PURPOSE:This study provides an updated analysis of research trends in the Journal of Korean Biological Nursing Science (JKBNS) by examining changes in publication volume, methodological approaches, and thematic evolution among articles published between 2011 and 2025. METHODS:Retrospective descriptive and bibliometric analyses were conducted on 537 articles published in JKBNS. Publication characteristics and statistical methods were summarized, and annual trends were examined. Keyword co-occurrence networks were generated using VOSviewer, and changes in research topics over time were explored using burst keyword analysis based on abstract-derived keywords. RESULTS:Annual publication volume fluctuated but increased markedly in recent years, rising from 35 articles in 2024 to 58 articles in 2025. A language crossover occurred in 2024, when English-language articles (n = 19, 54.3%) exceeded Korean-language articles (n = 16, 45.7%); this predominance of English-language articles became more evident in 2025 (n = 36, 62.1%). Adult patients were the most common study population (n = 127, 23.7%). Analysis of variance was the most frequently used statistical method (n = 236, 43.9%), followed by linear regression (n = 84, 15.6%) and logistic regression (n = 59, 11.0%). Burst keyword analysis highlighted recent increases in aging- and health behavior-related terms. Co-occurrence mapping identified interconnected thematic areas spanning health behavior and risk, nursing knowledge and practice, and biologically oriented research. CONCLUSION:Between 2011 and 2025, JKBNS demonstrated growth in publication volume, a shift toward English-language articles, and evolving research topics, while maintaining thematic continuity with its biological orientation.

BACKGROUND:The US is experiencing an unprecedented sexually transmitted infections (STIs) epidemic. Although recent provisional data show some stabilization or minor declines in case rates for chlamydia, gonorrhea and syphilis, overall rates remain significantly higher than a decade ago. Local health departments (LHDs) play a crucial role in preventing and treating STIs, but some LHDs are demonstrably more effective than others. This study utilized a positive deviance (PD) approach to identify and analyze US counties with unexpectedly low STI rates. METHODS:We used a cross-sectional study design, analyzing data from 981 counties across the US, using a two-step approach: (1) multivariate linear regression to identify PD counties, and (2) multivariate logistic regression to examine predictors of PD status. RESULTS:We identified 187 (19.06%) high-performing counties, considering internal and external factors, and investigated predictors that affect the identification of these high-performing counties. These counties were more likely to have the smallest population category (<25,000), which had 6.47 times odds of being identified as PD counties compared with counties of ≥1 million, counties with high social vulnerability in specific subcategories (racial and ethnic subgroup, housing, and transportation), and counties with LHDs that provided STI-related treatment services directly and through community partnerships. CONCLUSIONS:Our findings demonstrate the potential of using a PD approach for identifying and learning from high-performing LHDs. The identification of high-performing counties provides a foundation for future research to explore the nuanced interventions contributing to their success, ultimately informing targeted public health strategies and resource allocation.

Adults with diabetes mellitus are at an increased risk of poor oral health; however, how individual- and community-level factors jointly contribute to oral health disparities in this population remains unknown. This study aimed to examine multilevel determinants of self-rated oral health among adults with diabetes in South Korea. A cross-sectional analysis was conducted using data from 21,996 adults aged ≥19 years with physician-diagnosed diabetes who participated in the 2021 Korea Community Health Survey. Self-rated oral health was dichotomized as good or poor. Individual- and community-level variables representing health behaviors, clinical care, social and economic factors, and physical environment were selected, guided by the County Health Rankings model. Multilevel logistic regression models accounted for clustering within administrative districts. At the individual level, poorer self-rated oral health was significantly associated with sociodemographic disadvantages (older age, male sex, not married, lower education, and economic inactivity), poorer general health status, adverse health behaviors (lifetime smoking and inadequate toothbrushing), and unmet dental care needs (all p < 0.05). At the community level, greater accessibility to public transportation was associated with better self-rated oral health (OR = 0.997, 95% CI: 0.993-1.000), whereas a higher prevalence of moderate-intensity physical activity was associated with poorer oral health (OR = 1.006, 95% CI: 1.000-1.011). Self-rated oral health among adults with diabetes is influenced by individual-level socioeconomic and behavioral factors alongside selected community-level contextual conditions. Multilevel strategies integrating oral health into chronic disease management are required, while addressing structural barriers to dental care.

