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The Effectiveness of Short Term Mobile Phone Text Reminders in Improving Compliance among Hypertensive Patients.

Jung Ah LEE ; Woo Sang KIM ; Moon Jung BAE ; Young Sik KIM ; Han Jin OH ; Sang Yeoup LEE ; Chul Min KIM ; Dong Hyeok SHIN ; Seong Ho HAN ; Kyung Hwan CHO

Korean Journal of Health Promotion.2014;14(1):1-8. doi:10.15384/kjhp.2014.14.1.1

BACKGROUND: For the effective management of hypertension, drug adherence and life style modification are important. We investigated the effects of mobile phone text-message reminders on compliance and life style modification in patients with hypertension. METHODS: The study was performed at family medicine outpatient clinics at 15 hospitals in South Korea from July 2008 to June 2010. Study subjects included 1,449 patients who were all prescribed candesartan cilexetil. Patients were randomly divided into two groups- mobile phone text-message reminder group and control group. In the reminder group, contents of text messages were recommendations for antihypertensive adherence, exercise, low salt diet, and reduction of weight and alcohol. In the control group, the date of next visit was sent at 10 week. Mobile phone text-messages were sent at 2, 4, 6, 8 and 10 weeks by the coordinating center. Thereafter, they were followed up for 12 weeks. Chi-square test was performed to compare compliance and performance indexes of the two groups. RESULTS: The reminder group had 719 (49.6%) patients vs. 730 (50.4%) patients in the control group. Attendance rate were 92.8% for the reminder group and 94.7% for the control group (P=0.14). 94.7% of the reminder group and 94.0% of the control group took their medication regularly (P=0.59). The target blood pressure was attained in 75.8% of the reminder group and 75.4% of the control group (P=0.87). Similarly, rates of weight loss, decreased alcohol use, increased physical activity and a low salt diet showed no significant differences between the two groups. CONCLUSIONS: In our study, mobile phone text reminders did not show to have any significant positive effect on the management of hypertension.
Ambulatory Care Facilities ; Blood Pressure ; Cellular Phone* ; Compliance* ; Diet ; Humans ; Hypertension ; Korea ; Life Style ; Motor Activity ; Text Messaging ; Weight Loss

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Association between Alcohol Drinking and the Ratio of Aspartate Aminotransferase to Alanine Aminotransferase in Korean Adult Male.

Young Hee CHO ; Jong Sung KIM ; Sung Soo KIM ; Jin Kyu JUNG ; Seok Joon YOON ; Hyeun Young KIM ; Yoon Kyung BAE

Korean Journal of Health Promotion.2017;17(2):64-70. doi:10.15384/kjhp.2017.17.2.64

BACKGROUND: The aspartate transaminase (AST)/alanine transferase (ALT) ratio increases with alcohol consumption. This study investigated AST/ALT ratio according to alcohol drinking and predictive power of AST/ALT ratio for heavy drinking in Korean men. METHODS: In 2015, 830 men with no history of disease or medication affecting liver function values were selected. Using 14 g of alcohol as the standard glass, odd ratios (ORs) of AST/ALT ratio over 1 among the drinking group were compared with the non-drinking group by multiple logistic analyses. Screening of heavy drinkers was conducted according to both NIAAA and Korean guidelines. Using AST/ALT ratio >1, sensitivity, specificity, positive predictive values, negative predictive values, positive likelihood ratios, negative likelihood ratios and odds ratios were investigated. RESULTS: After correcting for age, body mass index, exercising, and smoking history, ORs (95% confidence interval) of AST/ALT >1 were 1.607 (1.048-2.464) in <8 glasses group, 2.172 (1.160-4.065) in the 14 glasses group, and 3.670 (2.218-6.053) in the >14 glasses group. When AST/ALT >1 in the drinking group, sensitivity, specificity, positive predictive values, negative predictive values, likelihood ratios (LR)+, LR- and OR according to NIAAA guidelines, were 57.2%, 52.7%, 23.2%, 76.8%, 1.21 (1.04-1.41), 0.81 (0.67-0.98), and 1.49 (1.05-2.01), respectively. By Korean guidelines, these values were 55.2%, 55.3%, 33.7%, 66.3%, 1.24 (1.03-1.36), 0.84 (0.72-0.98), and 1.40 (1.04-1.89), respectively. CONCLUSIONS: Healthy male adults showed a positive correlation between risk of AST/ALT >1 and drinking amount compared to the non-drinking group. Use of the AST/ALT >1 in combination with other blood markers to predict excessive drinking is advisable.
Adult* ; Alanine Transaminase* ; Alanine* ; Alcohol Drinking* ; Aspartate Aminotransferases* ; Aspartic Acid* ; Body Mass Index ; Drinking ; Eyeglasses ; Glass ; Humans ; Liver ; Male* ; Mass Screening ; National Institute on Alcohol Abuse and Alcoholism (U.S.) ; Odds Ratio ; Sensitivity and Specificity ; Smoke ; Smoking ; Transferases

