Earticle

목적 : 지역사회기반 중재가 뇌졸중환자의 일상생활활동에 미치는 효과에 대한 근거를 제공하고자 하였다. 연구방법 : 체계적 고찰과 메타분석방법을 사용하였다. 데이터베이스는 PubMed, MEDLINE, Cochran CENTRAL, RISS, 국회도서관을 사용하여 자료를 수집하였고 각 연구의 질 평가는 PEDro Scale을 사 용하였다. 두 명의 저자가 독립적으로 자료수집 및 질 평가를 실시하였다. 포함기준에 맞는 연구는 7편 의 연구가 최종적으로 포함되었다. 분석은 대상 논문의 실험군 및 대조군의 대상자 수, 평균, 표준편차를 사용하여 메타분석을 실시하였다. 결과 : 대상자는 388명 이었다. 메타분석을 실시한 결과 일상생활활동에 대한 중재 효과크기는 2.63으로 지역사회기반 중재가 뇌졸중 환자의 일상생활활동에 효과적이었다. 결론 : 지역사회기반 중재가 뇌졸중 환자의 일상생활활동에 효과적임을 알 수 있었다. 연구결과는 뇌졸중 환자를 위한 지역사회 중재에 대한 근거로 제시할 수 있으며, 근거를 기반으로 다양하고, 폭넓은 지역사 회기반 중재가 이루어져야 할 것이다.

Objective : The purpose of this study was a meta-analysis on the effects of community-based intervention for activities of daily living performance in stroke. Methods : We using searches PubMed, MEDLINE and Cochran CENTRAL, RISS. The study used a PEDro scale for each section in the evaluation of the quality. Included studies were analyzed based on the sample size, pre-post mean difference and standard deviation, with 95.0% confidence interval. Results : Total 7 studies included for meta-analysis. Involved 388 participants. The effective sizes based on the stroke for ADL 2.63 which could be interpreted as having a “large effect size”. The results community- based intervention was statistically significant for ADL with stroke. Conclusion : Community-based intervention proved to be effective for ADL with community residence stroke. We suggestion community based intervention evidence for stroke in results. Also community based interventions should be variety and wide range for stroke.

Purpose: Early detection and management of coronary heart disease (CHD) are embedded into many community health service and primary care practices in western countries. The Framingham CHD risk score has been used to predict CHD and mortality for nearly 20 years, and it has predicted CHD event risk accurately in multiethnic populations. The aim of this study was to access the effect of a 6-month community-based intervention on CHD risk in individuals at high risk. Methods: A randomized controlled trial of individuals with a high 10-year CHD risk were recruited from two communities in China. Individuals in the intervention group (n ¼ 53) received a 3-month group education and a 3-month coaching session. Physical examination and self-report questionnaires were used to collect both pre- and postintervention data on blood pressure, glucose, cholesterol, body mass index, smoking, depression, and health-related quality of life (HRQoL). Results: A total of 102 participants (85.0%) completed the 6-month study. Compared with the usual care group, the intervention group had a 5 mmHg greater reduction in systolic blood pressure (t = 2.01, p = .047), larger declines in glucose (t = 2.49, p = .015), cholesterol (t = 2.44, p = .017), body mass index (t = 2.58, p = .011), and depression (t = 2.05, p = .043), and better reports of HRQoL (t = 3.36, p = .001). No significant group differences in smoking behaviors were reported. Conclusion: A 6-month community-based intervention in a CHD high-risk population improved diseaserelated risk factors, depression, and HRQoL. Results provide preliminary evidence for primary prevention of cardiovascular disease risk in a community high-risk population.

Purpose: The manifestation of behavioral and psychological symptoms of dementia (BPSD) poses a considerable care burden and precipitates adverse health outcomes. Despite the increasing development of digital interventions, their application in the dementia population, specifically regarding their effectiveness in addressing BPSD, remains limited. Therefore, in this study, we aimed to describe a study protocol for evaluating the effectiveness of a mobile app-based individualized non-pharmacological intervention to improve BPSD in community-dwelling older adults. Methods: Employing a randomized control group pretest-posttest design, 36 dyads comprising people living with dementia (PLWD) and their family caregivers will be assigned to either an experimental or control group. The experimental group will engage in a 4-week regimen using a mobile app-based individualized non-pharmacological intervention, which includes recording and predicting BPSD. The control group will use the BPSD record system without accessing the individualized interventions. Both groups will continue with their usual care practices throughout the study period. Subsequently, an evaluation of the effectiveness of the mobile app-based individualized non-pharmacological intervention on BPSD will be conducted, which will serve as the primary outcome. Discussion: We hypothesize that the implementation of the mobile app-based individualized non-pharmacological intervention will alleviate BPSD. However, the research team may encounter several challenges owing to the novelty of digitalized interventions. Nevertheless, the results of this study will provide robust evidence regarding the efficacy of mobile app-based individualized non-pharmacological interventions for community-dwelling older PLWD.Trial registration: This trial has been registered with the Clinical Research Information Service in South Korea (CRIS No. KCT0008713; registered August 18, 2023).