The global COVID-19 pandemic caused substantial psychological burden, resulting in a 25% increase in the prevalence of anxiety and depressive disorders worldwide. This study examined factors associated with the multifaceted fear of COVID-19 among South Korean adults, providing crucial insights for culturally tailored public health interventions. We utilized a cross-sectional secondary data analysis from the 2022 Korea Community Health Survey (n = 228,470) and the Korean Statistical Information Service. Using multilevel linear regression, we evaluated three pre-specified primary community-level hypotheses: the proportion of one-person households, the density of internal medicine clinics by jurisdiction, and unmet healthcare needs. Results revealed that a higher proportion of one-person households correlated with increased fear, while a greater density of internal medicine clinics by jurisdiction was linked to reduced fear. To estimate these community-level associations, we adjusted for individual-level covariates. Exploratory analyses of these covariates suggested that factors such as female sex, older age, higher education, living with a spouse, economic activity, and better self-rated health were associated with heightened COVID-19 fear. These findings emphasize the need for culturally sensitive mental health support, community-based initiatives, and strategic healthcare resource allocation in Asian communities to strengthen resilience during future health crises.

Background: To shift home-based program delivery, public health initiatives seek to increase capacity of community-based organizations (CBOs) to provide such services. Yet, no study measured how a public health initiative used equity principles for capacity-building (EPCB). Objectives: Study aims were measured at 2 time points 6 months apart and explored how participants rated (1) the Initiative’s use of 10 EPCB; (2) their CBO’s organizational strengths and conditions; and (3) the relationships among EPCB, CBOs’ organizational strengths, and CBOs’ organizational conditions. Design and Sample: Community-based participatory research was conducted with 20 multicultural, multilingual participants from 9 CBOs. Methods: Equity principles were measured in May and November 2019. Demographics, CBOs’ organizational strengths, and CBOs’ organizational conditions were collected. Descriptive and correlational analysis was employed. Results: Between May and November, 4 significant findings were observed: (1) There was a significant decrease in transformational principle use, reducing CBOs’ power and leadership. (2) Racial equity principle use was significantly associated with CBOs’ total organizational strengths and CBOs’ clear communication. (3) Participants’ confidence significantly decreased. (4) Workloads become manageable with funding. Conclusion: Power transfer using the transformational principle is vital. Equity principles need repeated measurement.

INTRODUCTION:Sexually transmitted infections including chlamydia, gonorrhea, and syphilis, remain a serious public health concern in the U.S. Social determinants of health, such as local social capital, eviction rate, and prison incarceration rate, impact health outcomes and potentially influence risk of sexually transmitted infection acquisition and transmission. This study investigated longitudinal associations between social determinants of health and sexually transmitted infection case rates at the county level in the U.S. over 20 years from 2000 to 2019. METHODS:The study team compiled data on social determinants of health and annual sexually transmitted infection case rates (chlamydia, gonorrhea, and syphilis) for all U.S. counties over the 20-year period. Panel regression models were employed to examine associations between social determinants of health and sexually transmitted infection case rates, controlling for confounders. RESULTS:The study team found significant links between social capital, eviction rate, prison incarceration rate and sexually transmitted infection case rates. Higher social capital was associated with lower chlamydia (β= -6.77, p<0.05) and gonorrhea rates (β= -7.22, p<0.01), while higher eviction rates were associated with higher rates of all 3 sexually transmitted infections (β=9.71, p<0.001 for chlamydia, β=7.32, p<0.001 for gonorrhea, and β=0.15, p<0.001 for primary and secondary syphilis, respectively) and higher prison incarceration rates were associated with higher gonorrhea rates (β=0.13, p<0.05). CONCLUSIONS:This study provides valuable insights into the annual associations of social determinants on sexually transmitted infection rates over 20 years. These findings inform the development of effective interventions and policies to address rising sexually transmitted infection case rates and promote health equity across diverse communities.

