Objectives This study examined the social and behavioral factors influencing community leaders’ participation in community-based surveillance (CBS) of infectious diseases. We hypothesized that knowledge, attitudes, and perceptions significantly predict the behavioral likelihood of engaging in CBS activities.
Methods A cross-sectional study was conducted among 470 schoolteachers in Kelantan, Malaysia, from March to June 2024. Participants were selected using multistage sampling, with random selection of schools followed by convenience sampling of teachers. Data were collected using the validated KAP-CBS-ID questionnaire, which was based on the Theory of Reasoned Action and Health Belief Model. Structural equation modeling was used to analyze relationships among the study variables with the maximum likelihood robust estimator.
Results The final model demonstrated good fit (comparative fit index, 0.921; standardized root mean square residual, 0.071; root mean square error of approximation, 0.040 [90% confidence interval, 0.036–0.044]). Ten significant path relationships were identified, explaining 46.1% of the variance in behavioral likelihood. Knowledge of infectious diseases (β=0.419, p<0.001), subjective norms (β=0.235, p=0.038), and negative attitudes (β=–0.432, p<0.001) significantly influenced intention. Behavioral likelihood was directly predicted by intention (β=0.347, p<0.001), perceived susceptibility (β=0.310, p<0.001), perceived benefits (β=0.198, p=0.001), and perceived barriers (β=–0.132, p=0.008). Self-efficacy showed significant indirect effects through perceived benefits (β=0.785, p<0.001) and perceived susceptibility (β=0.765, p<0.001).
Conclusion Knowledge and psychosocial factors significantly influence community engagement in CBS of infectious diseases. Public health interventions should address these interconnected determinants to strengthen early disease detection and reporting systems.
Objectives
This study aimed to validate the psychometric properties of the recently developed knowledge, attitudes, and perceptions questionnaire for community-based surveillance of infectious diseases (KAP-CBS-ID questionnaire), using confirmatory factor analysis (CFA) and item response theory (IRT).
Methods
A cross-sectional study using multistage sampling recruited 470 schoolteachers from Kelantan, Malaysia. The self-administered KAP-CBS-ID questionnaire consists of 3 domains: knowledge (31 items), attitudes (23 items), and perceptions (21-items). Two-parameter logistic (2-PL) IRT analysis and CFA were performed to validate the knowledge section. For attitudes and perceptions sections, CFA proceeded using a 4-factor model to evaluate both model fit and construct validity.
Results
Two-PL IRT analysis of the knowledge section resulted in elimination of 14 items due to inadequate discrimination or difficulty parameters. The 3-factor CFA model demonstrated good fit indices for knowledge (root mean square error of approximation [RMSEA], 0.028; comparative fit index [CFI], 0.945; Tucker-Lewis index [TLI], 0.941) without any modifications. The attitudes section required re-specification, ultimately yielding 21 items across 4 factors with acceptable fit indices (standardized root mean square residual [SRMR], 0.067; RMSEA, 0.055; CFI, 0.937; TLI, 0.927). Similarly, the perceptions section was refined to 17 items across 4 factors, showing good model fit (SRMR, 0.055; RMSEA, 0.059; CFI, 0.962; TLI, 0.954). Factor loadings ranged from 0.33 to 0.98, while Raykov’s rho reliability estimates ranged from 0.71 to 0.93. Factor determinacy exceeded 80% for all factors.
Conclusion
The KAP-CBS-ID is a valid and reliable instrument for assessing community representatives’ knowledge, attitudes, and perceptions regarding community-based surveillance of infectious diseases.
Objectives This study aimed to describe and compare health-related quality of life (QoL) as measured by the World Health Organization Quality of Life–BREF (WHOQoL-BREF) and the EuroQol-5 Dimensions (EQ-5D) among the Malaysian population, examining differences by sociodemographic characteristics including age, income, sex, ethnicity, educational level, and occupation. Methods: This cross-sectional study used data from 19,402 individuals collected as part of a health and demographic surveillance system survey conducted in the Segamat district of Malaysia in 2018–2019. Descriptive statistics and measures of central tendency were produced. Differences in QoL among demographic sub-groups were examined using the t-test and analysis of variance, while the correlations between the WHOQoL-BREF and EQ-5D were evaluated using Pearson correlation coefficients. Results: Based on complete case analysis (n=19,129), the average scores for the 4 WHOQoLBREF domains were 28.2 (physical), 24.1 (psychological), 12.0 (social relationships), and 30.4 (environment). The percentages of participants not in full health for each EQ-5D dimension were 12.8% (mobility), 3.1% (self-care), 6.9% (usual activities), 20.9% (pain/discomfort), and 6.8% (anxiety/depression). Correlations between the 4 WHOQoL-BREF domains and the 5 EQ-5D dimensions were relatively weak, ranging from –0.06 (social relationships with self-care and pain/discomfort; p<0.001) to –0.42 (physical with mobility; p<0.001). Conclusion: Although health-related QoL as measured by the WHOQoL-BREF and the EQ-5D are correlated, these 2 measures should not be considered interchangeable. The choice between them should be guided by the specific research questions and the intended use of the data.
