减盐干预对山东省儿童青少年人群盐与高血压相关知信行的影响

Influencing of salt reduced intervention on related knowledge-attitude-practice of salt and hypertension in youngsters of Shandong Province

目的评价山东省减盐防控高血压项目对6~17岁儿童青少年人群盐与高血压相关知识、态度及行为的干预效果,探索有效可行的学校减盐干预模式。方法采用多阶段随机整群抽样方法于2011年6—9月抽取山东省27所学校81个班的4898名学生进行基线调查,于2016年6—9月采用相同方法抽取3710名学生进行终末评估调查。干预前后通过问卷调查盐与高血压知信行变化情况。采用SAS 9.4中的SURVEYLOGISTIC检验比较减盐干预前后居民盐与高血压相关知信行变化情况。结果减盐干预5年后,山东省儿童青少年高血压诊断标准、每人每天6 g盐、少吃盐降血压和低钠盐的知晓率分别从2011年的18.2%、30.0%、45.6%和17.8%上升至2016年的47.8%、75.0%、77.9%和60.4%;钠(盐)含量标注必要率以及赞成低盐饮食的比例分别从2011年的78.9%、49.3%上升至2016年的86.9%、70.7%;使用定量盐勺、关注预包装食品钠(盐)含量及主动采取减盐措施的比例分别从2011年的14.2%、28.1%、38.8%上升至2016年的56.6%、54.7%、63.8%。干预前后上述指标差异均有统计学意义(P<0.05,P<0.01)。结论以学校为基础,采取综合减盐干预措施可以提高儿童青少年盐与高血压的认知水平,有助于建立低盐饮食习惯。

Objective To evaluate the intervention effects of Shandong-Ministry of Health Action on Salt and Hypertension(SMASH)program on related knowledge,attitude and practice of salt and hypertension in youngsters,and to explore the schoolbased salt reduction intervention model.Methods The multistage random cluster sampling method was used to select 4898 students from 81 classes in 27 schools of Shandong Province for the baseline investigation from June to September of 2011,and 3710 students were selected by the same method for conducting final assessment survey.Changes of knowledge-attitude-practice of salt and hypertension were evaluated by questionnaire after and before intervention.The SURVEYLOGISTIC test was used to compare the knowledge,attitudes and behavior of salt and hypertension before and after the salt reduced intervention,the software SAS 9.4 was used to analyze the data.Results After salt reduced intervention for 5 years,the awareness rates of hypertension diagnosis standard,6 g salt per day and person,low salt for reducing blood pressure,low sodium salt increased from 18.2%,30.0%,45.6%and 17.8%in 2011 to 47.8%,75.0%,77.9%and 60.4%in 2016;the approval rate of labeling sodium(salt)content and low salt diet increased from 78.9%and 49.3%in 2011 to 86.9%and 70.7%in 2016;the usage rate of quantitative salt spoon,attention rate of sodium(salt)content and rate of active salt reduction measures increased from 14.2%,28.1%and 38.8%in 2011 to 56.6%,54.7%and 63.8%in 2016(P<0.05 or P<0.01).Conclusion On the basis of schools,the comprehensive salt reduced measure can increase the awareness level of salt and hypertension in youngsters,and improve the behavior of low salt diet.