad or very bad sleep quality had 5.9 times higher risk of preeclampsia development (95% CI, 1.5 to 22.8; p=0.011).

Conclusions: This cohort study demonstrated the role of short sleep duration and prolonged sleep latency as the main components of poor sleep quality in the development of preeclampsia.

Objectives: Accurate and complete cancer staging is essential for effective prognosis and treatment planning. This study investigated the feasibility of enhancing the completeness of tumor-node-metastasis (TNM) staging by integrating Surveillance, Epidemiology, and End Results (SEER) Summary Stage data.

Methods: We analyzed data from 5 cancer types (stomach, colorectum, liver, lung, and breast) in Korea (2012-2017). The study assessed the impact of supplementing missing TNM information with SEER Summary Stage data on both staging completeness and 5-year relative survival rates.

Results: The study included 173 061 stomach cancer, 159 199 colorectal cancer, 89 639 liver cancer, 137 103 lung cancer, and 110 286 breast cancer patients. The percentage of missing TNM stage data varied by cancer type, ranging from 65.1% (breast cancer) to 93.0% (liver cancer). Supplementation significantly reduced missing values-most notably in stomach cancer, where missing data dropped by 50.6 percentage points (%p), followed by liver (21.5%p) and breast cancers (13.6%p). For stomach cancer, supplementation led to a 3.6%p decrease in stage I survival rates, whereas liver cancer exhibited the most pronounced changes, with stage IV survival rates declining from 17.7% to 7.9%.

Conclusions: Integrating SEER Summary Stage data enhances TNM staging completeness. However, further evaluation incorporating treatment information is essential.

Objectives: The rise of flexible and diverse work schedules has become increasingly common in modern society. This study aims to investigate whether non-standard work schedules are related to sleep difficulty and other aspects of health-related quality of life (HRQoL) in Korea, with special attention to gender differences.

Methods: Data from the 2019 and 2021 National Health and Nutrition Examination Survey (Phase 8) were used, with a final sample consisting of 6735 participants. Ordinal logistic regression analysis was performed on sleep difficulty and the other seven items of the Health-related Quality of Life Instrument with 8 items (HINT-8) to examine associations with work schedules. Linear regression analysis was also conducted using the HINT-8 index as a composite measure.

Results: Non-standard work schedules were associated with a higher likelihood of sleep disturbances compared to the standard daytime work schedule. In particular, the negative impact of the night work schedule on sleep was greater for women than for men. Women working under the night work schedule were 12.2 percentage points more likely to report severe sleep difficulty than women under the day work schedule (9.6%). Additionally, the working, happiness, and vitality items of the HINT-8 were negatively associated with the night work schedule, whereas the other HINT-8 items and the HINT-8 index did not exhibit similar results.

Conclusions: Non-standard work schedules are associated with increased sleep difficulty, particularly among women, and negatively affect several aspects of HRQoL, including vitality, happiness, and work performance. Given their rising prevalence and adverse impact on workers' sleep, health, well-being, as well as workplace safety and performance, non-standard work schedules should be recognized as a significant public health concern.

Objectives: Non-specific low back pain (NSLBP) is a prevalent health issue that can progress from acute to chronic, resulting in prolonged disability and diminished quality of life. This study aimed to develop a prognostic scoring model to predict the transition from acute to chronic NSLBP in primary care settings.

Methods: This prospective cohort study enrolled 112 adults with acute NSLBP from primary health care units in Indonesia. Participants were assessed at baseline and at a 3-month follow-up visit. Bivariate and multivariable analyses were conducted to identify significant predictors of chronicity. A scoring system was then developed based on the final logistic regression model.

Results: Three factors were found to be significant predictors of the transition to chronic NSLBP: age above 30 years, low education level, and moderate to severe pain intensity. The prognostic scoring model demonstrated good discrimination, with an area under the receiver operating characteristic curve of 0.705, 70.8% sensitivity, and 62.5% specificity at the optimal cut-off score of 2.5.

Conclusions: This simple prognostic scoring model can help clinicians identify patients at high-risk of developing chronic NSLBP. Early identification of at-risk patients could guide targeted interventions to prevent chronicity. Further validation in diverse populations is necessary to confirm the broader applicability of this model.

Objectives: Premarital screening can reduce the risk of genetic disorders and sexually transmitted diseases by providing early detection before conception. College students represent a group of young adults with higher education who are approaching marriageable age. However, many students still lack a strong intention to undergo premarital screening in the future. Therefore, this study examines the factors influencing screening intentions among students at one of Indonesia's leading universities, the State Islamic University (UIN) Jakarta.

Methods: This study used a cross-sectional design, with a total sample of 563 college students obtained through a multistage random sampling technique. Descriptive statistics were used to summarize the data, and ordinal logistic regression was applied for hypothesis testing.

Results: Among the 563 students, 97.0% indicated an intention to undergo premarital screening. The intention variable was classified into three levels: no/low (13.0%), moderate (43.5%), and high (43.5%). Ordinal logistic regression revealed that lower knowledge about premarital screening was significantly associated with a reduced intention to undergo screening (odds ratio [OR], 2.84; 95% confidence interval [CI], 1.58 to 5.10). In addition, negative attitudes toward premarital screening (OR, 2.85; 95% CI, 1.41 to 5.75), negative perceived behavioral control (OR, 1.63; 95% CI, 1.12 to 2.37), and being enrolled in a non-health-related field of study (OR, 1.96; 95% CI, 1.04 to 3.68) were significantly linked to lower screening intentions.

Conclusions: Comprehensive premarital health education is essential for young adults, even those with a high level of formal education. Such education not only improves knowledge but also promotes more positive perceptions and attitudes toward premarital screening.

Objectives: 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 2023 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: This study aimed to investigate the role of time preferences in compliance with coronavirus disease 2019 (COVID-19) preventive behaviors in an adult population of Iran.

Methods: A web-based questionnaire was utilized to conduct a cross-sectional survey of 672 Iranian adults. The parameters of time preferences were estimated using a quasi-hyperbolic discounting model, and the relationship between COVID-19 preventive behaviors and time preferences was examined using a probit regression model.

Results: A significant association was observed between the preventive behaviors of COVID-19 and the levels of patience and present-biased preferences among the study participants. Individuals who exhibited low levels of patience were found to be 12.8 percentage points less inclined to follow preventive behaviors compared to those with high levels of patience. The likelihood of having good preventive behaviors of COVID-19 was found to decrease by 14.3 percentage points among individuals with a present bias as opposed to those with a bias toward future.

Conclusions: Patience and present-biased preferences are important determinants of adopting preventive behaviors against COVID-19. These behavioral characteristics should be considered in the design of control and prevention programs. Considering people's discounting behavior and time (in)consistency in their preferences in the design of COVID-19 policy interventions can provide valuable insights for developing tailored public health policy interventions.

Objectives: 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 (PA). This study investigated the prevalence of digital addiction among Korean adults and explored its association with PA 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. PA was defined as exercise and regular walking. Multiple logistic regression was conducted to examine the association between PA and digital addiction in the full sample and by age group (<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, PA 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: PA, 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.

Objectives: 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 United States adolescents.

Methods: A total of 1449 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, -0.265; standard error [SE], 0.074; p=0.001), HGS/BMI (β, -0.021; SE, 0.004; p<0.001), HGS/weight (β, -0.008; SE, 0.002; p<0.001), ALM/BMI (β, -0.008; SE, 0.003; p=0.010), and ALM/weight (β, -0.003; SE, 0.001; p=0.005).

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