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<title>Objectives</title>
<p>The aim of this study was to assess community participation in Dengue virus control measures, and community satisfaction in the Dengue surveillance workers (DSWs) performance in Semarang municipality after 3 years of empowerment.</p></sec>
<sec>
<title>Methods</title>
<p>A cross-sectional survey involved 1,018 selected participants from 12 groups of social roles in 141 villages in Semarang municipality, Indonesia. A direct interview was performed using a structured questionnaire to evaluate the acceptance, and satisfaction of the community towards the DSWs. The data were analyzed descriptively.</p></sec>
<sec>
<title>Results</title>
<p>The majority of the members of the community considered that the DSWs play an important role in reducing Dengue cases, and vectors of the Dengue virus, as well as increasing the community participation in Dengue control measures. The survey showed that DSWs performance, attitudes, and abilities regarding their main tasks were perceived to be good.</p></sec>
<sec>
<title>Conclusion</title>
<p>Overall, people in Semarang municipality were satisfied with the performance of the DSWs, and considered them important enough to be maintained and strengthened in the future so that Dengue could be controlled. This new policy needs to be disseminated to other regions that may encounter the problems associated with Dengue virus.</p></sec>
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<sec>
<title>Objectives</title>
<p>In this study the relationship between neighborhood deprivation and the unmet health care needs of elderly individuals (≥ 65 years) was examined. Some previous studies suggested that neighborhood characteristics affect access to health care, yet research on the unmet needs of older individuals is limited.</p></sec>
<sec>
<title>Methods</title>
<p>Multilevel logistic regression analysis was used to assess the relationship of neighborhood-level factors with unmet health care needs due to costs, adjusting for individual-level factors, in individuals ≥ 65 years in the 2017 Korean Community Health Survey (<italic>n</italic> = 63,388).</p></sec>
<sec>
<title>Results</title>
<p>There were 2.6% of elderly individuals who experienced unmet health care needs due to costs. Following adjustment for individual and neighborhood characteristics, the neighborhood deprivation in urban areas was found to have an inverse association with unmet needs (odds ratio = 0.50; 95% confidence interval = 0.24–1.06) for the most deprived quartile versus the least deprived quartile). However, in rural areas neighborhood deprivation was not a significant variable. Among the individual-level variables, household income was one of the strongest correlates with unmet needs in both urban and rural areas.</p></sec>
<sec>
<title>Conclusion</title>
<p>The present findings suggest that targeted policy interventions reflecting both neighborhood and individual characteristics, should be implemented to reduce the unmet health care needs of elderly individuals.</p></sec>
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<title>Objectives</title>
<p>This study aimed to develop a high-risk drinking scorecard using cross-sectional data from the 2014 Korea Community Health Survey.</p></sec>
<sec>
<title>Methods</title>
<p>Data were collected from records for 149,592 subjects who had participated in the Korea Community Health Survey conducted from 2014. The scorecard model was developed using data mining, a scorecard and points to double the odds approach for weighted multiple logistic regression.</p></sec>
<sec>
<title>Results</title>
<p>This study found that there were many major influencing factors for high-risk drinkers which included gender, age, educational level, occupation, whether they received health check-ups, depressive symptoms, over-moderate physical activity, mental stress, smoking status, obese status, and regular breakfast. Men in their thirties to fifties had a high risk of being a drinker and the risks in office workers and sales workers were high. Those individuals who were current smokers had a higher risk of drinking. In the scorecard results, the highest score range was observed for gender, age, educational level, and smoking status, suggesting that these were the most important risk factors.</p></sec>
<sec>
<title>Conclusion</title>
<p>A credit risk scorecard system can be applied to quantify the scoring method, not only to help the medical service provider to understand the meaning, but also to help the general public to understand the danger of high-risk drinking more easily.</p></sec>
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<p>The aim of this study was to determine whether there were differences in mental health specific to regions in Korea, and the factors that affected mental health status.</p></sec>
<sec>
<title>Methods</title>
<p>Data from the 2016 Community Health Survey in Korea were used; 224,421 health survey participants provided responses on mental health issues, demographics, and health behavior, and were included in the study.</p></sec>
<sec>
<title>Results</title>
<p>A statistically significant difference was observed in the incidence of mental health status between different regions of Korea. Independent variables that affected mental health were sex, age, marital status, household income, economic activity, whether living with dementia patients, self-reported health status, smoking, alcohol drinking, sleep time, and chronic diseases. Risk factors associated with symptoms of depression were gender (female), bereavement or being divorced, low household income, family member with dementia, poor self-reported health status, currently smoking, level of physical activity, insufficient hours of sleep and suffering from chronic diseases.</p></sec>
