Korean Journal of Community Nutrition

Research Article

[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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Original Articles

[English]
Effects of Worksite Nutrition Counseling for Health Promotion; Twelve-Weeks of Nutrition Counseling Has Positive Effect on Metabolic Syndrome Risk Factors in Male Workers: Mi Sun Lee, Hae Jin Kang, Hye Sun Oh, Yun Mi Paek, Ryo Won Choue, Yoo Kyoung Park, Tae In Choi; Korean J Community Nutr 2008;13(1):46-61. Published online February 29, 2008

Abstract PDF: The purpose of this study was to investigate the effect of nutrition counseling on improving metabolic syndrome (MS) risk factors. Sixty-eight subjects were grouped according to their numbers of MS risk factors. Subjects who have three or more risk factors of MS were defined as "High risk", subjects who have two risk factors of MS were defined as "low risk", and subjects who have below two risk factors of MS were defined as "no risk" group. All groups finished nutrition counseling every three weeks for 12 weeks. Anthropometric, dietary assessments (24 hr-recall) and blood samples were measured at 0 and 12 weeks nutrition counseling. After 12 weeks of intervention, anthropometric data (weight, BMI, body fat (%), and waist/hip ratio) were significantly decreased (p < 0.05) in all groups. Daily consumption of calorie was decreased significantly (p < 0.05) in the group of low risk and high risk. Blood level of fasting plasma glucose was significantly decreased (p < 0.001) in all groups after 12 weeks of intervention. Significantly, the fasting plasma glucose level was returned to normal range in the high risk group. The number of people who have three or more risk factors of MS (high risk group) was decreased from 25 to 12. Sum of MS Criteria decreased from 85 to 52 in the group of MS and decreased from 143 to 99 in all groups. These results indicate that nutrition counseling for male workers at the worksite proved to be helpful by reducing the risk factors of MS and thereby reducing the risk of cardiovascular disease. Continuing and systematic nutritional management programs should be developed and implemented for male workers at the worksites.

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[English]
Dietary Behavior and Nutritional Status of the Elderly Women Attending at the Health Promotion Program in an Urban Community: Jin Hee Kwon, Hee Jung Yoon, Jae Moo Lee, Sung Kook Lee; Korean J Community Nutr 2002;7(6):814-823. Published online December 31, 2002

Abstract PDF: This study was conducted to evaluate the nutritional status of the elderly women, who attended the Health Promotion Program of the Seogu Health Center in Daegu. The study subjects were 158 elderly women in an urban community. The general characteristics, dietary behavior (nutritional knowledge, nutritional attitudes and dietary habits), food and nutrient intake were surveyed by an individual interview. The average age of the study subjects was 70.9 +/- 2.3 years of the subject group 79.1% ranged in age from 65 to 74 years and 20.9% were over 75 years. Their average score for nutritional knowledge, nutritional attitudes and dietary habits was 7.3 (total mark of 10), 7.2 (total mark of 10) and 9.1 (total mark of 22) respectively. Specifically, the level of the dietary habits of the study subjects was very low. In relation to food group intake of the study subjects according to age, their food intake was low. The total, plant, and animal food intake were 1078.9 g, 954.4 g (88.5%), and 244.4 g (11.5%), respectively. The mean daily energy intake and nutrient intake according to percentage of the Korean RDA were higher in the from 65 to 74 year group than in those people over 75 years. The average calories and the mean percentage of nutrient intake, except for vitamin C and phosphorus, were below 75% of the Korean RDA. It seems that the nutrient intake was very low. The mean nutrient adequacy ratio (MAR) was 0.59. Nutritional status of age over 75 years old was significantly lower than that of 65 - 74 years old group (Mar = 0.60 VS 0.54, p < 0.05). The correlation coefficients between their dietary behavior (nutritional knowledge, nutritional attitudes, dietary habit) and their mean nutrient adequacy ratio (MAR) showed significant linear relations. In conclusion, if nutritional education is to affect the dietary behavior of elderly women, it should be included in a program to promote their nutrition and health status.

