Evaluating the effect of the COVID-19 pandemic on hypertension and diabetes care in South Korea: an interrupted time series analysis.

BACKGROUND: Access to healthcare services is important, especially for patients with chronic diseases. We evaluated the effect of the COVID-19 pandemic on outpatient visits and medication for patients with hypertension and diabetes in South Korea. METHODS: Nationwide claims data were extracted for patients with hypertension and diabetes from January 2019 to July 2020. We used an interrupted time series (ITS) analysis to evaluate the pandemic's impact on outpatient care using the number of outpatient visits and days of medication supplied per visit. We identified the change in the continuity of care in medication, a consequence of the change in outpatient care, using the Medication Possession Ratio (MPR). RESULTS: The number of outpatient visits for diabetes significantly declined in February 2020, when community transmission began. However, when high-intensity social distancing was relaxed in April 2020, outpatient visits for hypertension and diabetes rebounded significantly. Moreover, when the outpatient visits declined, the number of days of medication supplied per visit increased. Consequently, the average MPRs significantly increased compared to 2019, increasing the ratio of patients with appropriate medication supply (MPR ≥ 0.8). CONCLUSIONS: Outpatient visits decreased immediately when COVID-19 spread to local communities. However, the number of days of medication supplied per visit increased to compensate for the longer intervals between visits. Rather, the change in the continuity of care in medication improved; thus, the temporary decrease in outpatient visits might have had a limited negative impact on health outcomes.

Global Trends in Social Prescribing: Web-Based Crawling Approach.

BACKGROUND: Social loneliness is a prevalent issue in industrialized countries that can lead to adverse health outcomes, including a 26% increased risk of premature mortality, coronary heart disease, stroke, depression, cognitive impairment, and Alzheimer disease. The United Kingdom has implemented a strategy to address loneliness, including social prescribing-a health care model where physicians prescribe nonpharmacological interventions to tackle social loneliness. However, there is a need for evidence-based plans for global social prescribing dissemination. OBJECTIVE: This study aims to identify global trends in social prescribing from 2018. To this end, we intend to collect and analyze words related to social prescribing worldwide and evaluate various trends of related words by classifying the core areas of social prescribing. METHODS: Google's searchable data were collected to analyze web-based data related to social prescribing. With the help of web crawling, 3796 news items were collected for the 5-year period from 2018 to 2022. Key topics were selected to identify keywords for each major topic related to social prescribing. The topics were grouped into 4 categories, namely Healthy, Program, Governance, and Target, and keywords for each topic were selected thereafter. Text mining was used to determine the importance of words collected from new data. RESULTS: Word clouds were generated for words related to social prescribing, which collected 3796 words from Google News databases, including 128 in 2018, 432 in 2019, 566 in 2020, 748 in 2021, and 1922 in 2022, increasing nearly 15-fold between 2018 and 2022 (5 years). Words such as health, prescribing, and GPs (general practitioners) were the highest in terms of frequency in the list for all the years. Between 2020 and 2021, COVID, gardening, and UK were found to be highly related words. In 2022, NHS (National Health Service) and UK ranked high. This dissertation examines social prescribing-related term frequency and classification (2018-2022) in Healthy, Program, Governance, and Target categories. Key findings include increased "Healthy" terms from 2020, "gardening" prominence in "Program," "community" growth across categories, and "Target" term spikes in 2021. CONCLUSIONS: This study's discussion highlights four key aspects: (1) the "Healthy" category trends emphasize mental health, cancer, and sleep; (2) the "Program" category prioritizes gardening, community, home-schooling, and digital initiatives; (3) "Governance" underscores the significance of community resources in social prescribing implementation; and (4) "Target" focuses on 4 main groups: individuals with long-term conditions, low-level mental health issues, social isolation, or complex social needs impacting well-being. Social prescribing is gaining global acceptance and is becoming a global national policy, as the world is witnessing a sharp rise in the aging population, noncontagious diseases, and mental health problems. A successful and sustainable model of social prescribing can be achieved by introducing social prescribing schemes based on the understanding of roles and the impact of multisectoral partnerships.