This study was conducted to measure the effect of a community-based nutritional intervention program on dietary behaviors and nutrient intakes of low-income elderly women in Korea. The subject of the study was a group of 88 elderly women using the free meal service in Dong-gu, Gwangju city in Korea. The study was carried out from April to July 2009, and the pretest, application of nutrition education, and post-test were applied in each stage. This community-based nutrition intervention program consisted of snack supplement and nutrition education provided three times a week and 36 times in total. The nutrition education was led by the nutritionists and professionals using various educational media. Snack supplement included were milk, soymilk, carrot juice, bread, yogurt, and bananas. The result of pretest showed that the nutrient intakes of the subjects were much below the Recommended Nutrient Intake (RNI) level of Dietary Reference Intake for Koreans. Comparison of the dietary behavior score and nutrient intakes before and after the nutritional intervention program indicated that the food behavior score increased from 3.1 to 5.6 (P<0.001) and intake of energy, protein, carbohydrate, thiamin, niacin, vitamin C, iron, and potassium of the subjects all increased significantly (P<0.05). Mean Adequacy Ratio (MAR) of their nutrient intakes was also improved from 0.53 to 0.64 (P<0.01). These results indicated that the nutrition intervention program conducted in this study was effective in improving dietary behavior and nutrient intakes of elderly women in local community.

Purpose: The aim of the study was to determine the effects of a community based participatory program in obese middle-aged women. Methods: One-group pretest-posttest design was used. The subjects were 35 middle-aged women. Data were collected at public health centers in Chungcheongnam-Do from March to May, 2013. To evaluate the effect of the program, physiological indexes(body mass index, skeletal muscle mass, body fat mass, visceral fat area) and health behavior indexes(dietary practice guidelines score, moderate physical activity, drinking frequency) were measured. Analysis was performed using a Wilcoxon Signed Rank Test. Results: After the program, physiological indexes (BMI, BFM, SMM, VFA) and health behavior indexes (dietary guidelines scores, frequency of physical activity, drinking frequency) were significantly improved. Conclusion: The community based participatory obesity program by public health centers is considered to be effective. Therefore, greater effort is needed for better participatory program development of several health promoting fields, and more research is needed in order to examine a continuous effect.

Purpose: The purpose of this study was to apply intervention mapping (IM) to develop a community-based disease self-management support program for patients with osteoarthritis. Methods: IM was applied as follows: i) a needs assessment has been carried out by a literature review, survey and interview with osteoarthritis patients; ii) on the basis of the needs assessment, identification of expected outcomes and change objectives for the target population; iii) selection of theory-based methods and practical applications to influence self-management and the determinants of behavior; iv) design of the intervention by developing activities and materials such as osteoarthritis self-management guide and smart patient pocket book. The activities were integrated into an existing healthcare activities; v) implementation and evaluation plan has been developed. Results: The program is aimed at improving health status through activating patients by a patient-centered and tailored intervention for patients with osteoarthritis; consists of 8 sessions with coaching and cognitive emotional psychological skills; includes smart patient, communication, osteoarthritis, medication adherence, pain control, depressive mood control, physical activity and healthy diet. Conclusion: The IM is a systematic and feasible method for developing the program. The next step is to evaluate the impact of the intervention on activation, and health status.

