This study aimed to develop a reliable and valid scale, i.e. the Heart-Healthy Information Questionnaire (HHIQ). The HHIQ was developed in three phases: (i) creating the item pool, (ii) conducting a preliminary evaluating the items, and (iii) refining the scale and evaluating psychometric properties. An initial item pool of 77 items with a 3-point True/False format with a ‘Don’t know’ option was extracted from the literature review and 54 items reached content validity. The psychometric properties of HHIQ were tested with 1315 individuals without cardiovascular disease. By using the exclusion criteria of the difficulty index (>0.95), discrimination index (<10.0), and item-total correlation (tetrachoric coefficient <0.2), 50 items were finally selected. The construct validity was determined by using the known-groups validation: Individuals (n = 107) who were educated with heart-healthy education sessions showed significantly higher scores of the HHIQ than those (n = 107) who were not educated (P = 0.015). The Kuder–Richardson formula 20 coefficient indicated good internal consistency (0.85), and the test–retest reliability coefficient with a 15-day interval also indicated good stability (0.78). A total score of the HHIQ was significantly correlated with a total score of the Evaluation Tool for Metabolic Syndrome Modification Lifestyles (ρ = 0.23, P < 0.001). The HHIQ showed good psychometric properties of validity and reliability and may be useful to evaluate the knowledge levels of heart-healthy information in the areas of cardiovascular disease prevention.

김지은, et al. J Korean Acad Community Health Nurs. 2022 Mar;33(1):13-31. https://doi.org/10.12799/jkachn.2022.33.1.13

This study explores the levels of COVID-19 knowledge, risk perception, and preventive behavior practice in Seoul, to determine whether knowledge and risk perception are significantly associated with the full adoption of preventive behaviors, for the delivery of a customized public campaign to Seoul’s citizens. A total of 3000 Seoul residents participated in this study through an online questionnaire survey. They had a mean score of 84.6 for COVID-19 knowledge (range: 0–100 points) and 4.2 (range: 1–7 points) for risk perception. Of the participants, 33.4% practiced full adoption of all three preventive behaviors: hand hygiene, wearing a face mask, and social distancing; wearing a face mask was practiced the most (81.0%). Women significantly adopted these three preventive behaviors more often compared with men. Both COVID-19 knowledge and risk perception were found to be significantly associated with the full adoption of preventive behaviors; however, this association differed by the type of preventive behavior. This indicates that city-level information on the levels of COVID-19 knowledge, risk perception, and preventive behaviors should be clearly and periodically communicated among public officers and healthcare professionals to continually raise the public’s awareness of the full adoption of non-pharmaceutical preventive behaviors.

Background: University students have been known as having a higher rate of problem drinking than the general population in South Korea. In particular, the university freshmen may experience problem drinking from increased occasions of frequent social gatherings at the first school year as they have increased time to freely use compared to the high school days. Problem drinking among university freshmen may be influenced by multiple factors. The present study aimed to examine the prevalence of problem drinking and to identify individualand family-level factors associated with university freshmen's problem drinking.Methods: A cross-sectional, correlation study was conducted. Participants were 227 university freshmen (70 men and 157 women) under the parenting of mother and father from 10 universities in Seoul. The problem drinking was evaluated by using the Alcohol Use Disorder Identification Test. Alcohol Abstinence Self-Efficacy Scale and Parental Authority Questionnaire for parenting behaviors were used.Results: The prevalence of problem drinking was 58.6% among university freshmen. An individual-level factor of alcohol abstinence self-efficacy was significantly associated with the prevalence of problem drinking (odds ratio, 0.94; 95% confidence interval, 0.91-0.96) among university freshmen. However, any of family-level factors including types of parenting behaviors were not significantly associated with the prevalence of problem drinking.Conclusions: Alcohol abstinence self-efficacy may be a strong protective factor against university freshmen's problem drinking. University-based alcohol abstinence programs should comprise of nursing strategies including the enhancement of abstinence self-efficacy at the first school year.