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Prospective Study for Evaluating Therapeutic Efficacy of Obese Patients of Low Socioeconomic Status in Korea.

Sang Joon AN ; Eun Jung PARK ; Ji Hyeon CHEON ; Hee Jin HWANG ; Min Jeong KIM

Korean Journal of Health Promotion.2017;17(2):54-63. doi:10.15384/kjhp.2017.17.2.54

BACKGROUND: Recently, the prevalence of obesity and socioeconomic costs stemming from obesity are increasing steeply. Obesity, in particular, has a highly polarization caused by income levels. Obesity in low-income patients is expected to become a serious social problem in the future. This study aims to observe the effects of consistent consultation and drug therapy during a six months period, and to develop the treatment process of obesity for low-income people. METHODS: The body weight, waist circumference, body mass index (BMI), and blood pressure (BP) was measured every 2 weeks, and laboratory blood tests with a survey including Beck Depression Inventory (BDI) and eating behavior index was checked at 0, 3, and 6 months. Paired t-test and linear mixed model was done to evaluate the difference between pre-treatment data and post-treatment data. RESULTS: Twenty-one patients (2 males, median age [interquartile range] of 39 years [29-46]) were analyzed. There were statistically significant reductions of body weight (P<0.01), BMI (P<0.01), waist circumference (P<0.01), low-density lipoprotein (P=0.01), BDI-I (P<0.01), eating behavior index (P<0.01). There was no statistically significant difference of safety outcome of the BP and blood tests. CONCLUSIONS: Proper obesity treatment of obese patients of low socioeconomic status was meaningful enough to affect depression and eating patterns as well as reducing body weight and decreased waist circumference.
Blood Pressure ; Body Mass Index ; Body Weight ; Depression ; Drug Therapy ; Eating ; Feeding Behavior ; Hematologic Tests ; Humans ; Korea* ; Lipoproteins ; Male ; Obesity ; Prevalence ; Prospective Studies* ; Social Class* ; Social Problems ; Socioeconomic Factors ; Waist Circumference

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Serum Ferritin Levels Are Associated with the Higher Risk of Diabetes Mellitus in Men and Post-menopausal Women, Based on the 2010-2012 KNHANES.

Joo Yeon KIM ; Hee Taik KANG ; Yong Jae LEE ; Jin Young KIM ; Tae Jong KIM ; Hyoung Ji LIM ; Jae Woo LEE

Korean Journal of Health Promotion.2017;17(2):47-53. doi:10.15384/kjhp.2017.17.2.47

BACKGROUND: The aim of this study was to investigate the relationship between serum ferritin and diabetes mellitus (DM) in the Korean population. METHODS: This cross-sectional study included 9,576 subjects (4,264 men, 2,394 pre-menopausal women, and 2,918 post-menopausal women) older than 19 years using data from the 2010-2012 Korean National Health and Nutrition Examination Survey. DM was defined as fasting plasma glucose ≥126 mg/dL, glycosylated hemoglobin ≥6.5%, or use of any glucose-lower medication including insulin therapy. RESULTS: The overall prevalence of DM was 12.0, 3.6, and 17.3% in men, pre-menopausal women, and post-menopausal women, respectively. DM prevalence was greater with ferritin levels from Q1 to Q4: 10.3, 10.2, 12.7, and 14.8% in men; 2.0, 2.8, 2.8, and 6.4% in pre-menopausal women; and 13.9, 14.4, 18.1, and 22.9% in post-menopausal women, respectively. Compared with participants in Q1, the odds ratios (95% confidence intervals) for DM among participants in Q4 were 1.67 (1.20-2.32) in men, 2.06 (0.91-4.66) in pre-menopausal women, and 1.60 (1.09-2.35) in post-menopausal women after adjusting for age and other covariates. CONCLUSION: Serum ferritin concentration was positively associated with a higher risk of DM in adult men and post-menopausal women.
Adult ; Blood Glucose ; Cross-Sectional Studies ; Diabetes Mellitus* ; Fasting ; Female ; Ferritins* ; Hemoglobin A, Glycosylated ; Humans ; Insulin ; Insulin Resistance ; Male ; Nutrition Surveys ; Odds Ratio ; Prevalence

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The Relationship between Socioeconomic Status and Metabolic Syndrome, Using Structural Equation Modelling.

