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A comparison of the outcomes of families with children aged less than 2 who received universal versus sustained nurse home visiting services in Korea: a cross-sectional study
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Yu-Mi Kim, Sun Hwa Park, Kyung Ja June, Sung-Hyun Cho, Ji Yun Lee, Hong-Jun Cho, Young-Ho Khang
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Epidemiol Health. 2025;47:e2025004. Published online February 6, 2025
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DOI: https://doi.org/10.4178/epih.e2025004
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Abstract
OBJECTIVES
This study aimed to compare maternal outcomes and the home environment between non‑vulnerable families with children under 2 receiving universal home visiting services and vulnerable families receiving sustained home visiting services.
METHODS This study was conducted in Seoul, Korea, where the country’s first nurse‑led early childhood home visiting program was introduced. A total of 551 mother‑child dyads participated in cross‑sectional surveys conducted at various child ages (6±2 weeks, 6±1 months, 12±1 months, and 24±1 months). Universal home visiting services were provided within six weeks postpartum to non‑vulnerable families, while vulnerable families received sustained services consisting of 25 visits over 24 months. Maternal knowledge of sudden infant death syndrome (SIDS) and childcare, maternal distress, and the Korean Infant‑Toddler Home Observation for Measurement of Environment (K‑IT‑HOME) were assessed.
RESULTS Overall, the universal home visitation group demonstrated higher levels of maternal knowledge regarding SIDS and childcare compared to the sustained home visitation group (all p-values <0.05), while the sustained home visitation group reported higher levels of maternal distress (p<0.001). The total K‑IT‑HOME score was 1.47 points higher in the universal home visitation group than in the sustained home visitation group (p<0.001). No significant differences were observed in the acceptance, organization, or involvement subscales of the K‑IT‑HOME (all p-values >0.05).
CONCLUSIONS This study demonstrated that disparities in maternal outcomes and home environments persisted in early childhood between the sustained and universal home visitation groups.
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Summary
Korean summary
이 연구는 단면 조사로, 보편방문 가족(취약하지 않은 가정)과 지속방문 가족(취약한 가정)을 네 시점(출산 후 6±2주, 6±1개월, 12±1개월, 24±1개월)에서 엄마의 결과 지표와 가정환경 지표를 비교하였다. 이 연구의 결과는 조기 아동기 지속적 가정 방문 프로그램만으로는 엄마의 결과 지표와 가정환경 지표의 격차를 완전히 없애기에 충분치 않다는 점을 시사한다.
Key Message
This study is a cross-sectional survey comparing outcomes between universal home visitation group (non-vulnerable families) and sustained home visitation group (vulnerable families) at four time points: 6±2 weeks postpartum, 6±1 months postpartum, 12±1 months postpartum, and 24±1 months postpartum.
Study results suggest that merely implementing a maternal and early childhood sustained home-visiting program is insufficient to close the gap in maternal outcomes and home environments.
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The Relationships between Calcium Intake and Bone Mineral Density in Korean Postmenopausal Women.
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Young Sik Kim, Soo Ho Lee, Seoung Oh Yang, Ji Yun Lee, Moon Chan Kim
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Korean J Epidemiol. 1999;21(2):119-130.
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Abstract
BACKGROUND
The evidence for a protective effect of calcium on bone mineral density is controversial. Despite this conflicting evidence an assessment of dietary calcium is often included in the clinical evaluation of osteoporosis risk. The purpose of this study was to assess the relationships between calcium intake and bone mineral density(BMD) in postmenopausal women.METHODS The subjects consisted of 143 postmenopausal women over 40 years old who visited the Department of Family Medicine and Orthopedic Surgery in Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea from June 1997 to September 1998. They were divided into three groups such as osteoporosis, osteopenia and control groups according to the level of BMD. The BMD of the lumbar was measured by dual-energy X-ray absorptiometry. Dietary assessment was performed by semi-quantitative food frequency questionnaire.RESULTS Total calcium intakes were directly proportional to the BMD among three groups : they were 385.5+/-298.8mg/d, 438.3+/-216.5mg/d and 548.3+/-405.3mg/d in osteoporosis, osteopenia and control groups, respectively. Multivariate analysis, which was adjusted for age, place of residence in teenage, education, body mass index, exercise, muscular strength and energy intake, was performed between osteoporosis and control groups. As a result, the odds ratio of the highest 25% vs the bottom 25% of calcium distribution by milk consumption was 0.037(95% CI 0.002~0.891). In comparison of milk consumption at least once per day with that of less than 1 time per week, the odds ratio was 0.081(95% CI 0.008~0.793).CONCLUSIONS Levels of BMD in postmenopausal women are associated with amount and frequency of milk consumption.
Therefore, more than 100mg/d of calcium intake - that is, at least a half glass of milk a day - should be recommended in postmenopausal women in order to prevent osteoporosis.
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