Predictors of health-promoting behavior associated with cardiovascular diseases among Korean blue-collar workers

Factors influencing quality of life in low-income women with young children in Korea: a cross-sectional study

Purpose

This study aimed to investigate the effects of health-promoting behaviors (HPB), marital intimacy, and parenting stress on the quality of life (QoL) of low-income women with young children in Korea, an underserved group.

Methods

This cross-sectional survey employed a descriptive correlational design. Using convenience sampling, 123 low-income women with children younger than 6 years were recruited from 14 health and community centers in Jeonju, Korea, from June 2020 to May 2021. Participants completed a questionnaire on QoL, HPB, marital intimacy, and parenting stress. Data were analyzed using descriptive statistics, independent t-test, analysis of variance, Pearson correlation, and hierarchical regression analysis.

Results

Participants, who were on average 37.41±3.65 years old and had 1 to 2 children (n=98, 79.7%), reported a mid-level (3.14 out of 1–5) of QoL. Marital intimacy (β=.38, p<.001) was the most influential factor on the QoL of low-income women with young children. In descending order, HPB (β=.35, p<.001) and non-employment status (β=–.21, p=.003) had a significant influence on QoL (F=15.64, p<.001), and the overall explanatory power was 49.0%.

Conclusion

Considering the mid-level QoL of low-income women with young children, programs aimed at improving the QoL of low-income women need to promote marital intimacy and maintain HPB, while considering their employment status. Strategies that include couple counseling, health care to encourage healthy lifestyles, and reemployment education are needed.

The Effects of Lifestyle Interventions on the Health-Promoting Behavior, Type D Personality, Cognitive Function and Body Composition of Low-Income Middle-Aged Korean Women

Low-income middle-aged women (LMW) who are vulnerable have various physical and psychosocial problems. They need lifestyle interventions to actively cope with these risk factors. This study used a randomized control group pretest-posttest design. LMW aged from 40 to 60 years were recruited and randomly assigned to an experimental group (n = 31) and a control group (n = 32). The lifestyle interventions for this study, which were implemented for eight weeks, included nutritional management, physical activity, stress management and cognitive function improvement based on King’s goal attainment theory. The measured outcomes were health-promoting behaviors, Type D personality, cognitive function and body composition. The experimental group scored significantly higher than the control group for health-promoting behaviors (effect size (ES) = 0.68~1.27, p < 0.001~0.014) and cognitive function (ES = 0.79~1.31, p < 0.001~0.005). The negative affectivity (ES = 0.70, p = 0.012) and the prevalence of a Type D personality (x² = 4.39, p = 0.047) and the systolic blood pressure (ES = 0.65, p = 0.019) decreased significantly in the experimental group compared with the control group. Lifestyle interventions for LMW were effective in improving health-promoting behavior, Type D personality traits and cognitive function.

Risk Perception & Risk-Reduction Behavior Model for Blue-Collar Workers: Adapted From the Health Promotion Model

This study examined the health promotion model (HPM) as a framework for assessing perceptions and health-related behaviors related to cardiovascular disease (CVD) risk among blue-collar workers. This was done with the aim of providing time-sensitive educational and training materials for workers while on the job or functioning in their communities. The revised HPM was evaluated in the above context using specific criteria developed by Chinn and Kramer (2008) and scoping literature review. Specifically, we assessed the model based on five criteria such as its clarity, simplicity, generality, accessibility, and importance. The revised HPM showed strengths in both accessibility and generality. That is, it applied to all populations and chronic illnesses through clearly defined and specified major concepts. However, there were several weaknesses in areas of clarity and consistency; the model included three new concepts (i.e., activity-related affect, commitment to a plan of action, and immediate competing demands and preference) that actually decreased these elements. In this context, situational influences require adequately reflected external variables. Nevertheless, the revised HPM showed predictive power among this study's target population. The HPM was modified to address deficiencies in regard to the concept of risk perception. Work-related situational influences were also restructured based on individual and environmental characteristics. The modified framework can be used to clarify health-related behaviors among blue-collar workers.

