上海市浦东新区1~3年级小学生伤害健康教育干预效果评价

Evaluation of Intervention Based on Health Education for Injury among Primary School Students:Grades One to Three in Pudong,Shanghai

目的评价上海市浦东新区1~3年级小学生伤害健康教育的干预效果,为制定小学生伤害干预方法提供依据。方法采用分层整群抽样方法,按照地理区域划分,在浦东新区城区和郊区分别抽取2所小学1~3年级学生并随机分到干预组和对照组。给干预组1~3年级学生开展预防伤害的安全教育和防范措施,采用χ^(2)检验分析伤害发生率和类型的变化,采用t检验和双重差分法(differences-in-differences,DID)模型分析1~3年级小学生及其监护人伤害知、信、行(knowledge,attitude,practice,KAP)得分变化情况。结果经伤害健康教育干预后,干预组1~3年级小学生的伤害发生率降为16.50%,低于干预前的24.68%,差异具有统计学意义(χ^(2)=18.832,P<0.05),且干预组1~3年级小学生伤害发生率低于对照组的24.86%,差异具有统计学意义(χ^(2)=18.984,P<0.05);双重差分效应值为-0.062,且呈现出显著性(P<0.05)。干预前后1~3年级小学生第一、二位伤害类型均为跌倒/坠落伤和碰撞/挤压伤,第一、二位伤害发生部位均为手指/脚趾和下肢。干预前伤害地点主要在学校(27.89%)和家中(37.77%),干预后以校外其他公共场所(43.62%)为主。干预后干预组1~3年级小学生和监护人KAP评分分别是42.52±4.68和23.33±1.74,高于干预前的40.83±3.25和22.08±2.10(t=9.051,P<0.05;t=13.989,P<0.05),且高于对照组(t=5.749,P<0.05;t=13.840,P<0.05);监护人和1~3年级小学生双重差分效应值分别为1.091和0.781,且具有统计学意义(P<0.05)。结论以预防伤害的健康教育为主的综合干预措施能够明显降低小学生伤害的发生率,成效明显。强化学校、家庭对小学生伤害安全的教育及防范措施,是预防小学生伤害发生的有效途径。

Objective This study was aimed at evaluating effectiveness of intervention based on health education in protecting primary school students from grades one to tree in Pudong New Area of Shanghai and at providing basis for developing intervention measures.Methods Grades one to three students from two urban primary schools and from two suburban schools were recruited using a stratified cluster sampling method.These students were then randomly divided into a intervention group and a control group.The students and their guardians in the intervention group were provided with a series of safety educations and injury prevention measures within 2 years.乂test was used to analyze the incidence rates and types of injuries.T test and DID model were used to analyze the changes of KAP scores of these students and their guardians before and after the mtervention.Results After the intervention based on health education,the incidence rate of injuries for the intervention group was reduced to 16.50%,which was lower than the 24.68%before the intervention and the 24.86%of the control group.The difference between the two groups was statistically significant(X^(2)=218.832,P<0.05;X^(2)=218.984,P<0.05).The difference effect value was-0.062,which was significant(P<0.05).In addition,the most common accident for them was injuries from falling down,and injuries from collision were ranked second.Among vulnerable body parts,fingers were ranked first and legs were ranked second.The locations for accidents causing injuries were in schools with 27.89%and at home with 37.77%.However,after the intervention,accidents occurred outside schools with 43.62%.Further more,the KAP scores for the intervention group were 42.52±4.68 and 23.33±1.74,which were respectively higher than before with 40.83±3.25 and 22.08±2.10 and the control group(t=9.051,P<0.05;t=13.989;t=5.749,P<0.05;t=13.840,P<0.05).The difference effect values of guardians and students were 1.091 and 0.781,which were significant(P<0.05).Conclusions Comprehensive intervention measures based on health education about injury significantly reduced the incidence of injuries among primary school students,and strengthened the education and prevention measures of safety in schools and families,which is an effective way to prevent primary school students from injuries.