Sung Hi KIM

Korean Journal of Health Promotion.2016;16(2):92-100. doi:10.15384/kjhp.2016.16.2.92

BACKGROUND: This study aimed to investigate the complexity of the relationships between socioeconomic status, health behaviors, stress and risks of metabolic syndrome. By applying structural equational modelling, modified generalized conceptual model had described the associations and interactions among them. METHODS: 24,210 participants (8,242 men, 15,968 women) registered with the Korean Health Examinee Cohort (KOEX) between 2004 to 2008. This study collected data on the socioeconomic status, health behaviors, and stress through individual interviews. Socioeconomic status (education, house income, occupation), health behaviors (diet, physical activity, smoking, alcohol consumption) and stress level were defined as exogenous factors. Endogenous variables were risks of metabolic syndrome based on modified National Cholesterol Education Program Adult Treatment Panel-lll (NCEP ATP-lll, 2006). RESULTS: According to model fitness test, these proposed model were acceptable in men, comparative fit index=0.877, incremental fit Index=0.877, Tucker-Lewis index=0.757, root-mean-squared error associated=0.055. These were compatible also in women as comparative fit index=0.924, incremental fit index=0.924, Tucker-Lewis index=0.851, root-mean-squared error associated=0.050. There were sex difference related to risks of metabolic syndrome: in men socioeconomic status (β=-0.08), health behaviors (β=-0.25) and stress (β=-0.25) were relevant, but in women only socioeconomic status (β=-0.25) was relevant (P<0.05). CONCLUSIONS: A conceptual model properly explains how Socioeconomic status may influence on health behaviors, stress, and risks of metabolic syndrome. Health behaviors in men and socioeconomic status in women had the strongest associations with risks of metabolic syndrome. In addition, socioeconomic status was strongly associated with health behaviors, stress and age.
Adult ; Cholesterol ; Cohort Studies ; Education ; Female ; Health Behavior ; Humans ; Male ; Motor Activity ; Sex Characteristics ; Smoke ; Smoking ; Social Class*

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Predictability of Complete Blood Count Parameters for Heavy Drinking according to the Facial Flushing.

Hyun Chul JOUNG ; Hyun Ju YANG ; Jong Sung KIM ; Sung Soo KIM ; Seok Joon YOON ; Jung Wei CHANG

Korean Journal of Health Promotion.2016;16(2):84-91. doi:10.15384/kjhp.2016.16.2.84

BACKGROUND: Alcohol is personal and social problem around the world. Though binge drinking is associated with the elevation of arbohydrate deficient trasnferrin and r-glutamyl transpeptidase, studies of the relationship between heavy drinking and other biological markers are rare. The purpose of this study is to investigate the association between heavy drinking and CBC figures through flushing and non flushing using both NIAAA and Korean guidelines. METHODS: The subjects were 581 Korean adult males: who had undergone a comprehensive medical evaluation at Chungnam National University Hospital between June and December of 2013. 98 of total were non-drinkers, 225 of them flushers, and the rest 258 of them were non-flushers. One standard drink is defined as any drink that contains 14 grams of alcohol. Criteria for immoderate drinking was applied to greater than 14 glasses/week and more than 8 glasses on any day for a non-flush group with reference to the United States' guideline (National Institute in Alcohol Abuse and Alcoholism, NIAAA) and South Korean guideline, and it was also applied to greater than seven glasses/week, and more than four glasses on any day for a flushing group. It was to investigate whether immoderate drinking would be predictable according to increased mean corpuscular volume (MCV), decreased hemoglobin (Hb), and decreased platelet (PLT). Our investigation was to find the correlation with the increased MCV, decreased Hb, and decreased PLT as a means of predictions for immoderate drinking. The study was to examine the CBC's predictability of immoderate drinking through a combination of increased MCV, decreased Hb, or decreased PLT. If one of these three items were abnormal: group A, if two of the three items were abnormal: group B. RESULTS: Predictability of group A was 23.1% in flushing drinkers and 21.7% in non-flushing drinkers for US NIAAA immoderate drinking, whereas 30.8% in flushing drinkers and 30.4% in non-flushing drinkers considering Korean guideline immoderate drinking. Predictability of B group was 100% in flushing and non-flushing drinkers for both NIAAA guidelines and Korean guidelines. CONCLUSIONS: It is desirable for physicians to use any combination of the three CBC indicators (increased MCV, decreased Hb, or decreased PLT) for predicting immoderate drinking.
Adult ; Alcoholism ; Binge Drinking ; Biomarkers ; Blood Cell Count* ; Blood Platelets ; Chungcheongnam-do ; Drinking* ; Erythrocyte Indices ; Eyeglasses ; Flushing* ; Glass ; Humans ; Male ; National Institute on Alcohol Abuse and Alcoholism (U.S.) ; Social Problems

