The effectiveness of a tailored programme to promote reproductive-health-promoting behaviour in young women based on the Precaution Adoption Process Model: A randomized controlled trial.

AIM: The study aimed to evaluate a tailored reproductive health promotion programme based on the Precaution Adoption Process Model (PAPM) for young adults. DESIGN: This was a two-group, non-blinded randomized controlled trial. METHODS: This study was performed with women aged 18-25 who were not performing reproductive health-related behaviour from September 2018 to November 2018 in Seoul, South Korea. The participants were stratified by stage of PAPM (1, 2 or 3) and were randomly allocated to the intervention group (n = 30) and the control group (n = 30). Women in the intervention group were given the programme, which was customized according to the stage of PAPM over 8 weeks, such as lectures, giving information, discussions, practical training, Q&A, case experience and counselling. The control group received educational material. The primary outcomes were reproductive-health-promoting behaviour and rate of contraception use. RESULTS: Reproductive-health-promoting behaviour was significantly higher in the intervention group than the control group post-intervention, as were reproductive health beliefs, motivation and self-efficacy.

Factors Affecting Human Papillomavirus Vaccination in Men: Systematic Review.

BACKGROUND: Despite the high risks associated with human papillomavirus (HPV), the HPV vaccination rate of men is far lower than women. Most previous review studies have focused on female vaccination and related affecting factors. However, previous studies have reported that the factors affecting HPV vaccination differ by gender. OBJECTIVE: The aim of this review was to identify the factors affecting HPV vaccine initiation in men through a systematic review approach. METHODS: A literature review was conducted across 3 central electronic databases for relevant articles. A total of 30 articles published between 2013 and 2019 met the inclusion criteria and were reviewed in this study. RESULTS: In total, 50 factors affecting HPV vaccination in men were identified, including 13 sociodemographic factors and social structure factors, 12 belief-related variables, 4 family factors, 4 community factors, 14 variables related to needs, and 3 environmental factors. CONCLUSIONS: To increase HPV vaccination rates in men, strategies targeting young males and their families should consider frequent visits to or contact with health care providers so that health care professionals can provide recommendations for HPV vaccination.

Factors influencing health-related quality of life in adolescent girls: a path analysis using a multi-mediation model.

BACKGROUND: Recent studies have reported gender differences in adolescents' health-related quality of life (HRQOL), with females scoring significantly lower than males. Researchers have identified the female puberty process as one of the causes of the differences in HRQOL between male and female adolescents. This study examines mechanisms of how social support, dietary habits, sleep quality, and depression contribute to predicting HRQOL in relation to menstrual health among adolescent girls. METHODS: A cross-sectional study was conducted with 295 students recruited from middle and high schools in Korea using a self-report questionnaire. A multi-mediation model was constructed based on previous literature and tested using path analysis with AMOS, version 21.0. RESULTS: The study results showed that menstrual health, social support, sleep quality, dietary habits, and depression had significant effects on HRQOL. Both sleep quality and depression had significant direct effects on menstrual health. Dietary habits, social support, sleep quality, and depression had significant indirect effects on HRQOL, mediated through menstrual health. According to serial mediation analysis, the path from social support to HRQOL via dietary habits → sleep quality → depression → menstrual health → HRQOL was significant. However, mediation models including the path of dietary habits → depression were not supported. The study variables explained 57% of the total variance for HRQOL. CONCLUSIONS: The findings suggest menstrual health is an important factor that mediates the effects of eating, sleeping, psychological health, and social support on HRQOL. Early complaints about sleep disorders and depressive symptoms with poor dietary habits could be an ominous sign for adolescent girls at high risk of menstrual problems and lower HRQOL. Empirical evidence from this study suggests the need to develop and test interventions addressing multiple modifiable behavioral and psychosocial factors to improve HRQOL in adolescent girls. Interventions or supportive systems that aim to improve eating habits and sleep quality thereby achieving a healthier lifestyle need to be developed and incorporated into school health services.

Promoting Physical Activity and Weight Loss With mHealth Interventions Among Workers: Systematic Review and Meta-analysis of Randomized Controlled Trials.

BACKGROUND: Physical activity (PA) is a vital factor in promoting health in the workforce. Mobile health (mHealth) interventions have recently emerged in workplace health promotion as an effective strategy for inducing changes in health behaviors among workers; however, the effectiveness of mHealth interventions in promoting PA and weight loss for workers is unclear. OBJECTIVE: This study aims to provide a comprehensive analysis of current evidence on the effectiveness of mHealth interventions in promoting PA and weight loss among workers. METHODS: We searched relevant databases, including PubMed, Embase, CINAHL Complete, and the Cochrane Library, for publications on mHealth interventions in the English or Korean language from inception to December 2020. Randomized controlled trials that evaluated the effectiveness of mHealth in improving PA and weight loss were retrieved. A meta-analysis with a random effects model and subgroup analyses was performed on PA types and mHealth intervention characteristics. RESULTS: A total of 8 studies were included in this analysis. More than half of the studies (5/8, 63%) were identified as having a high risk of bias. The mHealth intervention group showed a significant improvement in PA (standardized mean difference [SMD] 0.22, 95% CI 0.03-0.41; P<.001; I2=78%). No significant difference in weight loss was observed when comparing the intervention group with the control groups (SMD 0.02, 95% CI -0.07 to 0.10; P=.48; I2=0%). A subgroup analysis was also performed; walking activity (SMD 0.70, 95% CI 0.21-1.19; P<.001; I2=83.3%), a multicomponent program (SMD 0.19, 95% CI 0.05-0.33; P=.03; I2=57.4%), objective measurement (SMD 0.58, 95% CI 0.05-1.10; P<.001; I2=87.3%), and 2 or more delivery modes (SMD 0.44, 95% CI 0.01-0.87; P<.001; I2=85.1%) were significantly associated with an enhancement in PA. CONCLUSIONS: This study suggests that mHealth interventions are effective for improving PA among workers. Future studies that assess long-term efficacy with a larger population are recommended.

