Lee-Lan Yen

Prevalence of overweight and obesity and its associated factors: findings from National Nutrition and Health Survey in Taiwan, 1993-1996

BACKGROUND To report the overall and regional prevalence of obesity/overweight in Taiwan and to study its associated risk factors. METHODS A total of 3046 adults > or = 20 years of age collected in National Nutrition and Health Survey in Taiwan, 1993-1996. RESULTS Prevalence rates of overweight and obesity were 21.1 and 4.0% under the current WHO definition. The prevalence rates of overweight and obesity, using the Taiwanese definition (BMI = 24-26.99 kg/m(2) and > or = 27 kg/m(2), respectively), were 22.9 and 10.5% for males and 20.3 and 13.2% for females, respectively. The highest prevalence rates of obesity were found in the mountainous areas. In addition to age and residing location, education level in women and metabolic equivalent (MET) score and alcohol consumption in men were correlates of obesity. Effects of nutrition/health-related behaviors might be in part explained by education level and residing location of the subjects. CONCLUSION The prevalence of obesity defined by WHO criteria among people in Taiwan was moderate, with considerable regional variation. The regional differences in obesity prevalence could not be completely accounted for by the sociodemographic and lifestyle factors studied.

Smoking, health knowledge, and anti-smoking campaigns: an empirical study in Taiwan.

This paper uses a measure of health knowledge of smoking hazards to investigate the determinants of health knowledge and its effect on smoking behavior. In our analysis, two equations are estimated: smoking participation and health knowledge. The simultaneity problem in estimating smoking behavior and health knowledge is also considered. Overall, the estimated results suggest that anti-smoking campaigns have a significantly positive effect on the publics health knowledge, and this health knowledge in turn, has a significantly negative effect on smoking participation. The health knowledge elasticities of smoking participation are -0.48 and -0.56 for all adults and adult males, respectively.

THE EFFECT OF CRASH EXPERIENCE ON CHANGES IN RISK TAKING AMONG URBAN AND RURAL YOUNG PEOPLE

A 20-month prospective study was conducted to investigate the effect of motorcycle crash experience on changes in risk taking among 2514 urban and 2304 rural students in Taiwan. Risk taking was assessed using a 14-item self-administered questionnaire at the beginning and end of the study. A risk-taking score for each student at the initial and the last follow-up assessments was generated from adding up points across all 14 items. For exposure variables, the study documented past motorcycle crash history at the initial assessment and collected detailed information about any motorcycle crash involvement that occurred during the study period. A general linear mixed model was applied to assess the effects of prior and recent crash involvements on the path of risk-taking behavior. The results show that at the initial assessment, students with crash experience had higher risk-taking levels than those without crash experience. However, crash experience, irregardless of whether it was measured in terms of crash history prior to the study, crash frequency, time elapsed since the last crash, or crash severity, did not significantly change the risk-taking path among students, even though its effect differed between urban and rural areas.

Child and adolescent behaviour in long-term evolution (CABLE): a school-based health lifestyle study.

The analysis of the data collected from the CABLE project during 2001 will be able to answer many research questions posed by our study objectives. In view of the length limitations of this report it will only include the results of the statistical analysis of health behaviours and will describe the distribution of health behaviours among first and fourth graders. Further reports will be compiled and released in the future. As shown in Table 2 many behaviours beneficial to health such as eating breakfast paying attention to safety whilst walking drinking water wearing a seatbelt brushing teeth before sleeping eating fruit and vegetables wearing a helmet when on a motorcycle and washing hands before eating were reported by about 70-80% of both first and fourth graders as being performed either frequently or always. However the proportion of students participating in exercise (apart from school physical education classes) was lower at about 50 to 60%. The proportion of students reporting certain health behaviours was compared according to sex area and year group (see Table 3). The variation in behaviours amongst first graders was relatively small however that amongst fourth graders was larger. When comparing behavioural differences between boys and girls apart from a few behaviours (the proportion of fourth graders who wear seatbelts and do exercise in Hsinchu County) that were more prevalent in boys the proportion of girls practising positive health behaviours was higher than that of boys. (excerpt)

The incidence of experimental smoking in school children: an 8-year follow-up of the child and adolescent behaviors in long-term evolution (CABLE) study

BackgroundStudies have established that most regular adult smokers become addicted in their adolescent years. We investigated the incidence of and risk factors associated with initial experimental smoking among a group of school children who were followed for 8 years.MethodsWe used cohort data collected as part of the Child and Adolescent Behaviors in Long-term Evolution (CABLE) study, which selected nine elementary schools each from an urban area (Taipei City) and a rural area (Hsingchu county) in northern Taiwan. From 2002 to 2008, children were asked annually whether they had smoked in the previous year. An accelerated lifetime model with Weibull distribution was used to examine the factors associated with experimental smoking.ResultsIn 2001, 2686 4th-graders participated in the study. For each year from 2002 to 2008, their incidences of trial smoking were 3.1%, 4.0%, 2.8%, 6.0%, 5.3%, 5.0% and 6.0%, respectively. There was an increase from 7th to 8th grade (6.0%). Children who were males, lived in rural areas, came from single-parent families, had parents who smoked, and had peers who smoked were more likely to try smoking earlier. The influence of parents and peers on experimental smoking demonstrated gradient effects.ConclusionsThis study used a cohort to examine incidence and multiple influences, including individual factors, familial factors, and community factors, on experimental smoking in adolescents. The findings fit the social ecological model, highlighting the influences of family and friends. School and community attachment were associated with experimental smoking in teenagers.

