Earticle

연구목적: 이 연구의 목적은 일부 초등학교에서 호주의 천식친화학교 프로그램에 기반한 시범사업의 실시를 통해 우리나라 초등학교에서 소아천식관리프로그램의 적용 가능성을 검토하고 향후 발전방향을 위한 기초자료를 제시하는 데 있다. 연구방법 : 호주의 천식친화학교사업을 모델로 하여 초등학교에서 천식아동들을 위한 시범사업내용을 개발하였다. 시범사업의 내용은 천식아동발견사업, 학교 모든 교직원 및 천식아동 학부모 대상 교육사업, 교내 관리활동으로 구성된다. 시범사업은 도심에 위치한 한 초등학교와 농촌지역의 두 개 초등학교를 대상으로 6개월 간 시범 적용하였다. 시범사업 추진팀과 학교관계자들 간 그룹토의를 통해 사업과정에 대한 평가를 실시하였고 이 사업에 참여한 천식아동을 가진 144 가구를 대상으로 사업과정과 만족도에 대한 우편 설문조사를 실시하였다. 연구결과 : 천식아동발견사업은 일차스크리닝과 확진검사로 구성하였으며 시행결과 신규환자의 조기발견 효과는 있었으나 확진검사를 포함할 경우 환자발견사업의 경제성 평가의 필요성이 대두되었다. 학교보건교사를 대상으로 한 4시간 교육은 보건교사 업무에 도움이 된다고 평가하였으나 일반교사 교육은 참석률이 45.0%로 학교장과 보건교사의 의지에 따라 학교별로 다소 편차가 있었다. 천식아동을 가진 학부모의 교육 참석률은 총 122 대상가구 중 24.1%이었으며 참석하지 못한 이유로 증상이 경미하여 교육의 필요성을 못 느끼거나 바쁜 일정으로 참석하지 못한 경우가 가장 많았다. 반면 참석한 34명의 부모 중 도움이 되었다고 응답한 경우는 33명(97.1%)이었다. 설문조사에 응답한 122명의 학부모 중 92%가 학교에서 천식아동을 위한 관리프로그램이 필요하다고 응답하였다. 교내 관리활동으로 천식아동 명부를 작성하여 보건교사와 담임교사가 공유하였는데 천식아동의 건강상태를 더 자세히 기록한 건강관리카드의 필요성이 제기되었다. 천식 발작 시 대응요령을 위한 인쇄물과 천식조절제인 흡입제와 보조기구가 들어 있는 응급키트를 보건실에 비치하였으며 천식아동들의 안전을 위해 매우 필요하다는 의견이 많았다. 결론: 호주의 천식친화학교를 모델로 하여 초등학교에서 시범사업을 수행한 결과 이 사업에 참여한 각 학교의 학교장, 보건교사, 일반교사들, 그리고 천식아동의 학부모들은 천식아동들을 위한 학교 차원에서 관리활동에 긍정적이었다. 또한 프로그램의 수정과 보완이 필요성이 제기되었으며, 향후 효과평가를 통하여 우리나라 실정에 맞는 천식친화학교 모형을 정립해 나가야 할 것이다.

Purposes: The objective of this study was to develop a management program for Korean elementary school students suffering from asthma, which would be based on the Australian Asthma-Friendly Schools (AFS) program. Methods: On the basis of the AFS program, we designed a 6-month pilot project for asthmatic students in two elementary schools in a rural area and one elementary school in an urban area of Korea. The pilot project consisted of the following processes: identifying students with asthma in a school, educating school staffs and the parents of an asthmatic child, registering those with asthma, and installing emergency kits for asthma attacks in school health rooms. In order to evaluate these processes, group discussions were held between project team members and school staffs in each area. In addition, we conducted a postal survey of 144 households having an asthmatic child. Results: The screening process adopted in this program resulted in the early diagnosis in asthma; however, it needs to be evaluated economically due to expensive diagnostic test for asthma. For the school nurses, asthma lessons were evaluated as being very helpful for their tasks, while teachers tended to take less interest in the program with only 45% of all teachers attending these lessons. Almost all participating parents reported that such lessons would be beneficial for the care of their child, even though only 24.2% of the survey respondents (122 households) attended the lessons. Installing emergency kits in school health rooms was regarded as a key feature of this project. The introduction of a register card containing more specific health records of asthmatic students was considered necessary to replace the existing list of students with asthma. Conclusion: This study has merit in that a Korean asthma-friendly schools program was developed for the first time, despite the many obstacles to such programs becoming more common.

