Korean Journal of Family Medicine

"Program"

Original Articles

Experience of Lifetime Health Maintenance Program: An Observational Study of a 30-Year Period of Outpatient Primary Care in a Tertiary Hospital: Seo Young Kang, Young Sik Kim; Korean J Fam Med 2023;44(5):281-288. Published online August 14, 2023; DOI: https://doi.org/10.4082/kjfm.23.0023

Abstract
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Background
This study aimed to identify the clinical content of patients registered with the Lifetime Health Maintenance Program (LHMP) under the care of a single family physician who introduced and operated the program in Korea at a tertiary hospital for over 30 years.
Methods
We analyzed the electronic medical records of 745 patients who had registered for more than 3 times with the LHMP under the care of a single family physician between January 1, 2010 and December 31, 2019. We reviewed medical records from June 1989, when the hospital was established, to February 2022. The participants’ age at the time of LHMP enrollment, sex, initial consultation date, final consultation date, and consultation content were evaluated.
Results
Patients visited the LHMP for various reasons, including acute symptom management, chronic disease management, psychiatric consultation, counseling on health behaviors, health checkups, and vaccination. The top five diagnoses for acute symptom management were upper respiratory infection, abdominal pain, dizziness/vertigo, headache, and lower back pain, whereas those for chronic disease management were dyslipidemia, hypertension, osteoarthritis, osteoporosis/osteopenia, and diabetes. More than one in five patients received psychiatric consultation and counseling on health behaviors. As the duration of the program enrollment increased, the proportion of patients visiting the LHMP for acute symptoms, vaccinations, and health checkups also increased. Furthermore, the number of categories of consultation content increased for each patient.
Conclusion
The LHMP emphasized the need to systematize regular primary care physicians in Korea. Policy changes are necessary to strengthen primary care, and the LHMP serves as an intermediate step in organizing regular primary care physicians in Korea.

Citations

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Pharmacotherapy guidelines for smoking cessation in primary healthcare clinics
Cheol Min Lee, Yu Jin Paek, Yoo Bin Seo, Eon Sook Lee
Journal of the Korean Medical Association.2024; 67(4): 230. CrossRef

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Satisfaction and Difficulties of Korean Family Medicine Resident Training Faculty: Jung-Ha Kim, Ju Young Kim, Kil Young Kwon, Chul-Min Lee, Tae-Hee Jeon, Seung Soo Hyun; Korean J Fam Med 2013;34(5):357-363. Published online September 26, 2013; DOI: https://doi.org/10.4082/kjfm.2013.34.5.357

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Background

Practitioners of family medicine are essential to primary care practices in Korea. Resident training staffs in Korean family medicine departments have a crucial role in producing well-trained family physicians. This study assesses the aspects of satisfaction and difficulties of Korean family medicine resident training staffs.

Methods

We surveyed the resident training staffs of various Korean family medicine departments using an online survey tool. The survey used in this study was modified from previously used questionnaires. Respondents rated items using a five-point Likert scale and a 0-10 visual analogue scale.

Results

The response rate was 43.9% (122/278). The mean satisfaction score with regard to current family medicine residency programs was 7.59 out of 10. Resident training staffs found the administrative aspects of their role to be the most difficult. There were considerable differences in the reported difficulties of resident training according to the differing characteristics of each staff member, including age, sex, type of hospital, number of staff members, role as chief, and duration of staff. Most respondents (91.9%) cited a need for faculty development programs.

Conclusion

Korean family medicine resident training staffs need faculty development programs for the improvement of resident training. For the strengthening of core competencies among resident training staffs, faculty development programs or courses should be designed and implemented in Korea.

Citations

Citations to this article as recorded by

Current status and challenges of faculty development in Korean medical education and strategies for advancement
Dong Hyeon Lee
Korean Journal of Medical Education.2024; 36(4): 415. CrossRef

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The Effect of Preparatory Education Program on Discomfort and Retching of Examinees during Upper Gastrointestinal Endoscopy: Ju-Yeon Lee, Min-Whon Anhn, Eun-Tae Kim, Dae-Hyun Kim, Hyuk-Jung Kweon, Dong-Yung Cho, Hyung Moon Yoon; Korean J Fam Med 2012;33(4):219-228. Published online July 25, 2012; DOI: https://doi.org/10.4082/kjfm.2012.33.4.219

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Background

Although upper gastrointestinal (UGI) endoscopy is highly sensitive for the detection of esophago-gastroduodenal lesions, pain and discomfort during the procedure cause examinees to experience stress and anxiety. Moreover, there have been only a few studies on relief of pain and discomfort during UGI endoscopy through preparatory interventions. Therefore, the aim of this study was to investigate the relationship between a preparatory education program and the discomfort and retching experienced by examinees during endoscopy.

Methods

A total of 306 examinees who visited a health promotion center and underwent non-sedated endoscopy from May 13 to July 3, 2009 were included in this study. After they were assigned to experimental (n = 154) and control groups (n = 152), their discomfort and retching were measured with a visual analogue scale. The preparatory education program consisted of cognitive intervention, behavioral intervention and information.

Results

The preparatory education program relieved discomfort during endoscopy in male subjects, in subjects aged 60 and over, or in subjects with previous endoscopic experience with statistical significance (P < 0.05). It also relieved retching during endoscopy in subjects aged 60 and over with statistical significance (P = 0.023). Multiple logistic regression analysis showed that the preparatory education program significantly relieved the discomfort of examinees during endoscopy (P = 0.028).

