Korean Journal of Community Nutrition

Research Articles

[Korean]
Program Evaluation using the RE-AIM Framework: A Systematic Review and Application to a Pilot Health Promotion Program for Children: Ji-Eun Lee, Jae Eun Shim, Kirang Kim, Jae-Heon Kang, Ji-Yun Hwang; Korean J Community Nutr 2022;27(4):296-308. Published online August 31, 2022; DOI: https://doi.org/10.5720/kjcn.2022.27.4.296

Abstract PDF: Objectives
This study aimed to develop evaluation criteria for the elementary-school-based health promotion program using the RE-AIM framework and to examine their feasibility.
Methods
Previous evaluation studies on health interventions for elementary-school students using the RE-AIM framework were reviewed systematically to identify appropriate evaluation criteria. A diet and physical activity intervention based on the transtheoretical model was implemented in a pilot study using the “Happy Me” application. The feasibility of using the RE-AIM framework to evaluate it was examined.
Results
The review yielded the following evaluation criteria: “reach,” the ratio of participants out of the total target population; “efficacy/effectiveness,” the difference in outcomes between the intervention and control groups, or between a pre- and post-test; “adoption,” the rate of use of the program and participation in the next stage of the program; “implementation,” the progress on the program components; “maintenance,” the participants’ and teachers’ intention to continue using the program. The pilot study reached 76.6% of the targeted population. The intake of sugar-sweetened beverages decreased (P < 0.0001), and the duration of walking increased (P < 0.0001). Other indicators could not be evaluated; therefore, potential indicators were suggested.
Conclusions
This study produced feasible evaluation criteria for elementary-school-based health promotion using the RE-AIM framework. Nevertheless, the feasibility needs to be validated with a broader range of studies and long-term interventions.

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[English]
Current Barriers of Obesity Management of Children Using Community Child Care Centers and Potential Possibility of Utilizing Mobile Phones: A Qualitative Study for Children and Caregivers: Bo Young Lee, Mi-Young Park, Kirang Kim, Jea Eun Shim, Ji-Yun Hwan; Korean J Community Nutr 2020;25(3):189-203. Published online June 30, 2020; DOI: https://doi.org/10.5720/kjcn.2020.25.3.189

Objectives
This study was performed to identify the current barriers of obesity management for children using Community Child Care Centers and their caregivers (parents and teachers working in the Centers). Further, this study explored the possibility of utilizing a mobile phone application for tailored obesity prevention and management programs to overcome the current difficulties associated with children's obesity management.
Methods
The qualitative data were collected through in-depth interviews with 20 obese and overweight children or children who wanted to participate in this study using Community Child Care Centers, 12 teachers working at the Centers, and a focus group interview with five parents of children using the Centers. Data were analyzed with a thematic approach categorizing themes and sub-themes based on the transcripts.
Results
The current barriers of obesity management of obese and overweight children using Community Child Care Centers were lack of self-directed motivation regarding obesity management (chronic obesity-induced lifestyles and reduced self-confidence due to stigma) and lack of support from households and Community Child Care Centers (latchkey child, inconsistency in dietary guidance between the Center and household, repetitive pressure to eat, and absence of regular nutrition education). Mobile phone applications may have potential to overcome the current barriers by providing handy and interesting obesity management based on visual media (real-time tracking of lifestyles using behavior records and social support using gamification), environmental support (supplementation of parental care and network-based education between the Community Child Care Center and household), and individualized intervention (encouragement of tailored and gradual changes in eating habits and tailored goal setting). It is predicted that the real-time mobile phone program will provide information for improving nutritional knowledge and behavioral skills as well as lead to sustainable children’s coping strategies regarding obesity management. In addition, it is expected that environmental factors may be improved by network-based education between the Community Child Care Centers and households using the characteristics of mobile phones, which are free from space and time constraints.
Conclusions
The tailored education program for children using Community Child Care Centers based on mobile phones may prevent and reduce childhood obesity by overcoming the current barriers of obesity management for children, providing environmental and individualized support to promote healthy lifestyles and quality of life in the future.