Purpose: This study was performed to investigate the attitude and recognition on how to describe the elderly of elementary school students. Methods: The subject of this study was total 806 students of 4, 5, 6 grade at 2 elementary schools in Gyunggi-do. The data were collected through self-reporting questionnaires for a month. Results: First, the score of attitude about the elderly was 107.8 and image score was the highest. Second, there were significant differences in the attitude about the elderly according to grade, birth order of siblings, domestic atmosphere, and economic status, domestic education on respect about the elderly, and education about the elderly at school. Third, there were significant differences in the attitude about the elderly according to parent-grandparent relationship, health and economic status of grandparents, meeting frequency with grandparents. Fourth, the score of word recognition about the elderly was 43.3 and social score was the highest. fifth, there were significant differences in recognition on how to describe the elderly according to grade, birth order of siblings of students and parents, domestic atmosphere, and economic status, domestic education on respect about the elderly. Sixth, there were significant differences in recognition on how to describe according to parent-grandparent relationship, health status and economic status of grandparents, meeting frequency with grandparents. Lastly, The attitude and recognition about the elderly showed significant positive relationship. Conclusion: We should provide qualitative education programs to improve the attitude and recognition about the elderly of elementary school students.

Purpose: The purpose of the study was to find the strategies of mental health screening in school. Based on the literature review, we discuss the importance of screening students in schools for mental health problems. Methods: Data from the 2008 Korean Mental Health Screening in Schools(2008-KMHSS) are used to estimate the outline of this screening. We administered the questionnaire for satisfaction of 2008-KMHSS for students(N=1,280), parents(N=2,672), school nurses(N=75), teachers(N=685), district personnels(N=6), and mental health center staffs(N=37). Also we interviewed a part of them by telephone and e-mail. And we reviewed the tools and methods for screening students for emotional/behavioral problems. Results: Mental health screening in schools is a very important, yet worrisome, agenda that is in its very early stages. From the 2008 Korean Mental Health Screening in Schools, 9,588 students(12.9%) needed more evaluation in the first stage. Of these, 6,910(72.1%) completed the second stage screening. In this sample, 1,975(28.6%) utilized the mental health services in school or community. 38.3% of students and 43.7% of their parents notified the 2008-KMHSS. But only 12.1% of students and 10.9% of their parents dissatisfied with the screening. 9.9% of teachers and 22.7% of school nurses dissatisfied with the screening. Among them the school nurses were mostly dissatisfied, and they complained work burden from KMHSS. Mental health center staffs complained similar issues. The Children's Problem-behavior Screening Questionnaire(CPSQ) and Adolescents' Mental-health & Problem-behavior Screening Questionnaire(AMPQ) were compatible to screen students in schools for mental health problems in first stage. Conclusion: Mental health screening in schools needs careful planning and implementation. For successful mental health screening in schools, several elements need to be considered: careful planning, collaboration, staff training, and integrative mental health programs and services in community or schools.