Menstrual Cycle Patterns and the Prevalence of Premenstrual Syndrome and Polycystic Ovary Syndrome in Korean Young Adult Women.

Menstruation is one of the important indicators of reproductive health. Therefore, in order to improve the reproductive health of women in puberty and early adulthood, it is necessary to investigate menstrual health and symptoms. This cross-sectional descriptive correlational study was conducted to identify young women's menstrual cycle patterns, prevalence of Premenstrual Syndrome (PMS), Polycystic Ovary Syndrome (PCOS) and the relationships of health-related factors according to menstrual regularity and PCOS. 462 women participated in the first phase of the study and completed the menstrual health and health-related behaviors questionnaire. In the second phase, 88 women with irregular menstruation in phase one had blood tests taken and body composition measured. As a result, Menarche was slightly later in irregular menstruation group. Women with regular menstruation had a mean number of 11.7 menstrual cycles over the past year, 93.0% of them reported a normal menstruation cycle frequency (21-35 days), 95.2% reported a normal duration (2-7 days) and 55.9% of participants had heavy menstrual bleeding. In the irregular menstrual group, there were higher percentages of underweight and obese women as well as more women experiences weight and diet changes. The estimated prevalence rates of PMS and PCOS were 25.5%, 5.2% respectively. This study provides updated basic data about menstrual health among Korean young women but more extensive and sophisticated studies are needed in the future.

Development and Effects of College-Based Lifestyle Modification Program for Menstrual Health of Young Adult Women with Irregular Menses: A Randomized Controlled Trial.

Purpose: This study was conducted to develop the 'College-based Lifestyle Modification Program' (College-based LMP) for young adult women with irregular menstruation and examine its effects after intervention. Methods: The College-based LMP consisted of small group education, individual physical exercise counseling/training, individual diet counseling, and feedback and support. Participants were comprised of 38 females who reported less than 10 irregular menstruations in a year and were randomly assigned to the experimental and control groups. The primary outcome variables consisted of menstrual cycle index (MCI), sex hormone binding globulin (SHBG), and androgenic profile (testosterone-T, free androgen index-FAI), while the outcome variables included premenstrual symptoms (PMS), menstrual volume, body composition parameters, glycemic parameters (fasting blood sugar-FBS, insulin, HOMA-IR), sleep duration, perceived stress, and nutrient intake.. Results: There were no significant differences in primary outcome variables (MCI, SHBG, T, and FAI). In the variables, there were no significant differences except for the partial domain of PMS (symptoms of depression and anxiety) and sleep duration. Conclusions: The study was significant in that it demonstrated the importance of lifestyle, which could provide ordinary young adult women with healthy menstruation. The College-based LMP needs to be elaborated with further studies.

Development and psychometric validation of the Menstrual Health Instrument (MHI) for adolescents in Korea.

The aims of the researchers were to develop and test initial psychometric properties of the Menstrual Health Instrument, a measure of menstrual health in adolescents that comprehensively evaluates menstrual health. Data were collected with a convenience sample of 230 Korean adolescent girls. As a result of exploratory factor analysis with the 29-item instrument, five factors were extracted: affective symptoms, somatic symptoms and school life, daily habits for menstrual health, menstrual cycle characteristics, and attitudes and perceptions on menstruation. The reliability and validity estimates indicate the Menstrual Health Instrument could be used for screening in school or community settings.

Application and Effect of Mobiletype-Bone Health Intervention in Korean Young Adult Women with Low Bone Mass: A Randomized Control Trial.

