Factors associated with Unintentional Injuries to Korean Adolescents at School: A Multilevel Study

Jung-Ok Yu; Myo-Sung Kim

doi:10.12799/jkachn.2016.27.4.337

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Original Article
Factors associated with Unintentional Injuries to Korean Adolescents at School: A Multilevel Study: Jung-Ok Yu¹, Myo-Sung Kim²; Journal of Korean Academy of Community Health Nursing 2016;27(4):337-345.
DOI: https://doi.org/10.12799/jkachn.2016.27.4.337
Published online: December 12, 2016

¹Department of Nursing, Dong-A University, Busan, Korea

²Department of Nursing, Dong-Eui University, Busan, Korea

Corresponding author: Kim, Myo-Sung Department of Nursing, Dong-Eui University, 176 Eomgwang-ro, Busanjin-gu, Busan 47340, Korea. Tel: +82-51-890-2862, Fax: +82-505-182-6876, E-mail: myosg@deu.ac.kr

• Received: August 6, 2016 • Revised: November 13, 2016 • Accepted: November 14, 2016

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.

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Abstract
References

Abstract

Purpose
This study aims at identifying individual- and school-level factors associated with unintentional injuries to Korean adolescents at school by applying multilevel modeling.
Methods
From the database of the eleventh Korea Youth Risk Behavior Web-based Survey (KYRBS), the researchers selected 68,043 adolescents from the 7^th to the 12^th grades. Data were analyzed using x² test for prevalence and multilevel modeling for related factors of unintentional injuries at school.
Results
About 22.9 percent of the adolescents had treatment experiences for unintentional injuries at school in the past 12 months. At the individual level, the significant factors associated with unintentional injuries at school included gender, grade, academic achievement, current smoking, alcohol consumption, frequency of high caffeine intake, depression, and relief of fatigue after sleep. At the group level, the significant factors included number of physical education per week and safety education.
Conclusion
School based injury prevention programs should be sensitive to both individual- and school-level factors associated with unintentional injury at school among Korean adolescents.
Key Words: Adolescent; Injuries; Schools; Multilevel analysis

Table 1.

Prevalence of Unintentional Injury to Korean Adolescents at School (N=68,043)

Variables	Characteristics	Categories	Injured prevalence	Injured	No injured	x²	p
Variables	Characteristics	Categories	(%)^‡	n^† (%)^‡	n^† (%)^‡	x²	p
Total			22.9	15,533 (100.0)	52,510 (100.0)
Individual variables	Gender	Male	27.4	9,647 (62.5)	25,557 (49.1)	864.02	＜.001
	Gender	Female	17.9	5,886 (37.5)	26,953 (50.9)
	Grade	7	24.1	2,539 (14.5)	8,247 (13.5)	143.50	＜.001
		8	25.8	2,885 (17.6)	8,557 (15.0)
		9	24.4	2,939 (18.8)	9,132 (17.3)
		10	20.7	2,324 (15.8)	8,798 (17.9)
		11	21.9	2,456 (16.9)	8,657 (17.8)
		12	20.8	2,390 (16.4)	9,119 (18.6)
	Academic achievement	High	23.6	6,090 (39.0)	19,600 (37.3)	15.53	.001
	Academic achievement	Middle	22.1	4,172 (27.0)	14,780 (28.2)
		Low	22.6	5,271 (34.0)	18,130 (34.5)
	Current smoking	Yes	31.0	1,612 (10.5)	3,511 (6.9)	216.33	＜.001
	Current smoking	No	22.2	13,921 (89.5)	48,999 (93.1)
	Alcohol consumption	Yes	29.5	3,272 (21.5)	7,749 (15.3)	337.28	＜.001
	Alcohol consumption	No	21.5	12,261 (78.5)	44,761 (84.7)
	Frequency of high caffeine intake	No	22.0	13,167 (84.7)	46,669 (89.1)	252.21	＜.001
		＜1/day	28.8	2,166 (14.0)	5,516 (10.3)
		≥1/day	38.7	200 (1.3)	325 (0.6)
	Depression	Yes	30.5	4,860 (31.5)	11,034 (21.2)	701.65	＜.001
	Depression	No	20.5	10,673 (68.5)	41,476 (78.8)
	Obesity	Yes	23.3	1,691 (11.1)	5,480 (10.8)	1.78	.235
	Obesity	No	22.6	13,281 (88.9)	45,571 (89.2)
	Relief of fatigue after sleep	Very enough	22.5	1,313 (8.2)	4,564 (8.4)	73.18	＜.001
		Enough	21.4	2,942 (18.4)	10,707 (20.0)
		So-so	22.2	5,059 (32.5)	17,732 (33.8)
		Not enough	23.4	4,130 (27.1)	13,635 (26.3)
		Never enough	26.0	2,089 (13.8)	5,872 (11.6)
School variables	Number of physical education per week	0	16.6	1,816 (11.9)	9,160 (17.6)	715.82	＜.001
		1	19.9	2,390 (15.4)	9,448 (18.4)
		2	21.7	4,403 (29.7)	16,008 (31.8)
		3	28.3	6,924 (43.0)	17,894 (32.2)
	Safety education	Yes	24.0	13,778 (88.2)	43,705 (82.5)	287.18	＜.001
	Safety education	No	16.6	1,755 (11.8)	8,805 (17.5)

