{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T13:36:11Z","timestamp":1790861771289,"version":"4.1.0"},"reference-count":30,"publisher":"MDPI AG","issue":"14","license":[{"start":{"date-parts":[[2020,7,17]],"date-time":"2020-07-17T00:00:00Z","timestamp":1594944000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100003725","name":"National Research Foundation of Korea","doi-asserted-by":"publisher","award":["2017R1A2B4008496"],"award-info":[{"award-number":["2017R1A2B4008496"]}],"id":[{"id":"10.13039\/501100003725","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100003710","name":"Korea Health Industry Development Institute","doi-asserted-by":"publisher","award":["HI18C1317"],"award-info":[{"award-number":["HI18C1317"]}],"id":[{"id":"10.13039\/501100003710","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJERPH"],"abstract":"<jats:p>Contextual factors are associated with risks of cardiovascular disease (CVD) perceived by personnel employed in small\u2013medium-sized workplaces. In an ecological model, data collection and analysis were undertaken, stratified by intrapersonal, interpersonal, and organizational contexts of blue-collar workers. Data were collected in face-to-face (n = 36) and focus group (n = 4) interviews and subjected to qualitative content analysis, to generate three main themes, 10 generic categories and 18 sub-categories. At the intrapersonal level, \u201cphysical burden\u201d, \u201cburn out due to overtime work\u201d, \u201cno time to take care of health because of family responsibility\u201d, and \u201clack of recognition and knowledge of CVD risks\u201d were derived from the individual interviews. At the interpersonal level, \u201cstress of possible job losses\u201d, \u201cdislike of stigmatization of unhealthy persons\u201d, \u201csmoking and drinking to reduce relationship stress\u201d, and \u201cunhealthy work environment\u201d differed by level of risk perception. \u201cPreferred economic value\u201d and \u201clack of understanding about importance of CVD management of an employer\u201d emerged at the organizational level. Factors that influence CVD risks among workers in small\u2013medium-sized business were present at the multiple levels. Therefore, healthcare providers in the field of occupational health should consider CVD risks in the context of blue-collar workers and organizational level for health-promotion programs.<\/jats:p>","DOI":"10.3390\/ijerph17145155","type":"journal-article","created":{"date-parts":[[2020,7,17]],"date-time":"2020-07-17T10:22:02Z","timestamp":1594981322000},"page":"5155","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["An Exploration of Contextual Aspects that Influence Cardiovascular Disease Risks Perceived by Workers in a Small\u2013Medium-Sized Workplace"],"prefix":"10.3390","volume":"17","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8884-0818","authenticated-orcid":false,"given":"Jin Ah","family":"Kim","sequence":"first","affiliation":[{"name":"Department of Nursing, Gyeongju University, 188, Taejong-ro, Gyeongju-si, Gyeongsangbuk-do 38065, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0498-6183","authenticated-orcid":false,"given":"Won Ju","family":"Hwang","sequence":"additional","affiliation":[{"name":"College of Nursing Science, East-West Nursing Institute, Kyung Hee University, Seoul 02447, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Juhye","family":"Jin","sequence":"additional","affiliation":[{"name":"Department of Nursing, Korea National University of Transportation, Chungbuk 27909, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2020,7,17]]},"reference":[{"key":"ref_1","unstructured":"Ryu, H.S., Song, N.H., So, A.Y., Park, J.M., Kim, E.J., Im, M.Y., Suk, M.H., Chu, J.A., Hwang, L.I., and Gu, B.J. (2014). Community Health Nursing II, Soomoonsa Publishing Company."},{"key":"ref_2","unstructured":"Korean Statistical Information Service (2016, August 20). No. of Establishments and Workers (by Employment Status and Gender) by Industry and Establishment Size, Available online: http:\/\/kostat.go.kr\/portal\/korea\/index.action."