PURPOSE: This randomized control trial was designed to examine the effect on the self-managing ability for promoting bone health of mobile type-bone health intervention (mobile type-BHI). METHODS: The mobile type-BHI consisted of a mobile application called "Strong bone, Fit body" (SbFb) and group education. A total of 82 college women with low bone mass (Z score < -1) participated. They were assigned randomly to three groups, experimental group I, (n = 28), experimental group II (n = 32), and control group (n = 22). This study ran from June 2014 to January 2015. The outcome variables were bone mineral density, minerals related to bone metabolism (calcium, phosphorus, vitamin D), biochemical markers related to bone remodeling (osteocalcin, C-terminal telopeptide, sclerostin), food intake diary by 24 hours recall, and psychosocial variables related to bone health (knowledge, health belief and self-efficacy). Data were analyzed using SAS program and a computer aided nutritional analysis program. RESULTS: Both the experimental group I, who used mobile type-BHI, and experimental group II, who only received group education, showed outcomes regarding knowledge of the benefits of exercise and calcium as compared with the control group. The two experimental groups also demonstrated results in the serum levels of calcium, vitamin D, and sclerostin compared to those of the control group. CONCLUSION: Although both experimental groups exhibited positive outcomes in regards to the promotion of bone health, this study did not show an additional effect of the mobile application on self-management ability for the promotion of bone health. Nonetheless, the SbFb application is very meaningful as it is the first application developed with the aim of improving women's bone health.

Self-Management Program for Heart Healthy Behavior Among Middle- and Old-Aged Korean Women at Risk for Metabolic Syndrome.

BACKGROUND: The prevalence of metabolic syndrome (MetS) has been increasing among Koreans, and middle-aged and older women are at risk of metabolic syndrome. Effective strategies to promote lifestyle modification need to be developed. OBJECTIVE: We examined the effects of a self-management program on improving the cardiovascular health status and promoting healthy behaviors among overweight or obese Korean women at risk of metabolic syndrome. METHODS: A pretest and posttest intervention design was used. Sixty women participated in a group teaching session. They also received a pedometer and a diary for self-monitoring. On the basis of blood test results, women's metabolic syndrome status was identified. Thirty women with metabolic syndrome received additional tailored counseling and weekly follow-up calls for 4 weeks, whereas 30 women without metabolic syndrome did not receive any tailored counseling or follow-up calls. Twenty-three women in the MetS group and 22 women in the non-MetS group completed the posttest. RESULTS: Overall, women significantly improved their cardiovascular health status including systolic blood pressure, diastolic blood pressure, body mass index, low-density lipoprotein, triglycerides, number of metabolic syndrome risk factors, and 10-year risk estimates from pretest to posttest. Seventy-eight percent of the MetS group (n = 18) no longer had metabolic syndrome, whereas 5% of the non-MetS group (n = 1) became to have metabolic syndrome. Women significantly increased frequency and duration of walking per week and significantly decreased the time spent sitting. CONCLUSIONS: Promoting self-management for healthy behaviors might be effective for obese or overweight women to prevent metabolic syndrome and cardiovascular diseases, if it is tailored to their health needs.

Anger, anger expression, cardiovascular risk factors, and gastrointestinal symptoms by hwa-byung symptoms in Korean adult women.

PURPOSE: This study explored relationships of anger and anger expression to cardiovascular (CV) risk factors and gastrointestinal (GI) symptoms in Korean women based on hwa-byung (HB) symptoms. METHODS: A descriptive, comparative design was used. One-hundred four women who are from 20 to 65years old were recruited. Based on the HB score, 22 women indicated for HB and the rest were classified as normal. Data collection was done with several questionnaires including HB symptom scale, state-trait anger expression inventory, and GI symptom questionnaire and clinical information. RESULTS: Women with HB demonstrated significantly higher levels of trait anger and dysfunctional anger expression such as anger suppression and anger expression than normal group. Although blood pressure was higher in women with HB, the differences were not significant. Self-report of GI symptoms were significantly more in women with HB, however no significant difference was found in gastroscopy results. CONCLUSIONS: Women with HB were younger and might lack of sufficient social support. This study suggests relationship of anger and anger expression to functional GI symptoms. Characteristics of women with HB should be considered in developing intervention programs for healthy coping. Future studies need more women with HB for better comparison.

[Bone mineral density, biochemical bone turnover markers and factors associated with bone health in young Korean women].

PURPOSE: This study was done to assess the bone mineral density (BMD), biochemical bone turnover markers (BTMs), and factors associated with bone health in young Korean women. METHODS: Participants were 1,298 women, ages 18-29, recruited in Korea. Measurements were BMD by calcaneus quantitative ultrasound, BTMs for Calcium, Phosphorus, Osteocalcin, and C-telopeptide cross-links (CTX), body composition by physical measurements, nutrients by food frequency questionnaire and psychosocial factors associated with bone health by self-report. RESULTS: The mean BMD (Z-score) was -0.94. 8.7% women had lower BMD (Z-score≤-2) and 14.3% women had higher BMD (Z-score≥0) than women of same age. BTMs were not significantly different between high-BMD (Z-score≥0) and low-BMD (Z-score<0) women. However, Osteocalcin and CTX were higher in women preferring caffeine intake, sedentary lifestyle and alcoholic drinks. Body composition and Calcium intake were significantly higher in high-BMD. Low-BMD women reported significantly higher susceptibility and barriers to exercise in health beliefs, lower bone health self-efficacy and promoting behaviors. CONCLUSION: Results of this study indicate that bone health of young Korean women is not good. Development of diverse strategies to intervene in factors such as exercise, nutrients, self-efficacy, health beliefs and behaviors, shown to be important, are needed to improve bone health.