Purpose: The aim of this study was to identify the factors related with the intention of smoking abstinence among elementary students in a metropolitan city in Korea. Methods: All the elementary schools in the city were stratified by region, and then schools as a primary sampling units (PSU) were selected by probability proportional to size (PPS) sampling. One class per grade was sampled randomly from 5th and 6th grade in the sampled schools from October to December in 2004. The students completed a standardized self-administered questionnaire anonymously. A total number of 1,712 respondents who did not smoke was included in the final analysis. The dependent variable was an intention of smoking in the future, and it was dichotomized into 'absolutely confident in smoking abstinence' and 'others'. The risk of non-absolute confidence in smoking abstinence was calculated with simple and multiple logistic regression, which were conducted with STATA 9.0 by a design-based analysis considering strata variable, PSU, and sampling weight. Results: In the final model of multiple logistic regression analysis, those who were more likely to have non-absolute confidence in smoking abstinence were male students (OR=2.66, p<0.001); barely attending religious services (OR=3.32, p=0.002) or having no religion (OR=1.95, p=0.027); exposure to environmental tobacco smoke outside home 12 days per week (OR=1.60, p=0.013); having friends who smoked (OR=1.93, p=0.011); non-absolute confidence in refusing to smoke (OR=5.35, p<0.001); having relatively less negative attitude (OR=2.88, p<0.001), positive attitude (OR=2.35, p<0.001), and indifference (OR=4.05, p=0.034) toward peer smoking; not good relationship with mother (OR=1.52, p=0.016). Conclusion: The factors related with non-absolute confidence in smoking abstinence were coincided with those of smoking among children. The results of this study suggest the smoking prevention education should be applied to the children more actively, especially who are not confident in smoking abstinence in the future.

AIMS: Korean National Growth Chart was newly developed at 2007. Prevalence of obesity is expected to be changed according to reference data. This study was performed to compare the prevalence of obesity based on the newly developed growth curve with that of previous data. We also investigate the incidence of obesity, overweight, and normal criteria by two kinds of growth curves. Method: We obtained weight, height from 438 middle school students and 1786 high school students. We divided enrolled students into four groups (middle school boys, middle school girls, high school boys, high school girls). The obese, over weight group was defined as BMI(body mass index) more than 95th, 85th94th percentile respectively for age and sex. Obesity by relative weight was defined more than 20% of ideal body weight. We compare the prevalence of obesity in each group by the newly developed Korean National Growth Chart in 2007 and that in 1998. Result: Prevalence of obesity by BMI based on 2007 Korean National Growth Chart and that in 1998 were 8.2-12.9% and 9.0-20.4% respectively. The concordance rate were 99.0%-100% in obese group and 45.0%-91.9% in overweight group according to two kinds of reference data. Prevalence of obesity by relative weight was 11.7-23.0% that was same between 2007 Korean National Growth Chart and that in 1998 except middle school boys group. Conclusion: We found that there is a decrease in prevalence of Obesity by BMI based on 2007 Korean National Growth Chart. It is necessary to evaluate correlation between criteria for obesity and obesity related comorbid conditions for finding proper BMI or relative weight cut off value to prevent obesity and obesity related complications effectively.

Purpose: The purpose of this study was to examine the relationship between the toothpaste squeezing methods and the amount of toothpaste that the daycare teachers apply for the children in order to prevent the overuse of fluoride-containing toothpaste among children, and to understand their educational experiences on oral health and their awareness of the right amount of toothpaste used. Methods: The subjects in this study were 87 teachers at 16 different daycare centers in the city of Sokcho, Gangwon Province. They were interviewed to find out whether they had ever received oral health education and whether they were cognizant of the right amount of toothpaste to be used. And a transverse technique and a pea-sized squeezing technique were selected to look for connections between their toothpaste squeezing methods and the amount of toothpaste used by them. Results: 89.7 percent of the daycare teachers investigated taught to preschoolers how to do toothbrushing after they took meals and had a snack. 36.8 percent of the daycare teachers had children squeeze toothpaste on their own. The amount of toothpaste applied by the daycare teachers at a time was 0.58ｇ. When they utilized two other squeezing methods, transverse technique and pea-sized squeezing technique, they used each 0.38 g (p<0.005) and 0.38 g (p=0.405) of toothpaste. Conclusion: To prevent children from being overly exposed to fluoride-containing toothpaste, daycare teachers should learn about the right amount of toothpaste to be used when oral health education is provided, and the transverse technique should be recommended to ensure the use of the proper amount of toothpaste.

