新疆石河子市中学生结核病健康促进效果评价

Effect evaluation on tuberculosis health promotion among middle school students in Shihezi City of Xinjiang

目的了解石河子市中学生结核病知晓情况,对结核病健康促进干预效果进行评价,为学校结核病防治工作的开展提供依据。方法 2016年1月1日—2017年6月30日,采取多阶段随机抽样的方式抽取石河子市10所中学(初、高中)作为调查干预现场,对抽取学校的每个年级的班级进行分层整群抽样,抽取共计2 575名在校中学生,在健康教育前后进行问卷调查,对干预前数据进行多因素分析,并对干预前后效果进行评价。结果健康教育干预实施前后学生的总体知晓率从62.3%(18 973/30 464)上升到79.7%(24 281/30 464),差异有统计学意义(P<0.01);结核病防治知识知晓率由64.9%升至干预后的81.6%,结核病态度行为知晓率由57.8%升至76.5%;对干预前结核病知晓基线数据进行单因素及多因素分析发现,男性(OR=1.36,95%CI=1.05~1.75,P<0.05)、维吾尔族(OR=0.42,95%CI=0.30~0.57,P<0.01)及哈萨克族(OR=0.70,95%CI=0.51~0.95,P<0.05),初中生及父母有较低文化程度(OR=1.62,95%CI=1.17~2.25,P<0.05)的学生得低分的危险性较大;单个信息知晓情况中,干预前学生对个别相关知识匮乏,干预后均有提高(均P<0.01),但对"结核病的严重性,是法定的哪类传染病"(69.5%)、"结核患者服药治疗需要多久"(70.4%)等问题的知晓仍然较低。结论干预前学生对结核病的知晓率较低,健康促进对其提高效果显著,但中学生部分结核病知识仍然不足,对结核病的部分相关态度也仍需进一步改善;应进一步加强对少数民族、初中生以及家庭文化程度较低的学生的宣传教育。

[Objective] To investigate the awareness status of tuberculosis（TB） knowledge among middle school students in Shihezi City, evaluate the effect of TB health promotion, and provide a basis for the development of TB prevention and control in schools. [Methods] From January 1, 2016 to June 30, 2017, 10 middle schools（junior high school and senior high school） in Shihezi City were randomly selected as the investigation intervention site by a multistage random sampling, while the classes were sampled in every grade of 10 schools by a stratified cluster sampling, and totally 2 575 students were enrolled. The questionnaire survey was performed before and after health education, the data were analyzed to evaluate the effects before and after the intervention. [Results] The total awareness rate increased from 62.3%（18 973/30 464） before health education to 79.7%（24281/30 464） after health education, and the difference was statistically significant（P〈0.01）. The awareness rate of knowledge about TB control increased from 64.9% to 81.6%, and the awareness rate of TB attitude and behavior rose from 57.8% to 76.5%.Single factor and multi factor analysis of the baseline data on tuberculosis awareness before intervention found that male（OR =1.36, 95%CI=1.05~1.75, P〈0.05）, Uyghur（OR=0.42, 95%CI=0.30~0.57, P〈0.01）, and Kazak（OR=0.70, 95%CI=0.51~0.95,P〈0.05）, junior middle school students and the parents with lower cultural degree（OR=1.62, 95%CI=1.17~2.25, P〈0.05） had higher risk of getting a lower score. For the awareness rate of each question, students lacked of knowledge about individual question before intervention, which all awareness rates improved after intervention（all P〈0.01）. But the awareness rates of the question about the severity of tuberculosis and classification of tuberculosis（69.5%） and the standard cure of tuberculosis（70.4%） were still lower. [Conclusion] The awareness rate of TB knowledge is low among students before intervention, and the effect of TB health promotion is remarkable. However, middle school students still lack of knowledge about some TB questions,and the attitude of TB still needs to be further improved. It is necessary to further strengthen the publicity and education of minority, junior high school students and students with lower family culture.