Miyong Kim

Johns Hopkins University, Baltimore, MD, United States

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Publications (13)24.49 Total impact

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    ABSTRACT: Adequate self-care is crucial for blood pressure control. A number of hypertension (HBP) self-care instruments are available, but existing tools do not capture all the critical domains of HBP self-care and have limited evidence of reliability and validity. The purpose of this study was to develop and validate a new tool-the HBP Self-Care Profile (HBP SCP)-in a sample of inner-city residents. The HBP SCP encompasses comprehensive domains of HBP self-care behaviors. Guided by 2 validated theoretical approaches-Orem's self-care model and Motivational Interviewing-the HBP SCP includes 3 scales that can be used together or independently: Behavior, Motivation, and Self-efficacy. The sample included 213 English-speaking inner-city residents with HBP (mean age, 68.6 years; 76.1% women; 81.7% African American). Item-total correlations ranged from 0.20 to 0.63 for Behavior, 0.46 to 0.70 for Motivation, and 0.40 to 0.74 for Self-efficacy, meeting the cutoff set a priori at 0.15. Internal consistency reliability coefficients ranged from 0.83 to 0.93. Concurrent and construct validities of the HBP SCP were achieved by significant correlations between HBP SCP scales and theoretically selected instruments (P < .05 for all correlation coefficients). The HBP SCP-Behavior scale also successfully discriminated between those with or without blood pressure control (P < .05). The reliability and validity of the HBP SCP were supported in this sample of inner-city residents with HBP. The high reliability estimates and strong evidence of validity should allow researchers to use the HBP SCP to assess and identify gaps in HBP self-care behavior, motivation, and self-efficacy. Future research is warranted to evaluate the HBP SCP in diverse ethnic and age samples of hypertensive patient populations.
    The Journal of cardiovascular nursing 10/2013; · 1.47 Impact Factor
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    ABSTRACT: Cardiovascular disease (CVD) disparities continue to have a negative impact on African Americans in the United States, largely because of uncontrolled hypertension. Despite the availability of evidence-based interventions, their use has not been translated into clinical and public health practice. The Johns Hopkins Center to Eliminate Cardiovascular Health Disparities is a new transdisciplinary research program with a stated goal to lower the impact of CVD disparities on vulnerable populations in Baltimore, Maryland. By targeting multiple levels of influence on the core problem of disparities in Baltimore, the center leverages academic, community, and national partnerships and a novel structure to support 3 research studies and to train the next generation of CVD researchers. We also share the early lessons learned in the center's design. (Am J Public Health. Published online ahead of print September 12, 2013: e1-e13. doi:10.2105/AJPH.2013.301297).
    American Journal of Public Health 09/2013; · 3.93 Impact Factor
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    ABSTRACT: OBJECTIVES: To determine the level of agreement between dementia rating by trained community health workers (CHWs) based on the Clinical Dementia Rating (CDR) and the criterion standard: physician diagnosis. DESIGN: Cross-sectional validation study. SETTING: Community gathering places such as ethnic churches, senior centers, low-income elderly apartments, and ethnic groceries in the Baltimore-Washington metropolitan area. PARTICIPANTS: Ninety community-dwelling Korean-American individuals aged 60 and older. MEASUREMENTS: The CDR is a standardized clinical dementia staging instrument used to assess cognitive and functional performance using a semistructured interview protocol. Six CHWs trained and certified as CDR raters interviewed and rated study participants. A bilingual geriatric psychiatrist evaluated participants independently for dementia status. RESULTS: CHWs rated 61.1% of the participants as having mild cognitive impairment (MCI; CDR = 0.5) or dementia (CDR≥1), versus 56.7% diagnosed by the clinician. A receiver operating characteristic (ROC) curve analysis demonstrated good predictive ability of CDR rating by trained CHWs (area under the ROC curve = 0.86, 95% confidence interval = 0.78-0.93, sensitivity = 85.5%, specificity = 88.6%) in detecting MCI and dementia. CONCLUSION: The findings provide preliminary evidence that trained CHWs can effectively identify community-dwelling elderly Korean adults with MCI and dementia for early follow-up assessment and care in a community with scarce bilingual caregivers and programs.