An Exploration of Contextual Aspects that Influence Cardiovascular Disease Risks Perceived by Workers in a Small-Medium-Sized Workplace

Contextual factors are associated with risks of cardiovascular disease (CVD) perceived by personnel employed in small-medium-sized workplaces. In an ecological model, data collection and analysis were undertaken, stratified by intrapersonal, interpersonal, and organizational contexts of blue-collar workers. Data were collected in face-to-face (n = 36) and focus group (n = 4) interviews and subjected to qualitative content analysis, to generate three main themes, 10 generic categories and 18 sub-categories. At the intrapersonal level, "physical burden", "burn out due to overtime work", "no time to take care of health because of family responsibility", and "lack of recognition and knowledge of CVD risks" were derived from the individual interviews. At the interpersonal level, "stress of possible job losses", "dislike of stigmatization of unhealthy persons", "smoking and drinking to reduce relationship stress", and "unhealthy work environment" differed by level of risk perception. "Preferred economic value" and "lack of understanding about importance of CVD management of an employer" emerged at the organizational level. Factors that influence CVD risks among workers in small-medium-sized business were present at the multiple levels. Therefore, healthcare providers in the field of occupational health should consider CVD risks in the context of blue-collar workers and organizational level for health-promotion programs.

Who does what the cardiologist recommends? Psychosocial markers of unhealthy behavior in coronary disease patients

Patients diagnosed with coronary heart disease should follow lifestyle recommendations that can reduce their cardiovascular risk (e.g., avoid smoking). However, some patients fail to follow these recommendations and engage in unhealthy behavior. With the aim to identify psychosocial factors that characterize patients at high risk of repeated cardiovascular events, we investigated the relationship between social support, mental health (coping, self-esteem, and perceived stress), and unhealthy behavior. We conducted a cross-sectional study of 419 patients recently diagnosed with coronary heart disease (myocardial infarction or angina) who participated in the National Health Survey in Spain (2018). Unhealthy behaviors were defined according to the European Guidelines on cardiovascular disease prevention. Only 1% of patients reported no unhealthy behaviors, with 11% reporting one, 40% two, 35% three, and 13% four or more unhealthy behaviors. In multiple regression controlling for demographic and traditional risk factors, mental health was the only significant psychosocial factor, doubling the odds of accumulated unhealthy behaviors, OR(high vs. low) = 2.03, 95% CI [1.14, 3.64]. Mental health was especially strongly related to unhealthy behavior among patients with obesity, OR(high vs. low) = 3.50, 95% CI [1.49, 8.45]. The relationship between mental health and unhealthy behaviors suggests that a large proportion of patients may not adhere to lifestyle recommendations not because they purposefully choose to do so, but because they lack coping skills to maintain the recommended healthy behaviors. Low mental well-being may be especially detrimental for behavior change of patients with obesity.

Developing a Health-Promotion Program Based on the Action Research Paradigm to Reduce Cardiovascular Disease Risk Factors among Blue Collar Workers

This study developed and evaluated a health management program based on the participant-centered concept of action research to reduce cardiovascular disease (CVD) risk factors among blue collar workers. Data from structured questionnaires completed by 32 workers in a small-to-medium sized workplace from September 2015 to October 2016 as well as participants’ anthropometrical (weight and waist) and biological (blood pressure, glucose, total cholesterol, triglyceride, high-density lipoprotein (HDL), and low-density lipoprotein (LDL) cholesterol) data were analyzed using paired t-test and Fisher’s exact test. To examine the longitudinal effect of the intervention, survival analysis and linear mixed model (LMM) were used. There was an improvement in participants’ self-regulation in maintaining health-promoting behaviors, body weight, blood pressure, and HDL cholesterol following the intervention. Furthermore, the effects of the health management program continued even after the program ended. These findings suggest that the health management program developed in this study could be effective in reducing CVD risk factors among workers in small-to-medium sized workplaces and should be applied to other small-to-medium sized workplaces to foster health-promoting behaviors.