Conclusion

We found that the preparatory education program used in this study could significantly relieve the discomfort caused by endoscopy, particularly in subjects aged 60 and over, or in male subjects with a high incidence of stomach cancer in Korea.

Citations

Citations to this article as recorded by

Effect of electroacupuncture on discomfort during gastroscopy: A randomised controlled trial
Xuan Yin, Bingyu Yu, Philippa Jemma Hazlewood, Kun Xu, Hongyu Yue, Yiqun Mi, Shifen Xu
Complementary Therapies in Medicine.2023; 73: 102936. CrossRef
Effective communication enhances the patients’ endoscopy experience
D. P. Toomey, M. Hackett-Brennan, G. Corrigan, C. Singh, G. Nessim, P. Balfe
Irish Journal of Medical Science (1971 -).2016; 185(1): 203. CrossRef
Effects of Video- and Pamphlet-based Patient Educations on Anxiety and Satisfaction Among Candidates for Gastroscopy
Nasrin Kamyabi, Maryam Nakhaei, Ahmad Nasiri, Ehsan Akbari, Gholamreza Sharifzadeh
Modern Care Journal.2016;[Epub] CrossRef

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The Perception and Opinions for the 'Compulsory Clinical Training Program' of Postgraduate Medical Trainee.: Junghyoun Cho, Jaeho Lee, Seolly Jeong; Korean J Fam Med 2009;30(11):864-871. Published online November 20, 2009; DOI: https://doi.org/10.4082/kjfm.2009.30.11.864

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Background
Nowadays 2-year 'Compulsory Clinical Training Program' is on issue. The perception and opinions for the new training system of residents and interns may be essential to establish ideal postgraduate medical education. Methods: A questionnaire survey of postgraduate trainee from March to April 2008 was performed by person to person method. Gender, age, specialty, the location and the facility of the hospital, and 7 questions reflecting individual perception and opinions for the 'Compulsory Clinical Training Program' were reviewed. Results: Among in 1,314, 1,284 subjects completed the survey fully. We divided 1,284 sujects into 4 groups; Intern; Resident of Family Medicine; Resident of Internal Medicine or Pediatrics; Resident of other than Family Medicine, Internal Medicine and Pediatrics. About the vision for independent clinical skills through the 'Compulsory Clinical Training Program', most were negative. They were afraid of 'prolongation of current Internship' or 'unclear quality of the training course'. In case of setting the 'Compulsory Clinical Training Program', most chose additional resident courses for specialty. The main opinion about the ideal model of a primary physician was medical doctors who obtained primary care specialty. Conclusion: Most of the residents and interns think that the specialists of family medicine, internal medicine or pediatrics are suitable for primary care. And on wishing the additional residency course even after 'Compulsory Clinical Training Program', they doubt about the effi cacy of the new training system.

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Reviews

Methodology of Korean Lifetime Health Maintenance Program.: Soo Young Kim, Young Sik Kim, Min Seon Park, Sung Sunwoo, Jung Jin Cho; Korean J Fam Med 2009;30(10):769-776. Published online October 20, 2009; DOI: https://doi.org/10.4082/kjfm.2009.30.10.769

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Korean Lifetime Health Maintenance Program (KLHMP) represents one of several efforts to take a more evidence-based approach to the development of recommendations on a wide range of preventive services. This paper summarizes the methods of the third KLHMP developed by Korean Academy of Family Medicine. The review process of KLHMP was mainly based on trans contextual guideline adaptation of United States preventive service Task force (USPSTF) recommendation. The method of review process was done according to categories of recommendation (adotion of USPSTF's recommendation, adatation of USPSTF's recommendation, development of new recommendation). If the recommendation done by USPSTF is up to date and acceptable in Korean context, it was translated and adopted. If the USPSTF recommendation was not up to date, nor applicable, the recommendation was drawn by adaptation process. If the condition has not been reviewed by USPSTF, the recommendation was drawn by de novo development process, forming key question, literature search (primary researchs, systematic reviews, guidelines), literature evaluation, evidence systhesis, considering of applicability and acceptability of evidence.

Citations

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Tobacco cessation: screening and interventions
Yoo-Bin Seo, Sang-Wook Song, Sung-Goo Kang, Soo Young Kim
Korean Journal of Family Medicine.2025; 46(1): 12. CrossRef
Effects of Green Tea Powder on Bone Markers in Female Rats Fed High Fat Diet
Yun-Jung Jung
Journal of the East Asian Society of Dietary Life.2024; 34(3): 183. CrossRef
Experience of Lifetime Health Maintenance Clinic in a Tertiary Hospital: Patients Satisfaction and Associated Factors
Seung Woo Lee, Na Ra Cho, Seung Hyun Yoo, Sung Sunwoo
Korean Journal of Health Promotion.2017; 17(3): 176. CrossRef
Evidence Base Medicine and Pre-Appraised Resources
Hyun Ah Park
Korean Journal of Family Medicine.2010; 31(12): 897. CrossRef

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4 Crossref

Periodic Health Examination and Prevention Guidelines for Koreans.: Minseon Park, Soo Young Kim, Young Sik Kim, Sung Sunwoo, Jung Jin Cho; Korean J Fam Med 2009;30(10):761-768. Published online October 20, 2009; DOI: https://doi.org/10.4082/kjfm.2009.30.10.761

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Periodic Health Examination and Prevention Guidelines for Koreans were first proposed since 1988. Based on that guideline, clinical preventive services has been applied to clinic population in a few University Hospitals since 1991. In 1995, LHMP development committee in Korean Academy of Family Physician Society first published evidence based clinical practice guidelines and updated the guidelines in 2003. Lifetime Health Maintenance Program (LHMP) committee represents efforts to take a more updated evidence-based approach to the development of the third updated clinical practice guideline in 2009. We focused on approaches that can reliably assess the extent of updating required, a model of limited literature searches with modest expert involvement to reduce the cost and time.