^†Unweighted;

^‡Weighed.

Table 2.

Relating Factors of Unintentional Injury to Korean Adolescents at School

Parameter		Variables		Model 1		Model 2		Model 3
				Null model		Individual model		Individual-school model
				OR	p	OR	p	OR	p
Fixed effect	Level 1	Intercept		0.28	＜.001	0.21	＜.001	0.04	＜.001
		Gender (ref : Female)	Male			1.82	＜.001	1.83	＜.001
		Grade				0.92	＜.001	0.97	.002
		Academic achievement (ref: High)	Low			0.87	＜.001	0.87	＜.001
		Academic achievement (ref: High)	Middle			0.93	.003	0.93	.004
		Current smoking (ref: No)	Yes			1.12	.002	1.14	＜.001
		Alcohol use (ref: No)	Yes			1.44	＜.001	1.45	＜.001
		Frequency of high caffeine intake (ref: No)	≥1/day			1.52	＜.001	1.52	＜.001
		Frequency of high caffeine intake (ref: No)	＜1/day			1.21	＜.001	1.22	＜.001
		Depression (ref: No)	Yes			1.72	＜.001	1.72	＜.001
		Obesity (ref: No)	Yes			1.00	.893	1.00	.849
		Relief of fatigue after sleep (ref: Very enough)	Never enough			1.22	＜.001	1.23	＜.001
		Relief of fatigue after sleep (ref: Very enough)	Not enough			1.12	.002	1.13	.001
			So-so			1.05	.177	1.05	.155
			Enough			0.98	.691	0.98	.666
	Level 2	Physical education per week						1.30	＜.001
	Level 2	Safety education						2.67	＜.001
Random effect	Level 2, μ₀ (τ)			0.10		0.07		0.05
Random effect	x² (p)			1,970.11 (＜.001)		1,537.93 (＜.001)		1,373.15 (＜.001)

References

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Citations

Citations to this article as recorded by

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Factors associated with Unintentional Injuries to Korean Adolescents at School: A Multilevel Study