Assessing the Fear Factor of Coronavirus Disease 2019 (COVID-19) in Korea Using the COVID-19 Phobia Scale: A Cross-Sectional Study.

BACKGROUND: A study on coronavirus disease 2019 (COVID-19) phobia among students revealed that fear of contracting COVID-19 was associated with commuting to school and spending time with others at school. Therefore, it is the need-of-the-hour for the Korean government to identify factors affecting COVID-19 phobia among university students and to consider these factors while framing the policy direction for the process of returning to normalcy in university education. Consequently, we aimed to identify the current state of COVID-19 phobia among Korean undergraduate and graduate students and the factors affecting COVID-19 phobia. METHODS: This cross-sectional survey was conducted to identify the factors affecting COVID-19 phobia among Korean undergraduate and graduate students. The survey collected 460 responses from April 5 to April 16, 2022. The questionnaire was developed based on the COVID-19 Phobia Scale (C19P-S). Multiple linear regression was performed on the C19P-S scores using five models with the following dependent variables: Model 1, total C19P-S score; Model 2, psychological subscale score; Model 3, psychosomatic subscale score; Model 4, social subscale score; and Model 5, economic subscale score. The fit of these five models was established, and a P-value of less than 0.05 (F test) was considered statistically significant. RESULTS: An analysis of the factors affecting the total C19P-S score led to the following findings: women significantly outscored men (difference: 4.826 points, P = 0.003); the group that favored the government's COVID-19 mitigation policy scored significantly lower than those who did not favor it (difference: 3.161 points, P = 0.037); the group that avoided crowded places scored significantly higher than the group that did not avoid crowded places (difference: 7.200 points, P < 0.001); and those living with family/friends scored significantly higher than those in other living situations (difference: 4.606 points, P = 0.021). Those in favor of the COVID-19 mitigation policy had significantly lower psychological fear than those who were against it (difference: -1.686 points, P = 0.004). Psychological fear was also significantly higher for those who avoided crowded places compared to those who did not difference: 2.641 points, P < 0.001). Fear was significantly higher in people cohabitating than those living alone (difference: 1.543 points, P = 0.043). CONCLUSION: The Korean government, in their pursuit of a policy that eases COVID-19-related restrictions, will also have to spare no efforts in providing correct information to prevent the escalation of COVID-19 phobia among people with a high fear of contracting the disease. This should be done through trustworthy information sources, such as the media, public agencies, and COVID-19 professionals.

Status of school health programs in Asia: National policy and implementation.

BACKGROUND: The WHO's Health Promoting Schools (HPS) framework is based on an understanding of the reciprocal relationship between health and education, and the need to take a holistic approach to health promotion in schools. We aim to clarify the degree to which the HPS framework is reflected in the national policies of eight target countries and the issues surrounding its successful implementation. METHODS: Date were collected through two expert workshops with participants from eight Asian countries: Cambodia, China, Japan, Korea, Lao PDR, Nepal, the Philippines, and Thailand. In the first workshop, data collected on national policy were mapped against the HPS framework. From this, key issues were identified, and follow-up data collection was conducted in each country for a second workshop. RESULTS: We identified a policy shift toward the HPS framework in six out of the eight countries. Neither Japan nor Korea had changed their national policy frameworks to reflect an HPS approach; however, in the latter, model programs had been introduced at a local level. We identified various barriers to successful implementation, especially in relation to mental health and wellbeing. CONCLUSION: Given the recent shift toward the HPS approach in six out of the eight countries in this study, there is a need to conduct research to assess the impact of this framework on the health and wellbeing of students and school staff. At the same time, we call for more dialog in the context of Japan to explore the possible benefits of introducing the HPS framework into schools.