Citations

Citations to this article as recorded by

Experience of Lifetime Health Maintenance Clinic in a Tertiary Hospital: Patients Satisfaction and Associated Factors
Seung Woo Lee, Na Ra Cho, Seung Hyun Yoo, Sung Sunwoo
Korean Journal of Health Promotion.2017; 17(3): 176. CrossRef

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Original Articles

Inpatient Smoking Cessation Program and Its Success Rate for Abstinence among Korean Smokers.: Ki Yun Jung, Sang Ho Yoo, Seung Hyun Ma, Sun Hyoung Hong, Yun Sang Lee, Un Young Shim, Jong Lull Yoon, Mee Young Kim; Korean J Fam Med 2009;30(7):503-510. Published online July 20, 2009; DOI: https://doi.org/10.4082/kjfm.2009.30.7.503

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Background
Inpatient smoking cessation programs have been known to be quite effective for smoking cessation, but it was rarely conducted among Koreans. This study was to investigate the effect of inpatient smoking cessation program among Korean smokers. Methods: From March 1 to April 30, 2008, we carried out a randomized controlled trial for inpatient smoking cessation program among 70 smokers who were 18 years of age or over and admitted to a university hospital in Seoul, Korea. For the intervention group, a trained doctor conducted the systematic educational program for smoking cessation of 30 minutes to an hour. For the control group, they were advised with a 3-minute explanation for smoking cessation. We assessed the abstinence rates of study participants at 1 week, 1 month, and 3 months after discharge. Results: In 3 months after the discharge, the abstinence rate for the intervention group was 37.1% while that of the control group was 14.3%. In simple logistic regression analysis, the smokers among the intervention group were 3.5 times more likely to abstain than those in the control group. After controlling for confounding factors, the smokers among the intervention group was 11.4 times more likely to abstain than those in the control group. Conclusion: For Korean smokers, the inpatient smoking cessation program showed a higher success rate of abstinence compared to simple advice and limited counselling.

Citations

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Factors Related to Smoking Relapse Within Six-Months of Smoking Cessation Among Inpatients
Ji Eun Bae, Chul-Woung Kim, Seung Eun Lee, Myungwha Jang
Research in Community and Public Health Nursing.2023; 34: 307. CrossRef
Factors Related to Smoking Recurrence within Six-months Smoking Cessation among Employees in Enterprises with Smaller than 300 Workers
Byung Jun Jin, Chul-Woung Kim, Seung Eun Lee, Hyo-Bin Im, Tae-Yong Lee
Journal of Korean Academy of Community Health Nursing.2021; 32(1): 107. CrossRef
Factors Associated with Indoor Smoking at Home: A Focus on Socioeconomic Status in South Korea
Bomgyeol Kim, Yejin Lee, Young Dae Kwon, Tae Hyun Kim, Jin Won Noh
Epidemiology and Health.2020; : e2020067. CrossRef
Decrease in Smoking and Related Factor after the Price Raise of Tobacco in Hypertension Patients: Using 2015 Korea National Health and Nutrition Examination Survey
Mi Hyun Joo, Mi Ah Han, Jong Park, Seong Woo Choi, So Yeon Ryu, Jun Ho Shin
Journal of Health Informatics and Statistics.2019; 44(1): 83. CrossRef
Factors associated with the satisfaction of smoking cessation programs in clinics among Korean military personnel: An application of Transtheoretical model
Eunjoo Kwon, Eun-Hee Nah
Korean Journal of Health Education and Promotion.2019; 36(5): 1. CrossRef
The Abstinence Rate of the Inpatient Smoking Cessation Program
Jae-Hang Cho, Seock-Hwan Lee, Jung-Woo Sohn, Hye-Young Yang
Journal of the Korean Society for Research on Nicotine and Tobacco.2017; 8(2): 88. CrossRef
Continuous Abstinence Rates from Smoking Over 12 Months according to the Frequency of Participation in a Hospital-based Smoking Cessation Program among Patients Discharged after Acute Myocardial Infarction
Young-Hoon Lee, Mi-Hee Han, Mi Rim Lee, Jin-Won Jeong, Nam-Ho Kim, Seok Kyu Oh, Kyeong Ho Yun, Sang Jae Rhee, Jum Suk Ko, Gyung-Jae Oh
Korean Journal of Health Promotion.2016; 16(1): 48. CrossRef
Predictors of Successful Smoking Cessation after Inpatient Intervention for Stroke Patients
Eugene Ha, Jun-Yong Jo, Ah-Leum Ahn, Eun-Jung Oh, Jae-Kyung Choi, Dong-Yung Cho, Hyuk-Jung Kweon
Korean Journal of Family Medicine.2016; 37(2): 85. CrossRef
Compliance and Effectiveness of Smoking Cessation Program Started on Hospitalized Patients
Gun Hee Shin, Sung Won Yi, Yoo Seock Cheong, Eal Whan Park, Eun Young Choi
Korean Journal of Family Medicine.2016; 37(3): 149. CrossRef
Effects of Brief Smoking Cessation Education with Expiratory Carbon Monoxide Measurement on Level of Motivation to Quit Smoking
Won-Young Choi, Cheol-Hwan Kim, Ok-Gyu Lee
Korean Journal of Family Medicine.2013; 34(3): 190. CrossRef
Effects of a Smoking Cessation Education on Smoking Cessation, Endothelial Function, and Serum Carboxyhemoglobin in Male Patients with Variant Angina
Sook-Hee Cho
Journal of Korean Academy of Nursing.2012; 42(2): 190. CrossRef
The Effects of the Brief Inpatient Smoking Cessation Counseling on Quit Success and Stage of Change
Kyeong-Su Kim, Eon-Sook Lee, Jun-Hyung Lee, Yeong-Sook Yoon, Yun-Jun Yang, Seon-Hyeon Park, Hyungjun Kwak
Journal of the Korean Society for Research on Nicotine and Tobacco.2012; 3(1): 10. CrossRef
User Satisfaction as a Tool for Assessment and Improvement of Quitline in the Republic of Korea
B. Y. Jeong, M. K. Lim, E. H. Yun, J.-K. Oh, E. Y. Park, S. H. Shin, E.-C. Park
Nicotine & Tobacco Research.2012; 14(7): 816. CrossRef