Citations

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An Interactive Live and Online Cooking Program for Children in Vulnerable Families—An Exploratory Study
Jiyoung Park, Sein Hwang, Seolhyang Baek, Gill A. Ten Hoor
Healthcare.2022; 10(12): 2389. CrossRef

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Original Articles

[English]
A Qualitative Study on the Potential Utilization of a Mobile Phone for Obesity Management in Elementary-School Children : Parents Perspective: Bo Young Lee, Mi Young Park, Kirang Kim, Jea Eun Shim, Ji Yun Hwang; Korean J Community Nutr 2019;24(2):117-126. Published online April 30, 2019; DOI: https://doi.org/10.5720/kjcn.2019.24.2.117

Abstract PDF PubReader

OBJECTIVES
This study was conducted to investigate the current difficulties surrounding children's obesity management and evaluate the application of a mobile phone as a tool to overcome such difficulties of obesity management from the perspective of main caregivers of elementary school students.
METHODS
The qualitative data were collected through 3 focus group interviews including 6 full-time housewives, 7 mothers with overweight children, and 4 working mothers. Data were analyzed using a thematic approach.
RESULTS
The limitations of current children's obesity management included difficulty in diet management and exercise as well as challenges of setting goals and lack of support at the household and school levels. Mobile technology may be useful to overcome the current problems by providing real-time knowledge on diet management and physical activity, online compensation scheme according to goal setting, and interactive environmental supports at both household and school levels for promoting overall health.
CONCLUSIONS
The mobile-based multiple support program may assist in overcoming the current limitations of child obesity management by providing tailored information and by creating a more supportive environment.

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Current Barriers of Obesity Management of Children Using Community Child Care Centers and Potential Possibility of Utilizing Mobile Phones: A Qualitative Study for Children and Caregivers
Bo Young Lee, Mi-Young Park, Kirang Kim, Jea Eun Shim, Ji-Yun Hwang
Korean Journal of Community Nutrition.2020; 25(3): 189. CrossRef
Consumers’ Impulse Buying Behavior on Instagram: Examining the Influence of Flow Experiences and Hedonic Browsing on Impulse Buying
Forough Shahpasandi, Azim Zarei, Mohsen Shafiei Nikabadi
Journal of Internet Commerce.2020; 19(4): 437. CrossRef

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[English]
Leveraging Multimodal Supports using Mobile Phones for Obesity Management in Elementary-School Children: Program Providers' Perspective from a Qualitative Study: Mi Young Park, Jae Eun Shim, Kirang Kim, Ji Yun Hwang; Korean J Community Nutr 2017;22(3):238-247. Published online June 30, 2017; DOI: https://doi.org/10.5720/kjcn.2017.22.3.238

Abstract PDF PubReader

OBJECTIVES
This study was conducted to investigate providers' perspectives on current challenges in implementing a program for prevention and management of childhood obesity and adoption of mobile phone as a potential solution of leveraging multimodal delivery and support in a school setting.
METHODS
The qualitative data were collected through face-to-face in-depth interviews with 23 elementary-school teachers, 6 pediatricians, and 6 dieticians from community health centers and analyzed using a qualitative research methodology.
RESULTS
Current challenges and potential solutions of obesity-prevention and -management program for obesity program for elementary school children were deduced as two themes each. Lack of tailored intervention due to limited recipient motivation, lack of individualized behavioral intervention, and different environmental conditions can be solvable by mobile technology-based personalized intervention which brings about interactive recipient participation, customized behavioral intervention, and ubiquitous accessibility. Lack of sustainable management due to stigmatization, limited interactions between program providers and inconsistent administrative support can be handled by multimodal support based on school setting using mobile platform providing education of health promoting behaviors toward larger scale and interactive networking between program participants, and minimizing administrative burden.
CONCLUSIONS
Adoption of mobile-based health management program may overcome current limitations of child obesity program such as lack of tailored intervention and sustainable management via personalized intervention and multimodal supports although some concerns such as increased screen time need to be carefully considered in a further study.

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A Qualitative Study on the Potential Utilization of a Mobile Phone for Obesity Management in Elementary-School Children : Parents Perspective
Bo Young Lee, Mi-Young Park, Kirang Kim, Jea Eun Shim, Ji-Yun Hwang
Korean Journal of Community Nutrition.2019; 24(2): 117. CrossRef

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[English]
Breast-feeding and Obesity in Early Childhood: Based on the KNHANES 2008 through 2011: Miyong Yon, Haeng Shin Lee, Dohee Kim, Jeeyeon Lee, Jiwoon Nam, Gui Im Moon, Jinhwan Hong, Cho il Kim; Korean J Community Nutr 2013;18(6):644-651. Published online December 31, 2013; DOI: https://doi.org/10.5720/kjcn.2013.18.6.644