Analysis of personal and national factors that influence depression in individuals during the COVID-19 pandemic: a web-based cross-sectional survey.

BACKGROUND: The World Health Organization (WHO) declared coronavirus disease (COVID-19) a pandemic on March 11, 2020. Previous studies of infectious diseases showed that infectious diseases not only cause physical damage to infected individuals but also damage to the mental health of the public. Therefore this study aims to analyze the factors that affected depression in the public during the COVID-19 pandemic to provide evidence for COVID-19-related mental health policies and to emphasize the need to prepare for mental health issues related to potential infectious disease outbreaks in the future. RESULTS: This study performed the following statistical analyses to analyze the factors that influence depression in the public during the COVID-19 pandemic. First, to confirm the level of depression in the public in each country, the participants' depression was plotted on a Boxplot graph for analysis. Second, to confirm personal and national factors that influence depression in individuals, a multi-level analysis was conducted. As a result, the median Patient Health Questionnaire-9 (PHQ-9) score for all participants was 6. The median was higher than the overall median for the Philippines, Indonesia, and Paraguay, suggesting a higher level of depression. In personal variables, depression was higher in females than in males, and higher in participants who had experienced discrimination due to COVID-19 than those who had not. In contrast, depression was lower in older participants, those with good subjective health, and those who practiced personal hygiene for prevention. In national variables, depression was higher when the Government Response Stringency Index score was higher, when life expectancy was higher, and when social capital was higher. In contrast, depression was lower when literacy rates were higher. CONCLUSIONS: Our study reveals that depression was higher in participants living in countries with higher stringency index scores than in participants living in other countries. Maintaining a high level of vigilance for safety cannot be criticized. However, in the current situation, where coexisting with COVID-19 has become inevitable, inflexible and stringent policies not only increase depression in the public, but may also decrease resilience to COVID-19 and compromise preparations for coexistence with COVID-19. Accordingly, when establishing policies such as social distancing and quarantine, each country should consider the context of their own country.

Depression in public officials during the COVID-19 pandemic in Paraguay: a web-based study.

BACKGROUND: According to the World Health Organization, the coronavirus disease 2019 (COVID-19) pandemic has created situations that have a negative effect on people and threaten their mental health. Paraguay announced the Estado de Emergencia Sanitaria (Presidential Decree No. 3456) on March 16, 2020, which was followed by the imposition of a 24-h restriction on movement order on March 21. Self-quarantine at home may have been the most effective method of preventing the spread of infectious diseases; however, with the global pandemic becoming more prolonged and the consequent lengthening of the 24-h self-quarantine period, it is highly probable that both physical and psychological problems will arise. METHODS: In this study, a web-based cross-sectional method was used to analyze the factors influencing COVID-19-induced depressive feelings in Paraguayan public officials. RESULTS: Public officials reported a high level of depressive symptoms with a high level of apprehension in early stage of COVID-19. In addition, this study identified that when the self-quarantine period increased, levels of depressive feelings also increased. Since self-quarantine is characterized by the requirement that individuals endure an undetermined period within a confined area, it may have caused stress and anxiety, as well as the consequent experience of depressive feelings. CONCLUSIONS: Paraguayan government should develop a program for the delivery of mental health care and services to public officials in COVID-19 Pandemic period. Moreover, a program is required for people facing deteriorating mental health due to social isolation and loneliness caused by social distancing during the prolonged period of self-quarantine. Finally, mental health care programs should be organized in a community-focused way by utilizing online systems to enhance the effectiveness of mental health recovery.

Effectiveness of a comprehensive blood pressure control program in primary health care in Peru.