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Geriatrics in Family Medicine Residency Program: Training Conditions and Suggestions.: Bodri Son, Chang Won Won, Il Sin Kim, Hyun Rim Choi, Byung Sung Kim; J Korean Acad Fam Med 2008;29(9):687-694. Published online September 10, 2008

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Background: With the number of geriatric population on a steep increase, the roles of family physicians broaden to give comprehensive medical care to the elderly. Therefore, geriatrics is becoming increasingly more important for the residents of family medicine. The authors have surveyed and researched on resident's current attention, actual training conditions, and future needs on geriatrics. Methods: Family medicine residents in 79 hospitals registered to Korean Family Medicine Resident Union were enrolled. By means of electronic and postage mail surveys, informations were gathered; including demographics, the order of importance of nine training curricula, the necessity of training itself, the facility and academic conference of geriatrics training. Results: A total of 173 residents in 45 hospitals replied with return rates of 51.9%. Among the total, 169 (97.7%) of the answered agreed on the necessity of geriatrics training. Of the nine curricula, geriatrics was considered the most important. And residents considered family medicine outpatient department and inpatient ward to be the most important place for geriatrics training. Furthermore, the residents considered elderly's diseases or symptoms as more important conference title, but the parameters such as the quality of life, physiology of aging, care in nursing home were considered less important. Conclusion: The geriatrics training program is not up to the standards of residents' satisfaction. This is considered to be due to the absence of a formal training program. To provide a better care for the elderly, it is compulsory to gain broad knowledge of geriatrics and actual experience out in the field. (J Korean Acad Fam Med 2008;29:687-694)

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Body Mass Index Change during and after the Childhood Obesity Prevention Program.: Wook Je Cho, Kayoung Lee, Tae Jin Park; J Korean Acad Fam Med 2008;29(8):572-578. Published online August 10, 2008

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Background
This study was designed to find out the effect of school based obesity prevention intervention by considering the changes of BMI during both at the time of intervention and post-intervention. Methods: The research was conducted at an elementary school located in Busan metropolitan city, where we measured the height and weight of 260 students at baseline, 6 months after the initiation, and 6 months after the intervention. The students were classified into three weight groups of normal, overweight and obesity according to the age and sex-specific BMI. Results: The BMI decreased or maintained in 60% of the boys and 65% of the girls after the initial six months of the intervention, while after six months from the end of the intervention, BMI increased in 91% of the boys and 83% of the girls. The children's BMI significantly decreased during the intervention (P＜0.01), whereas it significantly increased post intervention (P＜0.05). In the logistic regression model including age, sex, initial BMI, and the follow-up status after the intervention, the increase of BMI by 1 unit was associated with 11% lower odds (95% CI 0.83∼0.98) for BMI decrease and maintenance. Likewise, the increase of age by 1 year was associated with 24% lower odds (95% CI 0.59∼0.98) for BMI decrease and maintenance. However, there was no significant predictors for BMI decrease and maintenance after the intervention. Conclusion: As the positive effect of this intervention for children is not consistent, the research should be more focused in finding out the effective method for prevention of obesity among elementary school children, as a better solution in the longrun. (J Korean Acad Fam Med 2008;29:572-578)

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Effect of Short-term Obesity Management Program for Local Community Residents.: Ji Won Lee, Jee Aee Im, Duk Chul Lee; J Korean Acad Fam Med 2008;29(2):121-133. Published online February 10, 2008

Abstract
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Background
The incidence of obesity is acutely increasing resulting in increased mortality rate and medical expenses among Koreans. But it is rare to find effective obesity management program, that are readily accessible by general local community residents. This study was aimed to develop and evaluate an effective and specialized obesity management program utilizing the local public health institutes. Methods: One hundred forty nine obese adults residing in Kwangju were enrolled in a tentative, 12-week scheduled obesity management program from August 2006 to October 2006. The program constituted of weekly education and practice by specialists, and exercise for more than an hour for 5 days a week. The effectiveness of the program was evaluated according to the change of body weight, body component, blood pressure, and serum lipid concentration. After the program was completed, each participant was surveyed on the degree of satisfaction and lifestyle changes. Results: Ninety participants (60.4%) completed the program to the end. The average decrement of body weight after the program was 1.9±1.5 kg. Eleven participants (12.2%) lost more than 5% of the initial body weight. The waist circumference and average blood pressure significantly decreased among the group who lost more than 5% of the initial body weight. The total cholesterol and triglycerides also slightly decreased among this group. Overall 87.3% of the participants were satisfied with the results of the program. The lifestyle of the participants had also changed by the program. Conclusion: The authors expect that establishing easily- approachable obesity management program in local public health institutes will make a great contribution to the maintenance of proper body weight and decrement of cardiovascular diseases among local community residents. (J Korean Acad Fam Med 2008;29:121-133)