목적:지역사회기반 중재로 인한 치매환자에게 미치는 효과의 근거를 제공하고자 한다. 연구방법:체계적 고찰 방법을 사용하였다. 데이터베이스는 RISS, Pubmed, Google Scholar 사용하여 자료 를 수집하고, 각 연구는 PEDro Scale을 사용하여 질을 평가 하였다. 선정기준에 적합한 9편의 논문을 선 정하였고, 중재방법, 중재 시 사용된 평가도구, 평가영역, 중재를 실시한 전문가 등에 관해 분석하였다. 선 정된 연구는 Patient, Intervention, Comparison, Outcome (PICO) 형식으로 체계적으로 정리하였다. 결과:연구의 질적 수준은 9편 모두 무작위대조군연구를 분석하였기 때문에 연구수준 5 단계 분류 방법에 서 모두 1단계에 속하였다. 중재 대상자는 치매환자만을 대상으로 한 논문이 55.5%로 가장 많은 비율 을 차지했다. 운동프로그램을 사용한 중재가 3편(33.3%)으로 가장 많았으며, 복합적 중재보다는 단편적 중재의 비율이 더 많이 차지하였다. 지역사회기반 중재는 운동, 인지, 삶의 질, 일상생활활동영역에서 모 두 효과적이었으며 치매환자에게 신체적 영역을, 보호자에게 삶의 질 영역을 결과로 보는 빈도가 가장 많았다. 중재자는 물리치료사, 작업치료사, 간호사의 빈도가 가장 많았다. 결론:연구결과는 작업치료사들이 지역사회 중재가 치매환자에게 미치는 효과에 대한 근거로 활용할 수 있 을 것이다.

Objective: The purpose of this study was to provide a basis for the effects of community-based interventions on dementia patients. Methods: The study was used systematic review method. The databases were collected using RISS, Pubmed, Google Scholar. Each articles were assessed for quality using the PEDro Scale. Nine articles were chosen, and the articles analyzed about the method of intervention, the evaluation tool, the evaluation area, and the experts who performed the intervention. Selected articles were systematically organized in PICO. Results: The qualitative level of the articles were all level 1 in the study of the level 5 step classification. Because all nine articles analyzed the randomized control study. The 55.5% of the articles’ subjects were dementia only. The most frequent intervention was the exercise program(33.3%), and the use of the single domain intervention was higher than complex domain intervention. Community-based intervention was effective in the physical domain of dementia patients and in the quality of life domain of the caregivers. The interventions were effective in the areas of exercise, cognition, QOL, and ADL. Specialists were often referred to as physical therapists, occupational therapists, and nurses. Conclusion: This study could be used by occupational therapists as a basis for community intervention for patients with dementia.

서울 소재 지역아동센터의 만 10세~15세 아동․청소년들 19명(남 10, 여 6)을 대상으로 인간의 긍정적 특성에 대한 분류체계(Value in Action: VIA)에 따른 6개의 미덕을 구성하는 성격강점을 인식 및 활용하기 위한 내용으로 구성된 성격대표강점 활용 프로그램을 매회기 50분씩16회기동안 시행하였다. 프로그램 시행 전후, 성격강점 검사(CST-A), 옥스퍼드 행복 질문지(OHQ), 또래관계 기술척도(PRSS)를 실시하여 단일집단 사전사후 설계로 대응표본 t검증을 통해 효과성을 검증하였다. 분석 결과, 참여 아동․청소년들은 지혜, 절제, 정의와 관련된 성격대표강점을 유의하게 더 잘 인식하는 것으로 나타났으나 행복수준과 또래관계기술에서는 유의한 변화가 나타나지 않았다. 따라서 16회기 집단으로 실시된 성격대표강점 활용 프로그램을 통해 아동․청소년들이 지혜, 절제, 정의와 관련된 성격대표강점을 더 명료하게 인식함으로써 자기이해를 증진시키는 효과성을 확인하였다. 그러나 다른 선행연구와 달리 지역아동센터의 아동․청소년들의 경우, 습득한 성격대표강점을 실질적으로 활용함으로써 긍정정서가증진되고 또래관계 기술이 향상되는 등의 일반화에는 제한적이었다. 이처럼 사회경제적 기반이 취약한 지역아동센터의 아동․청소년들 대상의 성격대표강점 활용 프로그램은 보다 집중적이고 장기적인 집단프로그램을 통해 성격대표강점을 충분히 연습하고 체득함으로써 일상생활 속에서 활용하는 것이 습관화되는데 초점을 두어 본 프로그램을 수정하여 적용하는 것이필요하겠다.