BACKGROUND:To shift home-based program delivery, public health initiatives seek to increase capacity of community-based organizations (CBOs) to provide such services. Yet, no study measured how a public health initiative used equity principles for capacity-building (EPCB). OBJECTIVES:Study aims were measured at 2 time points 6 months apart and explored how participants rated (1) the Initiative's use of 10 EPCB; (2) their CBO's organizational strengths and conditions; and (3) the relationships among EPCB, CBOs' organizational strengths, and CBOs' organizational conditions. DESIGN AND SAMPLE:Community-based participatory research was conducted with 20 multicultural, multilingual participants from 9 CBOs. METHODS:Equity principles were measured in May and November 2019. Demographics, CBOs' organizational strengths, and CBOs' organizational conditions were collected. Descriptive and correlational analysis was employed. RESULTS:Between May and November, 4 significant findings were observed: (1) There was a significant decrease in transformational principle use, reducing CBOs' power and leadership. (2) Racial equity principle use was significantly associated with CBOs' total organizational strengths and CBOs' clear communication. (3) Participants' confidence significantly decreased. (4) Workloads become manageable with funding. CONCLUSION:Power transfer using the transformational principle is vital. Equity principles need repeated measurement.

OBJECTIVES:Older adults living in long-term care facilities (LTCFs) are at high risk for falls. Interventions to prevent falls and fall-related injury in this population may be individual-level or system-focused interventions. However, relatively little attention has been given to research on system-focused interventions. This scoping review seeks to synthesise previous studies on the effects of system-focused interventions for fall prevention in LTCFs. METHODS:We searched Ovid-Medline, CINAHL and Embase databases from 2007 to 2024 following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) extension for Scoping Reviews. We conducted a narrative synthesis to summarise findings from the included studies. RESULTS:In the initial search, 403 studies were identified and underwent title and abstract screening resulting in 116 articles retrieved for full-text review. 20 studies were included in the final data extraction. System-level fall prevention interventions evaluated in LTCFs include (1) multicomponent and multidisciplinary programmes, (2) environmental adaptations, (3) technological adaptations, and (4) staff education and training programmes. 11 out of 17 included quantitative studies reported significant effects of system-focused interventions to reduce falls in LTCFs. CONCLUSIONS:This scoping review reveals the effectiveness of system-level fall prevention strategies in LTCFs. Enhancing training, customising tools and fostering a supportive leadership culture are vital for improving fall prevention practices in LTCFs.

Abstract Falls are a significant concern in long-term care facilities (LTCFs) as fall-related injuries (FRI) can result in functional impairment, disability, and death. Older adults living in LTCFs are at greater risk for falls than those in the community. Using scoping review methodology, we aimed to synthesize evidence examining intervention effects of person-focused interventions for risk assessment and prevention in LTCFs to identify evidence-based practices. Databases searched included Medline, CINAHL, and EMBASE to identify original research from 2017 to April 2022 in accordance with the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) guideline. Following the removal of duplicates, 888 articles were identified for possible review, following title and abstract screening 84 studies underwent full-text review against inclusion/exclusion criteria, with 30 studies remaining for analysis. We conducted a narrative synthesis to summarize the included studies. Evidence-based interventions for fall prevention identified include (1) exercise programs (e.g., high-intensity functional exercise, aerobic exercise, short stick exercises, etc.); (2) balance training programs (e.g., Wii Fit); (3) multifaceted, nurse-led education; and (4) others (e.g., whole body vibration, and lavender olfactory stimulation). Outcomes of included studies included the number of falls, fall rate, risk of falls, and fear of falls before and after interventions. Overall, most studies reported significant effects of person-focused interventions in LTCFs. Available evidence supports that well-designed person-focused interventions can reduce falls and fear of falls for individuals in LTCFs.

Background: 9-1-1 telecommunicators are frequently exposed to indirect traumatic events that impact their mental and physical health and are often required to work overtime with rotating shifts. Previous studies reported various harmful effects of overtime on the health and well-being of workers, such as musculoskeletal injuries, burnout, low job satisfaction, fatigue, and intent to leave. However, there is limited research on the impact of overtime hours on 9-1-1 telecommunicators’ stress symptoms, especially mandatory overtime hours. This study aimed to examine the relationship between overtime hours—mandatory and voluntary—and the level of stress symptoms among 9-1-1 telecommunicators. Methods: We used secondary data from the surveys of the “Multi-tasking to hyper-tasking: Investigating the impact of Next Generation 9-1-1” study for analysis. Linear mixed-effects regression was applied to examine the association of overtime hours with the stress level. Results: Of the 403 participants, 47.6% reported that they were required to work mandatory overtime, and the mean mandatory overtime was 7.51 ( SD = 12.78) hours in the past month. 58.3% reported working voluntary overtime, and the mean voluntary overtime was 11.63 ( SD = 17.48) hours. This study found that mandatory overtime hours were associated with an increase in self-reported stress symptoms (β = 0.30, p = .002), whereas no significant association was found between voluntary overtime and the level of stress symptoms (β = −0.01, p = .885). Conclusion/Application to Practice: Study results highlight the importance of reducing mandatory overtime in call centers as one possible strategy for reducing stress levels among this critical workforce.