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Evaluation of School-based Obesity Prevention and Management Program in Korean Children.: Kyung Hee Park, Sun Mi Yoo; J Korean Acad Fam Med 2006;27(6):471-480. Published online June 10, 2006

Abstract
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Background
: Childhood and adolescent obesity are major health concern impacting on short and long-term health. Prevention programs for obesity through school channel are essential. With the increasing prevalence of obesity and overweight among children and adolescence since 1990's, obesity prevention and management have been pursued in Korea. Schools, where students spend much of their daytime, are in a unique position to play a pivotal role in performing obesity prevention and management programs. The objective of this study was to assess the effectiveness of school-based interventions designed to prevent or manage obesity among elementary, middle, and high school students in Korea.

Methods : Electronic database were searched using the following key words; obesity, obesity prevention, obesity prevention program, child, adolescence, and effectiveness. In this systematic review, school-based programs were evaluated with the assessment items.

Results : Thirteen studies were included in the study. Most programs include at least one of the following components: dietary changes, physical activity, behavioral modifications, and parental participation. Studies that involved multidisciplinary measures including dietary education, increased physical activity, parental involvement and behavioral modification and studies focused on increased physical activity among subjects showed positive results. But the majority of studies were short-term and secondary prevention among children, not adolescents, not randomized, and without control. Few studies used validated questionnaires and process evaluation.

Conclusion : The development and application of evidence-based and feasible strategies in support of communities and families to the school-centered obesity prevention program are needed in the near future.

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An Interview Survey on Opinions Concerning the Necessity for Family Doctor Registration Program and its Major Services.: Seung Won Bong, Tae Hoon Kim, Shin Sil Kim, Young Sik Kim; J Korean Acad Fam Med 2006;27(5):370-375. Published online May 10, 2006

Abstract
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Background
: Recently, reinforcement and innovation of primary care has been propeled and family doctor registration program has been proposed as one of the solutions for the problem. The aim of this study was to understand the Korean population's perception concerning the need of the family doctor registration program.

Methods : The study subjects included 865 adults from 16 different cities who were applying for health insurance. The interview for study subjects was performed by 53 nurses during 3 months. The questionnaire was composed of questions eliciting general information about the subject, subject's perception on the necessity and the role of family doctor registration program, and on regarding services offered by the family physician.

Results : Seventy seven percent of the respondents were in favor of the family doctor registration program. The most importantly considered benefits of the program were medical examination, stress management, and management of chronic diseases. Sixty one percent of the respondents preferred internists as their family doctor, where as 42 percent preferred a family physician. Most people thought it was reasonable to pay 120,000 won per year as a registration fee. Services thought to be necessary by respondents were medical examination for family members, telephone call counseling, and physician's home visit.

Conclusion : The results revealed that 77 percent of the subjects responded favorably towards the family doctor registration program. The most importantly considered benefits of the program were medical examination, stress management, and management of chronic diseases.

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The Effectiveness and Satisfaction of Personal Computer Based Smoking Cessation Program for Adolescents.: Eun Kyung Kim, Yoo Seock Cheong, Eal Whan Park, Eun Young Choi, Jae Hun Kim, Ran Lee, Sung Ook Jo; J Korean Acad Fam Med 2005;26(9):544-550. Published online September 10, 2005

Abstract
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Background
: Although smoking hazards are acknowledged worldwide, recent study of Korean teenage smokers shows that students' first smoking experiences are occurring at younger ages. Therefore, we have developed an internet-based smoking prevention program, and assessed the effectiveness of the self-administered internet program by comparing with traditional lecture.

Methods : Between April and June of 2004, 463 female eighth-grade students at a middle school were divided into two groups. One group (n=252) received the lecture-based smoking prevention education by an expert, while the other group (n=212) learned themselves via the internet program. Prior to both smoking prevention programs, the students filled out questionnaires about their basic information. One month after their education, the students were tested on the information included in the programs without prior notice and filled out another questionnaire on the level of comprehension, satisfaction and other factors.

Results : According to the pre-education questionnaire, the percentage of current smoking rate was 2.8%, and the first smoking experience was largely between the sixth and seventh grades. When comparing the scores of self-administered internet education with that of the lecture, the mean scores were 56.7 and 57.8, respectively, which was not significantly different (P=.267). The survey on comprehension, satisfaction, and other factors did not show any significant difference between the two groups.

Conclusion : There was no significant difference between the internet-based program and the lecture-based one, in terms of effectiveness as well as comprehension, satisfaction, and other factors. Considering that the internet-based program is not restricted by time or location, it will no doubt be an effective tool in teenage smoking prevention programs.