<sec>
<title>Conclusion</title>
<p>This study suggests that a standardized healthcare policy is needed to reduce regional variation in mental health. In the future, similar studies that include medical expenses for mental healthcare and relevant variables according to regions of Korea should be conducted.</p></sec>
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Objectives
The aim of this study is to ascertain and identify the effectiveness of area-based initiatives as a policy tool mediated by societal and individual factors in the five World Health Organization (WHO)-designated Safe Communities of Korea and the Health Action Zones of the United Kingdom (UK). Methods
The Korean National Hospital discharge in-depth injury survey from the Korea Centers for Disease Control and Prevention and causes of death statistics by the Statistics Korea were used for all analyses. The trend and changes in injury rate and mortality by external causes were compared among the five WHO-designated Safe Communities in Korea. Results
The injury incident rates decreased at a greater level in the Safe Communities compared with the national average. Similar results were shown for the changes in unintentional injury incident rates. In comparison of changes in mortality rate by external causes between 2005 and 2011, the rate increase in Safe Communities was higher than the national average except for Jeju, where the mortality rate by external causes decreased. Conclusion
When the Healthy Action Zones of the UK and the WHO Safe Communities of Korea were examined, the outcomes were interpreted differently among the compared index, regions, and time periods. Therefore, qualitative outcomes, such as bringing the residents' attention to the safety of the communities and promoting participation and coordination of stakeholders, should also be considered as important impacts of the community-based initiatives.
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Objectives
There are an increasing number of studies being carried out on depression in patients with diabetes. Individuals with diabetes have been reported as having a higher prevalence of depression compared to those without diabetes. However, only a few studies involving Korean patients have been conducted. The aims of this study were to examine the prevalence of depression and to find various risk factors according to the degree of depression among Korean patients with Type 2 diabetes mellitus (T2DM). Methods
An Ansan-community-based epidemiological study was conducted from 2005 to 2012. The total number of participants in this study was 3,540, from which patients with diabetes (<i>n</i> = 753) have been selected. The presence of depression was evaluated using the Beck Depression Inventory total score. Results
The prevalence of depression was 28.8%. The mean age of participants was 55.5 ± 8.2 years. We divided the participants into three groups (without-depression, moderate-depression, and severe-depression groups) to examine the depression prevalence among Korean T2DM patients. The unemployed participants had 2.40 [95% confidence interval (CI) 1.21–4.76], the low-income participants had 2.57 (95% CI 1.52–4.35), the participants using an oral diabetes medicine or insulin had 2.03 (95% CI 1.25–3.32), the participants who are currently smoking had 2.03 (95% CI 1.10–3.73), and those without regular exercise had 1.91 (95% CI 1.17–3.14) times higher odds of depression in the severe-depression group, compared with the without-depression group. Conclusion
There was a significant association between depression prevalence and diabetes, and we found various risk factors according to the degree of depression in Korean patients with T2DM.
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In 2008, Korea Centers for Disease Control and Prevention initiated the first nationwide survey, Korea Community Health Survey (KCHS), to provide data that could be used to plan, implement, monitor, and evaluate community health promotion and disease prevention programs. This community-based cross-sectional survey has been conducted by 253 community health centers, 35 community universities, and 1500 interviewers. The KCHS standardized questionnaire was developed jointly by the Korea Centers for Disease Control and Prevention staff, a working group of health indicators standardization subcommittee, and 16 metropolitan cities and provinces with 253 regional sites. The questionnaire covers a variety of topics related to health behaviors and prevention, which is used to assess the prevalence of personal health practices and behaviors related to the leading causes of disease, including smoking, alcohol use, drinking and driving, high blood pressure control, physical activity, weight control, quality of life (European Quality of Life-5 Dimensions, European Quality of Life-Visual Analogue Scale, Korean Instrumental Activities of Daily Living ), medical service, accident, injury, etc. The KCHS was administered by trained interviewers, and the quality control of the KCHS was improved by the introduction of a computer-assisted personal interview in 2010. The KCHS data allow a direct comparison of the differences of health issues among provinces. Furthermore, the provinces can use these data for their own cost-effective health interventions to improve health promotion and disease prevention. For users and researchers throughout the world, microdata (in the form of SAS files) and analytic guidelines can be downloaded from the KCHS website (<ext-link ext-link-type="uri" xlink:href="http://KCHS.cdc.go.kr/" id="intref0015-main">http://KCHS.cdc.go.kr/</ext-link>) in Korean.