},{"key":"ref_3","unstructured":"National Law Information Center (2016, August 20). Occupational Safety and Health Act, Available online: http:\/\/www.law.go.kr\/lsSc.do?menuId=0&p1=&subMenu=1&nwYn=1\u00a7ion=&tabNo=&query=%EC%82%B0%EC%97%85%EC%95%88%EC%A0%84%EB%B3%B4%EA%B1%B4%EB%B2%95%20%EC%8B%9C%ED%96%89%EB%A0%B9#undefined."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"5","DOI":"10.1186\/1476-072X-10-5","article-title":"Cardiovascular disease occurrence in two close but different social environments","volume":"10","author":"Wennerholm","year":"2011","journal-title":"Int. J. Health Geogr."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"41","DOI":"10.5807\/kjohn.2016.25.1.41","article-title":"A Systematic Review of Interventions for Workers with Cardiovascular Disease Risk Factors: Using an Ecological Model","volume":"25","author":"Hwang","year":"2016","journal-title":"Korean J. Occup. Health Nurs."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"857","DOI":"10.4040\/jkan.2015.45.6.857","article-title":"Ecological Correlates of Cardiovascular Disease Risk in Korean Blue-collar Workers: A Multi-level Study","volume":"45","author":"Hwang","year":"2015","journal-title":"J. Korean Acad. Nurs."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"351","DOI":"10.1177\/109019818801500401","article-title":"An Ecological Perspective on Health Promotion Programs","volume":"15","author":"McLeroy","year":"1988","journal-title":"Health Educ. Q."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"1095","DOI":"10.4040\/jkan.2012.42.7.1095","article-title":"Factors Associated with Blue-collar Workers\u2019 Risk Perception of Cardiovascular Disease","volume":"42","author":"Hwang","year":"2012","journal-title":"J. Korean Acad. Nurs."},{"key":"ref_9","unstructured":"Korea Occupational Safety and Health Agency (2009). Risk Assessment for the Prevention of Cardiocerebrovascular Disease at Workplace, National Report No.: KOSHA Code H-46-2009."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"45","DOI":"10.1016\/S0749-3797(18)31296-0","article-title":"Risk Perception, Knowledge, and Lifestyles in Siblings of People with Premature Coronary Disease","volume":"3","author":"Becker","year":"1987","journal-title":"Am. J. Prev. Med."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"107","DOI":"10.1111\/j.1365-2648.2007.04569.x","article-title":"The qualitative content analysis process","volume":"62","author":"Elo","year":"2008","journal-title":"J. Adv. Nurs."},{"key":"ref_12","first-page":"63","article-title":"Strategies for ensuring trustworthiness in qualitative research projects","volume":"22","author":"Shenton","year":"2004","journal-title":"Educ. Inf."},{"key":"ref_13","first-page":"75","article-title":"Criteria for assessing the trustworthiness of naturalistic inquiries","volume":"29","author":"Guba","year":"1981","journal-title":"Educ. Technol. Res. Dev."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"18","DOI":"10.1080\/01446193.2014.997259","article-title":"Improving the health of male, blue collar construction workers: A social ecological perspective","volume":"33","author":"Lingard","year":"2015","journal-title":"Constr. Manag. Econ."},{"key":"ref_15","first-page":"235","article-title":"Health Belief Model-based Needs Assessment for Development of a Metabolic Syndrome Risk Reduction Program for Korean Male Blue-collar Workers in Small-sized Companies","volume":"27","author":"Park","year":"2018","journal-title":"Korean J. Occup. Health Nurs."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"222","DOI":"10.1002\/smi.2549","article-title":"Job Stress in the United Kingdom: Are Small and Medium-Sized Enterprises and Large Enterprises Different?","volume":"31","author":"Lai","year":"2013","journal-title":"Stress Health"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"1085","DOI":"10.1038\/ajh.2009.146","article-title":"Individual Socioeconomic Factors Conditioning Cardiovascular Disease Risk","volume":"22","author":"Saez","year":"2009","journal-title":"Am. J. Hypertens."},{"key":"ref_18","doi-asserted-by":"crossref","unstructured":"Hwang, W.