The purpose of this study was to examine the effects of signature strengths use group intervention based on character strengths for children and adolescents in child community center. 19 children and adolescents from 10 to 15 were participated in 50 minutes group interventions per week for 16 weeks. All participants completed scales employed for this study such as Character Strengths Test for Adolescents(CST-A), he Oxford Happiness Questionnaire(OHQ), Peer Relational Skills Scale(PRSS) across according to pretest and posttest. The results were as follows: All participants became more aware of strengths related to wisdom, moderation and justice. However, happiness and peer relational skills didn't improve after the intervention. This implies that interventions based on character strengths for children and adolescents in child community center are effective in more intensive and longer period intervention to focus on practice enough, learn and internalize character strengths.

목적 : 본 연구는 작업기반 라이프스타일 중재 프로그램이 지역사회 노인에게 미치는 효과를 알아보고 적용가능성을 알아보기 위해 진행되었다. 연구방법 : 지역사회에 거주하고 있는 노인 9명을 대상으로 진행되었으며 단일집단 사전-사후 검사 설계를사용하여 연구를 진행하였다. 참가자들은 해외 연구를 통해 효과가 확인된 라이프스타일 리디자인 프로그램(Lifestyle redesign program)을 기반으로 한 작업기반 라이프스타일 중재 프로그램을 그룹회기 12회, 개인회기 1회로 총 7주에 걸쳐 제공받았다. 효과를 알아보기 위해 작업균형, 시간사용, 활동참여 수준, 활동 수행도및 만족도, 우울, 건강관련 삶의 질에 대한 평가를 프로그램 전, 후로 진행하고 평가 결과를 분석하였다. 또한 후기평가 시 프로그램에 대한 설문을 진행하여 참가자들이 생각하는 주관적인 프로그램의 타당성, 필요성, 효과성에 대해 알아보았다. 결과 : 초기평가와 후기평가를 통해 얻은 자료를 분석한 결과 전반적인 작업균형(p=.012)과 하위영역인 건강(p=.017), 관계(p=.012), 도전 및 흥미(p=.012), 자아정체성(p=.012)에 대한 작업균형 그리고 활동참여수준(p=.008), 활동 수행도(p=.012) 및 만족도(p=.008), 전반적인 건강관련 삶의 질(p=.034) 및 하위영역 중 신체적건강(p=.041)이 향상되었으며, 여가(p=.008)와 휴식(p=.008)에 대한 시간사용에 변화가 있었고, 마지막으로우울(p=.012)이 감소한 것을 확인할 수 있었다. 또한 프로그램에 대한 설문 결과 참가자들이 생각하는 프로그램에 대한 주관적 타당성, 필요성, 효과성 모두 적절한 수준을 나타내는 것을 확인하였다. 결론 : 작업기반 라이프스타일 중재프로그램은 지역사회 노인에게 충분히 받아들여질 수 있으며 건강에 긍정적인 영향을 미칠 수 있는 중재법으로 사료된다.

Objective : This study aimed to assess the effects of occupation-based lifestyle intervention programs on older adults in the local community. Methods : Nine community-dwelling older individuals participated in this study using a one-group pre-post design. The occupation-based lifestyle intervention program consisted of 12 group sessions, and one individual session was conducted for seven weeks. Occupational balance, activity occupancy, activity participation, depression, health-related quality of life, and program satisfaction were assessed. Results : The average attendance rate of the nine participants was 10.11 (SD=1.36). Overall occupational balance (p=.012), activity participation status (p=.008), performance (p=.012), and satisfaction with activity participation (p=.008) were increased. Furthermore, the results showed changes in leisure time (p=.008) and rest time (p=.008). Finally, there were some improvements in the overall health-related quality of life (p=.034) and depression scores (p=.012). Conclusions : Occupation-based lifestyle intervention programs positively affected occupational balance, activity occupancy, activity participation, depression, and health-related quality of life in community-dwelling older adults. This research suggests promising benefits and feasibility of the program for community-dwelling older adults.

