Epidemiology and Health

Original Article

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: Yu-Mi Kim, Sun Hwa Park, Kyung Ja June, Sung-Hyun Cho, Ji Yun Lee, Hong-Jun Cho, Young-Ho Khang; Epidemiol Health. 2025;47:e2025004. Published online February 6, 2025; DOI: https://doi.org/10.4178/epih.e2025004

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Abstract Summary PDF Supplementary Material: 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.; 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.

Cohort Profile

Cohort profile: the Ewha Birth and Growth Study: Hye Ah Lee, Bohyun Park, Jungwon Min, Eun Jeong Choi, Ui Jeong Kim, Hyun Jin Park, Eun Ae Park, Su Jin Cho, Hae Soon Kim, Hwayoung Lee, Young Ju Kim, Young Sun Hong, Eui-Jung Kim, Eun Hee Ha, Hyesook Park; Epidemiol Health. 2021;43:e2021016. Published online February 22, 2021; DOI: https://doi.org/10.4178/epih.e2021016

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Abstract Summary PDF Supplementary Material

Abstract

With the introduction of life-course epidemiology, researchers realized the importance of identifying risk factors in early life to prevent chronic diseases. This led to the establishment of the Ewha Birth and Growth Study in 2001; the study is a prospective birth cohort designed to provide evidence of early life risk factors for a child’s growth and health. Participants were recruited from those who visited Ewha Womans University Mokdong Hospital (a tertiary hospital in southwest Seoul, Korea) for prenatal care at 24-28 weeks of gestation. In total, 891 mothers enrolled in this study between 2001 and 2006 and their offspring (n=940) were followed-up. Regular check-up examinations of offspring were conducted at 3 years, 5 years, and 7 years of age and every year thereafter. To consider age-related health issues, extensive data were collected using questionnaires and measurements. In 2021, the study subjects will reach 19 years of age, and we are planning a check-up examination for early adulthood. About 20 years have passed since the cohort data were collected, and we have published results on childhood health outcomes associated with prenatal and birth characteristics, genetic and epigenetic characteristics related to childhood metabolism, the effects of exposure to endocrine disruptors, and dietary patterns in childhood. Recently, we started reporting on topics related to adolescent health. The findings will facilitate identification of early life risk factors for chronic diseases and the development of interventions for diseases later in life.

Summary

Korean summary
이화영아성장코호트는 만성질환 예방을 위한 생애초기 위험인자에 대한 근거를 제공하기 위해 2001년에 시작되었습니다. 이화영아성장코호트는 국내에서 선도적인 장기 추적관찰 연구로, 소아기 건강과 관련된 산전 및 출생 시 특징, 소아기 대사와 관련된 유전적 혹은 후성학적 특성, 내분비 장애물질 노출에 따른 영향, 소아기의 식이패턴과 같은 다양한 연구결과들을 발표하였습니다. 추후 청년기의 자료 수집을 계획하고 있으며, 우리의 연구결과는 만성질환 예방을 위한 중재 개발에 기여할 것으로 기대됩니다.

Key Message
To provide evidence of early life risk factors for the prevention of chronic diseases, the Ewha Birth and Growth Study was started in 2001. The Ewha Birth and Growth cohort is a leading long-term follow-up study in Korea, and we have published results on childhood health outcomes associated with prenatal and birth characteristics, genetic and epigenetic characteristics related to childhood metabolism, the effects of exposure to endocrine disruptors, and dietary patterns in childhood. We are planning to collect data for early adulthood, and our findings will contribute to the development of interventions to prevent chronic diseases.