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A Study of Periodic Health Examination of the First Grade of High School in Seongnam City.: Byoung Du Kang, Tae Hwan Kwak, Doo Yup Koo; J Korean Acad Fam Med 2005;26(4):224-228. Published online April 10, 2005

Abstract
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Background
: It is evident that obesity and other associated chronic diseases are increasing. Since 1998, periodic health examination has been taken in the first grade of high school in accordance with the law nationally and will be expanded to other grades. We evaluated the health status of this population and thought the problems and pitfalls of this program.

Methods : We took 983 students of the first grade of 3 high schools in Seongnam city from April to June 2002. We used the questionnaire and test results as the first line methods of evaluation. Phone counselling was used as the follow-up method. Chi-square test was the main analytic method.

Results : Impaired visual acuity and absence of hepatitis B viral antibody were shown in over 40% of this population. Obesity, anemia, hyperlipidemia, hypertension were followed as the next most popular problems. Though 7.9% of 983 students were to be examined again, only 53.8% of them were re-examined. 52.7% of the student who took re-examination was proved normal. 47% of the test students thought that they were not healthy. Over half of students had the problems of exercise and eating behavior.

Conclusion : We concluded that many students had the behavioral problems causing the chronic diseases. Medical prevention and education program is needed and medical faculties must participate in these programs. In periodic health examination various follow-up programs and screening-questionnaires on psychologic problems must be invented and applied for students.

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Current State and Demand of Esophagogastroduodenoscopy Training in Family Practice Residency Programs.: Jung Han Chun, Yeong Sook Yoon, Sang Woo Oh, Eon Sook Lee, Min Gyu Kim, Young Seong Kim, Yang Hyun Kim, John Yang; J Korean Acad Fam Med 2003;24(12):1092-1098. Published online December 10, 2003

Abstract
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Background
: Most recently, there is an increased use of EGD (esophagogastroduodenoscopy) for primary care among family physicians, which tends to promote EGD training programs in the course of Family Practice Residency. This study determined to survey current status of EGD training programs among residents in family medicine, identify relevant problems, and present some suggestions for their improvement.

Methods : The subjects were residents selected among family medicine training hospitals, which were registered in the KAFM (Korean Academy of Family Medicine). The residents were in their 3rd year of training or had already completed the EGD training program. Surveys were sent out to those hospitals by mail and electronic mail surveys were performed by researchers.

Results : Among 66 subject hospitals a total of 27 surveys (40.9%) were returned. Most EGD training were performed in the department of internal medicine. The mean duration of training period was 8 weeks. The averale number of hands on experience of the procedure was 62. It was found that most residents thought that EGD training period and the number of hands on experience of the procedure were insufficient. The longer period of actual experience of the procedure and the more number of EGD caseloads they had, the more they were satisfied with their EGD training programs. It was also found that there was a high demand for a follow-up learning opportunities for EGD (p＜.05), because the residents who had already had many EGD caseloads further wanted to receive continuous education even, after they acquired license. There were no relationships observation period, period of actual experience of the procedure, and number of EGD caseloads during residency with demand for follow-up learning opportunities.

Conclusion : In summary, there was insufficient EGD training period and actual experience of the EGD procedure in family practice residency. There was low satisfaction of EGD training programs and high demand for continuous education. Therefore, it is recommended to establish EGD training program, proper practice training, and regular continuing education after completing residency.

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Short Term Effects of School-Based Obesity Control Programs Performed on Elementary Students.: Youn Hee No, Seon Yeong Lee, Jae Heon Kang; J Korean Acad Fam Med 2002;23(12):1470-1479. Published online December 10, 2002

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3-Day adolescent smoking cessation program in a tertiary level hospital.: Jee Young Pak, Youn Hee No, Seoung Won Kim; J Korean Acad Fam Med 2002;23(4):485-495. Published online April 1, 2002

Abstract
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Background
: Despite the fact that adolescent smokers are increasing in Korea, an effective smoking cessation program is not widely available. The purpose of the present study was to develop and evaluate a short term smoking cessation program.

Methods : The subjects involved in the smoking cessation program were 89 students from 9 different middle and high schools located in Seoul. They were referred to our program by their school teacher as a penalty for smoking in school. The duration of the program was a total of 270 minutes and the program was carried out in 3 sessions during a period of one week. The program included cigarette related experiments and life skills enhancement training, such as self-assertiveness, cigarette refusal skills and self esteem enhancement. The students considered to be smoke free at the end of less than 8 ppm. The stage of smoking cessation was also assessed at the beginning to later evaluate if any progress in stage had occurred. Certification was given to those who succeeded in meeting the smoke free criteria. The students who were not able to meet the smoke free criteria were given the certification only under the condition that they achieve a level of expiratory CO measurement close to that of a nonsmoker's.

Results : Eighty seven students out of the 89 received the certification and 90.7% had attempted smoking cessation during the program. 39.1% Among, met the smoke free criteria used in this study. There was a significant difference between those who declared to be smoke free (54.1%) on the questionnaire and those who actually met the smoke free criteria. There was an average of a 0.75 stage advancement in terms of the stage of smoking cessation (P<0.005).

Conclusion : The program yielded high smoking cessation attempt and cessation rate in spite of the short duration of the program.

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Alterations in body composition of obese females following in-community supervised exercise program.: Hyun Soon Kim; J Korean Acad Fam Med 2002;23(2):233-241. Published online February 1, 2002

Abstract
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Background
: A variety of techniques for assessing human composition have been developed. However, the vaidity f these methods has not been compared in the same subjects after training program. In this study, the dependent variable used as a criterion of changes in body composition is body weight (BW), which consists of fat-free weight (FFW) and body fat (BF) in the two-compartment model, on the assumption that FFM does not change significantly during the exercise program. The purpose of this investigation was to evaluate the validity of percentage body fat using indirect methods-bioelectrical impedance (BI) analyzer and skinfold thickness (SFT) and to discuss the accuracy of each method.