Abstract PDF PubReader

Although there has been a significant increase in breast-feeding (BF) rate in Korea, it is plateaued since 2008 and still low compared with that of other countries. Because BF has been related to lower obesity prevalence in many studies and the increase in childhood obesity became evident in Korea, we wondered if a relatively lower BF rate has anything to do with this increase. Therefore, we looked into the relationship between mode & duration of BF during infancy and weight status of toddlers using the data from Korea National Health and Nutrition Examination Survey 2008 through 2011. Number of 2-3 year old toddlers with complete information on BF, anthropometry and normal birth weight was 674. While 87% of them were ever-breastfed, 6.2% each of them were either obese or overweight based on the Standard Growth Chart for Korean Children. Not only the obesity prevalence was different among groups of different mode of feeding, but also the mean duration of BF was significantly longer in normal weight group (9.2 mo.) compared with obese group (5.5 mo.). Accordingly, overweight and obesity prevalence of the toddlers breast-fed for 12 months or longer was significantly lower than that of the toddlers breast-fed for less than 12 months (OR 0.53, 95% CI 0.32-0.87). This study revealed that both BF and duration of BF affect the childhood obesity and, BF for 12 months or longer should be encouraged more aggressively as one of the main strategies to prevent and/or decrease childhood obesity in Korea.

Citations

Citations to this article as recorded by

Breastfeeding and impact on childhood hospital admissions: a nationwide birth cohort in South Korea
Jeong-Seon Lee, Jae Il Shin, Sunyeup Kim, Yong-Sung Choi, Youn Ho Shin, Jimin Hwang, Jung U Shin, Ai Koyanagi, Louis Jacob, Lee Smith, Han Eol Jeong, Yunha Noh, In-Sun Oh, Sang Youl Rhee, Chanyang Min, Seong Ho Cho, Steve Turner, Guillaume Fond, Laurent B
Nature Communications.2023;[Epub] CrossRef
Association of Infant Feeding Characteristics With Dietary Patterns and Obesity in Korean Childhood
Kyoung-Nam Kim, Moon-Kyung Shin
Journal of Preventive Medicine and Public Health.2023; 56(4): 338. CrossRef
Feeding characteristics in infancy affect fruit and vegetable consumption and dietary variety in early childhood
Kyoung-Nam Kim, Moon-Kyung Shin
Nutrition Research and Practice.2023; 17(2): 307. CrossRef
Relations among Maternal Employment, Depressive Symptoms, Breastfeeding Duration, and Body Mass Index Trajectories in Early Childhood
Jihyoung Kim
Journal of The Korean Society of Maternal and Child Health.2020; 24(2): 75. CrossRef
Knowledge and health beliefs about gestational diabetes and healthy pregnancy's breastfeeding intention
Seungmi Park, Jung Lim Lee, Jang In Sun, Youngji Kim
Journal of Clinical Nursing.2018; 27(21-22): 4058. CrossRef
Exclusive breastfeeding and partial breastfeeding reduce the risk of overweight in childhood: A nationwide longitudinal study in Korea
Seon-Joo Park, Hae-Jeung Lee
Obesity Research & Clinical Practice.2018; 12(2): 222. CrossRef
Dietary status of young children in Korea based on the data of 2013 ~ 2015 Korea National Health and Nutrition Examination Survey
Eun-kyung Kim, Byengchun Song, Se-Young Ju
Journal of Nutrition and Health.2018; 51(4): 330. CrossRef
The Relationship Between Breastfeeding Duration and Preschooler Problem Behavior: The Mediating Role of Cognitive Development
Sujeong Kang, Yea-Ji Hong, Naya Choi, Kangyi Lee
Korean Journal of Child Studies.2017; 38(6): 63. CrossRef
Factors Affecting Obesity and Overweight in Korean Preschool Children: Based on the Korea National Health and Nutrition Examination Survey 2013-2014
Inju Hwang, Kyung-Sook Bang
Child Health Nursing Research.2016; 22(4): 237. CrossRef
Dietary Habits and Nutrient Intakes according to Feeding Method during Infant Period in Elementary School Students
Myung-Hwa Kang, Mi-Kyeong Choi, Hyun-Jin Kim, Yun-Jung Bae
Journal of the Korean Society of Food Science and Nutrition.2015; 44(1): 57. CrossRef

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[English]
Development and Evaluation of a Nutrition Education Website for the Prevention and Management of Childhood Obesity: Miyong Yon, Chan Park, Kwan Hee Yoo, Taisun Hyun; Korean J Community Nutr 2012;17(4):390-406. Published online August 31, 2012; DOI: https://doi.org/10.5720/kjcn.2012.17.4.390

