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Purpose: Growing evidence indicates that adolescents from multicultural families are more vulnerable to drug use than those from non-multicultural families. This study aimed to compare the factors associated with the habitual drug use among adolescents from multicultural and non-multicultural families. Methods: A descriptive cross-sectional design was employed. Data were obtained from the 14~15th (2018~2019) Korea Youth Risk Behavior Web-based Survey. Overall, 91,443 multicultural (n=1,725) and non-multicultural adolescents (n=89,718) were included. Data were analyzed using descriptive statistics, univariate analysis, and logistic regression analysis. Results: The multicultural adolescents engaged in more habitual drug use than did non-multicultural adolescents. In both groups, those who currently drank, experienced violent victimization, had sexual experiences, and did not live with their family were at greater risk of engaging in habitual drug use. The odds ratios of these factors were higher in multicultural adolescents than in non-multicultural adolescents. In non-multicultural adolescents, those who were boys, had experienced depression and suicidal ideation, perceived their body image as normal, overweight, or obese, and had poor subjective health status were at greater risk of engaging in habitual drug use. Conclusion: These results highlight the need to develop customized strategies for adolescents from both multicultural and non-multicultural families to reduce and prevent their habitual drug use.

Purpose: This research was conducted to investigate the characteristics of emotional exhaustion that Korean school nurses suffer, to suggest policy implications to address this issue, and to propose preventive and supervisory measures regarding emotional exhaustion experienced by school nurses in elementary, middle, and high schools in Korea. Methods: A survey was conducted under the authorization of Chungcheongnam-do Office of Education. Out of 400 copies first distributed, 376 copies were returned. Among the 376 copies, 117 copies which were judged insincere or from teachers with less than 1 year of experience were exclded from the study. Through this process, only 259 copies were finally selected. Results: As a result of assessing the fit of the model, it was found that x2=67.247 (df=28,p<.001), GFI=.953, AGFI=.911, TLI=0.936, CFI=0.965 and RMSEA=.074. Emotional exhaustion was found to have a direct effect on job demand (β=.26) and an indirect effect on stress response (β=.31). The total effect was β=.57. There was a positive complete indirect effect of β=.52 between emotional intelligence and emotional exhaustion. The total effect was not significant, respectively. Conclusion: Since job demands of school nurses affect emotional exhaustion, it is necessary to reconstruct their jobs and operations to alleviate their job demands.

Purpose: Discrimination experienced in the early stages of life among ethnic minority adolescents is known to affect depression and also adversely affect health throughout adulthood and old age. The purpose of this study was to identify whether discrimination experienced by ethnic minority adolescents and their mothers and depression among mothers affect depression in ethnic minority adolescents according to gender. Methods: This was a cross-sectional study using the data of 2018 National Multicultural Family Survey in Korea. The study sample comprised 2,446 ethnic minority adolescents aged 11~18 and their mothers. The data were analyzed using descriptive statistics, pearson correlation analysis, and ordinal logistic regression with SPSS/WIN 25.0 and STATA IC 16. Results: 18.4% of the adolescents (boys: 15.1%, girls: 20.5 %) felt sad or frustrated sometimes or more often for at least two weeks during the past year. Also, 8.3% of the adolescents and 29.6% of their mothers experienced discrimination during the past year. Boys were influenced more than girls by bullying at school (OR=5.17, 95% CI: 2.85~9.38), academic performance (very bad’s OR=5.79, 95% CI: 1.54~21.63) and mother’s depression (often’s OR=2.31, 95% CI: 1.14~4.64). Girls were influenced more than boys by experience of discrimination (OR=2.72, 95% CI: 1.69~4.39). Conclusion: The findings showed that discrimination experienced by ethnic minority adolescents and their mothers in Korean society increases depression in ethnic minority adolescents and has different effects by gender. Therefore, a gender-specific and mother-inclusive intervention is recommended to prevent depression in ethnic minority adolescents.

Purpose: Exploring the variables that predict teachers' intent when referring students to mental health professionals is important. The Theory of Planned Behavio (TPB) is a theory of predicting people's intentions of performing a particular behavior; the intent to perform a certain behavior is determined by three factors. (1) attitudes toward the behavior, (2) subjective norms, and (3) perceived control. This study aimed to develop a TPB measurement to investigate what variables predict the intentions of teacher’s referral behaviors. Methods: A qualitative study following standardized manuals and guidelines for developing a TPB measurement was used. As a qualitative research method, the Consensual Qualitative Research-Modified (CQR-M) was used. According to the findings from the qualitative study, the quantitative measurement to assess teachers’ referral intention, attitude, subjective norm, and behavioral control was developed. Results: The reliability and validity of the newly developed measurement were tested and verified. Conclusion: The newly developed measurement would contribute to a future empirical study that will examine predictors of teachers' referral intention.