AimsThis study of a levy-voter funded public health initiative program (1) identifies capacity-building concerns, (2) summarizes those concerns at the community-based organization (CBO) level, and (3) documents the desired CBO capacity-building outcome. ParticipantsNineteen participants from nine CBOs were included, representing 95% of participants (19/20) and 90% of CBOs (9/10) from the initiative's program population. MethodsInterviews were conducted. A focus group validated data. Demographic surveys were completed. Methodology and AnalysisData were analyzed using demographic and inductive content analyses. Fifteen capacity-building unexpected concerns were identified. Participants from eight out of nine (88.8%) CBOs shared at least ten concerns. Seven CBO capacity-building outcomes were identified. ResultsCapacity-building providers helped participants mitigate the Initiative's capacity-building testing of the National Implementation Research Network (NIRN) model. Participants' NIRN processes were Western and mainstream. Participants wanted community-designed processes and the funder to understand CBO clients' backgrounds, cultures, and languages. The contract money did not match the needed capacity-building processes, time, and workload. DiscussionThe funder's pre-selected the NIRN Western majority approach did not fit. Participants wanted to lead. Capacity-building only for home-based program development was less desired. Social justice leadership could have made a difference.

OBJECTIVE:To compare the estimated associations between annual sexually transmitted diseases (STD) expenditures per capita and STD incidence rates among Florida and Washington local health departments (LHDs) from 2001 to 2017, using two approaches-a longitudinal regression model with lagged STD spending and a regression model with the Arellano-Bond panel estimator. DATA SOURCES:Secondary data for LHDs were obtained from Florida and Washington state government offices and combined with county sociodemographic and health system data from the federal government. STUDY DESIGN:We examined LHDs in Florida and Washington using a longitudinal panel study design to estimate ecological relationships between annual STD expenditures per capita and annual STD incidence rates from 2001 to 2017, with LHDs as the unit of analysis. We compared two regression models: generalized estimating equations (GEE) and the Arellano-Bond panel estimator (an instrumental variable approach). DATA COLLECTION:The secondary data were combined to build a longitudinal panel database for LHDs in Florida and Washington from 2001 to 2017. PRINCIPAL FINDINGS:In the GEE model with both states, greater STD spending in a prior year was associated unexpectedly with greater STD incidence rates in succeeding years. The Arellano-Bond models for both states had the expected inverse associations but were not significant. In the Arellano-Bond models for Florida, a $1 increase in STD spending in previous years was followed by decreases in STD incidence rates ranging between 29 and 58 points in succeeding years (0.09 ≥ p ≥ 0.04). CONCLUSIONS:In longitudinal panel data for LHDs in two states, the Arellano-Bond estimator, or other instrumental variable approach, is preferred over conventional regression models to obtain unbiased estimates of the relationship between annual STD spending rates and annual STD rates. Future studies will require accurate, standardized, and detailed longitudinal data and rigorous analytic approaches, such as those illustrated in our study.

Public health spending is important for managing increases in sexually transmitted diseases (STDs) in the United States. Although previous studies suggest that a beneficial link exists between public health spending and changes in STD rates, there have been no systematic reviews synthesizing existing evidence regarding the association for STDs at the population level. The objective of this study was to synthesize evidence from studies that assessed the associations between general and STD-specific public health spending and STD rates. We conducted a systematic review using Ovid-Medline, EMBASE, CINAHL, Cochrane Library, Web of Science, and EconLit for relevant studies that examined the association between public health spending and gonorrhea, syphilis, chlamydia, and chancroid rates following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. A total of 5 articles (2 regarding general public health spending and 3 regarding STD-specific public health spending) met our inclusion criteria. There was a significant decrease in gonorrhea, syphilis, chlamydia, and chancroid rates associated with increased public health spending. We also found that STD-specific public health spending has a greater effect on STD rates compared with general public health spending. Our review provides evidence that increases in general and STD-specific public health spending are associated with a reduction of STD rates. Such research regarding estimates of the impact of STD prevention spending can help policy makers identify priority funding areas and inform health resource allocation decisions.