OBJECTIVE: To assess the effectiveness of a comprehensive blood pressure (BP) control program on improving lifestyle indicators, BP levels, and laboratory examination results among people living in low-income urban areas of Peru. METHODS: A prospective before-and-after study design was applied to 1 271 participants with hypertension or pre-hypertension. The intervention was implemented for 2 years, from May 2015 - April 2017, in three health centers in Lima (2 in Comas and 1 in Callao). The changes in participants over the study period were compared. All participants were provided with individualized consultations, group health education sessions, regular group meetings to improve self-management, and text messages providing health education. Paired t- and chi-square tests were used to determine the significance of the changes in indicators before and after the intervention. RESULTS: Lifestyle behaviors, such as weight and blood pressure monitoring, reduced salt consumption, increased fruit and vegetable consumption, and stress control improved during the intervention (P < 0.001). The EuroQol-Five Dimension Scale showed improvement (P < 0.001) and body mass index, waist circumference, and systolic and diastolic BPs of the participants significantly decreased (P < 0.001). Low-density lipoprotein cholesterol (LDL-C) and triglyceride decreased (P < 0.01) and high-density lipoprotein cholesterol (HDL-C) increased. The estimated glomerular filtration rate (eGFR) increased after the program (P < 0.001). CONCLUSIONS: This comprehensive BP control program was effective in improving lifestyle indicators, BP levels, and laboratory results among people living in a low-income urban area of Peru. Increasing opportunities for BP measurement, systematic management of hypertensive patients, and community-based prevention and education programs are paramount to hypertension detection, prevention, and control.

COVID-19 Perception, Knowledge, and Preventive Practice: Comparison between South Korea, Ethiopia, and Democratic Republic of Congo.

In Africa, the first confirmed case of COVID-19 was reported in Egypt on February 14, 2020. Since then, the number of cases has continued to increase with Ethiopia, the Democratic Republic of Congo (DRC), Nigeria, Sudan, Angola, Tanzania, Ghana, and Kenya identified as vulnerable countries. The present study aimed to: 1) identify differences in trust level of COVID-19 diagnosis, recent healthcare utilization experiences, and COVID-19-related knowledge, information, and prevention practices in South Korea, Ethiopia, and DRC; and 2) identify factors influencing trust level in healthcare facilities regarding COVID-19 diagnosis. The present study was cross-sectional. The questionnaire survey was conducted between May 1-14, 2020 using Google forms, and 748 respondents were included in the final analysis. The data collected were analyzed using ANOVA, post- hoc test, and binary logistic regression analysis. South Korea showed higher rate of practice for COVID-19 prevention such as hand washing, mask wearing, and etc. than Ethiopia and DRC. The results showed significant differences with the trust level being 3.129 times higher in respondents from DRC than those from Ethiopia (aOR=3.129, 95% CI: [1.884-5.196], p <.000) and 29.137 times higher in respondents from South Korean than those from Ethiopia (aOR=29.137, 95% CI: [13.869-61.210], p <.000). Gender, age, number of family members, healthcare utilization experience, information, and practice were significant variables. Health education expansion for information and practice about COVID-19 in Ethiopia and DRC is necessary.

Community-based maternal and child health project on 4+ antenatal care in the Democratic Republic of Congo: a difference-in-differences analysis.

BACKGROUND: Despite efforts to achieve the Millennium Development Goals, the maternal mortality ratio in the Democratic Republic of Congo was 693 per 100,000 in 2015-the 6th highest in the world and higher than the average (547 per 100,000) in sub-Saharan Africa. Antenatal care (ANC) service is a cost-effective intervention for reducing the maternal mortality ratio in low-income countries. This study aimed to identify the intervention effect of the maternal and child health care (MCH) project on the use of four or more (4+) ANC services. METHODS: The MCH project was implemented using the three delays model in Kenge city by the Ministry of Public Health (MoPH) of the DRC with technical assistance from Korea International Cooperation Agency (KOICA) and the Yonsei Global Health Center from 2014 to 2017. Furthermore, Boko city was selected as the control group. A baseline and an endline survey were conducted in order to evaluate the effectiveness of this project. We interviewed 602 and 719 participants in Kenge, and 150 and 614 participants in Boko in the baseline and endline surveys, respectively. We interviewed married reproductive-aged women (19-45 years old) in both cities annually. The study instruments were developed based on the UNICEF Multiple Indicator Cluster Surveys. This study used the homogeneity test and the binary logistic regression difference-in-differences method of analysis. RESULTS: The odds of reproductive-aged women's 4+ ANC service utilization at the intervention site increased 2.280 times from the baseline (OR: 2.280, 95% CI: 1.332-3.902, p = .003) as compared to the control site. CONCLUSIONS: This study showed that the KOICA MCH project effectively increased the 4+ ANC utilization by reproductive-aged women in Kenge. As the 4+ ANC services are expected to reduce maternal deaths, this project might have contributed to reducing maternal mortality in Kenge. In the future, we expect these findings to inform MCH policies of the MoPH in the DRC.

