A network analysis of school refusal behavior among Hani adolescents in rural border regions of Yunnan, China.

Recently, the issue of low birth rates has emerged not only in South Korea but also in countries including Europe, the United States, and East Asia []. The birth rate in South Korea has rapidly declined. As of March 2022, the total fertility rate was 0.86, the lowest in South Korean history and the lowest among the Organization for Economic Co-operation and Development countries []. Since 2001, the South Korean government has been implementing countermeasure policies in various fields by investing a large amount of budget to increase the total fertility rate, but to date, the results have been skeptical. Accordingly, the South Korean government has developed a new response strategy that focuses on improving the quality of life for women rather than simply aiming to increase the total fertility rate []. Improving the quality of life of individual women in connection with low fertility means that they will help women who have made the right to self-determination about pregnancy and childbirth to achieve successful pregnancy and childbirth [,]. This study's unique focus on self-determination and its influence on health behaviors, particularly in the context of reproductive health, significantly contributes to the field. Such self-determination has been shown to influence mental health aspects such as anxiety and depression in the context of sexual activity within marital relationships or with dating partners, as well as being associated with the frequency of risky sexual behaviors and violence. This highlights one perspective among various approaches related to sexual behavior []. However, individuals' self-determination is activated by environmental factors, such as stress or uncertainty []. Consequently, recent research has increasingly focused on elucidating the correlation between self-determination and health behaviors []. In broader domains, significant correlations were observed between self-determination and individual well-being, morbidity, and mortality rates []. It has also been reported to affect the onset and management of conditions such as alcohol consumption, smoking, obesity, diabetes, cardiovascular disease, heart attack, and stroke [].