목적：본 연구의 목적은 지역사회중심 뇌졸중작업치료프로그램이 클라이언트의 기능향상과 삶의 질 향상에 효과가 있었는지 분석하고, 실습교육으로서 학생들의 프로그램 운영에 따른 만족도를 분석하여 지역사회중심 임상실습교육프로그램의 기초 자료를 제공하고자 한다. 연구방법：연구대상은 뇌졸중작업치료프로그램에 참여한 클라이언트와 프로그램의 운영에 참여한 작업치료과 재학생을 대상으로 하였다. 1) 클라이언트는 2006년 4월-11월 동안 2차로 나누어 초기평가-10주 중재-재평가를 실시하였으며, 26명을 분석 대상으로 하였다. 2) 작업치료과 학생들은 평가, 중재프로그램 계획, 프로그램 실행, 재평가에 참여하였으며, 그중 설문에 응답한 50명의 학생을 대상으로 교과목과 연결된 임상실습교육으로서의 만족도를 분석하였다. 분석은 클라이언트의 전·후 변인의 차이를 검증하기 위해 윌콕슨 쌍대비교(Wilcoxon matched-paired sign-ranks test), 학생들의 만족도분석은 기술통계를 이용하였다. 결과： 1) 클라이언트의 기능향상에서는 전반적으로 호전되었으며, 특히 균형능력과 감각 중 통증과 심부압박이 유의한 결과를 보였다(p<.05). 삶의 질은 전반적으로 좋아졌으며, 특히 일반적 건강은 통계학적으로 유의한 차이를 보였다(p<.05). 2) 학생들의 실습교육 프로그램 운영에 따른 만족도는 전체 평균이 4.32/5점 척도로 높게 나타났으며, 작업치료사의 역할에 대한 이해 향상의 만족도가 4.46±0.61(M±SD)로 가장 높았다. 결론：지역사회중심 뇌졸중작업치료프로그램에 참여한 클라이언트의 기능향상과 삶의 질 향상에 효과가 있었으며, 학생들의 실습교육 프로그램 운영에 따른 만족도도 매우 높게 나타났다. 그러므로 다양한 지역사회중심 임상실습교육프로그램의 개발·운영을 통해 지역사회에 공헌하고, 학생들에게는 학교 졸업 후 임상에서 초임 작업치료사로서 역할을 다할 수 있도록 다양한 경험과 자신감을 제공할 수 있는 질적인 임상실습교육이 필요하다.

Objective : The objective of this paper is to determine if a community-based stroke occupational therapy program is effective in improving the clients’ functionality and quality of life, and to provide the basic materials of a community-based fieldwork education program by analyzing the degree of student satisfaction with the fieldwork education. Method : The subjects consisted of clients who participated in a stroke occupational therapy program and students from the department of occupational therapy who took part in operating the program. 1) The clients had an initial evaluation, 10-week intervention, and two re-evaluations from April to November, 2006. The number of clients who were studied was 26. 2) The students participated in an evaluation, intervention planning, implementing the program, and a re-evaluation, and their satisfaction with the fieldwork education connected to their school subject was measured using 50 of the students who responded to the survey. A Wilcoxon matched-paired sign-ranks test was used to prove the difference between the clients' before and after variables, and descriptive statistics were employed to measure the students' satisfaction. Result : 1) There was improvement in client functionality overall, and particularly significant results were in balance ability, pain, and pressure (p<.05). Quality of life improved on the whole, and general health showed a significant difference (p<.05). 2) The mean of student satisfaction with the operation of the field education was 4.32 out of 5, which was high, and that of satisfaction with a better understanding of the role of an occupational therapist was 4.46±0.61 (M±SD), which was the highest. Conclusion : The community-based stroke occupational therapy program was effective in improving client functionality and quality of life, and the students were highly satisfied with the managing of the field education. Therefore, a contribution to the community through developing and operating various community-based stroke occupational therapy programs and high-quality field education where students can have enough experience and confidence to help them conduct their roles as occupational therapists after graduation is required.