Factors Associated with Postpartum Health Problems among Married Women of Reproductive Age in the Democratic Republic of the Congo: A Cross-sectional Study in Kenge City.

Maternal mortality is attracting attention worldwide, but maternal health problems after delivery have received less attention. Most studies focus on prenatal maternal health problems. We aimed to identify factors associated with postpartum health problems among married women of reproductive age in Democratic Republic of the Congo. We employed a cross-sectional study design and randomly enrolled 700 married women of reproductive age in Kenge city. Data collection instrument was developed using the UNICEF Multiple Indicator Cluster Survey. T-test, chi-square test, and binary logistic regression analysis were performed using the SPSS version 24.0. Significant risk factors associated with postpartum health problems were initial postnatal care period; within 24 hours (Odds Ratio [OR]=2.197, 95% confidence interval [CI]: [1.156-4.174], p=.016); within 7 days (OR=1.972, 95% CI: [1.102-3.528, p=.022]; within 14 days (OR=2.124, 95% CI: [1.082-4.172], p=.029) among reproductive health and health service utilization characteristics. Health education by RECO (Relais Cmunataure) was associated with postpartum health problems including PCIME (Prise en Charge Integree des Maladies de l'Enfant; OR=1.845, 95% CI: [1.038- 3.282], p=.037); hand washing (OR=1.897, 95% CI: [1.060-3.396], p=.031); malaria (OR=2.003, 95% CI: [1.192-3.366], p=.009) among Maternal and Child Health intervention characteristics. In conclusion, it is necessary to develop and promote health policies and educational programs focusing on PNC service within 24 hours, PNC services within 7 days, PCIME, hand washing, prevention of malaria.

Unintended pregnancy and its correlates among currently pregnant women in the Kwango District, Democratic Republic of the Congo.

BACKGROUND: Unintended pregnancy is an important reproductive health problem in both developed and developing countries and is most prominent in low-middle income countries. In the Democratic Republic of the Congo, the total fertility rate is high at 5.9 births per women, and a mother's probabily of dying at an age between 15-49 years is also high (53 %). Women with unintended pregnancies are less likely to utilize available necessary services for their own health and the health of their children. Therefore, unintended pregnancy is a crucial factor of maternal health in the Democratic Republic of the Congo. This study aims to identify the prevalence of unintended pregnancy and its associated factors in the Democratic Republic of the Congo. METHODS: Data were collected from June 20 to 29, 2014 among women aged 15-49 years who had children younger than 5 years old. The women were from a representative sample of 602 households. Multiple logistic regression analysis was performed to evaluate the associations between the dependent variable and the explanatory variables. RESULTS: Unintended pregnancy was reported in 51.4 % of the respondents. Multivariate logistic regression showed an association between education status (AOR, 3.4; CI, 1.21-9.90) and age of the last child (AOR, 5.17; CI, 1.23-21.70) with an unintended pregnancy. Unintended pregnancies were low among women who owner a cell phone (AOR, 0.18; CI, 0.47-0.73) and those who were aware of family planning method (AOR 0.20; CI, 0.06-0.60). CONCLUSION: The unintended pregnancy rate high and was significantly associated with female education, previous use of family planning methods, ownership of cell phone, and age of the last child. Maternal health interventions should focus on increasing family planning service utilization, awareness of family planning, and access to communication and income.