Comparison of children's self-reports of depressive symptoms among different family interaction types in northern Taiwan

BackgroundPrevious research has shown that family interactions are associated with depressive symptoms in children. However, detailed classifications of family interaction types have not been studied thoroughly. This study aims to understand the types of family interactions children experience and to identify the specific types of family interactions that are associated with a higher risk of depressive symptoms in children.MethodsData used in the study was collected as part of the Child and Adolescent Behavior in Long term Evolution (CABLE) project in 2003. CABLE is a longitudinal cohort study that commenced in 2001 and collects data annually from children in Taipei city and Hsinchu county in northern Taiwan. The data analyzed in this study was that obtained from the sixth graders (aged 11 to 12 years old) in 2003. Of the 2,449 sixth graders, 51.2% were boys and 48.8% were girls. Factor analysis and cluster analysis were used to investigate the types of family interactions. One way ANOVA was used to establish the relationship between family interaction types and childrens self-reports of depressive symptoms.ResultsBased on the results of factor analysis, the latent factors for family interactions included supporting activities, psychological control, parental discipline, behavioral supervision, and family conflict. After conducting cluster analysis using factor scores, four types of family interactions were revealed: supervised (29.66%), disciplined (13.56%), nurtured (40.96%) and conflict (15.82%). Children from the disciplined or conflict families were more likely to report depressive symptoms. Children from the nurtured families were least likely to report depressive symptoms.ConclusionFamily interactions can be classified into four different types, which are related to childrens self-reports of depressive symptoms. The creation of a family interaction environment that is beneficial for childrens mental health is an important issue for health education and health promotion professionals.

The effects of social structure and social capital on changes in smoking status from 8th to 9th grade: results of the Child and Adolescent Behaviors in Long-term Evolution (CABLE) study.

OBJECTIVE Social structure and social capital are important variables for public health strategies seeking to prevent smoking among adolescents. The purpose of this study was to examine the relationships between social structure, social capital and changes in smoking status from the 8th to 9th grade in Taiwan. METHODS Data were obtained from the Child and Adolescent Behaviors in Long-term Evolution (CABLE) project. The study analyzed a final sample of 1937 students (50.7% female). RESULTS Each layer of social structure was associated with a particular form of social capital. Students whose parents were married and living together had higher family social capital. After controlling for background variables, the social structure variable of friends who smoke was significantly associated with changes in smoking status. Students reporting more school attachment were less likely to start smoking. Students with higher parental supervision was associated with less chance of being a consistent smoker, whereas participation of social organization outside of school was associated with continued smoking. Attending school club was associated with higher probability of smoking cessation. CONCLUSION Smoking prevention and intervention strategies aimed at junior high school students should be tailored to the particular form of social capital important for each type of smoking status.

Expressed Emotion and its Relationship to Adolescent Depression and Antisocial Behavior in Northern Taiwan

BACKGROUND/PURPOSE Despite widespread recognition of the occurrence of antisocial behavior and depression in adolescents, the specifics of the relationship between them have not been clarified. The purpose of this study was to investigate the role of expressed emotion as a proximal factor for depression and antisocial behavior among adolescents, by looking at direct and indirect relationships. METHODS Secondary data analysis using path analysis was carried out on 2004 data from the Child and Adolescent Behaviors in Long-term Evaluation project. The study sample consisted of 1599 seventh-grade students in Northern Taiwan. Variables included family factors, personal factors (sex and academic performance), expressed emotion [emotional involvement (EI) and perceived criticism (PC)], depression, and antisocial behavior. RESULTS We found that one dimension of expressed emotion, PC, directly influenced student depression and related indirectly to antisocial behavior. Depression was an important mediator between PC and antisocial behavior. Another dimension, EI, did not influence either depression or antisocial behavior. Sex was related directly to expressed emotion, depression, and antisocial behavior, and also indirectly to antisocial behavior through PC and depression. Academic performance was related directly to expressed emotion and indirectly to antisocial behavior through PC and depression. CONCLUSION Greater PC from parents directly contributed to higher levels of student depression and was related indirectly to more student antisocial behavior. It is suggested that parents should decrease overly critical parenting styles to promote adolescent mental health and avoid the development of antisocial behavior.

The risky body mass index ranges for significant hepatitis B viral load: A campus-based study.

SUMMARY Significant hepatitis B viral load (≥10,000 copies/mL) was established to increase risk of advanced liver diseases. The aim of this study was to explore the metabolic risk factors for significant hepatitis B viral load. A campus-based cohort consisting of 146 participants of chronic hepatitis B virus (HBV) infection in Northern Taiwan was investigated in 2009. Clinical profiles including serum levels of deoxyribonucleic acid of hepatitis B virus (HBV DNA) were collected. Hepatitis B e antigen (HBeAg) serostatus, high alanine aminotransferase level, body mass index (BMI) ranges, and insulin resistance were related to significant HBV DNA levels in univariate analysis. Compared to individuals with BMI 23-24.9 kg/m(2) in multivariate analysis, those with BMI ≥25 kg/m(2) (OR = 3.86, 95% CI = 1.38-10.8, P = 0.010) and those with BMI <23 kg/m(2) (OR = 4.47, 95% CI = 1.32-15.2, P = 0.016) were at higher risk for significant HBV DNA levels. This phenomenon was also manifest in HBeAg seronegatives, who contributed to a majority of significant viral load in our study. Furthermore, insulin resistance and BMI ≥25 kg/m(2) had positive additive effects on significant HBV DNA levels (adjusted OR = 9.34, 95% CI = 1.74-50.3, P = 0.009). In conclusion, having certain BMI ranges (BMI ≥25 kg/m(2) or BMI <23 kg/m(2)) could be a risk factor of significant HBV DNA levels.:

Public opinion regarding earmarked cigarette tax in Taiwan.

BackgroundCigarette taxation has been perceived by academics and policy-makers as one of the most effective ways of reducing the use of cigarettes. On January 1 2002, the Taiwan government imposed a New Taiwan (NT)