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Association between Physical Activity and Hypertension in Chronic Obstructive Pulmonary Disease.

Jun Hwan JANG ; Sun Dong RYU ; Hye Shin KIM ; Keun Mi LEE ; Seung Pil JUNG

Korean Journal of Health Promotion.2016;16(2):77-83. doi:10.15384/kjhp.2016.16.2.77

BACKGROUND: Patients with chronic obstructive pulmonary disease (COPD) have increased likelihood of hypertension, which may lead to increased mortality rates. This study investigated the incidence of hypertension in patients with COPD according to the levels of their physical activities. METHODS: This study used data from the fifth Korean National Health and Nutrition Examination Survey, conducted from 2010 to 2012, including 1,243 people aged 40 years or older with COPD who were cross-classified according to their levels of physical activity. The relevance of morbidity associated with high blood pressure was also evaluated through cross and logistic regression analyses. RESULTS: Among patients with COPD who performed moderate-intensity physical activities, the group without hypertension had 4.3% higher compared to the group with hypertension (P=0.012). Adjusted analysis for patient age, sex, body mass index, smoking, drinking habit, income, diabetes mellitus, hyperlipidemia, and energy intake performed to determine the relationship between physical activity level and hypertension revealed that patients with moderate-intensity physical activity had 53.6% lower (95% confidence interval: 0.288-0.997) incidence of hypertension. CONCLUSIONS: The results of the current study suggest that patients with COPD who perform moderate-intensity physical activity have a lower incidence of hypertension.
Body Mass Index ; Diabetes Mellitus ; Drinking ; Energy Intake ; Humans ; Hyperlipidemias ; Hypertension* ; Incidence ; Logistic Models ; Mortality ; Motor Activity* ; Nutrition Surveys ; Pulmonary Disease, Chronic Obstructive* ; Smoke ; Smoking

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Relationship of Shift Work to Gastrointestinal Disorders in Hospital Nurses.

Eun Ju KIM ; Hye Sun JUNG ; Eun Hi CHOI

Korean Journal of Health Promotion.2014;14(4):172-179. doi:10.15384/kjhp.2014.14.4.172

BACKGROUND: This study researched the relationship between shift work and one of its relevant health problems, functional gastrointestinal disorders. The study targeted nurses working at a university hospital, and compared the differences in gastrointestinal disorders of shift workers and non-shift workers and identified causes that significantly influence these symptoms. METHODS: In August 2013, a self-report survey was conducted on nurses working at a university hospital. Among those sent out, 1,201 responded and 851 were used for the final analysis. RESULTS: It was shown that the frequency of gastrointestinal disorders in shift workers was 1.881 times higher than that of non-shift workers. Factors that influenced gastrointestinal disorders included age, marital status, work duration, type of employment, job satisfaction, and perceived health status. Gastrointestinal disorders were seen more often with older age, being married, longer duration of employment, non-regular worker, low job satisfaction, bad perceived health status, and shift works. CONCLUSIONS: To prevent gastrointestinal disorders in nurses who work shifts, a health checkup system should be in place for clinical nurses who are of older age and have longer employment records. To decrease the causes of gastrointestinal disorders, campaigns suggesting regular diet and quitting alcohol use should be held consistently. Also, a category related to gastrointestinal disorders should be added to the employee health checkup for nurses with long work experience.
Diet ; Employment ; Gastrointestinal Diseases ; Job Satisfaction ; Marital Status ; Occupational Health

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Structural Equation Modeling of Suicidal Ideation and Associated Factors among Elderly Women in Korea.