Citations

Citations to this article as recorded by

Prospective association between handgrip strength in childhood and the metabolic syndrome score and insulin resistance indices in adolescence: an analysis based on the Ewha Birth and Growth Study
Seunghee Jun, Hyunjin Park, Hyelim Lee, Hye Ah Lee, Young Sun Hong, Hyesook Park
Epidemiology and Health.2025; 47: e2025001. CrossRef
Keun Lee (October 10, 1942 – May 14, 2024): a pioneering pediatrician in the field of developmental screening tests in Korea and a beloved teacher at Ewha Womans University College of Medicine
Su Jin Cho
The Ewha Medical Journal.2024;[Epub] CrossRef
Prospective association between phthalate exposure in childhood and liver function in adolescence: the Ewha Birth and Growth Cohort Study
Seonhwa Lee, Hye Ah Lee, Bohyun Park, Hyejin Han, Young Sun Hong, Eun Hee Ha, Hyesook Park
Environmental Health.2023;[Epub] CrossRef
BMI trajectory and inflammatory effects on metabolic syndrome in adolescents
Ui-Jeong Kim, Eun Jeong Choi, Hyunjin Park, Hye Ah Lee, Bohyun Park, Jungwon Min, Eun Ae Park, Su Jin Cho, Hae Soon Kim, Hwayoung Lee, Young Ju Kim, Young Sun Hong, Eun Hee Ha, Seungyoun Jung, Hyesook Park
Pediatric Research.2023; 94(1): 153. CrossRef
The Effect of Childhood Obesity or Sarcopenic Obesity on Metabolic Syndrome Risk in Adolescence: The Ewha Birth and Growth Study
Hyunjin Park, Seunghee Jun, Hye-Ah Lee, Hae Soon Kim, Young Sun Hong, Hyesook Park
Metabolites.2023; 13(1): 133. CrossRef
Synergistic effect of serum uric acid and body mass index trajectories during middle to late childhood on elevation of liver enzymes in early adolescence: Findings from the Ewha Birth and Growth Study
Sung Hee Lee, Eun Jeong Choi, Ui Jeong Kim, Hyunjin Park, Bomi Park, Hye Ah Lee, Hyesook Park, Linglin Xie
PLOS ONE.2023; 18(4): e0282830. CrossRef
The association between urinary cotinine level and metabolic syndrome profiles among adolescents: findings from the Ewha Birth and growth study
Hyunjin Park, Ui-Jeong Kim, Eun Jeong Choi, Seunghee Jun, Bomi Park, Hye Ah Lee, Hae Soon Kim, Hyesook Park
BMC Public Health.2023;[Epub] CrossRef
The Mediating Effect of Inflammation between the Dietary and Health-Related Behaviors and Metabolic Syndrome in Adolescence
Ui-Jeong Kim, Eun-Jeong Choi, Hyunjin Park, Hye-Ah Lee, Bomi Park, Haesoon Kim, Youngsun Hong, Seungyoun Jung, Hyesook Park
Nutrients.2022; 14(11): 2339. CrossRef
Precision medicine via the integration of phenotype-genotype information in neonatal genome project
Xinran Dong, Tiantian Xiao, Bin Chen, Yulan Lu, Wenhao Zhou
Fundamental Research.2022; 2(6): 873. CrossRef
Association of participation in the Northern Finland Birth Cohort 1986 with mental disorders and suicidal behaviour
Martta Kerkelä, Mika Gissler, Juha Veijola
Epidemiology and Health.2022; 44: e2022005. CrossRef
Trajectory patterns for continuous metabolic syndrome score in childhood and the cardiovascular risk in adolescence
Eun Jeong Choi, Hye Ah Lee, Bomi Park, Bohyun Park, Hae Soon Kim, Young Sun Hong, Hyesook Park
Scientific Reports.2021;[Epub] CrossRef

Original Article

Evaluating maternal and child health indicators for the Sustainable Development Goals in 2018: what is Iran’s position?: Elham Khatooni, Isa Akbarzadeh, Elham Abdalmaleki, Zhaleh Abdi, Elham Ahmadnezhad; Epidemiol Health. 2019;41:e2019045. Published online October 11, 2019; DOI: https://doi.org/10.4178/epih.e2019045

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Abstract PDF

Abstract

OBJECTIVES
Since many Millennium Development Goals (MDGs) were not achieved, countries including Iran—despite achieving some of the MDGs—need regular planning to achieve the Sustainable Development Goals (SDGs) by 2030. This article examines maternal and child health indicators in the early years of the SDGs in Iran relative to several other countries.