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[English]
Antropometric and Health Status of the Elderly Women Attending a Health Promotion Program in an Urban Community: Jin Hee Kwon, Hee Jung Yoon, Hyo Jung Moon, Jae Moo Lee, Yoon Hee Son, Sung Hwa Park, Hee Kyung Lee, Sung Kook Lee; Korean J Community Nutr 2002;7(6):762-768. Published online December 31, 2002

Abstract PDF: This study was conducted to evaluate the health status of elderly women who attended in a Health Promotion Program of the Seo-gu Health Center in Daegu. The study subjects were 158 elderly women (over 65 years) in an urban community. The subjects were investigated by means of individual interviews using a questionnaire, Blood tests for analyzing their biochemical status were carried out. The average age of the study subjects was 70.9 +/- 2.3 years. Of the subject group 79.1% ranged in age from 65 to 74 year and 20.9% were over 75 years. With respect to health related factors, 23.4% of subjects drank alcoholic beverages and 15.2% of sujects currently smoker. The prevalence with chronic diseases was 51.9%, and 26.6% of the subjects were healthy. The diseases most frequently reported as having been or being treated were arthritis (38.1%), hypertension (21.4%), and diabetes (17.9%). The average height of subjects was below the standard established in the Korean Recommended Dietary Allowances, while the average weight was close to the standard. The means of systolic and diastolic blood pressure were 130.2 mmHg and 71.9 mmHg, respectively. The mean serum albumin level was 4.5 mg/dl, and the value of hemoglobin and hematocrit was 12.5 mg/dl and 0.7%, respectively. The mean serum cholesterol level was 207.1 mg/dl and the mean triglyceride level was 187.7 mg/dl. The serum lipid levels were higher then in those reported in research. The serum cholesterol levels of 71.5%of subjects were within the normal range. The GOT and GTP levels were within the moderate range. In conclusion, the health status of the elderly who attended the Health Promotion Program in the Seo-gu Health Center were very average. However, it was necessary to prepare a health management program to deal with the serum lipids so as to establish and maintain good health. When we carry out the health promotion program in a community, individual program of adequate to health status should be developed more.

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[English]
Analysis of the Characteristics of an Attendee in an Elderly Nutrition Education Program -Using the Factors of Health Promotion Model: Kyeong Sook Yim; Korean J Community Nutr 1998;3(4):609-621. Published online October 31, 1998

Abstract PDF: Although many people initially enroll in health education programs, there are many instances of erratic participation and dropouts. Inconsistent participation in intervention programs minimizes their impact on health promotion. Therefore, a theoretical understanding of factors influencing participation in these programs can potentially enhance the effectiveness of its educational strategy. This study used the Pender's Health Promotion Model to examine specific factors influencing incentives to participate in an elderly nutrition education program. The Elderly Nutrition Counseling and Education Program was conducted with 147 volunteers (76 males, 71 females), aged 60 to 87, at 5 separate community elderly centers, by public health dietitians from February to April 1997. Some participants dropped out during the program. Overall, 61 people(18 males, 43 females) finished all 7 steps over 2 months. Pre-intervention data were collected by trained dietitians. This data included individual cognitive-perceptual factors(perceived benefits of nutrition improvement, importance of health, perceived control over health by multidimensional health locus of control, self esteem, perceived health status, concern about health, depression scale and social health scale), which were known to influence the likelihood of health behavior, and modifying factors(socioeconomic variables, biological characteristics, behavioral factors, such as smoking, alcohol drinking and exercise). Male finalists had a significantly lower chance for health locus of control, and better social health status with their children and grandchildren, compared to males who dropped out. Female finalists had a significantly higher locus of control regarding food behavior, higher self-esteem, better recognized nutritional status, worse self-recognized health status and lower concern about health than those who dropped out. There was no significant difference between the attendees and dropouts in age, BMI( kg/m2), Nutritional Risk Index, depression scale and daily nutrient intake. These results suggest that elderly nutrition intervention plans should focus on the individual cognitive and perceptual factors, with interpersonal influences, to increase participation in nutrition in nutrition improvement programs.

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