Strengthening Health Systems to Accelerate Achievement of Millennium Development Goals 4 and 5: A Case Study of Ketu South and Keta Municipalities in Ghana.

This study aims to determine means of strengthening the health system to accelerate achievement of MDGs 4 and 5 in the Volta Region of Ghana, with a particular emphasis in the Ketu South and Keta municipalities. Secondary data have been used in this study. High maternal and infant mortality is a crucial issue in Ghana. Maternal and infant mortality is high in rural area compared to urban area due to unavailability of the service facilities. A community based health planning and services programs have been established to improve access and quality of health care in Ghana. Our study suggests that health system strengthening with community health care programs improved access to quality health care and resulted in a decrease of maternal and child mortality in Ketu South and Keta Municipalities in Ghana.

Empowerment for Healthy Cities and communities in Korea.

The Healthy Cities project started in 1998 in Korea. Around the world, public health and healthy cities are becoming bigger and bigger priorities. Capacity mapping is an important tool for improving a country's health status. This study aims to review the initiation of the Korean "Healthy City" project. Korea follows a bottom-up approach for the development of Healthy City policies and has implemented plans accordingly. Korea has created a unique program through Healthy Cities; it has developed a Healthy City act, indicators for evaluating the program, a health impact assessment program, an award system, and a domestic networking system.

Does South Korea have hidden female smokers: discrepancies in smoking rates between self-reports and urinary cotinine level.

BACKGROUND: Female smoking is perceived very negatively in East Asian countries such as South Korea, Japan, and China, as well as in Islamic countries. These countries' self-reported surveys (SRs) tend to produce results that underestimate the number of smokers, owing to the social desirability response bias. The present study seeks to assess South Korea, Europe, and the Americas, by comparing data from SRs with those from urinary cotinine samples. METHODS: Current smoking rates were calculated using the SRs and the urinary cotinine concentration (UCC) methods according to socioeconomic factors. In order to examine response accuracy regarding current smoking status in the SRs, participants who both completed the SRs and acquired UCC results were subject to analyses of sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and difference ratio (DR) with respect to gender, age, region, economic level, household status, and the presence of chronic disease. RESULTS: Based on self-reports, the current smoking rate among women was 7.1% (official smoking rates), while that according to the UCC was 18.2%; the rates for men were 47.8% and 55.1%, respectively. The sensitivity of males was 0.8553, the specificity 0.9768, PPV 0.9783, NPV 0.8465, and the difference ratio (DR) was 1.143. The sensitivity for females was 0.3670, the specificity 0.9956, PPV 0.9486, NPV 0.8761, and the DR was 2.6. These results exhibit a very low response alignment rate compared to males. CONCLUSION: This study shows that the actual female smoking rate is significantly higher than that reported officially, but also that the gap is decreasing steadily. Females exhibited a higher rate of false responses, which resulted in an underestimation of the female smoking rate.

Exploring COVID-19 Phobia among International Chinese College Students in South Korea Before Ending COVID-19 Restrictions.

BACKGROUND: College students, considered to be the driving force of society, are highly vulnerable to COVID-19. At a time when facing a new pandemic wave in 2022, China's policy was in contrast with that of Korea. We investigated the phobia levels of international Chinese college students studying in Korea. OBJECTIVE: This study aimed to investigate the relationship between the frequency of use and trust of information sources, and COVID-19 phobia (C19P) among Chinese college students studying in Korea before ending related restrictions. METHODS: This study employed a cross-sectional design, conducting an online survey among Chinese college students studying in Korea from April 8-15, 2022 (before Korea ended the limitations due to COVID-19). Data about 319 respondents were analyzed, including socio-demographics, information variables, knowledge, attitudes, practices (KAP), and C19P. Hierarchical regression analysis with different models was used to examine the relationship between information trust, KAP, and C19P. RESULTS: Results showed that students performed well in knowledge and preventive practices, had diverse sources of getting information related to COVID-19, and highly depended on the internet and news. Students who perceived a higher severity of infection showed higher levels of COVID-19 phobia. The tendency to wear masks with family/friends, avoid crowded places, and not agree with Korean government mitigation policies reported higher levels of COVID-19 phobia. CONCLUSIONS: More authority and proactive communication strategies, such as consultations or education programs, are needed for international students to alleviate their phobias and psychological stress.