METHODS

This study was carried out through a secondary analysis of maternal and child health indicators in Iran. The results were compared with data from other countries divided into three groups: countries with upper-middle income levels, countries in the Eastern Mediterranean region, and the countries covered by the Outlook Document 1,404 (a regional classification). Then, the relationship between these indicators and the Human Development Index was investigated.

RESULTS

Iran has attained better results than other countries with respect to maternal mortality, family planning, skilled birth attendance, under-5 deaths, incidence of hepatitis B, diphtheria-tetanus-pertussis vaccination coverage, and antenatal care. In contrast, Iran performed worse than other countries with respect to under-5 wasting, under-5 stunting, and care-seeking behavior for children.

CONCLUSIONS

Overall, among the 11 indicators surveyed, Iran has attained better-than-average results and seems to be improving. We recommend that Iran continue interventions in the field of maternal and child health.

Summary

Citations

Citations to this article as recorded by

Iranian women's birth experiences: a cross-sectional study
Mona Ghobadi, Farzaneh Pazandeh, Barbara Potrata, Ehsan Kazemnejad Lili
British Journal of Midwifery.2022; 30(12): 685. CrossRef
Sanctions on Iran and their impact on child health*
Yasmin Madani-Lavassani
Medicine, Conflict and Survival.2020; 36(4): 359. CrossRef

Data Profile

The current status of health data on Korean children and adolescents: Eunyoung Lee, Dahye Baik, Yoon Park, Moran Ki; Epidemiol Health. 2017;39:e2017059. Published online December 26, 2017; DOI: https://doi.org/10.4178/epih.e2017059

18,464 View
271 Download
2 Web of Science
2 Crossref

Abstract Summary PDF Supplementary Material

Abstract

Childhood and adolescence are critical periods that affect adults’ health status. Therefore, the factors influencing the health of children and adolescents should be analyzed. In Korea, a wide range of youth-related health data has been obtained, both on the regional level and on the national level. This report summarizes the current status of studies related to the health of Korean children and adolescents. Data for which open access is offered include the Korea Youth Risk Behavior Web-based Study, the Panel Study on Korean Children, the Korean Youth Panel Survey, the Korean Children and Youth Panel Survey, and the Student Health Examination. In addition, the Health Examination of Korean Youth Outside of School, the Korean Children and Adolescents Obesity Cohort Study, the Korean Children’s Environmental Health Study, the Korea Youth Media Use and Harmful Environment Survey, the Comprehensive Survey of Korean Youth, and the Multicultural Adolescents Panel Study are summarized.

Summary

Korean summary
청소년시기는 성인의 건강상태에 영향을 미치는 중요한 시기이다. 따라서 청소년의 건강에 영향을 미치는 여러 가지 요소들에 대한 분석이 필요하다. 한국에서 청소년건강과 관련한 데이터는 지역 단위에서뿐 아니라 국가 단위에서도 수집되고 있다. 해당 데이터가 공개되고 있는 것으로는 청소년건강행태온라인조사, 한국아동패널, 한국청소년패널조사, 한국아동ㆍ청소년패널조사, 학교건강검사가 있다. 이외에도 학교 밖 청소년 건강검진조사, 소아비만 및 대사질환 코호트, 어린이 환경 보건 출생코호트, 청소년 매체이용 및 유해환경 실태조사, 청소년 종합실태조사, 다문화청소년패널조사를 요약하였다.

Citations

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Dietary intake and nutritional status of Korean children and adolescents: a review of national survey data
Minji Kang, So Yoon Choi, Minyoung Jung
Clinical and Experimental Pediatrics.2021; 64(9): 443. CrossRef
Benefits of cooperation among large-scale cohort studies and human biomonitoring projects in environmental health research: An exercise in blood lead analysis of the Environment and Child Health International Birth Cohort Group
Shoji F. Nakayama, Carolina Espina, Michihiro Kamijima, Per Magnus, Marie-Aline Charles, Jun Zhang, Birgit Wolz, André Conrad, Aline Murawski, Miyuki Iwai-Shimada, Cécile Zaros, Ida Henriette Caspersen, Marike Kolossa-Gehring, Helle Margrete Meltzer, Sjur
International Journal of Hygiene and Environmental Health.2019; 222(8): 1059. CrossRef

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