阶段转变理论模型在农民人群中营养干预行为中的应用

Study on change of behavioral stages on nutritional intervention in farmers

目的探讨阶段转变理论模型在农民人群中开展"多吃蔬菜水果、少吃盐"的营养干预行为研究上的应用,评估其行为阶段转变的效果。方法选取干预与对照农民各500余人,对调查对象统一进行基线调查和干预一年后的评估调查;根据基线调查数据,按阶段转变理论模型对其多吃蔬菜水果行为的接受程度划分为五个阶段,对干预组农民及不同阶段人群开展营养干预活动,试验后应用此模型评估两组行为阶段的改变。结果应用阶段转变理论模型分析,干预后,干预组农民的多吃蔬菜水果的健康行为阶段前移,其准备期、行动期、维持期阶段人群比例分别增加了15.1%、20.7%和16.1%;农民的营养知识知晓率,每天蔬菜、水果的摄入量,叶酸、尿钾水平随着行为阶段的上升逐渐增加,而食盐摄入量,舒张压、同型半胱氨酸、尿钠水平随着行为阶段的上升而逐渐降低(P<0.05)。结论应用阶段转变理论模型对农民进行营养干预,农民多吃蔬菜水果行为发生了由无打算阶段转变为行动、维持阶段的变化,取得了行为阶段前移或上升的直观干预效果;处在行动、维持高阶段的人群确实要比低阶段的人群具有较高的营养知识水平、积极的健康信念和态度、健康的膳食行为、较低的慢性疾病危险因素水平,体现了该模型分析人们知-信-行在不同阶段转变的可应用性。

Objective To explore the applying stages of change model on nutrition intervention on ＂eating more vegetables and fruits,eating less salt＂ in farmers,and evaluate the change of behavioral stages.Methods The questionnaires were used to do baseline and evaluation survey on 500 farmers in trial group and control group respectively.Applying stages of change model to divide farmers into five stages according to their behavior of eating more vegetables and fruits.The intervention ways were used in trial group,especially in five stages farmers.After one year,the changes of behavioral stages in two groups were evaluated.Results There wer e statistical significance on proportion of behavioral stages between before intervention and after intervention in trial group（P0.05）： the upgrade of behavior stages has been gained,the proportion of preparation,action,maintenance increased by 15.1%,20.7% and 16.1% for eating more vegetables and fruits.With the rise of behavioral stage,the awareness rates of healthy knowledge,the average daily intake of vegetables and fruits,folic acid and urine potassium levels have rised,and the average daily intake of salts,diastolic pressure,homocysteine and urine sodium levels have reduced increasingly（P0.05）.Conclusion After intervention,through applying SOC model to analyse and show that the proportion of behavioral stages about eating more vegetables and fruits on farmers have changed from precontemplation to action and maintenance,the upgrade of behavior stages has been gained;The higher stages farmers have higher levels of heathy knowledge,more positive healthy belief and attitude,lower risk factors of chronic diseases than the lower stages farmers,the stages of change model has the practicability on behavior change.