    Journal of the American Geriatrics Society 06/2013; · 3.98 Impact Factor
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    ABSTRACT: Based on substantial formative research, the authors developed and implemented a year-long corner store-based program in East Baltimore focusing on Korean American (KA) stores. To understand acceptability of the intervention by storeowners, the authors examined the motivating factors for program participation, barriers to program implementation, perceived effectiveness of intervention materials, and perceptions about the program. Data collection methods included in-depth interviews with seven corner store owners, field notes by interventionists, and a follow-up survey. Stores varied considerably in terms of owners' perceptions about the program, supportive atmosphere, and acceptability of intervention strategies. The storeowners who showed strong or moderate support for the program were more likely to sustain the stocking of promoted foods such as cooking spray and baked or low-fat chips after the program was completed as compared to less supportive stores. The level of support and active participation of storeowners can greatly influence the success of corner store-based nutrition interventions.
    Health Promotion Practice 05/2011; 12(3):472-82.
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    ABSTRACT: Despite well-known benefits of health care utilization for the effective management of chronic diseases, the underlying mechanism of understanding health care utilization in ethnic minority population has not been systematically explored. The purpose of this paper is to examine the predictive ability of a health care utilization model by analyzing the interplay between predisposing, enabling, and need factors. The sample consisted of hypertensive Korean American immigrants (KAIs) 40-64 years of age who participated in a self-help intervention for high blood pressure care (SHIP-HBP). Using structured questionnaires, data were collected from 445 KAIs at baseline and analyzed with path analysis. Insurance status and relevant medical history were not just strong direct effects but also carried the most total effect on the health care utilization of these patients. Life priorities, years of residence in the US and perceived income level exerted indirect effects through the participants' insurance status. Our statistical analysis indicated a good fit for the proposed model (x (2) = 28.4, P = 0.29; NFI = 0.91; CFI = 0.99; RMSEA = 0.02). Overall, the model explained 18% of the variance in health care utilization of hypertensive KAIs. These findings strongly support a need to improve access to health care for KAIs by introducing a variety of community resources and building sustainable community infrastructures.
    Journal of Immigrant and Minority Health 09/2009; 12(4):513-9. · 1.16 Impact Factor
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    ABSTRACT: While corner store-based nutrition interventions have emerged as a potential strategy to increase healthy food availability in low-income communities, few evaluation studies exist. We present the results of a trial in Baltimore City to increase the availability and sales of healthier food options in local stores. Quasi-experimental study. Corner stores owned by Korean-Americans and supermarkets located in East and West Baltimore. Seven corner stores and two supermarkets in East Baltimore received a 10-month intervention and six corner stores and two supermarkets in West Baltimore served as comparison. During and post-intervention, stocking of healthy foods and weekly reported sales of some promoted foods increased significantly in intervention stores compared with comparison stores. Also, intervention storeowners showed significantly higher self-efficacy for stocking some healthy foods in comparison to West Baltimore storeowners. Findings of the study demonstrated that increases in the stocking and promotion of healthy foods can result in increased sales. Working in small corner stores may be a feasible means of improving the availability of healthy foods and their sales in a low-income urban community.
    Public Health Nutrition 05/2009; 12(11):2060-7. · 2.25 Impact Factor
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    ABSTRACT: Today's Korean American elderly are predominantly first-generation immigrants who face stern challenges of acculturation, which is often associated with depression. Social support has been identified as an effective personal resource for alleviating acculturative stress and achieving better mental health outcomes. The purposes of this study were to describe available sources of social support utilized by Korean elders and to examine the relationships among acculturative stress, social support, and depression. In particular, social support was operationalized as an integrative concept encompassing the size of the social network, satisfaction with the support received, and appraisals of the level of social support. This study was a secondary data analysis of an existing survey of 205 elderly Korean immigrants (>or=60 years) in a major metropolitan city on the East coast. Adult children were found to be the main source of support utilized by elders, even when the elder had a living spouse. Hierarchical multiple regression analysis revealed that higher acculturative stress and lower social support were associated with higher depression scores after demographics and health status were controlled for, whereas network size and satisfaction with support were not. Future interventions should address the cultural/social needs of these immigrants, not only by reinforcing their existing social network but also by providing additional support for their family members to prevent social isolation and depression in the population.
