基于健康教育机构水平拟合模型研究健康素养影响因素

Two-level statistical model study on factors that influencing residents’health literacy based on health education institutions’capacity

目的在2017年山东省健康教育机构人力资源数据结构层次上分析居民健康素养的影响因素,为促进健康教育机构科学发展及提高居民的健康素养水平提供依据。方法以健康素养调查对象的人口学特征为水平1,调查点健康教育机构人员特征为水平2,用MLwiN软件建立两水平统计模型的方差成分模型分析居民健康素养影响因素。结果2017年山东省抽取20个调查点的4801人进行健康素养调查,调查点的20个健康教育机构工作人员平均年龄为(39.59±8.11)岁,从事健康教育工作平均时间为(5.70±5.50)年,居民健康素养具备率为15.77%。分析显示,调查对象越年轻、文化程度越高、收入水平越高的,健康素养水平越高(P<0.01),且数据在健康教育机构水平上具有聚集性(P<0.01)。拟合两水平Logistic回归模型结果显示,健康教育机构工作人员年龄较高(OR=6.56)、专业为医学类(OR=2.09)时,当地居民健康素养具备率较高(P<0.01)。结论山东省健康教育机构与健康素养水平存在关联。健康教育机构工作人员如具备较强的医学专业能力或丰富的实践经验,可对提高辖区健康素养水平具有促进作用。

Objective To analyze the influencing factors of residents’health literacy using the human resources data of health education institutions in Shandong Province in 2017,and provide basis for promoting the scientific development of health education institutions and improving the health literacy level.Methods By taking the characteristics of the subject for health literacy investigation as level 1 and the human resources situation of local health education institutions in study counties as level 2,a variance component model of two-level statistical model was established by MLwiN software to analyze the influencing factors of residents’health literacy.Results 4801 residents from 20 counties(cities or districts)in Shandong Province were investigated on their health literacy in 2017,of where the institutions personnel’s average age is(39.59±8.11)years-old and the average working hours for health education is(5.70±5.50)years.The residents’health literacy rate is 15.77%.The analysis shows that the younger of the object,the higher of the education and income level,the level of health literacy is higher(P<0.01),and the data were aggregated at the level of health education institutions(P<0.01).The results of fitting two-level Logistic regression models showed that the older of the professional of health education institutions(OR=6.56)and majoring in medicine(OR=2.09),the local residents would have higher health literacy rates(P<0.01).Conclusion There is a correlation between health education institutions and health literacy level in Shandong Province.If the staff of health education institutions have strong medical professional ability or rich practical experience,it can promote the improvement of residents’health literacy level.