목적 : 본 연구는 가정환경 수정 및 보조도구 제공이 장애인의 작업수행 및 일상생활활동 수행 수준과 가 정 내 위험요인에 미치는 영향을 알아보고자 하였다. 연구방법 : 지역사회에 거주하고 있는 장애인을 대상으로 만성질환으로 인해 뇌병변과 지체 장애 등급을 받은 8명을 대상으로 하였다. 캐나다작업수행측정을 통하여 가정 내 중요한 일상생활활동을 선정하고 작 업 수행도와 만족도를 확인하였다. 가정 내 일상생활활동 평가를 통해 선정된 활동들의 독립성, 어려움, 안전성을 파악하고, 가정안전 자가 평가도구를 사용하여 가정 내 위험요소를 확인하였다. 가정환경 수정 및 보조도구 제공 중재 전·후의 장애인의 작업 수행도와 만족도, 일상생활활동 수행 수준과 가정 내 위 험요인에 미치는 영향을 비교하기 위하여 Wilcoxon signed rank test로 분석하였다. 결과 : 가정 내 현관, 거실 및 침실, 주방, 욕실, 화장실 공간에서 작업 수행을 실시하는데 중요한 공간으로 선정 되었으며 가정환경 수정 및 보조도구 제공 후의 수행도와 만족도는 유의하게 증가하였다. 가정 내 일상생활활동 수행 수준에서는 독립성과 어려움 영역에서 유의한 차이를 보였으며, 가정 내 위험요소는 전반적으로 감소되었고 특히, 침실과 욕실에서 유의하게 감소하였다. 결론 : 다양한 질환을 가진 장애인을 중심으로 작업기반의 가정환경 수정과 보조도구 제공을 통하여 작업 수행 능력을 향상시켰고 가정 내 위험요소를 제거하였다. 장애인의 독립적인 역할을 유지하고 일상생활 에서 능동적인 참여를 할 수 있는 기회를 제공할 수 있었다. 개인의 가정마다 적합한 중재를 제공하기 위해 다양한 평가도구 적용을 제안하고 보다 많은 작업 중심의 환경 수정이 이루어지기를 기대한다.

Objective : This study was conducted to investigate the effects of home modification and intervention using assistive devices on occupational performance, activities of daily living performance and risk factor at home in people with disabilities. Methods : Eight participants diagnosed with cerebrovascular diseases and physical disabilities due to chronic diseases were included in this study. The Canadian Occupational Performance Measure(COPM) was used to identify important daily activities at home and confirm the performance and satisfaction of the activities. The Assessment of Home-based Activities(AHA) was utilized to identifythe importance, difficulty and safety scores of selective activities . The Home Safety Self-Assessment Tool(HSSAT) was used to identify risk factors at home. In order to compare the effects of home modification and intervention using assistive devices on occupational performance, activities of daily living and risk factors at home before and after the intervention, Wilcoxon signed rank test was conducted. Results : The front entrance, living room, bedroom, kitchen and bathroom were selected as important spaces to conduct occupational performance. After the intervention of home modification and assistive devices application, performance and satisfaction significantly increased. There was a significant enhancement in independence and difficulty in the level of activities of daily living at home, and the overall risk factors at home significantly decreased, especially in the bedroom and bathroom. Conclusion : The occupation-based home modification and intervention using assistive devices improved occupational performance of people with disabilities and reduced the risk factors at home. Researchers were capable of providing chances of maintaining independent role and participating in daily lives to people with disabilities. We suggest applying various assesment tools for each individual’s household and expect more occupation-based home modifications to happen.

At the end of 2019, there was the major outbreak of “COVID-19” in China. In this outbreak prevention and control campaign, the property management enterprises(PME) performed actively, playing a vital role in China. This paper puts forward that the property management enterprises(PME) should be included as subjects of national urban and rural community governance from the perspective of the public product attribute of property management. Based on the properties of public goods in property management, this paper redefines the functions and positioning of PME with public affairs management, establishes the qualification of PME to participate in one of the main bodies of community public governance. And it forms a new model of community governance with community residents committees, owner’committee and PME as the main body. This research provides implications for national urban and rural community governance models by applying existing theories and practical examples.

Purpose: The purpose of this study was to describe the intervention model development of health promotion for women workers working in the traditional marketplace, using community capacity building framework. Methods: Need assessment of the target population, work-related environment investigation, social network group building, and setting health management in the marketplace were performed. Then the interventions including cardiovascular health, musculoskeletal health, and psychological health were conducted. The results were evaluated using NCEP-ATP III(National Cholesterol Education Program's Adult Treatment Panel III), OWAS, and CES-D. Results: It was found that the intervention program for the vulnerable group in marketplace was appropriate, promoting the improvement of metabolic syndrome and the reduction of pain complaints. Therefore, the intervention framework for health promotion of women workers in the marketplace was developed. Work-related environment assessment also was included in the framework development. Several community capacity building strategies, including developing community resources and promoting partnership, making small social network group, and promoting program participation. Conclusion: It is suggested that occupational health nurses and professionals consider the appropriateness of intervention framework development after identifying the needs of women workers’ work-related environmental problems.