    Journal of Cross-Cultural Gerontology 03/2007; 22(1):115-27.
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    ABSTRACT: Community-based participatory research (CBPR) is an increasingly used approach for conducting research to improve community health. Using Rogers' diffusion of innovations theory as a framework, it follows that future adoption of CBPR will occur if academic and community partners perceive CBPR to have greater relative advantage, compatibility, trialability, and observability, and less complexity than other research approaches. We propose that articles published in our new peer-reviewed journal--Progress in Community Health Partnerships: Research, Education, and Action (PCHP)--can influence academic and community partners' perceptions of CBPR that promote its adoption. Eight areas of scholarly activity are described that can promote health partnership research, education, and action: (1) original research, (2) work-in-progress and lessons learned, (3) policy and practice, (4) theory and methods, (5) education and training, (6) practical tools, (7) systematic reviews, and (8) community perspectives. These eight areas correspond with the eight main sections of PCHP. A brief description of each area's importance in promoting CBPR is provided along with examples of completed and ongoing work. Specific recommendations are made regarding issues, problems, and topics within each area on which CBPR work should focus. These recommendations, which present a vision for progress in community health partnerships, are based on idea generation and prioritization by a group of CBPR experts--PCHP's editors and editorial board.
    Progress in community health partnerships: research, education, and action 01/2007; 1(1):11-30.
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    ABSTRACT: The intensive care necessary for premature newborns is characterized by multiple procedures, many of which are painful. Given emerging evidence that such early pain during this time of high brain plasticity may affect long-term neurodevelopmental and social-emotional functioning, this study explored the impact of early repeated pain on emotionality and stress responsivity at maturity. From birth through postnatal day 7, Fischer 344 pups underwent either paw needle prick every day versus every other day or daily paw touch, or were left unperturbed. Each paw received the designated perturbation once per day. At maturity, some animals underwent emotionality testing: either a 4-day series of open field exposures or a single elevated plus-maze (EPM) exposure. The paw prick groups exhibited less open field habituation and occupied the EPM open arms more. Two weeks later, all animals were either subjected to forced swim or not. At 1h post-swim, animals underwent either blood withdrawal for plasma corticosterone (CS) levels and ex vivo natural killer cell activity (NKCA) or were injected intravenously with radiolabeled NK-sensitive syngeneic MADB106 tumor cells and assessed for lung tumor retention. Sex was a major factor in the manifestation of perturbation-related differences in the biologic outcomes. Whereas postnatal pain differentially affected baseline tumor retention between males and females, only males exhibited perturbation-related differences in swim stress-induced increases in tumor retention and CS. Finally, male-female differences were evident in CS, NKCA, and tumor responses to swim stress. These findings suggest that early pain affects neurodevelopmental function in the mature organism; however, these relationships are complicated by sex differences, the postnatal pain schedule, and the outcome measured.
    Brain Behavior and Immunity 02/2005; 19(1):78-87. · 5.61 Impact Factor
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    ABSTRACT: Breast cancer is the most commonly diagnosed cancer among Korean American women (KAW). Many KAW are not aware of the importance of regular screening. This research estimates the rates of regular breast cancer screening and examines the predictors and barriers to obtaining regular mammograms. Face-to-face surveys were conducted with 459 KAW residing in Maryland. Study participants were recruited through Korean churches and senior housing. About 33% had regular mammograms. In multiple logistic regression analyses, the strongest correlate of regular mammograms was knowledge of screening guidelines. Age, spoken English proficiency, and physician recommendations were associated with regular mammograms. Employment interacted with insurance: Employed women without insurance had lower rates of mammograms than those employed with insurance. The most frequent reason for not having regular mammograms was a woman's belief that she was at low risk for breast cancer. Results indicate that knowledge of screening guidelines and physician recommendations for screening are important in this minority population. Culturally relevant educational programs about breast cancer screening should be developed for less acculturated women and recent immigrants.
