Korea Centers for Disease Control and Prevention requested to improve personal hygiene by washing hands properly to prevent a number of infectious diseases such as typhoid, Middle East respiratory syndrome (MERS) viral eye infection, and etc. Washing hands is the most basic step we can take to prevent infectious disease and 50–70 percentages of waterborne diseases can be prevented through simply washing hands. Though most Korean citizens are aware of important of hand hygiene, it's not being actively put into behavior.1) Fine dust, which has recently become a social issue publicized concerns about air pollution because it was found to be a potentially serious threat to human health. In contemporary society, the factors for environmental danger, such as fine dust, appear on a constant basis. Although environmental pollution significantly affects the quality of our life, causing serious environmental problems, such as yellow dust and fine dust, both environmental education and preventive support are rarely provided.2)

According to the Seoul online panel survey on safety consciousness, 56.7% indicated very weak safety consciousness and 39.5% weak safety consciousness, while approximately 96% of the respondents indicated that the South Korean society had weak consciousness.3) The statistical yearbook of the Ministry of Public Safety and Security reported that 23,525 (52.9%) out of 44,435 fire accidents in 2015 were due to carelessness.4)

Although many people worry about safety and health, the statistics of safety and health reveals a gap between ‘perceiving’ and ‘behavior’. 64.0% had never participated personally in education or training to prevent and cope with sickness or accidents while 98.7% suggested the need for such education and training. Those in their twenties were from 5.7 to 10.5% more likely to make such answers.5) The role of communication campaigns that lead to changes in cognition, attitudes, and behaviors in order to perform health activity is becoming more important.

An observational survey done identified that 73 percentages of public bathroom users wash their hands and only 33 percentages of them use soap when washing hands.1) As few as three out of 10 persons wore a mask when a “high” risk of fine dust was predicted; in particular, only 19% of those aged 19–29 years wore a mask.6) The preparatory exercise relieves the tense body and prevents the rapid increase of the blood pressure due to the rapid increase of blood flow. The rate of regular physical activity among Koreans aged 15 and over is very low at 32.1%.7) However, the study on the pre-exercise rate before physical activity is insufficient.

This study aimed to identify the factors affecting the perception of danger and activity to address them among people in their twenties. According to the four stages of changes in behavioral science, behavioral changes need to involve changes in ‘perception’ and ‘attitude’ which may lead to group or organizational performance.8)

Preventive behavior refers to a person or a group's beliefs and actions regarding their health and well-being.9) We need to identify factors that affect practicality in order to promote preventive behavior. The current study targeted a population of college students to specifically examine attitudes, and risk perception in relation to behavior, and their impact on activity.

This study aimed, first, to determine the level of perception about health and risk among college students in relation to the large scale and increase of accidents due to no definite measures, such as preventive education and training, and to suggest the need to give education on a continuous basis; second, to determine if behavior depended on the perceived risk. Ultimately, it intended to find a way to help those with poor changes in attitude and knowledge.

Through several researches, we discovered a link between knowledge of disease, disease awareness, and health improvement practice among various other factors.1314) This study aimed to determine the need to give education on a continuous basis and the effects of attitude and perception on preventive behaviors for college students with poor health and safety consciousness.

First, safety-related attitude and perception differed by age (P<0.05). The respondents aged ≤21 (38.68) showed higher levels of attitude than those aged 22–23 years (36.41). As for the differences in preventive behaviors by age, while the literature review14) showed that older individuals had higher index (e.g., the index was higher for ≥30 than for <30). The older nurse practitioners showed a higher level of hand-washing performance. Nurse practitioners with ≥5 years of career showed higher levels of hand-washing performance than those with <1 year of career. Presently, safety-related prevention education is regularly/mandatory from kindergarten through high school.15) Through these regular safety-related training, respondents are properly habituated to a safe attitude. Therefore, it was found that the attitude average was high at the age of 20 years or younger. These results suggest that it is more important to continue education and habituation at educational institutions such as age 21 or university where independent life begins.

Second, attitudes were more strongly and positively correlated with behavior. Attitudes made no statistically significant changes in perception (r=0.043, P>0.05). In contrast, perception and attitudes were significantly correlated statistically with preventive behaviors: those with better attitudes were actually more sensitive to health and safety and were highly likely to do preventive behaviors. As for the correlations between health belief in hand-washing and hand-washing practice, perceived susceptibility was positively correlated with hand-washing performance.16) Perceived health risk (β=0.135) had significant positive influences on health-related Internet use.17)

Third, education experience significantly affected perception. Respondents with low level of perception (41, 71.9%) had no education experience (P=0.007). Before university entrance, 307 respondents (84.3%) had received prevention education and 57 (15.7%) had never received it. In contrast, after university entrance, 119 respondents (32.7%) had received prevention education and 245 (67.3%) had never received it. This result demonstrates that while the elementary and secondary curriculums contain prevention education, universities fail to provide prevention education on a continuous basis. It is necessary to give preventive education for health and safety to the group aged ≥20 years, including college students.

Fourth, understanding of prevention regulation and education experience significantly affected preventive behaviors. After the safety education based on experiential learning, the experimental group was significantly better statistically at practice than the control group.18) This agreed with the finding of this study that preventive education led to better practice. The previous research that compared the safety index between before and after education reported an increase in the mean percentile score following education.19) In contrast, no significant change in the mean was found for perception and attitude by the experience of receiving education after college entrance. Study participants having received education before college entrance are 2.8 times more likely to do preventive behaviors than those having received no education. However, there was a statistical result that the experience of receiving education after college entrance had no effect on preventive behaviors. This result demonstrates that college students make few efforts to raise the safety index than elementary and secondary school students. This paper regarding education mostly reviews improvement in safety capability by other adults to prevent accidents in early childhood and adolescence,20) and the research focusing on college students report that they have poor consciousness and practice21) in campus life. Now it is necessary to discuss the need for preventive education for those in their twenties and the quality of the education.

Fifth, attitude to preventive health most significantly affects preventive behaviors. Attitude to preventive health more significantly affected preventive behaviors than attitude to environmental pollution. Study participants with good attitude were about 3.1 times more likely to do preventive behaviors than those with poor attitude. This result suggests the need for methods to promote the attitude to health. Although people who are sensitive to health and safety observe prevention regulations relatively well in daily life, observation of prevention regulations may not correspond to perception. The level of perception about coping with sickness and accidents has no positive association with behaviors unless one makes personal efforts to obtain it or unless obligatory education is given. prevention.com recommends to ‘wash hands properly’ and ‘get regular sun exposure’ especially in between seasons to prevent catching a cold. Guidelines on putting prevention into practice are in place to support preventive health activities. Guidelines such as preventive health activities need to be utilized in the field of safety.

It is necessary to make it a habit to have perception, functions, and attitudes through preventive education and have safe living attitude basically with the objective of creating a healthy social environment safe. For preventive education, therefore, it is necessary to maintain safe conditions and functional education for healthy and safe behaviors in living, and education related to attitudes of cultivating a habit to predict and prevent risk factors. Preventive education can be more effective when it is given by stages in a long term than in a short term, and such education can be most effective.

We were able to identify a significant relationship between disease awareness (perception) and attitude towards disease, aside from other factors that have impact on health improvement practice, in fields related to health and safety.