健康指导员干预南充地区居民健康素养的效果分析

Analysis on the effect of health instructors'intervention in health literacy of residents in Nanchong Area

目的通过健康指导员对南充地区居民进行多元化健康素养干预并评价其干预效果,同时筛选重点干预人群,为推广提高居民健康素养水平的健康指导员干预模式提供参考依据。方法于2023年1月至2024年2月,采用分层随机抽样的方法,在南充市顺庆区、嘉陵区和高坪区共抽取6个社区和6个乡镇,每个社区和乡镇招募4~6名健康指导员,共招募60名并对其进行统一培训,培训合格后对其所在社区/乡镇的居民进行健康相关知识和技能的指导干预。每名健康指导员至少干预20名所在地的居民,干预前后分别纳入1147名居民并对其进行健康素养问卷调查。采用χ^(2)检验分析干预前后健康素养水平的差异,以P<0.05为差异有统计学意义。结果南充地区居民的总体健康素养水平在健康指导员干预前、干预后即刻及干预后第6个月随访分别为23.7%、29.8%和27.8%。南充地区居民总体健康素养水平和健康知识水平在健康指导员干预后即刻及干预后第6个月随访均高于干预前,且差异均有统计学意义(P均<0.05)。具有农村地区、女性、初中及以下学历、农民、家庭人均年收入低于6000元、合并慢病等人口学特征的南充地区居民干预后第6个月随访的健康素养水平均高于干预前,且差异均有统计学意义(P均<0.05)。结论健康指导员干预可有效提高南充地区居民总体健康素养水平,但短期干预对健康技能和行为影响较小;农民、女性、学历低、家庭人均年收入低和合并慢病的居民是实施干预的重点人群。

Objective Through health instructors to carry out diversified health literacy intervention for residents in Nanchong Area and evaluated the effect of intervention,and to screen key intervention groups,so as to provide reference for the promotion of health instructor intervention model to improve residents'health literacy level.Methods From January 2023 to February 2024,by using stratified random sampling method,six communities and six towns of Nanchong city were selected,four or six health instructors from each community and each town were recruited,a total of 60health instructors were recruited and trained.Health instructors who passed the exam of training they conducted the intervention and training of health related knowledge and skill and control for over 20 rural residents.1147 residents were selected as the study samples before and after the intervention.Questionnaire surveys were conducted before and after the intervention to evaluate the effect.The differences of health literacy levels before and after intervention were analyzed byχ^(2)test,P<0.05 was considered statistically significant.Results The health literacy level of residents in Nanchong Area was 23.7%before health instructors'intervention,29.8%of immediately after intervention,and 27.8%of 6 months after intervention.The overall health literacy level and health knowledge level of residents in Nanchong Area of follow-up immediately after the intervention and at the 6 months after intervention were higher than that of before intervention,and the differences were statistically significant(all P<0.05).The demographic characteristics of residents in Nanchong Area such as rural areas,females,junior high school education and below,peasants,income of less than 6000 yuan per capita annual,and with chronic diseases,their level of health literacy at6 months follow-up after intervention was higher than that before intervention,and the difference was considered statistically significant(all P<0.05).Conclusions The intervention of health instructors can effectively improve the overall heal th literacy level of residents,but short-term intervention had less impact on health skills and behaviors.Peasants,women,low education,low per capita annual income of the family and residents with chronic diseases were the key groups of the intervention.