Hung Sa LEE ; Dohyun LEE

Korean Journal of Health Promotion.2014;14(4):162-171. doi:10.15384/kjhp.2014.14.4.162

BACKGROUND: Although the suicide rate in Korea is the highest in the world, only limited studies have been done on suicide and its associated factors. In this regard, we studied a conceptual model and the relationships and interactions of activity of daily living (ADL), social support, depression, and suicidal ideation among elderly women in Korea. METHODS: A cross-sectional descriptive study, subjects included 194 community-dwelling elderly women. Their ADL, multi-dimensional scale of perceived social support (MSPSS), depression, and suicidal ideation (SI) were examined. The t-test, ANOVA test, Pearson's correlation coefficient, multiple regression analysis, and structural equation modeling were utilized in data analysis. RESULTS: There were significant correlations between SI and economic status, social support, and depression. Depression was correlated with not only SI but also ADL (r=0.195, P=0.006) and social support (r=-0.337, P<0.001). Absolute fit indices demonstrated that the research model had a good model fit. There were significant factor loading values from depression to SI (standardized estimate=0.157, P=0.023) and from social support to SI (standardized estimate=-0.308, P<0.001). There were two indirect effects from social support to SI and from ADL to SI. The mediating factor of these two indirect effects was depression. CONCLUSIONS: Suicidal ideation in the elderly needs to be prevented; and more attention should be given to this end. Social support programs encouraging family participation are greatly effective in prevention of senior citizens' suicidal ideation.
Activities of Daily Living ; Aged* ; Depression ; Female ; Humans ; Korea ; Negotiating ; Statistics as Topic ; Suicidal Ideation* ; Suicide

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Effects of Smoking Status on Chronic Obstructive Pulmonary Disease Prevalence in Males 40 years and Older: Findings from the Korean National Health and Nutrition Examination Survey.

In Sook JUNG ; In Kyung JUNG

Korean Journal of Health Promotion.2014;14(4):155-161. doi:10.15384/kjhp.2014.14.4.155

BACKGROUND: This is a study of the prevalence of chronic obstructive pulmonary disease (COPD), which shows high mortality worldwide, and the effects of smoking on COPD by using data from the Korea National Health and Nutrition Examination Survey V. METHODS: FEV1/FEV6<0.73 was used as a diagnostic criterion of COPD. Frequency analysis for prevalence, descriptive statistics for general characteristics and ventilation rate according to age-specifications, and complex sample logistic regression analysis for the effect of smoking on COPD prevalence were used. IBM SPSS Statistics 21 Standard, Complex Samples for Medical Science(Windows) was used for data analysis(alpha=0.05). RESULTS: Prevalence of COPD was 11.6+/-0.5% of Koreans in their forties or over, and 17.5+/-0.8% in males, and 6.2+/-0.5% in females. There was significant increase of COPD prevalence with age increment. Before adjusting for age and smoking index(SI), the COPD possibilities of past and current-smokers compared with non-smoking males were (odds ratio [OR] 2.112 [95% confidence interval [CI] 1.551-2.875]) and (OR 1.834 [95% CI 1.319-2.551]) respectively. After adjustments with age and SI, the COPD possibility of current-smoking was 2.099 (1.382-3.188) times higher and for past-smoking was 1.463 (1.012-2.115) times higher than non-smoking. The P-value of each group was significant. The regression coefficients (B) of current-smoking and past-smoking were 0.741 and 0.380 respectively. The prevalence of COPD increased 1.102 (1.090-1.115) times for every 1 year of age increase, and 1.012 (1.007-1.018) times for every 1 SI increase (P<0.001). CONCLUSIONS: After adjusting for age and SI, the prevalence of COPD in smokers was higher than non-smokers. And current-smoking had a higher OR and higher B than past-smoking.
Female ; Humans ; Korea ; Logistic Models ; Male ; Mortality ; Nutrition Surveys* ; Prevalence* ; Pulmonary Disease, Chronic Obstructive* ; Smoke* ; Smoking* ; Ventilation

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