干预依从性对流动工人呼吸防护用具使用效果影响评估

Evaluating the effect of intervention on the use of respiratory protective equipment among migrant workers

目的 探究干预依从性对职业性接触有机溶剂的流动工人呼吸防护用具(RPE)使用效果的影响。方法 采用三臂整群随机对照试验,选择广州市某区60家涉及有机溶剂作业的中小型企业901名流动工人为研究对象,按照企业数量随机分为3组。对照组人群不接受任何干预措施,干预组人群接受传统健康教育和移动健康(mHealth)干预,联合干预组人群在低干预组的基础上增加同伴教育。于干预第6个月观察3组人群过去1周是否始终佩戴RPE,以及2个干预组人群对干预措施的依从性。结果 联合干预组人群3个mHealth干预措施(关注项目微信公众号、加入项目微信/QQ群、阅读项目组推送信息)的依从率均高于干预组(74.8%vs 53.6%,70.7%vs 41.8%,78.5%vs 65.0%,P值均<0.01)。2个干预组人群中,参加传统健康教育(参加职业健康培训、浏览公益海报)的依从性均高于参加mHealth干预和(或)同伴教育(P值均<0.01)。Logistic回归分析结果显示,无论是mHealth干预措施、传统健康教育还是同伴教育,与对照组比较,2个干预组高依从亚组人群始终佩戴RPE的可能性更大(P值均<0.05),以联合干预组的干预效果优于干预组。结论 提高职业健康教育干预的依从性可促进流动工人对RPE的使用。实施同伴教育有利于提高流动工人的干预依从性和干预效果。

Objective To explore the effect of intervention adherence on the use of respiratory protective equipment(RPE) among migrant workers who occupationally exposed to organic solvents. Methods A total of 901 migrant workers from 60 small and medium-sized enterprises exposed to organic solvents in a district of Guangzhou City were selected as study subjects using three-arm cluster randomized controlled trial. The enterprises were divided into control group, intervention group, and combined intervention group. Migrant workers in the control group did not receive any intervention, while migrant workers in the intervention group received traditional health education and mobile health(mHealth) intervention, and migrant workers in the combined intervention group received interventions of the intervention group plus peer education. The use of RPE by the migrant workers was evaluated in these three groups in the last week, and at the sixth month. Results The adherence rates of the three mHealth intervention measures(following the WeChat official account of the project, joining the WeChat/QQ group of the project, and reading the provided messages from project team) in the combined intervention group were higher than that in the intervention group(74.8% vs 53.6%, 70.7% vs 41.8%, 78.5% vs 65.0%, all P<0.01). In the two intervention groups, the adherence rates of traditional health education(attending occupational health training, and browsing public welfare posters) were higher than that of mHealth intervention and/or peer education(all P<0.01). Logistic regression analysis showed that regardless of mHealth intervention, traditional health education or peer education, the high compliance subgroups of the two intervention groups were more likely to wear RPE all the time(all P<0.05) compared with the control group. The intervention effectiveness of the combined intervention group was better than that of the intervention group. Conclusion Improving compliance with occupational health education interventions can promote the use of RPE among migrant workers. The implementation of peer education is beneficial to improve intervention compliance and intervention effect of migrant workers.