Background: North East India has a high prevalence of tobacco consumption, but only few individuals seek help for tobacco cessation. Impact of community based tobacco cessation intervention in this part needs more research. Materials and Methods: Retrospective analysis was done on the dataset from a community-based tobacco cessation intervention pilot project conducted in Guwahati metro during 2009-10. Subjects, both male and female tobacco users, age > 15 years, permanent residents of these blocks giving consent were included in the study. Results: The sample was 800 tobacco users, of whom 25% visited any health care provider during last 12 months and 3% received tobacco cessation advice. An 18% quit rate was observed at six weeks follow up, more than the National average, with a 47% quit rate at eight months, while 52% of subjects reduced use. Conclusions: Higher tobacco quit rate and reduced tobacco use, no loss to follow up and negligible relapse was observed with this community based intervention design. Such designs should be given more emphasis for implementation in specified communities with very high tobacco consumption rates, cultural acceptance of tobacco and less motivation towards quitting.

Background/Aims: Postal distribution of a fecal immunochemical test (FIT) kit has been recommended as an effective method of increasing participation in colorectal cancer (CRC) screening. The present study was performed to assess the impact of the round-mailed FIT kit on screening participation in underserved regions of Korea and to identify factors related to nonparticipation. Methods: Residents were recruited from three rural regions of Korea that lack screening units for the National Cancer Screening Program. A package containing a FIT kit for stool self-sampling and a return envelope addressed to the local health center was postally distributed to each subject. Thirty days after the kits were mailed, nonresponders were reminded via telephone as the second intervention. The participation rates and odds ratios with 95% confidence intervals (CIs) for each intervention response were calculated to evaluate the effect of the interventions and factors related to screening participation in response to the interventions. Results: CRC screening participation rates increased from 24.5% (95% CI, 21.6% to 27.4%) to 42.6% (95% CI, 39.3% to 46.0%) as a result of postal screening and increased further to 51.4% (95% CI, 48.0% to 54.9%) after the telephone reminder. After controlling for the sex, age, and household type of each subject, factors associated with poor response to postal screening were identified as low educational attainment and poor previous participation in the National Cancer Screening Program. Conclusions: Round-mailed FIT kits with phone call reminders were an effective intervention, nearly doubling the screening rate in underserved regions of Korea.

The study objectives were to increase both the stage of readiness to eat fruit and vegetables as well as the intakes of women who participated in the Expanded Food and Nutrition Education Program (EFNEP) for families with limited incomes. The intervention was to enhance the currently used curriculum, Eating Right Is Basic III (ERIB3), with stage-specific processes based on the Trans-Theoretical Model of readiness to change. Trained EFNEP community workers taught the enhanced curriculum to 90 mothers in the experimental county and to 53 mothers in the control county. Pre- and post-intervention measures included stages of readiness to eat fruit and vegetables and to intake as assessed by 24-hour dietary recalls and staging questions. Most women recruited into EFNEP were in Action and Preparation Stages (53.5%). Fruit and vegetable intakes showed a linear trend along with the Stage of Change for fruit and vegetable. After intervention, some combination of the ERIB3 and the fruit and vegetables-enhanced ERIB3 resulted in a reported 1/2 servings/day increase in fruits and vegetables in both the control and the experimental counties, although changes were not significant. EFNEP women also moved along the Stage of Change Continuum for fruits and vegetables in both counties. The percentage of people who ate 5 or more servings of fruit and vegetables was significant, however, only in the experimental group. We encourage health professionals to apply lessons learned from this intervention and to continue to pursue theoretically based interventions to change dietary behaviors.

This qualitative research within the project entitled "Multiprofessional Intervention and training for Ongoing Volunteer-based Community Health Programs in the Northeast of Thailand (MITV-NET)" was aimed at explaining changes of health behavior of community people in the Northeast after the intervention. The participants comprised 15 community volunteers and 27 villagers. Data were collected by indepth interview, focus group discussion, participation and non-participation observation, and note taking. Analyses were conducted in parallel with data collection, through content and comparative analysis. It was found that the health behavior fell into 2 categories: easy-to-change. The former involved fun activities joined by community people that improved their health or made them recover from illnesses after a short period without becoming addicted. These activities could be done by themselves, for example, exercising and cooking. The difficult-to-change health behavior is habitual, for example, chewing betel nuts or eating uncooked food. The following factors were found affecting behavioral changes: 1) underlying disease; 2) enjoyment in doing activities; 3) habitual behaviour; 4) improved health in a short period; 5) ability of community leaders and volunteers; and 6) community health-supporting resources. It is suggested that improving people's health requires cooperation of community people through fun activities and some initial external support. People who persist in bad habits should be encouraged to stop by showing them health deteriorating effects.