Purpose: The purpose of this study was to develop a comprehensive health promotion program for North Korean young adult defectors in South Korea. Methods: The comprehensive health promotion program consisted of nutrition, mental healthcare, physical activity and sexual behavior was developed on the basis of need assessment results. For the evaluation of the program, 70 North Korean young adults who were attending two alternative schools for North Korean defectors were recruited. The program had taken place once a week for 13 or 19 weeks. Effectiveness of the health promotion program was evaluated using anthropometric measurement, 3-day food records and a questionnaires that comprised the Hospital Anxiety and Depression Scale (HADS), the Short Form with 36 questions (SF-36) and health behaviors. The surveys were proceeded at the beginning and after the program. Results: After health promotion program, participants' height was significantly increased (p=0.004) and body fat mass (0=0.004) and percentage of body fat mass (p=0.003) were significantly decreased. The number of subjects who ate breakfast alone was decreased whereas the number of subjects who ate breakfast with friends was increased (p<0.001). There were no significant changes in dietary intakes, mental health status and quality of life. North Korean young adult defectors' willingness to participate and interests in the health promotion program were high, however the practice rate was low. Conclusion: The health promotion program could induce interests and willingness to participate, but bring about limited effects on the health behaviors. These results imply that a health promotion program for North Korean young adult defectors should have a long-term strategy as well as short-term plan. Furthermore, it should be based on their health problems, health related behaviors, academic performance and daily life matters.

Purpose: This study aimed to investigate the prevalence of depression and to identify the influencing factors of depression. Methods: The data of the 2006 Youth Health Risk Behavior web-based Survey Collected by the Korea Center Disease Control was analyzed by Chi-square test, logistic regression using the SPSS program. Results: The influencing factors of depression by general characteristics were gender, school, health status, socioeconomic status and living with both parents. The influencing factors of depression by health risk behaviors were perceived stress, sleep, effort for weight loss, smoking, drinking and drug use. Conclusion: This study suggested that Depression prevention programs should be developed in considering preventing and reducing health risk behaviors

Purpose : The purpose of this study was to evaluate the effectiveness of first aid education module on convulsion and seizure for students in elementary, middle and high school. Methods : This study has implemented to 2 types of test groups and control group in each 3rd and 5th grade of elemenary school, 2nd grade of middle school and high school within target school. The data were collected through a self-reported questionnaire to before, after and one month after education from July, 11 to September 4, 2007. Results : The test group who received first aid education possessed greater knowledge about convulsion and seizure relative to the control group not received education. The overall students has satisfied and been understood well with this module. The educators agreed to the practical aspects of this module in school setting. Conclusion : The above results implicated the importance of a continuous and systematic first aid education program among students. For effective first aid education, there needs a development of targeted educational materials for each grade student and training programs for educators.

Purpose: The purpose of this study was to investigate usage of earplones, PCPs, and to give the basic data for adolescent's hearing health education. The study was a descriptive research about three factors affecting hearing loss; the knowledge and attitude about noise, the perception of hearing loss. Method: For research purposes, we conducted a questionnaire survey of 1,480 high school students in Suwon, from 27 October 2007 to 31 2007. Result: Most of the subjets used PCPs for 3-5 years, the average time of using earphones per day was 1-3 hours, awake hearing acuity decrease after using is the hearing acuity became worse some, PCPs type is MP3, use place house, listening contents ballade, disorder condition experience after using if the ear it is sick. The average of concern about hearing scored the highest 3.010.54. The average of perceived susceptibility scored 3.040.63 and the average of knowledge about noise scored 2.760.46. The average of total knowledge and attitude about noise scored 2.930.52. The average of discomfort of hearing loss(2.200.63) scored higher than that fear of hearing loss(1.660.30). The average of total perception of hearing loss scored 2.120.67. Conclusion: At least in this study are shown in the youth earphone, PCPs used as a spare because of the seriousness of the issue, so as a result of these problems related to hearing about the youth campaign, through advertising or seriousness of the young people need them. In addition, countries also need to create policies and the support for health education, especially during the regular curriculum subjects on subjects that include teenagers in the earphone, PCPs due to problems with spare on the contents of the reservoir. The severity of hearing loss young people, prevention of hearing to protect the youth.