Sociodigital Determinants of eHealth Literacy and Related Impact on Health Outcomes and eHealth Use in Korean Older Adults: Community-Based Cross-Sectional Survey.

Background: eHealth literacy is an essential skill for pursuing electronic health information, particularly for older people whose health needs increase with age. South Korea is now at the intersection of a rapidly digitalizing society and an increasingly aged population. eHealth literacy enables older people to maximize the effective use of emerging digital technology for their health and quality of life. Understanding the eHealth literacy of Korean older adults is critical to eliminating the gray digital divide and inequity in health information access. Objective: This study aims to investigate factors influencing eHealth literacy in older Korean adults and its impact on health outcomes and eHealth use. Methods: This was a cross-sectional survey. Community-dwelling older adults 65 years and older in 2 urban cities in South Korea were included. eHealth literacy was measured by the eHealth Literacy Scale. Ordinal logistic regression was used to analyze factors associated with eHealth literacy and multivariate ANOVA for the impact of eHealth literacy on health outcomes and eHealth use. Results: In total, 434 participants were analyzed. A total of 22.3% (97/434) of participants had high eHealth literacy skills. Increasing age, higher monthly income, and time spent on the internet were significantly associated with eHealth literacy (P<.001), and social media users were 3.97 times (adjusted odds ratio 3.97, 95% CI 1.02-15.43; P=.04) more likely to have higher skill. Higher eHealth literacy was associated with better self-perceived health and frequent use of digital technologies for accessing health and care services (P<.001). Conclusions: Disparity in socioeconomic status and engagement on the internet and social media can result in different levels of eHealth literacy skills, which can have consequential impacts on health outcomes and eHealth use. Tailored eHealth interventions, grounded on the social and digital determinants of eHealth literacy, could facilitate eHealth information access among older adults and foster a digitally inclusive healthy aging community.

Analysis of digital capacity-related factors influencing health promotion participation and active aging of older adults residing in rural areas in South Korea: A structural equation model.

Objective: This study aimed to identify the correlation between digital capacity, health promotion participation, and active aging of older people living in rural areas in South Korea to assess the factors influencing participation in programs for health promotion and active aging. Methods: Data were collected through a 1:1 face-to-face survey using a structured questionnaire from 13 February to 24 February 2023 during the older individuals' visits in the senior citizen welfare centers and senior citizen centers in the region. The Measuring Digital Skills questionnaire used to assess the digital competence of South Korean individuals was employed in this study. To confirm the structural relationship between digital capacity and health promotion participation and active aging in the older population aged 65 years and older based on the collected data, a structural equation modeling analysis was performed. Results: Active health promotion participation had a positive effect on active aging. The pathway that older adults in Korea can led to participation in health promotion and active aging in the current situation is not mainly through the digital competency whereas mobile internet skill showed positive influneces. Conclusions: In the digital era and super-aged society, various programs are provided to older individuals to enhance the utilization of smartphones. However, education and programs for strengthening digital capacity should be organized to explain the advantages of digital use and to inform of the dangers of addiction to ensure healthy aging through social participation and exchange both online and offline.

Validation of the Chinese version of the COVID-19 Phobia Scale among Chinese college students.