Abstract PDF PubReader

Childhood obesity has rapidly increased worldwide and is one of the most serious health problems in this age group. In order to prevent and manage childhood obesity, we developed a nutrition education website. The website consisted of three parts. The first part was made for self-assessment with regard to obesity index, dietary habits, food frequency, dietary attitude, nutrition knowledge, nutrient intake, energy expenditure, and the stage of behavioral change, and tailored messages and advice according to the assessment results. A total of 612 real-size food photos as well as a nutrient database of 3,346 foods and 541 dishes were created to help children estimate nutrient intakes accurately. In addition, an energy expenditure database of 156 activities for children was established to calculate calorie consumption. The second part was made for setting long-term and short-term goals and keeping track of the changes in energy intake and expenditure in one's own page. The third part was made for education. Various types of nutrition information were provided; texts, pictures, calculators and games. The readability and design of the website were evaluated by 46 obese children. Usefulness, design and readability of the website were found to be desirable for children. This website is expected to be used by an obese child alone or with parents or nutrition teachers in order to control body weight through healthy dietary habits and physical activities. In addition, a non-obese child can also use this website for maintaining healthy dietary habits and preventing obesity.

Citations

Citations to this article as recorded by

Development of Education Materials as a Card News Format for Nutrition Management of Pregnant and Lactating Women
Young-Hee Han, Jung Hyun Kim, Min Jun Lee, Taeksang Yoo, Taisun Hyun
Korean Journal of Community Nutrition.2017; 22(3): 248. CrossRef
Application and Evaluation of Web-based Food Frequency Questionnaire for Korean Adolescents
Jinhee Yum, Seungmin Lee
Korean Journal of Community Nutrition.2016; 21(5): 440. CrossRef
Development of Web-based u-Health Self-nutrition Management Program for Diabetic Patients
Yun Ahn, Jeahurn Bae, Hee-Seon Kim
Korean Journal of Community Nutrition.2014; 19(4): 372. CrossRef
A Study on the Development of a Metadata Schema for the Food Education Digital Library
Soojung Kim, Eunha Youn
Journal of the Korean Society for Library and Information Science.2014; 48(4): 323. CrossRef

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[English]
Effect of Nutrition Education Program in Obese Children and Their Parents(II) : Focus on Nutrition Knowledge, Eating Behaviors, Food Habit and Nutrient Intakes: Eun Kyung Shin, Hye Sung Lee, Yeun Kyung Lee; Korean J Community Nutr 2004;9(5):578-588. Published online October 31, 2004

Abstract PDF: The present study was conducted to investigate the effect of nutrition education program on nutrition knowledge, eating behaviors, food habit, nutrient intakes in obese children and their parents who live in Gumi city. The subjects were 16 obese boys, 20 obese girls with obesity index over 130% and 36 of their parents. The nutrition education for the subjects was carried out by the professional personnel such as doctors, professors, and dietitians. The children were provided with well-balanced lunch meals and had 40 min-lectures on the reasonable weight management, 40 min-games and also had regular exercises (stretching, swimming) for 90 mins everyday during 2 weeks of the program. The parents had 90 min-lectures on childhood obesity, diet therapy, behavior modification, and exercise for 6 times. The nutrition knowledge, eating behaviors and food habits were surveyed by using questionnaires before and after the education. The nutrition intakes of the children were surveyed before and after the education by 3-day food record method. The nutrition intakes of the parents were surveyed before and after the education by using semi-quantity questionnaires. After the education, the mean nutrition knowledge scores were significantly improved compared with the pretest scores in both children and parents. After the education, all subjects' eating behaviors were significantly changed positively and calorie and carbohydrates intakes were significantly decreased and vit. C was significantly increased in obese children. The food habits of the parents were significantly improved after the education. These findings show that the well-designed nutrition education program for obese children and their parents can be an effective approach to help them to improve their nutrition knowledge and to establish desirable food habits and eating behaviors.