Variables	Characteristics	Categories	Injured prevalence	Injured	No injured	x²	p
Variables	Characteristics	Categories	(%)^‡	n^† (%)^‡	n^† (%)^‡	x²	p
Total			22.9	15,533 (100.0)	52,510 (100.0)
Individual variables	Gender	Male	27.4	9,647 (62.5)	25,557 (49.1)	864.02	＜.001
	Gender	Female	17.9	5,886 (37.5)	26,953 (50.9)
	Grade	7	24.1	2,539 (14.5)	8,247 (13.5)	143.50	＜.001
		8	25.8	2,885 (17.6)	8,557 (15.0)
		9	24.4	2,939 (18.8)	9,132 (17.3)
		10	20.7	2,324 (15.8)	8,798 (17.9)
		11	21.9	2,456 (16.9)	8,657 (17.8)
		12	20.8	2,390 (16.4)	9,119 (18.6)
	Academic achievement	High	23.6	6,090 (39.0)	19,600 (37.3)	15.53	.001
	Academic achievement	Middle	22.1	4,172 (27.0)	14,780 (28.2)
		Low	22.6	5,271 (34.0)	18,130 (34.5)
	Current smoking	Yes	31.0	1,612 (10.5)	3,511 (6.9)	216.33	＜.001
	Current smoking	No	22.2	13,921 (89.5)	48,999 (93.1)
	Alcohol consumption	Yes	29.5	3,272 (21.5)	7,749 (15.3)	337.28	＜.001
	Alcohol consumption	No	21.5	12,261 (78.5)	44,761 (84.7)
	Frequency of high caffeine intake	No	22.0	13,167 (84.7)	46,669 (89.1)	252.21	＜.001
		＜1/day	28.8	2,166 (14.0)	5,516 (10.3)
		≥1/day	38.7	200 (1.3)	325 (0.6)
	Depression	Yes	30.5	4,860 (31.5)	11,034 (21.2)	701.65	＜.001
	Depression	No	20.5	10,673 (68.5)	41,476 (78.8)
	Obesity	Yes	23.3	1,691 (11.1)	5,480 (10.8)	1.78	.235
	Obesity	No	22.6	13,281 (88.9)	45,571 (89.2)
	Relief of fatigue after sleep	Very enough	22.5	1,313 (8.2)	4,564 (8.4)	73.18	＜.001
		Enough	21.4	2,942 (18.4)	10,707 (20.0)
		So-so	22.2	5,059 (32.5)	17,732 (33.8)
		Not enough	23.4	4,130 (27.1)	13,635 (26.3)
		Never enough	26.0	2,089 (13.8)	5,872 (11.6)
School variables	Number of physical education per week	0	16.6	1,816 (11.9)	9,160 (17.6)	715.82	＜.001
		1	19.9	2,390 (15.4)	9,448 (18.4)
		2	21.7	4,403 (29.7)	16,008 (31.8)
		3	28.3	6,924 (43.0)	17,894 (32.2)
	Safety education	Yes	24.0	13,778 (88.2)	43,705 (82.5)	287.18	＜.001
	Safety education	No	16.6	1,755 (11.8)	8,805 (17.5)

Parameter		Variables		Model 1		Model 2		Model 3
				Null model		Individual model		Individual-school model
				OR	p	OR	p	OR	p
Fixed effect	Level 1	Intercept		0.28	＜.001	0.21	＜.001	0.04	＜.001
		Gender (ref : Female)	Male			1.82	＜.001	1.83	＜.001
		Grade				0.92	＜.001	0.97	.002
		Academic achievement (ref: High)	Low			0.87	＜.001	0.87	＜.001
		Academic achievement (ref: High)	Middle			0.93	.003	0.93	.004
		Current smoking (ref: No)	Yes			1.12	.002	1.14	＜.001
		Alcohol use (ref: No)	Yes			1.44	＜.001	1.45	＜.001
		Frequency of high caffeine intake (ref: No)	≥1/day			1.52	＜.001	1.52	＜.001
		Frequency of high caffeine intake (ref: No)	＜1/day			1.21	＜.001	1.22	＜.001
		Depression (ref: No)	Yes			1.72	＜.001	1.72	＜.001
		Obesity (ref: No)	Yes			1.00	.893	1.00	.849
		Relief of fatigue after sleep (ref: Very enough)	Never enough			1.22	＜.001	1.23	＜.001
		Relief of fatigue after sleep (ref: Very enough)	Not enough			1.12	.002	1.13	.001
			So-so			1.05	.177	1.05	.155
			Enough			0.98	.691	0.98	.666
	Level 2	Physical education per week						1.30	＜.001
	Level 2	Safety education						2.67	＜.001
Random effect	Level 2, μ₀ (τ)			0.10		0.07		0.05
Random effect	x² (p)			1,970.11 (＜.001)		1,537.93 (＜.001)		1,373.15 (＜.001)

Table 1. Prevalence of Unintentional Injury to Korean Adolescents at School (N=68,043)

^†Unweighted;

‡

Weighed.

Table 2. Relating Factors of Unintentional Injury to Korean Adolescents at School