Background: Few mobile apps have strategies for self-monitoring multiple heart-healthy behaviors simultaneously, as well as automated and tailored feedback on individual behavioral outcomes for cardiovascular health. An app named “My HeartHELP” was developed for the general adult population to promote 6 heart-healthy lifestyle behaviors—physical activity, nonsedentary behaviors, healthy eating behaviors, nonsmoking, no alcohol binge drinking, and self-assessment of body weight. Three behavioral strategies were used: (1) text messaging the users for information on cardiovascular health, (2) self-monitoring of 6 heart-healthy behaviors to fill out the blanks of behavioral items, and (3) automated and tailored feedback messaging to users for behavioral outcomes obtained from self-monitoring. Objectives: This study aimed to evaluate the feasibility and acceptability of the “My HeartHELP” app. Methods: The participants were 29 community residents in Seoul, South Korea, who met at least 1 criterion of metabolic syndrome. To evaluate the feasibility, we assessed 3 records, which are as follows: First, the “record for self-monitoring” was determined as feasible if an average percentage for each of the 6 behaviors over 4 weeks was 75% or higher based on percentages of participants who completed to record each of 6 heart-healthy behaviors. Second, the “record for access to the app” was determined as feasible if users accessed at least once a day on average per week. Third, “records for behavioral changes” over 4 weeks were collected via a self-reported questionnaire. To evaluate acceptability, we used an assessment tool comprising 12 items that included subscales for comprehensibility, ease, health benefits, technical completeness, overall satisfaction, and recommendation to others on a 5-point Likert scale. Acceptability was determined as acceptable if the average scores for the total scale and each subscale were 3.5 points or greater. Second, qualitative data were collected through 2 focus groups, each consisting of 14 or 15 participants. All data were collected in June and July 2022. Results: During the 4 weeks, 95.6% (range: 85.8%-97.4%) of the participants adhered to more than 75% of “completion of daily self-monitoring of each heart-healthy behavior,” having met the criterion. The participants accessed the app on average 1.8 (SD 1.70) times per day, meeting the criteria. Participants had positive behavioral changes in all 6 behaviors, of which nonsedentary behavior (10%-28%; χ²₁=1.76; P<.001) and non–fast-food intake were especially statistically significant (72%-93%; χ²₁=5.64; P=.03) over 4 weeks. Participants reported 3.8 points for a total score of acceptability and more than 3.5 points for all subscales, which met the criterion. Qualitative data obtained from focus groups indicated that automated and tailored feedback messages motivated participants to promote healthy lifestyles. Conclusions: The “My HeartHELP” app may be a feasible and acceptable mobile app to promote self-monitoring and possibly behavioral changes in heart-healthy lifestyle behaviors.

Background: Smoke-free zone policies in school settings have been widely implemented; however, evidence regarding their impact on smoking-related attitudes and secondhand smoke (SHS) exposure remains limited. This study aimed to examine the association between a smoke-free zone policy implemented along school commuting routes and attitudes toward smoking and SHS exposure among elementary school students, their parents, and school staff in Seoul, South Korea. Methods: A cross-sectional study was conducted. Participants were 210 students, 272 parents, and 137 school staff from the five schools randomly selected according to the criteria of regional deprivation index and prevalence of designated smoke-free zones from all the 25 districts of Seoul, South Korea. “Attitudes toward smoking” and “exposure to SHS” were the outcome variables, and the “presence of a smoke-free zone along the school commuting route” was the predictor variable. All variables were assessed using self-reported questionnaires. Data were collected between November 2020 and December 2020. The multiple logistic regression analysis was performed to test main hypotheses. Results: Students and school staff in schools with designated smoke-free zones along school commuting routes were significantly less likely to be exposed to SHS along those routes, compared to their counterparts without such zones (odds ratio [OR] = 0.29; 95% confidence interval [CI], 0.098– 0.853; p =0.025 for students; OR = 0.09; 95% CI, 0.008– 0.939; p =0.044 for school staff). However, the presence of smoke-free zones along school commuting routes was not significantly associated with attitudes toward smoking among students, parents, or school staff. Conclusion: Designation of smoke-free zones along school commuting routes may be effective in reducing exposure to SHS among students and school staff. The active and consistent enforcement of smoke-free policies within school settings may play a critical role in further reducing SHS exposure among children and related stakeholders.