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[English]
Effect of Nutrition Education Program in Obese Children and Their Parents(I): Focus on Anthropometric Values and Serum Biochemical Index: Eun Kyung Shin, Hye Sung Lee, Yeun Kyung Lee; Korean J Community Nutr 2004;9(5):566-577. Published online October 31, 2004

Abstract PDF: The present study was conducted to investigate the effect of nutrition education program on anthropometric values and boichemical index in obese children who live in Gumi city. The subjects were 16 obese boys, 20 obese girls with obesity index over 130 and 36 of their parents. The nutrition education was carried out by the professional personnel such as doctors, professors, and dietitians. The children were provided with well-balanced lunch meals and had 40min-lectures on the reasonable weight management, 40 min-games and also had regular exercises (stretching, swimming) for 90 mins everyday during 2weeks of the program. The parents had 90 min-lectures on childhood obesity, diet therapy, behavior modification, and exercise for 6times. After the program, obesity index, BMI, % body fat were significantly decreased (p < 0.05) in boys and obese index, BMI, % body fat and WHR were significantly decreased (p < 0.05) in girls. Blood cholesterol and TG levels of girls were significantly decreased (p < 0.05). These findings show that the well-designed nutrition education program for obese children can be an effective approach to help them to improve their anthropometric values and biochemical index.

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[English]
A Study on the Obesity and Stress of Elementary School Children in the Kangnung Area: Eun Kyung Kim, Tae Sun Park, Ki Kyung Kim; Korean J Community Nutr 2001;6(5):715-725. Published online December 31, 2001

Abstract PDF: This study was carried to estimate the prevalence of obesity and to investigate the relationship between stress and obesity in children. The subjects were 508 children, who were randomly selected from the fifth and sixth grade at nine elementary schools in Kangnung. The height, body weight, waist and hip circumferences and body fat(%) were measured and the levels of stress were assessed by a questionnaire consisting of the following 3 domains ; 4 items for personal factors, 11 for home, and 18 for school. The prevalence of obesity in male and female children greatly varied by the indices from 2.5% and 1.7% when judged by BMI, 9.5% and 4.0% by obesity index, and 29.7% and 34.4% by body fat(%). The stress scores from personal(47.1%) and school (47.9%) factors were higher than the stress score from home(38.5%). The stress score from personal factors of female children is significantly higher than that of male children, but the stress score from home of female children is significantly lower than that of male children. The personal stress score and the total stress score of obese female children were significantly higher than those of non-obese female children. In male children, the obesity index(%) or body fat(%) have a significant positive correlation with the stress scores from over-expectation of parents, a lack of conversation with family, examinations, discontent about school, teacher's partiality to students, and sexual curiosity. The female children have a significantly positive correlation of obesity index (%) or body fat(%) with stress scores from appearance, quarrels of parents, and inferiority complex to brothers or sisters. These results suggested that counselling and education about not only balanced diet but also the strategies for actively coping with stress are needed to prevent and treat childhood obesity.

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[English]
Comparison of the Nutrition Knowledge, food Habits and Life Styles of Obese Children and Normal Children in Elementary School in Kyeong-gi Province: Hyun Ok Park, Eun Kyung Kim, Kyung Ah Chi, Tong Kyung Kwak; Korean J Community Nutr 2000;5(4):586-597. Published online December 31, 2000

Abstract PDF: The nutrition knowledge and food attitude of obese children were assessed and compared with their normal children counterparts to provide information for nutrition education programs. One hundred forty six obese children and 92 normal children from the fourth to sixth grade in Bucheon and Anyang elementary schools of Kyeong-gi Province were selected for the study. A multiple choice questionnaire, including 12 items of general nutrition knowledge and 13 items of weight control, were used to test the nutrition knowledge of children. The results of this study are as follows : 1) 57.5% of male and 40.9% of female obese children had experience with weight control, but the rate of correct answers on the nutrition knowledge test ranged from 53% to 58%, which does not show any significant difference between the two groups. The rate of correct answers on items conrerning 'general nutrition knowledge' and 'nutrition knowledge for weight control' did not show any significant difference among the two groups. 2) Obese male students showed a higher rate of correct answers(59.2%) on items of 'the proper food selection for obese children', compared with their counterparts and also obese female students showed a higher rate of correct answers(88.6%) on 'physical exercise', compared with their counterparts. 3) The rate of correct answers on nutrition knowledge of 'basic food groups', 'the functions of iron and vitamins', 'the concept of energy', and 'the principle of weight change' were lower than 40%. 4) The obese children frequently did not have breakfast, overate during lunch in many cases, and had low recognition on knowledge that was necessary to weight control. 5) Only 30.9% and 22.7% of male and female obese children replied that they would participate in weight control programs. However, 53.6% of males and 68.2% of females did not show any concern in participating the programs. From these results, it was suggested that it is necessary to motivate the obese to participate in weight-control program. When developing nutrition education programs for the obese, the contents of the questions that showed a low correct answering rates should be emphasized.

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