Purpose : The purpose of this study was to examine the effects of a self-efficacy promotion program on obesity in elementary school students. Methods : Forty five obese children from a elementary school were select for an experimental group and 53 obese children from another elementary school were chosen for the control group. Both schools located in Kimpo area. Obesity was defined as children whose age-specific BMI was 85th percentile or higher. Pre and post test were conducted to examine the effects of the self-efficacy promotion program. Chi-square test, t-test, paired t-test were used for analyses. SPSS 10.0 was used. Results : The decrease of BMI was significantly greater in the experimental group than the control group. Students' knowledge about obesity was significantly increased in the experimental group compared to the control group. Self-efficacy score was significantly increased in the experimental group. In addition, self-care behavior score was significantly increased in the experimental group. Therefore, the experimental group showed significant improvement in their knowledge, self-efficacy and self-care behavior compared to the control group. Conclusion : The results of this study suggest that self-efficacy promotion programs may have significant effects on the management of obesity in elementary school children. Thus, the results strengthen further research to develop effective intervention programs focusing on self-efficacy for obesity in elementary school children.

An evaluation in school education systems should identify what students achieve and what they do not. Since 2010, if the health education curriculum is provided as a selective course in middle and high school settings, the national health education standards are required because these affect on students' applications of a higher stage of education. It would be better that each school follows their autonomy to evaluate each student's achievement on the health education. In addition, the national health education standards should be set to assess the effectiveness of seven categories in health education. It is hard to achieve good results through 17 hours of the health education per a semester. Therefore, the health education would be better to provide more than 50 hours per a semester, and the 3th graders instead of 5th graders are suitable for taking the health education because they are more flexible to change their lifestyle toward healthier life. There are two categories in the health education, such as "Mental Health" and "Society and Health" which are expanded from originally seven categories of the health education. Moreover, professional training programs for school nurses should be provided because these two categories are relatively a new domain for them. Finally, all elementary middle and high schools have a school nurse to decrease inequal opportunities of the health education between urban and rural area. When these suggestions are all set in school systems, our students' health behaviors will be improved as well as the effectiveness of the health education.

International Safe School(ISS) model has focused as a public health approach to develop safety intervention to address injury problems in school setting. It needs school members involvement in partnership with community resources to address the needs for school based injury prevention and safety promotion. The characteristics and principles of ISS model discussed in this paper emphasizes participation, capacity and partnership building, evidence based process, and so on. A 7 criteria is introduced as ISS implementation strategy. Multilevel and multi-facet approaches are valuable on ISS as well as process evaluation. For the application of ISS model in Korea, finding evidence, building public health partnership between school and other public or private resources in community are necessary conditions for succesful ISS for health promotion in school setting

Purpose: The purpose of this study is to suggest the direction for improvement of educational curriculum for health education in future while investigating change of organization in curriculum for health education in Korea. Method: It is to analytic thinking the trend of curriculum development and organization of the health curriculum in national level. Results: As a result of this analysis of change of organization in curriculum for health education in Korea, the educational curriculum in Korea is proved to have established diverse subjects about health education in whole educational curriculum. The analysis of organization of educational curriculum in each term shows that subjects on health education has diminished in amount or weakened in content in the education of elementary, middle and high school, as they disappeared from organization of educational curriculum in 4th and 5th terms for education. Seventeen hours per year portioned for health education in revised educational curriculum for 2007, which is currently operated, has been analyzed as being very short to its full requirement. The significant increase of hours for education is demanded for health education to be systematic and practically helpful in actual field of education in schools. Conclusion: It is also demanded that the more diversified and systematic method of education should be applied to and operated for organization and operation of educational curriculum rather than strictly unified educational curriculum.