Methods : The subjects were 13 obese women, aged 42 to 63 years (52.4±6.4yr). The subjects pariticipated in supervised physical conditioning program 3 days per week, 30 t 60 min each session, for a period of 14 weeks.

Results : Small decrements were observed in BW (0.5±1.9 kg, p>0.05), body mass index (BMI, 0.6±1.8, p>0.05), waist girth (2.1cm, p<0.5), and SFT at the triceps (2.9mm, p<0.05) and subscapular (2.9mm, p<0.05). There were significant changes in BF (p<0.001) and FFM (p<0.001) calculated by the SFT method, while mean FFM computed by BI technique remained essentially unchanged. Correlational analyses indicated that the absolute amount of change in BW (i.e., delta BW) was significantly associated with delta abdominal girth and delta BF estimated by the BI technique. The relationship between delta BW and delta BF estimated by the SFT method technique was not statistically significant, thereby questioning the validity of using individual skinfold measurements solely to estimate alterations in body composition.

Conclusion : From these results, it is concluded that BI technique may provide more accurate estimates of changes in BF than SFT method.

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The opinion of private family practitioners on the family doctor registration program and it's major services.: Jae Ho Lee, Cheol Hwan Kim, Kyu Suck Kang; J Korean Acad Fam Med 2001;22(7):1021-1033. Published online July 1, 2001

Abstract
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Background
: Recently, many countries including Korea have been trying to enforce and reform their primary care system. The Family Doctor Registration Program(FDRP) which Korean government had tried and failed in 1996. continuously has been being highlighted because of it's importance. Several private family practitioners started grass root movement for conduction FDRP voluntarily. This survey aimed to know the willingness for private family practitioners to participate in voluntary FDRP and it's major services.

Methods : By mailing, the self-administered questionnaire were collected two times during May 20 to June 30 in 1998. The questionnaire contained following : demographic and practice related factors, willingness to participate FDRP, factors related to it's major services. Subjects were 496 private family physicians who had acquired the certification since 1989. Analyses were made by the Chi-square test, t-test, and multiple logistic regression analysis.

Results : Though overall response rate was only 44.8%(222/496), but age and sex distributions of respondents were similar to those of the total study subjects. The percentage of those having a willingness to participate in voluntary FDRP('Y' group) was 58.6%. The 'Y' group showed phone counseling frequence of 3.2(±2.6) times per day. They had much more home visiting experience than 'N' group(62.2% vs 44.9%, P=0.0019). After the conduction of FDRP. the frequency of possible night-time phone duty per month was 3.5(±2.6) times, and the frequency of possible home visiting per week was 1.9(±1.4) times in 'Y' group. After multiple logistic regression analysis on the meaningful variables, male(OR=2.25, P=0.027) rather than female, percentage of child patients<40%(OR=2.526, P=0.0149) rather than that>60%, and having home-visiting experience(OR=1.8, P=0.1131) rather than no experience showed relatively higher tendency of participation in voluntary FDRP.

Conclusion : The results of this survey should be reflected into the health care policy when retrying to implement FDRP in Korea.

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Factors associated with smoking cessation of male workers in a university hospital.: Ji Seon Han, Hyun Sook Hong, Kang Sook Lee; J Korean Acad Fam Med 2000;21(2):265-275. Published online February 1, 2000

Abstract
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Background
: The smoking rate of Korean male workers is top in the world. To establish the effective smoking cessation strategy, we conducted a study to evaluate the factors associated with smoking and smoking cessation.

Methods : We surveyed 509 male workers in a university hospital about age, marital status, drinking, exercise level and checked their awareness and seriousness for diseases due to smoking, benefits from smoking cessation, motivation derived from mass-media and books and their will to quit smoking by self-administered questionnaire.

Results : The significant factors associated with smoking cessation were higher education (OR=1.85, 95% CI 1.26-2.74), non-religion(OR=0.56, 95% CI 0.38-0.83), drinking(OR=0.40, 95% CI 0.27-0.61), awareness(OR=1.30, 95% CI OR=1.03-3.25) and seriousness (OR=1.29, 95% CI 1.19 95% CI 0.74-0.86), motivation(OR=1.21, 95% CI 1.12-1.30), and the will to quit smoking(OR=1.70, 95% CI 1.56-1.85).

Conclusion : This study suggested that effective smoking cessation program should be based on awareness and seriousness due to smoking related diseases, health benefit and barrier to quitting smoking, company's support, the individual's will to quit and various motivation methods.

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Core procedure of family medicine residency programs.: Ji Sun Kim, Jung Cheon Son, Young Ho Lee, Sun Im Moon, Jee Hye Han, Jae Yong Shim, Hye Ree Lee; J Korean Acad Fam Med 1999;20(2):147-157. Published online February 1, 1999

Abstract
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Background
: There has been no systematic investigation of the necessary core procedures in primary care in Korea. The purpose of this study is to examine the core procedures necessary in primary care and to have the results reflected in residency programs.

