基于双重差分模型的健康促进银牌学校创建效果评价

Effect evaluation of the construction of silver⁃medal health promoting schools based on the difference⁃in⁃differences model

目的评估宁波市健康促进银牌学校创建效果,为持续巩固健康促进银牌学校创建工作提供依据。方法以宁波市66所健康促进银牌学校和66所非健康促进学校为调查对象,采用“健康促进学校基本情况调查表”,应用双重差分模型(difference⁃in⁃differences,DID),从健康服务提供、师生健康状况、健康相关课程设置3个维度进行效果比较。结果创建组和非创建组分别纳入小学、初中、高中、九年一贯制、全日制六年中学各38所、18所、2所、7所和1所。双重差分模型显示,实施银牌学校创建和不创建的措施后,创建组与非创建组相比,学校心理辅导室每周开放时间净效应(DID=4.469小时,t=1.993,P=0.047)、体质健康良好人数占比净效应(DID=9.581%,t=2.086,P=0.038)均有所上升。学生肥胖率净效应、(DID=3.704%,t=-2.743,P=0.007)、贫血率净效应(DID=6.843%,t=-7.211,P<0.05)均有所下降。教职工高血压患病率(DID=3.632%,t=-2.135,P=0.034),甘油三酯异常率(DID=5.24%,t=-2.405,P=0.017)均有所下降。其他指标,包括医务室/保健室面积、专职卫技人员配备人数、专职保健教师配备人数、学生视力不良率净效应无统计学意义(P>0.05)。结论宁波市健康促进银牌学校创建工作对学校师生健康的提升有较好的促进作用。运用DID模型,科学评估了健康促进银牌学校创建工作的真实效果。

Objective To evaluate the effect of the construction of silver⁃medal health promoting schools in Ningbo City,and to provide basis for the continuous enhancement of the construction of such schools.Methods Sixty⁃six silver⁃medal health promoting schools and 66 non⁃health promoting schools in Ningbo City were selected as the subjects of the survey.The basic situation of health promoting schools was investigated with a questionnaire using the difference⁃in⁃differences model(DID),and the effects were compared from three dimensions:health service provision,health status of teachers and students,and health⁃related curriculum settings.Results Thirtyeight primary schools,18 middle schools,2 high schools,7 nine⁃year continuous⁃education school and 1 full⁃time six⁃year secondary school were included in the construction group and non⁃construction group respectively.The difference⁃in⁃differences model showed that in comparison with the non⁃construction group,after the construction of silver⁃medal schools,the construction group had increased net effects of the weekly opening time of the school psy⁃chological counselling room(DID=4.469 hours,t=1.993,P=0.047)and the proportion of people with good physical health(DID=9.581%,t=2.086,P=0.038),decreased net effects of obesity rate(DID=3.704%,t=-2.743,P=0.007)and anemia rate(DID=6.843%,t=-7.211,P<0.05)of students,and decreased prevalence rate of hypertension(DID=3.632%,t=-2.135,P=0.034)and abnormal rate of high triglyceride(DID=5.24%,t=-2.405,P=0.017)of teaching staff.Other indicators,including the net effects of the area of infirmary/health care room,the number of full⁃time health technical personnel,the number of full⁃time health care teachers,and the rate of poor eyesight of students,were not statistically significant(P>0.05).Conclusions The construction of silver⁃medal health promoting schools in Ningbo City has a good promotion effect on the health of teachers and students.The DID model is used to scientifically evaluate the real effect of the construction of such schools.