kjan Korean Journal of Adult Nursing Korean J Adult Nurs 1225-4886 2288-338X Korean Society of Adult Nursing 10.7469/kjan.2015.27.2.127 kjan-27-127 Original Article Factors associated with Hepatitis A Preventative Behaviors among University Students ChoiJeong-Sil 1 KoJi Woon 2 ParkSeungmi 3 College of Nursing, Gachon University, Incheon Department of Nursing Science, Sun Moon University, Asan Department of Nursing Research Institute for Basic Sciences, Hoseo University, Asan, Korea Corresponding author: Park, Seungmi Department of Nursing, Hoseo University, 20 Hoseo-ro, 79beon-gil, Asan 336-795, Korea. Tel: +82-41-540-9533, Fax: +82-41-540-9558, E-mail: seungmipark@hoseo.edu 042015 042015 272 127134 28082014 07012015 20012015 Copyright © 2015 Korean Society of Adult Nursing 2015 This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. Purpose

The purpose of this study is to identify health beliefs and knowledge related to hepatitis A vaccination (HAV). Preventative behaviors related to HAV were also examined.

 Methods

The convenience sample of 332 students were drawnfromauniversity in Chung-namprovince. The results were analyzedusingdescriptivesta-tistics, t-test, ANOVA, Scheffetest, Pearson ́ 'scorrelationcoefficient, andstepwisemultiple regressionwithSPSS for Windows 21.0 software.

 Results

Vaccination rates for hepatitis A were 23.4%. The mean scores of health beliefs, knowledge andpreventative behaviors related to hepatitis Awere 2.38±0.25, 0.34±0.30, and 3.15±0.40 respectively. The factorsfoundto berelated tohepatitis Apreventativebehaviors wereHAV, havingtheHAVanti-body andhealthbeliefs.

 Conclusion

An experience of HAV, having HAV anti body, and positive health beliefs related to hepatitis A may be necessary to increase voluntary hepatitis A preventive behaviors among university students. It is essential to develop the strategy of educating university students about HAV and having HAV antibody as well as reinforcing health beliefs about hepatitis A which prevent the hepatitis A occurrence.

 Hepatitis A Vaccination Health beliefs Knowledge Preventive behaviors REFERENCES World Health Organization Hepatitis A[Internet] Geneva World Health Organization 2000 [Cited 2014 March 24]. Available from http://www.who.int/csr/disease/hepatitis/whocdscsredc2007/en/index4.html#worldwide Korea Centers for Disease Control & Prevention Management and prevention guidelines of hepatitis A [Internet] Cheongju Korea Centers for Disease Control & Prevention 2009 [Cited 2014 March 4]. Available from http://www.cdc.go.kr/CDC/contents/CdcKrContentView.jsp?menuIds=HOME001-MNU1132-MNU1147-MNU0746-MNU0750&cid=18008 Roh HO Sohn YM Park MS Choi BY Bang KN Ki MR A seroepidemiologic study of hepatitis A virus in the healthy children and adolescent in Kyonggi-do Province Korean Journal of Pediatric Infectious Diseases 1997 4 23239 Heo JY Song JY Noh JY Seo YB Kim IS Cho iWS Low level of immunity against hepatitis A among Korean adolescents: vaccination rate and related factors American Journal of Infection Control 2013 41 10 e97e100 http://dx.doi.org/10.1016/j.ajic.2013.03.300 Cho SE Kim YD Seroepidemiology of hepatitis A in South Korea: a nationwide study by the Eone reference laboratory Journal of Epidemiology 2013 23 4 2704 http://dx.doi.org/10.2188/jea.JE20120188 Korea Centers for Disease Control & Prevention Hepatitis A [Internet] Cheongju Korea Centers for Disease Control & Prevention 2012 [Cited 2014 August 13]. Available from http://www.cdc.go.kr/CDC/contents/CdcKrContentView.jsp?menuIds=HOME001-MNU1132-MNU1147-MNU0746-MNU0750&cid=18008 FioreAE, Wasley A, BellB P. Prevention of Hepatitis A Through Activeor Passive Immunization: Recommendations ofthe Advisory Committee on Immunization Practices (ACIP) Recommendations and Reports Washington, DC Advisory Committee on Immunization Practices (ACIP) 2006 May ReportNO.: 55 (RR-7): 123 Oh HY Park JY Immunization, knowledge, and preventive health behaviors to hepatitis A in university students Korean Journal of HealthEducationand Promotion 2011 28 5 8395 Lee A Lim HS Nam CM Song SM Yoon HR Lee KR An epidemiology analysis of hepatitis A virus serologic markers during the recent four years in Korea Korean Journal of Laboratory Medicine 2009 29 56369 http://dx.doi.org/10.3343/kjlm.2009.29.6.563 Rhodes SD Hergenrather KC Using an integrated approach to understand vaccination behavior among young men who have sex with men: Stages of change, the Health Belief Model, and self-efficacy Journal of Community Health 2003 28 5 34762 http://dx.doi.org/10.1023/A:1025444629753 Rosenstock IM Historical origins of the health belief model Health Education Monographs 1974 2 18 http://dx.doi.org/10.1177/109019817400200403 Park JY Preventive behavior andhealth beliefabout hepatitis A of adults intheir twenties to thirties Korean Journal of Adult Nursing 2011 23 4 40411 Soto-Salgado M Suarez E Ortiz AP Adrovet S Marrero E Me-lendez M Knowledge of viral hepatitis among Puerto Ricanadults: Implications for prevention Journal of Community Health 2011 36 4 56573 ́http://dx.doi.org/10.1007/s10900-010-9342-6 Nyamathi A Tyler D Sinha K Marfisee M Cohen A Green-gold B. Predictors of hepatitis knowledge improvementamong methadone maintainedclients enrolledina hepatitis intervention program Journal of Community Health 2010 35 4 42332 http://dx.doi.org/10.1007/s10900-010-9266-1 Seo JY Choi BY Ki M Jang HL Park HS Son HJ Risk factors for acute hepatitis A infection in Korea in 2007 and 2009: A case-control study Journal of Korean Medical Science 2013 28 6 90814 http://dx.doi.org/10.3346/jkms.2013.28.6.908.Epub2013Jun3. Faul F Erdfelder E Lang AG Buchner A G*Power 3: A flexible statistical power analysis program for the social, behavioral, and biomedical sciences Behavior Research Methods 2007 39 17591 http://dx.doi.org/10.3758/BF03193146 Wasley A Fiore A Bell BP Hepatitis A in the era of vaccination Epidemiologic Reviews 2006 28 10111 http://dx.doi.org/10.1093/epirev/mxj012 Kim JH Recent epidemiological status and vaccination of hepatitis A in Korea Journal of Korean Medical Association 2008 51 2 1108 http://dx.doi.org/10.5124/jkma.2008.51.2.110 Kim MJ Park J The association between health beliefs and receiving hepatitis B vaccinations among college students Journal of Digital Convergence 2012 10 4 30916 Kim HS Oh EG Hyong HK Cho ES A study on factors influencing health promotion lifestyle in college students Journal of Korean Academy of Community Health Nursing 2008 19 3 50620 Bin SO Structuralrelationship of knowledge, perception, atti-tude andpreventivebehaviorforcommunicabledisease Journal of The Korea Society of Health Informatics and Statistics 2012 37 2 5771 Figures and Tables