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Objectives
Even though Philippines is widely known as exporters of health workers in the world, the Occidental Mindoro province suffers from a lack of health workers compared with the total population of each municipality. The aim of this study was to observe, identify, and understand the persisting health status, knowledge, and practices among the three selected communities in Occidental Mindoro, Philippines. Methods
The study applied a survey using basic questions with three key topics, with relevance to the health condition of the villagers, such as demographics (social capital and regional characteristics), lifestyle (healthy living, and healthy lifestyle and behavior), and status or position in the society (general demographics, and personal behavior and attitudes), with a random sample of 256 adult respondents. Results
Only about 54.3% rated themselves as fair/moderately healthy, and a total of 17.2% suffered from chronic diseases such as diabetes mellitus, cancers, chronic obstructive pulmonary disease, and cardiovascular disease, while 9% have been diagnosed with tuberculosis in the past 6 months. Respondents mostly have low income and low education. Conclusion
The majority of the respondents have only primary and secondary education, and a very low average income; these suggest that respondents were afflicted with poverty and low educational attainment. Respondents who are deprived of their rights to obtain a higher education also have a higher chance of having less knowledge on their well-being. Health programs do not guarantee a healthy individual and a healthy society, but a combination of health programs and socioeconomic support can help in creating a healthy community.
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Objectives
The aim of this study was to identify the effects of community-based home healthcare projects that influence service performances with regard to Korean national long-term care insurance services in older adults. Methods
The project's applicants were 18 operational agencies in national long-term care institutions in Korea, and participants were care recipients (<i>n</i> = 2263) registered in long-term care institutions. We applied our healthcare system to the recruited participants for a 3-month period from October 2012 to December 2012. We measured the community-based home healthcare services such as long-term care, health and medical service, and welfare and leisure service prior to and after applying the community-based home healthcare system. Results
After the implementation of community-based home healthcare project, all community-based home healthcare services showed an increase than prior to the project implementation. The nutrition management service was the most increased and its increase rate was 628.6%. A comparison between the long-term care insurance beneficiaries and nonbeneficiaries showed that health and medical services’ increase rate of nonbeneficiaries was significantly higher than beneficiaries (<i>p</i> < 0.001). Conclusion
Our community-based home healthcare project might improve the service implementation for older adults and there was a difference in the increase rate of health and medical services between Korean national long-term care insurance beneficiaries and nonbeneficiaries.
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Objectives
Our goal was to determine the diversity and abundance of <i>Staphylococcus</i> bacteria on different components of a public transportation system in a mid-sized US city (Portland, Oregon) and to examine the level of drug resistance in these bacteria. Methods
We collected 70 samples from 2 cm × 4 cm sections from seven different areas on buses and trains in Portland, USA, taking 10 samples from each area. We isolated a subset of 14 suspected <i>Staphylococcus</i> spp. colonies based on phenotype, and constructed a phylogeny from16S rRNA sequences to assist in identification. We used the Kirbye–Bauer disk diffusion method to determine resistance levels to six common antibiotics. Results
We found a range of pathogenic <i>Staphylococcus</i> species. The mean bacterial colony counts were 97.1 on bus and train floors, 80.1 in cloth seats, 9.5 on handrails, 8.6 on seats and armrests at bus stops, 3.8 on the underside of seats, 2.2 on windows, and 1.8 on vinyl seats per 8 cm<sup>2</sup> sample area. These differences were significant (p < 0.001). Of the 14 isolates sequenced, 11 were staphylococci, and of these, five were resistant to penicillin and ampicillin, while only two displayed intermediate resistance to bacitracin. All 11 isolates were sensitive to trimethoprim-sulfamethoxazole, vancomycin, and tetracycline. Conclusions
We found six different strains of <i>Staphylococcus</i>, and while there were varying levels of drug resistance, we did not find extensive levels of multidrug-resistant bacteria, and no <i>S. aureus</i> was found. We found floors and cloth seats to be areas on buses and trains that showed particularly high levels of bacteria.
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