Background and objective: Different languages and versions of the COVID-19 Phobia Scale (C19P-S) have been developed and tested in several countries. Chinese college students are a large vulnerable group and are susceptible to psychological problems during the COVID-19 pandemic. However, no studies had yet examined the reliability and validity of the C19P-S in China among college students group. This study aims to evaluate the COVID-19-related phobia of Chinese college students and examine the reliability and validity of this scale. Methods: A total of 1689 Chinese college students participated in this study from April 27 to May 7, 2022. They finished the online questionnaire including demographic information and C19P-S. Cronbach's alpha and split-half reliability were used to examine the internal consistency of the scale. Confirmatory factor analysis was further used to examine the scale's construct validity. Convergence validity was also confirmed. Results: This scale in Chinese had high reliability and validity. The Cronbach's alpha and split-half reliability of the total scale were 0.960 and 0.935, respectively. The construct validity-related indicators of the total scale met the standards (RMSEA = 0.064, IFI = 0.907, TLI = 0.906, and CFI = 0.907). Regarding the subscales, the composite reliability (CR) and average variance extracted (AVE) also met the cutoff values (CR > 0.7 and AVE >0.5). Comparison between gender groups showed that total and subscale scores between male and female students differed significantly. Conclusion: The Chinese version of the C19P-S was appropriate for evaluating phobic symptoms among Chinese college students. Therefore, this tool could be used to evaluate the mental health of college students in the future.

Relationship between Cognition, Depression, and Oral health status in Older adults: A longitudinal cross-lagged analysis.

BACKGROUND: The world's population is aging increasingly, and older adults' physical and mental health needs to be prioritized. Although several studies have explored the relationship between cognition, depression, and oral health in older adults, the exact nature and direction of this relationship are poorly understood. Moreover, most studies to date have been cross-sectional, with fewer longitudinal studies. The current longitudinal study explored the relationship between cognition, depression, and oral health in older adults. METHODS: We used data from two waves (2018, 2020) of the Korean Longitudinal Study of Aging, which included 4543 older adults aged 60 years and older. General socio-demographic characteristics were analyzed using descriptive analysis, and study variables were described using t-tests. Generalized Estimating Equations (GEE) and cross-lagged models were used to examine the longitudinal associations between cognition, depression, and oral health. RESULTS: The GEE results suggested that better cognition and less depression over time were associated with better oral health in older adults. Cross-lagged models further validated the effect of depression on oral health over time. LIMITATIONS: The directionality of the influence of cognition on oral health could not be determined. CONCLUSIONS: Although there were several limitations, our study provided novel ideas for verifying the effects of cognition and depression on oral health in older adults.

Impact of COVID-19 Fear on COVID-19 Policy Support Among University Students in South Korea.

Objective: As the fourth wave of COVID-19 spread in South Korea in 2022, society experienced various adverse effects, including COVID-19 phobia, depression, and loneliness. Addressing these factors became a vital part of the anti-COVID-19 individual and public mental health efforts, conducted partly by fostering COVID-19 knowledge, attitudes, and compliance with public prevention practice guidelines under the controversial policy of living "with COVID-19". Method: The study used a cross-sectional online survey-based design. Participants comprised a convenience sample of Korean university students (n = 460). A survey was distributed to the participants to measure their agreement/disagreement with the policy "with COVID-19" and a structural equation model and path analysis to examine the impact of the latent variables of COVID-19 phobia and COVID-19 knowledge, attitudes, and practice as of April 2022. Results: The mean COVID-19 phobia score was 48.13/100, with psychological and social phobia scores higher than in previous studies, while psychosomatic and economic phobia scores were lower than in previous research. Higher psychological phobia significantly increased COVID-19 practices and attitudes. Conversely, higher psychosomatic phobia decreased practices and attitudes. Moreover, higher psychological phobia was significantly associated with disagreement with the policy. Conclusion: The results suggest that efforts to increase South Korean university students' acceptance of easing COVID-19 restrictions should focus on mitigating psychological phobia.