AIMS:The study aim was to examine the impact of a home-based programme intervention on organizational contexts, implementation processes and organizational capacity outcomes from multicultural, multilingual participants working at community-based organizations. DESIGN:This was a sequential exploratory, mixed-methods longitudinal study using community-based participatory research principles. SAMPLE:Twenty participants from nine multicultural, multilingual community-based organizations were in this public health initiative's intervention to develop community-designed, home-based programmes. METHODS:Capacity building providers delivered the intervention selected by the funders. Workshop outcomes were descriptively measured in April/May 2019. In April/May and November 2019, participants completed surveys about organizational contexts, implementation processes and organizational capacity outcomes, which were analysed with t-tests using the organization as the unit of analysis. Qualitative data were analysed using content analysis. RESULTS:Seven programmes were new and two were modified. As workshop outcomes, 59% of participants reported increased overall implementation knowledge and 74% reported capacity building providers as the most helpful resource. After 6 to 7 months, no statistically significant changes were noted in organizational contexts, implementation processes or organizational capacity outcomes. Participants benefited from capacity building because they had programmes developed, formed partnerships with capacity building providers, gained implementation knowledge, and engaged in networking. CONCLUSION:Participants reported excellent individual and organizational strengths. Many Initiative factors contributed to no statistical changes. Namely, there was no opportunity for baseline data; limited community-based organization engagement in the intervention model selection, timeline and processes; the Initiative's timeline did not fit participants' timeline; insufficient time to develop culturally and linguistically appropriate programmes; late literature review abstracts; lack of adequate, planful and paid capacity building time; and a contract requirement to have the programme due when it was not implementable. These Initiative design factors, as reported by participants, limited the Initiative's home-based programme development. IMPACT:This study highlights the strengths of participants, community-based organizations and capacity building providers. Model selection, timeline and budget were identified as key factors for equitable implementation in multicultural, multilingual organizations.

Institutional discrimination matters. The purpose of this longitudinal community-based participatory research study was to examine institutional procedural discrimination, institutional racism, and other institutional discrimination, and their relationships with participants' health during a maternal and child health program in a municipal initiative. Twenty participants from nine multilingual, multicultural community-based organizations were included. Overall reported incidences of institutional procedural discrimination decreased from April 2019 (18.6%) to November 2019 (11.8%) although changes were not statistically significant and participants reporting incidences remained high (n = 15 in April and n = 14 in November). Participants reported experiencing significantly less "[when] different cultural ways of doing things were shared, the project did not support my way" from April 2019 (23.5%, n = 4) to November 2019 (0%, n = 0), Wilcoxon signed-rank test Z = -2.00, p < 0.05. Some participants reported experiencing institutional racism (29.4%, n = 5) and other institutional discrimination (5.9%, n = 1). Participants experiencing institutional racism, compared to those who did not, reported a higher impact of the Initiative's program on their quality of life (t = 3.62, p < 0.01). Participatory survey designs enable nurse researchers to identify hidden pathways of institutional procedural discrimination, describe the impacts experienced, and examine types of institutional discrimination in health systems.

The aim of this study was to evaluate the longitudinal influence of social capital and self-esteem on depressive symptoms among adolescents. A multivariate latent growth model was used to test secondary data obtained from the Korea Youth Panel Survey. Social capital and self-esteem tended to increase over periods of four years, whereas depressive symptoms had a tendency to decrease in the same periods. In the case of indirect effects on depressive symptoms by way of self-esteem, significant indirect associations were identified. The results indicated that the intercept of social capital had a significant indirect effect and total effect on the intercept of depressive symptoms. In addition, the slope of social capital had a significant indirect effect and total effect on the slope of depressive symptom. The initial development of social capital and self-esteem is shown to be effective for reducing adolescents' depressive symptoms.

The aim of this study was to measure the magnitude and distribution of a Korean’s lifetime dental expenses depending on age and sex, by constructing a hypothetical lifetime and life table of survival. Additionally, we estimated the difference in life expectancy between men and women and its impact on dental expenses. We used the 2015 Korea Health Panel Survey to calculate the total dental expenditure, including expenses paid directly by patients and those paid by insurers. We generated survival profiles to simulate dental expenses during a typical lifetime (from birth to age 95) using the abridged life table (five-year intervals for age groups) in 2015 from the South Korean Statistical Information Service. We independently calculated the remaining dental expenses for survivors of all ages. The results showed that an estimate of average lifetime dental expenditure was $31,851 per capita: $31,587 for men and $32,318 for women. Nearly 33% of the average per capita lifetime dental expenditure was attributable to the longer life expectancy of women, with no statistically significant difference in lifetime dental expenditure between men and women. Many survivors incurred 70% of their lifetime dental expenses before age 65. The results highlighted the need for policymakers to address spending on age-specific dental care owing to extended life expectancy, given the disproportionate share of healthcare resources supporting the elderly.

