运用健康行为程式模型对中小学生用眼卫生行为干预效果的评价

Evaluation on effects of an education program regarding ocular hygiene behavior among primary and middle school students by health action process approach

目的运用健康行为程式模型对新乡市中小学生用眼卫生行为进行健康促进干预,并对干预效果进行评价。方法采用多阶段抽样的方法抽取新乡市4所小学和3所中学,选取小学三、四年级、初一及初二年级学生,被抽取学校随机分为对照组和干预组。干预组的学生进行用眼行为信念+行为计划+自我控制能力干预,对照组学生实施用眼行为信念干预,动态监测2组干预前后社会心理学变量、用眼行为及视力指标,评价干预效果。结果干预后,干预组学生用眼行为阶段人数的分布呈逐渐增高趋势,与对照组相比,在干预后1个月和12个月差异有统计学意义(χ2=56.32,P<0.05;χ2=800.70,P<0.05)。干预组学生用眼行为评分呈逐渐增高趋势,在干预后1个月和12个月评分分别是10.95±0.21、12.78±0.73,而对照组是8.62±0.48、5.16±0.54,2组对比差异均有统计学意义(t=14.21,P<0.05;t=24.12,P<0.05)。干预后1个月干预组行为计划、应对计划和自我控制能力的得分分别是10.98±1.12、7.92±0.36、14.87±1.53,而对照组的得分分别是2.03±0.62、1.83±0.94、6.43±0.94,2组对比差异均有统计学意义(均为P<0.05)。干预组学生近视发病率(7%)明显低于对照组(18%),差异有统计学意义(χ2=36.26,P<0.01)。结论健康行为程式模型的综合干预措施能有效促进中小学生正确用眼卫生行为的形成,预防近视的发生。

Objective To evaluate the outcome of a health education program on the ocular hygiene behavior among primary and secondary school students through the health action process approach （HAPA）. Methods Four primary schools and three middle schools were selected and students from grade 3 to 4 in primary schools and grade 1 to 2 in middle schools were selected to take part in the program, as control and intervention groups, respectively. The behavioral beliefs ＋ action plan ＋ self-control intervention measures were provided to intervention group, the behavioral beliefs intervention measure were given to control group. The social psychology variables, ocular hygiene behavior and vision were dynamic measured for both groups to evaluate the effectiveness of intervention. Results The students with behavior stage in intervention group was gradually increased, there were significant differences compared with control group at 1 month and 12 months after intervention（x^2 = 56.32 ,P 〈 0.05 ;X^2 = 800.70 ,P 〈 0.05）. The health behavior levels of the intervention group were 10. 95 ± 0. 21 and 12.78 ±0.73 at 1 month and 12 months after intervention,respectively,while the control group were 8.62 ± 0.48 and 5.16 ± 0.54, respectively,there were significant differences among two groups （ t = 14.21 ,P 〈 0.05 ; t = 24.12 ,P 〈 0.05 ）. At 1 month after intervention ,the average score of behavior planning,response planning and self-control ability in intervention group were 10.98 ± 1.12,7.92 ±0.36 and 14.87 ± 1.53 ,respectively,the average score in control group were 2.03 ± 0.62,1.83 ±0.94 and 6.43± 0.94, respectively, there were significant differences among two groups （ all P 〈 0.05 ）. Myopia incidence ofintervention group （7%）was obviously lower than control group （18%） ,the difference was statistically significant （X^2 = 36. 26 ,P 〈 0.01 ）. Conclusion The comprehensive interventions based on the HAPA plays a significant role in the schoolaged children＇ s ocular hygiene behavior and prevent myopia.