-J., and Kim, J.A. (2019). Developing a Health-Promotion Program Based on the Action Research Paradigm to Reduce Cardiovascular Disease Risk Factors among Blue Collar Workers. Int. J. Environ. Res. Public Health, 16.","DOI":"10.3390\/ijerph16244958"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"289","DOI":"10.1080\/08870440802499382","article-title":"Making sense of being at \u2018high risk\u2019 of coronary heart disease within primary prevention","volume":"25","author":"Farrimond","year":"2010","journal-title":"Psychol. Health"},{"key":"ref_20","first-page":"1","article-title":"Factors Related to Cardiovascular Disease Risk Reduction in Midlife and Older Women: A Qualitative Study","volume":"5","author":"Folta","year":"2007","journal-title":"Prev. Chronic Dis."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"806","DOI":"10.1037\/0022-3514.39.5.806","article-title":"Unrealistic optimism about future life events","volume":"39","author":"Weinstein","year":"1980","journal-title":"J. Pers. Soc. Psychol."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"121","DOI":"10.1177\/1010539513500338","article-title":"Predictors of Health-Promoting Behavior Associated with Cardiovascular Diseases Among Korean Blue-Collar Workers","volume":"27","author":"Hwang","year":"2015","journal-title":"Asia Pac J Public Health."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"9","DOI":"10.1521\/jscp.1996.15.1.9","article-title":"Sufficient Grounds for Optimism: The Relationship between Perceived Controllability and Optimistic Bias","volume":"15","author":"Harris","year":"1996","journal-title":"J. Soc. Clin. Psychol."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"437","DOI":"10.1080\/0887044022000004920","article-title":"Perceived Control and the Optimistic Bias: A Meta-Analytic Review","volume":"17","author":"Klein","year":"2002","journal-title":"Psychol. Health"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"431","DOI":"10.1037\/0278-6133.3.5.431","article-title":"Why it won\u2019t happen to me: Perceptions of risk factors and susceptibility","volume":"3","author":"Weinstein","year":"1984","journal-title":"Health Psychol."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"20939","DOI":"10.5812\/ijhrba.20939","article-title":"Personal Fable: Optimistic Bias in Cigarette Smokers","volume":"4","author":"Masiero","year":"2015","journal-title":"Int. J. High Risk Behav. Addict."},{"key":"ref_27","first-page":"1238","article-title":"Unrealistic optimism in early-phase oncology trials","volume":"122","author":"Jansen","year":"2016","journal-title":"IRB"},{"key":"ref_28","first-page":"537","article-title":"Perceptions of barriers to cardiovascular risk factors and decision to seek treatment among middle-aged men with acute myocardial infarction","volume":"22","author":"Hwang","year":"2010","journal-title":"Korean J. Adult Nurs."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"392","DOI":"10.35371\/kjoem.2002.14.4.392","article-title":"The experience of occupational healthcare providers in the government-funded subsidized occupational health program for small scale industries: Use of focus group interview","volume":"14","author":"Han","year":"2002","journal-title":"Korean J. Occup. Environ. Med."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"334","DOI":"10.1177\/001789690406300405","article-title":"Health promotion in small workplaces\u2014A feasibility study","volume":"63","author":"Fine","year":"2004","journal-title":"Health Educ. J."}],"container-title":["International Journal of Environmental Research and Public Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1660-4601\/17\/14\/5155\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T09:49:17Z","timestamp":1760176157000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1660-4601\/17\/14\/5155"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,7,17]]},"references-count":30,"journal-issue":{"issue":"14","published-online":{"date-parts":[[2020,7]]}},"alternative-id":["ijerph17145155"],"URL":"https:\/\/doi.org\/10.3390\/ijerph17145155","relation":{},"ISSN":["1660-4601"],"issn-type":[{"value":"1660-4601","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,7,17]]}}}