We evaluated the effect of the National Health Insurance (NHI) policy including dental sealant on changes in the prevalence of sealant and caries, and examined how NHI affected sealant utilization and untreated caries in children from diverse income groups in South Korea. We used a multivariate logistic regression analysis to explore the effects of three stages of dental sealant policy (pre-policy: 2007-2009, first post-policy: 2010-2012, and second post-policy: 2013-2015) on the prevalence of dental sealant and untreated caries. Participant data (N = 8161, aged 6-14 years) were derived from the Korea National Health and Nutrition Examination Survey (2007-2015). We also conducted subgroup analysis to determine the effects of the NHI policy on dental sealant and untreated caries by income level. Implementation of dental insurance coverage was associated with higher likelihood of using dental sealant (odds ratio (OR) = 1.39 (95% confidence interval (CI): 1.18-1.63) for the first period and OR = 1.58 (95% CI: 1.33-1.87) for the second period) and lower odds of having untreated caries (OR = 0.79 (95% CI: 0.64-0.98) for the first period and OR = 0.65 (95% CI: 0.51-0.83) for the second period) after controlling for covariates. Results revealed that there was a greater prevalence of dental sealant and a lower prevalence of untreated caries in both middle- and low-income households compared to high-income households. The higher prevalence of dental sealant and lower untreated caries after the policy implementation. Moreover, we demonstrated children from low-or middle-income households were more associated with increasing dental sealant use and a declining prevalence of caries.

Public Health NursingVolume 35, Issue 6 p. 613-614 LETTER TO THE EDITOR In response to the published article: “Cultural Capital: A Concept Analysis” Sungwon Lim MPH, RN, Corresponding Author Sungwon Lim MPH, RN staroot1@uw.edu orcid.org/0000-0001-9086-5101 School of Nursing, University of Washington, Seattle, WashingtonSearch for more papers by this author Sungwon Lim MPH, RN, Corresponding Author Sungwon Lim MPH, RN staroot1@uw.edu orcid.org/0000-0001-9086-5101 School of Nursing, University of Washington, Seattle, WashingtonSearch for more papers by this author First published: 13 November 2018 https://doi.org/10.1111/phn.12554Citations: 1Read the full textAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinkedInRedditWechat No abstract is available for this article.Citing Literature Volume35, Issue6November/December 2018Pages 613-614 RelatedInformation

AIMS AND OBJECTIVES:To identify an association between overweight or obesity in early childhood and metabolic syndrome in adults. BACKGROUND:Early childhood overweight or obesity is important because it can predict metabolic syndrome in adulthood. A longer period of overweight or obesity leads to the accumulation of more risk factors. However, there are insufficient and inconsistent studies on this issue. DESIGN:A systematic review and meta-analysis. METHODS:We followed the Meta-Analysis of Observational Studies in Epidemiology guideline, MEDLINE, EMBASE, Cochrane library and CINAHL electronic databases as well as reference lists of included studies were searched, without published date restriction. We used the Newcastle-Ottawa Scale to assess the quality of the observational studies in the systematic review, and the meta-analysis was performed using random-effects models. RESULTS:All of the included studies were published from 2008-2014, and the participants of this study were only Asians or Europeans. A total of 12 results from five studies were included in the meta-analysis. Overweight or obesity in early childhood was associated with a higher risk of adult metabolic syndrome compared with the controls. When confirmed in each age group (at birth, 0-2 and 2-6 years), there was a statistically significant difference before and after the age of 2 years. As a result of the meta-regression, when the age of the children increased, the effect size of adult metabolic syndrome for overweight or obesity also increased. CONCLUSIONS:The results confirm that the aetiology of metabolic syndrome includes long-term impacts from the early stage of life and indicate that early intervention for overweight or obesity is needed. RELEVANCE TO CLINICAL PRACTICE:these findings could help community and clinical health nurses recognize the risk of overweight or obesity in early life, and provide evidence to develop and implement the preventive intervention for early childhood.