北京市大兴区创建健康促进学校工作现况调查

Cross-sectional investigation on establishment of health promoting school in Daxing District of Beijin

目的了解北京市大兴区健康促进学校（简称健促校）开展现状,并进行分析与评述。方法调查该区80所中小学校,采取定性和定量调查相结合的方法进行分析。结果 100%学校应急防控准备周全。其他指标不合格率大多变动在0~30%之间,如21.25%学校未对慢性病高危学生建档,31.25%学校未对视力下降和轻度近视学生分档管理,8.75%学校未开展对超重、肥胖学生的干预,15.00%学校未行窝沟封闭和龋齿填,46.25%学校未完全照要求开设健教课,10.00%学校开展控烟不力等,这些指标的不合格率基本遵从以非区市健促校、区级健促校并申报市级验收的学校、市级健促校的次序降低的规律。现场调研发现,健促校创建工作掣肘因素有许多,重要因素有家庭学校融合度不佳、教职工执行力不强、校内卫生工作者缺乏细节执行力和采集整理工作信息的能力、对健促校创建的行政干预和业务指导均显不足、各方缺乏激励机制,尤以校医为甚等。结论大兴区学校、家庭和社区3方互动不佳与校医体系效率较低影响到健促校工作深入开展;大兴区健促校建设虽取得很大成绩,但也正处于＂滞涨期＂,今后应注重顶层设计和精细化管理并重,宜期中和期末评审相结合,注重培育学校内生动力机制的完善,充分发挥创建群体的主动性。

[Objective] To describe and analyze the current situation of establishment of health promoting school（HPS）in Daxing District of Beijing. [Methods] 80 primary and middle schools in Daxing District were investigated by the combined method of qualitative and quantitative survey.[Results] 100% of schools had the complete emergency prevention and control measures. The unqualified rate of other indexes were between 0 and 30%,for example,21.25% of schools failed to establish record for students with serious chronic disease,31.25% of schools failed to classify and manage students with vision problems,8.75% of schools failed to carry out the intervention in students with overweight or obesity,15.00% of schools failed to carry out dental caries and fissure sealing for students,46.25% of schools failed to offer the health education courses according to standards,and 10.00% of schools indecisively put smoking control into practice. The unqualified rates of these indexes decreased according to the sequence of no-developing HPS,district-level HPS and applying for city-level authentication,city-level HPS. The field investigation showed that there were many adverse factors for HPS establishment, including poor integration between school and family, low implementation capacity of faculty,low ability to execute in details and collect relational information of school medical staff,weak administrative intervention and professional supervision,and absence of efficacious incentive mechanism,especially in school doctors. [Conclusion] The poor integration among school,family,and community,and low efficiency of school medical system have impeded the implementation of HPS establishment in Daxing District. Although HPS establishment work has achieved great accomplishment in Daxing District,it is in a stagflation period. In future,it is necessary to focus on the top-level design and fine management,carry out the combination of midterm evaluation and terminal evaluation,improve the endogenous power system of school,and foster the initiative of create groups.