    Preventive Medicine 10/2004; 39(3):474-81. · 3.50 Impact Factor
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    ABSTRACT: This study examined the prevalence and correlated factors of cigarette smoking in a cross-sectional, epidemiological survey of Korean American men living in Maryland (n=333). In this sample, 26.1% were current smokers and 42.3% were former smokers. The older age group (> or = 40 years) was more likely to have quit smoking than the younger age group (< 40 years). In multiple logistic regression analysis, acculturation was associated with smoking status; those who stayed more than 20 years in the U.S. were less likely to be current smokers (OR=0.32, 95% CI 0.13-0.77) than those who stayed less than 10 years. Alcohol use was associated with smoking status; those who consumed alcohol were more likely to be current smokers (OR=5.24, 95% CI 2.33-11.79) or former smokers (OR=5.45, 95% CI=2.69-11.04) than those did not. Those with hypertension were more likely to have quit smoking (OR=3.11, 95% CI=1.33-7.24). The results suggest that the role of acculturation in smoking status among Korean American men deserves further attention by researchers as well as by health professionals who develop smoking prevention and cessation programs.
    Yonsei Medical Journal 11/2003; 44(5):875-82. · 1.31 Impact Factor
  • Miyong Kim, Hae-Ra Han, Linda Phillips
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    ABSTRACT: Metric equivalence is a quantitative way to assess cross-cultural equivalences of translated instruments by examining the patterns of psychometric properties based on cross-cultural data derived from both versions of the instrument. Metric equivalence checks at item and instrument levels can be used as a valuable tool to refine cross-cultural instruments. Korean and English versions of the Center for Epidemiological Studies-Depression Scale (CES-D) were administered to 154 Korean Americans and 151 Anglo Americans to illustrate approaches to assessing their metric equivalence. Inter-item and item-total correlations, Cronbach's alpha coefficients, and factor analysis were used for metric equivalence checks. The alpha coefficient for the Korean-American sample was 0.85 and 0.92 for the Anglo American sample. Although all items of the CES-D surpassed the desirable minimum of 0.30 in the Anglo American sample, four items did not meet the standard in the Korean American sample. Differences in average inter-item correlations were also noted between the two groups (0.25 for Korean Americans and 0.37 for Anglo Americans). Factor analysis identified two factors for both groups, and factor loadings showed similar patterns and congruence coefficients. Results of the item analysis procedures suggest the possibility of bias in certain items that may influence the sensitivity of the Korean version of the CES-D. These item biases also provide a possible explanation for the alpha differences. Although factor loadings showed similar patterns for the Korean and English versions of the CES-D, factorial similarity alone is not sufficient for testing the universality of the structure underlying an instrument.
    Journal of Nursing Measurement 01/2003; 11(1):5-18.
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    ABSTRACT: With the current wave of Asian immigration to the United States, awareness of their use of traditional medicine, often in combination with Western medicine, is an increasingly salient issue for health care professionals. This paper describes the use of traditional and Western medicine by Korean American elderly and factors that are associated with their health-seeking behaviors and health service utilization. Data were obtained from a convenience sample of 205 Korean elderly immigrants through interview. The findings revealed that health service utilization among Korean American elderly covered a broad spectrum of health resources, including the use of Western medicine, the traditional Korean medicine (hanbang), or both Western and traditional clinics. In addition, health insurance status and the source of health care were found to relate to the types of health service that Korean American elderly chose to utilize. Better understanding of patterns of health service utilization may improve the quality of health care by increasing health providers' cultural sensitivity and facilitating adequate communication between Asian immigrant clients and their care providers. Implications for research and practice are discussed.
    Journal of Community Health 05/2002; 27(2):109-20. · 1.28 Impact Factor