Background: To illustrate multiple approaches and to assess participation rates adopted for a community based smoking cessation intervention programme in rural Kerala. Materials and Methods: Resident males in the age group 18-60 years who were 'current daily smokers' from 4 randomly allocated community development blocks of rural Thiruvananthapuram district, Kerala (2 intervention and 2 control groups) were selected. Smoking status was assessed through house-to-house survey using trained volunteers. Multiple approaches included awareness on tobacco hazards during baseline survey and distribution of multicolour anti-tobacco leaflets for intervention and control groups. Further, the intervention group received a tobacco cessation booklet and four sessions of counselling which included a one-time group counselling cum medical camp, followed by proactive counselling through face-to-face (FTF) interview and mobile phone. In the second and fourth session, motivational counselling was conducted. Results: Among 928 smokers identified, smokers in intervention and control groups numbered 474 (mean age: 44.6 years, SD: 9.66 years) and 454 respectively (44.5 years, SD: 10.30 years). Among the 474 subjects, 75 (16%) had attended the group counselling cum medical camp after completion of baseline survey in the intervention group, Among the remaining subjects (n=399), 88% were contacted through FTF and mobile phone (8.5%). In the second session (4-6 weeks time period), the response rate for individual counselling was 94% (78% through FTF and 16% through mobile phone). At 3 months, 70.4% were contacted by their mobile phone and further, 19.6% through FTF (total 90%) while at 6 months (fourth session), the response rate was 74% and 16.4% for FTF and mobile phone respectively, covering 90.4% of the total subjects. Overall, in the intervention group, 97.4% of subjects were being contacted at least once and individual counselling given. Conclusion: Proactive community centred intervention programmes using multiple approaches were found to be successful to increase the participation rate for intervention.

Background: Some 60 years after introduction of the Papanicolaou smear worldwide, cervical cancer remains a burden in developing countries where >85% of world new cases and deaths occur, suggesting a failure to establish comprehensive cervical-cancer control programs. Effective interventions are available to control cervical cancer but are not all affordable in low-income settings. Disease awareness saves lives by risk-reduction as witnessed in reducing mortality of HIV/AIDS and smoking-related cancers. Subjects and Methods: We initiated a community-based awareness program on cervical cancer in two low-income Muslim Uyghur townships in Kashi (Kashgar) Prefecture, Xinjiang, China in 2008. The education involved more than 5,000 women from two rural townships and awareness was then evaluated in 2010 and 2011, respectively, using a questionnaire with 10 basic knowledge questions on cervical cancer. Demographic information was also collected and included in an EpiData database. A 10-point scoring system was used to score the awareness. Results: The effectiveness and feasibility of the program were evaluated among 4,475 women aged 19-70 years, of whom >92% lived on/below US$1.00/day. Women without prior education showed a poor average awareness rate of 6.4% (164/2,559). A onetime education intervention, however, sharply raised the awareness rate by 4-fold to 25.5% (493/1,916). Importantly, low income and illiteracy were two reliable factors affecting awareness before or after education intervention. Conclusions: Education intervention can significantly raise the awareness of cervical cancer in low-income women. Economic development and compulsory education are two important solutions in raising general disease awareness. We propose that implementing community-based awareness programs against cervical cancer is realistic, locally affordable and sustainable in low-income countries, which may save many lives over time and, importantly, will facilitate the integration of comprehensive programs when feasible. In this context, adopting this strategy may provide one good example of how to achieve "good health at low cost".

This was a survey research conducted in Northestern Thailand during 2009-2010 and designed to evaluate the success of a health education program by comparing levels of health knowledge in the community before and after the launching of a Multi-professional Intervention and Training for Ongoing Volunteer-based Community Health Programme. The survey questionnaire included items about demographic characteristics and health knowledge. The participants were 1,015 members of various communities, who were randomly selected to be included in the survey before launching the intervention, and 1,030 members of the same communities randomly selected to be included in the survey after the intervention was completed. The demographic characteristics of both groups were similar. Overall knowledge and knowledge of all the diseases, except lung and cervical cancer, were significantly higher after the intervention. In conclusion, a Volunteer-based Community Health Programme has advantages for areas where the numbers of health personnel are limited. The use of trained community health volunteers may be one of the best sustainable alternative means for the transfer of health knowledge.