Medical Drama Viewing and Healthy Lifestyle Behaviors: Understanding the Role of Health Locus of Control Beliefs and Education Level

The present study advances the understanding of how medical drama viewing influences healthy lifestyle behaviors (e.g., smoking, exercising, and consuming vegetables) by examining the role of the health locus of control (HLOC) beliefs and education level. An analysis of nationally representative data reveals that watching medical dramas is positively associated with chance and powerful others' HLOC beliefs. In addition, healthy lifestyle behaviors are positively associated with the internal HLOC belief and are negatively associated with the chance and powerful others' HLOC beliefs. Research findings demonstrate that there are indirect effects of medical drama viewing on these behaviors via chance and powerful others' HLOC beliefs. The indirect effect through the powerful others' HLOC belief is also contingent on the education level. The implications for the role of HLOC beliefs and education level in terms of the effects of medical dramas on health-promoting behaviors are discussed.

Women's Smoking: Relationships Among Emotional Labor, Occupational Stress, and Health Promotion

Call centers in Korea have been found to be operated mainly by women, and they experience high levels of job-related stress. Compared with the general population, the prevalence of smoking among women in Korea's call centers is strikingly high. Little attention has been paid to the associations between smoking behavior and their emotional labor, occupational stress, and health-promotion behaviors. For this cross-sectional study, a paper-based survey was conducted in a sample of female employees in a credit card call center (N = 309). Among the participants, about 20% (n = 62) were current smokers. Smokers were less engaged in health-promotion behaviors than nonsmokers, and occupational stress was negatively associated with health-promoting behaviors in nonsmokers, but not in smokers. Smokers may use cigarettes as a way of alleviating the emotional burden of their work.

Blue-collar work and women's health: A systematic review of the evidence from 1990 to 2015

Despite the implications of gender and sex differences for health risks associated with blue-collar work, adverse health outcomes among blue-collar workers has been most frequently studied among men. The present study provides a "state-of-the-field" systematic review of the empiric evidence published on blue-collar women's health. We systematically reviewed literature related to the health of blue-collar women published between January 1, 1990 and December 31, 2015. We limited our review to peer-reviewed studies published in the English language on the health or health behaviors of women who were presently working or had previously worked in a blue-collar job. Studies were eligible for inclusion regardless of the number, age, or geographic region of blue-collar women in the study sample. We retained 177 studies that considered a wide range of health outcomes in study populations from 40 different countries. Overall, these studies suggested inferior health among female blue-collar workers as compared with either blue-collar males or other women. However, we noted several methodological limitations in addition to heterogeneity in study context and design, which inhibited comparison of results across publications. Methodological limitations of the extant literature, alongside the rapidly changing nature of women in the workplace, motivate further study on the health of blue-collar women. Efforts to identify specific mechanisms by which blue-collar work predisposes women to adverse health may be particularly valuable in informing future workplace-based and policy-level interventions.

Rapid emergence of atherosclerosis in Asia: a systematic review of coronary atherosclerotic heart disease epidemiology and implications for prevention and control strategies

PURPOSE OF REVIEW

There is a global epidemic of coronary heart disease (CHD) caused by atherosclerosis. We discussed its emergence, underlying reasons, and implications for prevention and control strategies in Asia.

RECENT FINDINGS

Most countries in Asia are experiencing the challenges from CHD, with the mortality rate varying from 103 to 366 per 100 000 adult populations, reported by recently published studies. Raised population cholesterol levels played a pivotal role. Men, older adults, and those with dyslipidemia, hypertension, and diabetes were high-risk individuals. During the past decade, there was a marked rising trend of atherosclerosis-related burden particularly in Eastern Asia where an alarming increase of 117.2 and 115.3% of total deaths and disability adjusted life-years, respectively, were observed. The rise of CHD could be attributed to unhealthy lifestyles, clinical-risk factors, psychosocial factors, and public health transitions. Ageing, urbanization, and increase in prosperity may serve as underlying key drivers.

SUMMARY

The burden of CHD is substantial, whereas contributors are multifactorial. This grand challenge should be a top priority for injecting healthcare resources. The formulation of public health measures will need to adopt an integrated and life-course approach, based on the need and risks of different population subgroups in Asia.