珠海市居民公共卫生应急素养结构方程模型分析

Public health emergency literacy among adult residents of Zhuhai city:a cross-sectional survey and structural equation modeling analysis

目的通过对广东省珠海市居民卫生应急素养的结构方程模型构建,探讨公共卫生应急知识、态度、行为的作用机制和相互关系。方法于2022年4月—2023年4月对2021名珠海市辖区内16~99岁常住居民进行公共卫生应急素养调查,采用AMOS 26.0建立居民卫生应急素养结构方程模型,分析各应急素养维度之间相互影响。结果回收有效问卷2013份,珠海市居民公共卫生应急素养水平为57.53%,其中卫生应急知识、态度、行为应急素养水平分别为34.08%、69.35%、60.76%。知识应急素养对态度、行为应急素养具有正向的促进作用效应(β_(知识→态度)=0.58,β知识→行为=0.46,P<0.001),态度应急素养对行为应急素养的作用效应(β_(态度→行为)=0.47)大于知识应急素养对行为应急素养的作用(β_(知识→行为)=0.46,P<0.001)。结论珠海市居民公共卫生应急素养整体水平较高,卫生应急态度对卫生应急行为的影响作用效应强于知识。亟需建立珠海市全民常态化应急意识体系,发挥卫生应急态度在卫生应急知识到行为的中介作用,促进卫生应急知识到行为的正向转化。

Objective To explore the status and interrelations of knowledge,attitude,and behavior about public health emergency among adult residents in Zhuhai city,Guangdong province using structural equation modeling analysis.Methods A face-to-face interview and a complementary online survey were conducted among 2201 permanent residents aged 16-99 years recruited through cluster sampling from businesses,institutions,factories,and communities in Zhuhai city from April 2022 to April 2023.Participants′public health emergency literacy information was collected using a selfdesigned questionnaire based on 12 items of the Citizen Public Health Emergency Literacy Entry developed by the China Population Communication Center of the National Health Commission.Using AMOS 26.0,a structural equation model of residents′public health emergency literacy was constructed to analyze the mutual influences among different dimensions of public health emergency literacy.Results Among 2013 participants with valid information,the proportion with public health emergency literacy(total score≥36 on a full scale of 45)was 57.53%,and the proportion with public health emergency knowledge,attitude,and behavior literacy was 34.08%,69.35%,and 60.76%,respectively.Knowledge literacy had a positive effect on both attitude and behavior literacy(β_(knowledge→attitude)=0.58,β_(knowledge→behavior)=0.46,P<0.001),and the effect of attitude literacy on behavior literacy(β_(attitude→behavior)=0.47)was greater than that of knowledge literacy(βknowledge→behavior=0.46,P<0.001).Conclusion The overall level of public health emergency literacy among adult residents of Zhuhai city is relatively high,with public health emergency attitudes having a stronger influence on emergency behaviors than knowledge.It is urgent to establish a system of normalized public health emergency education for all citizens in Zhuhai city to utilize the mediating mechanism of public health emergency attitudes in positively transforming public health emergency knowledge into behaviors.