信息-知识-信念-行为健康教育模式对中山市社区居民和小学生华支睾吸虫病防治效果

Effect of information⁃knowledge⁃attitude⁃practice theory⁃based health education on clonorchiasis control among community residents and primary school students in Zhongshan City

目的评价信息-知识-信念-行为(IKAP)健康教育模式对中山市社区居民和小学生华支睾吸虫病的防治效果,为针对不同人群制定华支睾吸虫病防控策略提供科学依据。方法2019—2021年,采用随机整群抽样方法抽取中山市火炬开发区两个社区居民和两所小学在校生作为调查人群,实施IKAP健康教育,比较干预前后小学生和居民华支睾吸虫病基本知识和信念知晓率、自评华支睾吸虫感染风险和饮食行为变化。结果调查的社区居民中,男性146、女性151人;小学生中,男性158、女性153人,社区居民和小学生性别构成差异无统计学意义(χ^(2)=0.16,P>0.05)。干预6个月后,小学生和社区居民掌握华支睾吸虫病基本知识平均知晓率分别提高44.71%和43.28%,干预前后小学生和社区居民各项华支睾吸虫病基本知识知晓率差异均有统计学意义(χ^(2)=41.53~284.44,P均<0.05);且小学生和社区居民认为具有非常高和高感染风险的人数比例分别从干预前的9.35%和6.71%升高至干预后的22.15%和37.75%,但仅社区居民信念态度干预前后差异有统计学意义(χ^(2)=92.18,P<0.05)。干预后,小学生和社区居民砧板、刀具生熟分开的行为比例均有所上升(χ^(2)=16.04~62.65,P均<0.05),小学生吃淡水鱼生(χ^(2)=32.85,P<0.05)、鱼片粥(χ^(2)=7.02,P<0.05)和鱼片涮火锅频率均下降(χ^(2)=4.88,P<0.05),而社区居民仅吃淡水鱼生行为比例较干预前显著下降(χ^(2)=11.77,P<0.05)。结论IKAP健康教育可有效提高中山市社区居民和小学生华支睾吸虫病防治知识知晓率、改善华支睾吸虫感染饮食行为。

Objective To evaluate the effect of information⁃knowledge⁃attitude⁃practice(IKAP)theory⁃based health education interventions on clonorchiasis control among community residents and primary school students in Torch High⁃tech Development Zone of Zhongshan City,so as to provide insights into formulation of clonorchiasis control strategies among different types of populations.Methods Residents were randomly sampled from two communities and students from two primary schools using a random cluster sampling method in Torch High⁃tech Development Zone,Zhongshan City from 2019 to 2021,and health education pertaining to clonorchiasis control was performed based on the IKAP theory.The changes in the awareness of basic clonorchiasis control knowledge and belief,self⁃reported risk of Clonorchis sinensis infections and dietary behaviors were compared among community residents and primary school students before and after health education interventions.Results The participants included 146 male and 151 female community residents and 158 male and 153 female primary school students,with no significant difference detected in gender distribution([χ^(2)]=0.16,P>0.05).The mean awareness of basic clonorchiasis control knowledge increased by 44.71%and 43.28%among primary school students and community residents 6 months following health education,and there were significant differences in the awareness of each item of basic clonorchiasis control knowledge before and after health education([χ^(2)]=41.53 to 284.44,all P values<0.05).The proportions of primary school students and community residents thinking very high and high risks of C.sinensis infections increased from 9.35%and 6.71%before health education to 22.15%and 37.75%after health education,but only the difference of the attitudes in community residents achieve statistical significance([χ^(2)]=92.18,P<0.05).The frequency of separation of raw and cooked foods with chopping board and knife significantly increased among community residents and primary school students following health education([χ^(2)]=16.04 to 62.65,all P values<0.05).The frequency of eating raw freshwater fish([χ^(2)]=32.85,P<0.05),fish congee([χ^(2)]=7.02,P<0.05)and fish fillet hot pot([χ^(2)]=4.88,P<0.05)significantly reduced among primary school students following health education,while only the frequency and proportions of eating raw freshwater fish have significantly reduced in community residents([χ^(2)]=11.77,P<0.05).Conclusions Health education interventions based on the IKAP theory are effective to increase the awareness of clonorchiasis control knowledge and improve dietary behaviors associated with C.sinensis infections among community residents and primary school students in Zhongshan City.