Preventive Behaviors by General Characteristics, Context of HAV Vaccination, and HAV Related Factors (N=332)

Characteristics Categories Categories n (%) or M±SD Range Preventive behavior t or F (p)
M±SD
General characteristics Gender Female 245 (73.8)   3.16±0.37 1.14
Male 87 (26.2) 3.10±0.49 (.287)
Aged in years 18 ＜ 104 (31.3) 3.17±0.37 0.61
19 ≥ 228 (68.7) 3.14±0.42 (.463)
  19.49±1.52 17~26    
Major Physical science 242 (72.9) 3.16±0.40 0.46
Non-physical science 90 (27.1) 3.12±0.39 (.500)
Religion Yes 136 (41.0) 3.15±0.40 0.04
No 196 (59.0) 3.14±0.40 (.839)
Allowance (10,000 won) 10 ＜ 56 (16.9) 3.12±0.38 0.49
10~ 20 ＜ 46 (13.9) 3.10±0.44 (.741)
20~ 30 ＜ 99 (29.8) 3.19±0.38  
30~ 40 ＜ 83 (25.0) 3.15±0.42  
40 ≥ 48 (14.4) 3.13±0.41  
Types of residence With familya 207 (62.4) 3.14±0.36 3.45
Self-boarding 93 (28.0) 3.12±0.42 (.033)
Dormitoryb 32 (9.6) 2.99±0.55 a b ＞
Experience of HAV vaccination No 254 (76.5) 3.08±0.37 30.84
Yes 78 (23.5) 3.36±0.43 (.001) ＜
Hepatitis A vaccination characteristics Experience of hearing about HAV vaccination No 71 (21.4) 3.04±0.41 7.01
Yes 261 (78.6) 3.18±0.39 (.008)
Possession anti-HAV Noa 40 (12.1) 3.09±0.44 12.25
Yesb 31 (9.3) 3.47±0.37 (＜.001)
Don't knowc 261 (78.6) 3.12±0.38 a, c ＜b
Family history of HAV infection No 327 (98.5) 3.15±0.40 0.09
Yes 5 (1.5) 3.20±0.61 (.764)
Family history of hepatic disease No 306 (92.2) 3.14±0.40 .69
Yes 26 (7.8) 3.20±0.40 (.406)
Experience of overseas travel within 6 months No 307 (92.5) 3.14±0.40 2.63
Yes 25 (7.5) 3.27±0.37 (.106)
Experience of HAV education within 3 months No 317 (95.5) 3.15±0.39 0.63
Yes 15 (4.5) 3.06±0.53 (.430)
Intention to HAV vaccination† No 25 (9.8) 3.00±0.40 1.23
Yes 229 (90.2) 3.09±0.36 (.270)
Related factor Health belief on HAV vaccination 2.38±0.25 1~4  
Knowledge on HAV vaccination 0.34±0.30 0~1
Preventive behavior 3.15±0.40 1~4

HAV=hepatitis A virus;

Case of 'No' in experience of HAV vaccination; a, b, c=Scheffe test. ́

Correlations among Health belief, Knowledge and Preventive Behaviors about HAV (N=332)

Variables Health belief Knowledge Preventive behavior
r (p) r (p) r (p)
Health belief 1    
Knowledge .15 (.007) 1  
Preventive behavior .16 (.003) .15 (.007) 1

HAV=hepatitis A virus.

Factors related to HAV Preventive Behaviors (N=332)

Variables B β t p Adjusted R2 F p
Experience of HAV vaccination† .22 .23 4.10 ＜.001 .083 30.84 ＜.001
Possession anti-HAV† .11 .13 2.30 .022 .093 18.06 ＜.001
Health belief .18 .11 2.14 .033 .103 13.69 ＜.001

HAV=hepatitis A virus;

Dummy (yes=1).