Purpose: With the development of media, the ways adolescents can obtain information related to sexual health have diversified. Prior quantitative research on adolescents’ sexual health information seeking behaviors (HISB) has limitations in grasping the details, and sexual issues of adolescents have tended to be underreported in quantitative studies. It is necessary to explore sexual HISB through an integrative review of qualitative research. The aim of the study was to analyze the literature on sexual HISB among adolescents, focusing on qualitative research. Methods: An integrative review was undertaken to explore the studies conducted between 2009 and 2018 that addressed sexual HISB such as source preferences, perceived trustworthiness, and tendency according to age and gender among adolescents. Results: Seven studies met the selection criteria and were analyzed according different sexual HISB. It was identified that adolescents preferred trustworthy sources and had a pattern of reviewing and comparing the content among diverse sources to confirm the quality of the information. Female adolescents valued privacy and confidentiality, while male adolescents would like to earn information along with their peers and perceived it as an opportunity to exchange their experiences and thoughts. Late adolescents preferred to seek sexual health information from peers and on the internet such as websites and social platforms compared to early adolescents. Conclusion: This study is significant in that it provides evidence that can be applied when developing programs for promoting sexual health in adolescents. It is suggested that programs should focus on building trustworthiness and consider differences in age and gender to improve the use of sexual health information among adolescents.

Purpose: The purpose of this study was to investigate the affect of eating behaviors on subjective health of multi-cultural adolescents in South Korea. Methods: This study is designed as cross-sectional. Using the statistics from the 15th (2019) Korea Youth Risk Behavior Web-based Survey, multiple logistic regression analysis was conducted. Overall, 711 multi-cultural adolescents were included in the analysis. Results: When analyzing the factors affecting the subjective health status of multi-cultural adolescents, normal body mass index (OR: 0.56, 95% CI: 0.35~0.89) and milk consumption (OR: 0.54, 95% CI: 0.35~0.83) showed a lower risk of being unhealthy, while skipping breakfast for 5 days (OR: 1.97, 95% CI: 1.33~2.93) and convenience store food consumption (OR: 1.59, 95% CI: 1.05~2.40) showed a higher risk of being unhealthy. Conclusion: It is necessary to form positive eating habits that influence the subjective health perception of multi-cultural adolescents. Therefore, appropriate dietary education and systematic support should be provided for multi-cultural families.

Purpose: Smoking among adolescents is a critical healthcare concern that needs to be tackled with respect to not only intrapersonal and interpersonal factors but also socio-cultural factors. This study was to identify the smoking behaviors and amount of tobacco consumption among adolescents, and to investigate the factors associated with the behaviors and amount. Methods: A cross-sectional study was conducted based on the theory of triadic influence using a nationally representative secondary data set, the 2018 Korea Youth Risk Behavior Survey (N=60,040). The analysis was performed by dividing smoking behaviors into lifetime, current, and daily smoking, and smoking amount into light, moderate, and heavy smoking. Descriptive statistics and multinomial logistic regression analyses were conducted. Results: Overall, 8.2%, 3.2% and 3.4% of the adolescents were involved in lifetime, current, and daily smoking, respectively. In addition, 5.3%, 0.8%, and 0.6% of the adolescents were involved in light, moderate, and heavy smoking, respectively. The factor associated with smoking behaviors and the amount of tobacco consumed were gender, academic achievement, depression, living with family, close friend’s smoking, violent victimization, household economic status, and school level (all ps<.05). Conclusion: A considerable number of adolescents are engaged in risky smoking behaviors and consume large amounts of tobacco. Adolescents who said yes to peer smoking, violent victimization, not living with their family, and depressive emotions were more likely to engage in risky smoking behaviors and consume large amounts of tobacco. Tailored interventions to decrease smoking should be planed and provided, while considering the school and home environment and individual needs of adolescents.

Purpose: This study was conducted to describe the experience of school health teachers in regard to the COVID-19 pandemic in South Korea. Methods: We conducted a qualitative study using content analysis. Ten school health teachers were recruited from 6 elementary schools, 2 middle schools and 2 high schools in Seoul, using purposive sampling. They participated in semi-structured in-depth interviews in person or using an online communication system from January to February, 2021. Interviews were transcribed verbatim and analysed using qualitative content analysis. Results: Three main categories and nine generic categories emerged from the analysis. Firstly, it was discovered that school health teachers had psychological and physical stress to cope with COVID-19 due to the 1) fear of the unexpected infectious disease, 2) burden of having to deal with it alone, 3) breakdown of personal life and physical exhaustion and 4) heavy duty as a health teacher caused by the lack of an organic cooperation system with institutions related to school infectious diseases. Secondly, school health teachers had an increased sense of empowerment in regard to infectious disease management as a result of 1) feeling rewarded and appreciated and 2) gaining confidence and trust in infectious disease management. Finally, school health teachers experienced the urgent need for an effective response strategy for infection control because of the 1) confusion over infectious disease response due to lack of practical manuals applicable to the field as well as training, 2) disappointing response system without an expert response team dedicated to managing infectious diseases in schools, and 3) growing awareness of the need for change. Conclusion: It is expected that school health teachers' experience of COVID-19 will be used as important data for building effective and advanced school infectious disease response systems.