Methods : A mail survey was conducted from May 2, to August 20, 1997 among 478 physicians who qualified as a family physician specialist since 1989. The contents of the questionnaire included 1) sex, age, location and size of the hospital 2) of the 93 procedures that should be taught during residency programs as suggested by the [American Academy of Family Physicians] and the [Korean Academy of Family Physicians] a) procedures taught in residency programs, b) procedures performed by practicing family physicians, and, c) procedures considered as necessary in primary care.

Results : 1) Of the 93 procedures, 78 were taught in residency programs, 35 were performed by practicing family physicians, and 77 were considered necessary in primary care. 2) All of the 35 procedures performed by family physicians were taught in the residency programs. Of the 77 procedures considered necessary in primary care, 71 were taught but the remaining 6 were infrequently taught. 3) 7 procedures were taught but were considered unnecessary ; Procedures taught but not actually performed amount-ed to a total of 43. 4) 42 procedures were considered necessary but not performed. 5) More procedures were performed by male doctors(p<0.05). Surgical procedures were performed more often in regional hospitals than those in Seoul and in the larger cities(p<0.05), and more were performed in private practice(p<0.05).

Conclusion : Although almost all of the procedures considered necessary in primary care were taught in residency programs, many procedures were not being performed in current medical practice. We suggest that it would be more effective to intensively train the core procedures than to provide exposure to a wide array of procedures. As the procedures performed were found to vary in relation to sex, location and size of the attending hospital, it would be desirable for training programs to accommodate individual needs, giving residents access to specific procedures needed for their future.

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The effects of the adolescent smoking cessation program.: Yong Kyung Shin, Yun Ju Kang, Sun Im Moon, Su Yeun Park, Hye Ree Lee; J Korean Acad Fam Med 1998;19(12):1387-1399. Published online December 1, 1998

Abstract
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Background
: Despite widespread recognition of the hazardous health effects of smoking, adolescent smoking continues increase, emerging as a public health problem. However few studies have focused on smoking cessation programs for adolescent smokers. The purpose of this study was to measure the short-term effects of adolescent smoking cessation program performed by the Seoul School Health Center.

Methods : Four hundred and twenty adolescent smokers referred from their schools form March to December of 1996 were assessed before and immediately after the program with a self-questionnaire. The data acquired from these 420 students was analyzed.

Results : Males were found to have a higher rate of daily smoking as compared with females. Middle school students had an earlier starting age than those of high school students. About 70% of the students had tried to stop smoking and about 1/3 had a high level of self-efficacy in stop smoking. More than 80% of the students were current alcohol drinkers and 10% ever had experience with other drugs. Many showed poor academic performance and low degree of satisfaction with their schools. More than 50% had experienced punishment at school. Middle and high economic status were more common than low status, 73.3% had smokers in their families and 43.3% showed severe dysfunction in family APGAR. Smoking cessation rate immediately after the program was 37.4%, highest in female high school students and lowest in male high school students. Factors shown to be significantly associated with smoking cessation in males were school age, FTQ scores, presence of peer smokers, smoking and alcohol status, self-efficacy in stop smoking and degree of satisfaction with their schools. School age, presence of peer smokers, smoking and other drug use status, self-efficacy in stop smoking, academic performance, degree of satisfaction with their school, experience of runaway from home, economic status and presence of smokers in their families were significant factors in females. Stepwise logistic regression showed that current alcohol users were less likely to succeed in smoking cessation and those with a higher level of self-efficacy in stop smoking were more likely to succeed in males. In females, high school students with higher economic status were more likely to succeed while those with smokers in their families or experience of runaway from home were less likely to succeed.

Conclusion : To promote smoking cessation, specified and risk-based approaches are considered to encourage the motivation of adolescent smokers. For more effectiveness, programs will need to comprehensively include the school, the family, peers, alcohol and other drug issues as well as smoking problem itself.

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Development of an OPD-based childhood obesity control program and the effects of its utilization.: Hye Ree Lee, Yun Ju Kang, Jae Yong Shim; J Korean Acad Fam Med 1998;19(10):787-800. Published online October 1, 1998

Abstract
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Background
: Although childhood obesity is an increasing public health problem in our society and a number of regimens have been developed and distributed for the treatment of adult obesity, few studies have focused on therapeutic programs for obese children. The objective of this study was to develop and measure the effects of an OPD-based childhood obesity control program.

Methods : The OPD-based childhood obesity control program was developed by reviewing the preexisting literature and consulting specialists. It was applied to the 4-6th grade obese(obesity index≥30%) children. The effects of intervention were assessed by the changes in obesity-related behavior, caloric and nutrient intake and exercise amount. The effects in the OPD-based group(group I) were also compared with the school-based group(group II)and the no intervention group(group III).

Results : The OPD-based program was developed based on behavioral modification principles such as self monitoring, stimulus control, positive reinforcement, social support, cognitive change and behavioral contracts and contained diet and exercise therapy. The developed program was applied to 34 pairs(child and mother) in the treatment group of which 21 pairs completed the basic sessions and 17 pairs completed the additional follow up session. Significant changes, decreases in obesity index were observed in the OPD-based group. No significant changes were found in the school-based group whereas increased degrees of obesity were found in the no intervention group. Obesity related behavior scores were significantly increased in both the OPD- and school-based groups. The children in both the OPD-based group showed significant decrease in dietary intake and increase in exercise amount.

Conclusion : Although it was a short-term treatment result, the OPD-based program was more effective than the school-based program in childhood obesity control. We suggest that a control program of comparable intensity and individualization as ours is required, for effective childhood obesity control.