Children＇s Problem Behaviors During Free Time as an Incentive for the Increase in Social Risks and Health Risks

Since children, as a rule, have more free time than adults, it is adults＇ responsibility to provide children with a chance to spend the time of relaxation, play, and fun in a beneficial way. Unfortunately, children＇s spare time is nowadays very frequently organized for the sake of brushing up children＇s knowledge, skills, and competences, which is accomplished by means of escalating extra-curriculum activities. When expressed by teacher and parents, these ambition-related attitudes pave the way for the disappearance of children＇s personal interests and motivations to perform complicated tasks which are perceived as unwanted or obscure by the affected children themselves. This form of adults＇ behavior may lead to the feelings of frustration, stress, demotivation, or rebellion on behalf of their children. The said emotional states, especially in relation to the lack of spontaneous play, give rise to serious psychic dysfunctions, and the instability of children＇s psychic balance. It may also pave the way for various forms of destructive behavior that mostly characterize children of younger school age who are about to start schooling.

Health behaviors of Korean adults with hepatitis B:Findings of the 2016 Korean National Health and Nutrition Examination Survey

AIM To assess the frequencies of five health-related behaviors(smoking, alcohol consumption, body weight, sleep dura-tion, and physical activity) in Korean adults with chronic hepatitis B.METHODS Data were obtained from the 2016 Korean National Health and Nutrition Examination Survey. In total, 5887 subjects(2568 males, 3319 females) over 19 years old were enrolled in this study. Interviews were performed to obtain information on demographic characteristics and medical conditions. A self-administered questionnaire and medical examination were used to assess the smoking history, alcohol use, physical activity, sleep duration, and body weight of the subjects. Chronic hepatitis B was diagnosed based on detection of hepatitis B surface antigen(HBs Ag). The subjects were categorized into HBs Ag positive and negative groups, and a complex sampling analysis was conducted to compare the health behaviors between these groups.RESULTS Among males, the current smoking rate in the HBs Ag positive group was higher than that in the negative group(45.5% vs 38.5%). In the positive group, the rates of monthly and high-risk alcohol use were 70.4% and 17.6% in males and 45.9% and 3.8% in females, respectively. The rate of alcohol use was similar between the two groups [P = 0.455(males) and P = 0.476(females)]. In the HBs Ag positive group, 32.3% and 49.9% of males and 26.5% and 49.6% of females were overweight and physically inactive, respectively. High-risk alcohol consumption and physical inactivity were significantly associated with self-perceived health status.CONCLUSION Our data demonstrate that a large proportion of Korean adults with chronic hepatitis B have poor health behaviors. Further studies are needed to confirm our results.

Preventing Behavioral-Risks Incidence among School Children: The Role of School-Based Health Promotion Program

This article addresses the important role school health education program can play in reducing youth risky behaviors that lead to incarceration, diseases and fatalities or that impact their academic performance in school. Children growing up are at risks of exposure to different behaviors and common social influences which if unchecked result in unexpected health consequences common among youth in America today. According to US Centers for Disease Control & Prevention, the six leading behaviors that cause death, disability, and social problems among American children are: unintentional injuries and violence, alcohol and drug use, tobacco use, unhealthy diets, inadequate physical activities, and sexual behaviors and diseases. This article shows that school health program: 1) can provide the foundation for children to learn desired healthy behaviors in order to preserve life, 2) protects the future of children and that of the nation, 3) can teach students skills to recognize risky behaviors and resist them, 4) can boost community efforts to achieve desired health behaviors, 5) closes socio-economic gaps that interfere with basic nurturing of children, and 6) finally links local stakeholders as partners in promoting community safety. Through review of literature, the authors found that it costs ($588) daily or (214,620) annually to incarcerate a juvenile and only $75 daily for the cost of individualized community-based services. The cost to New York is over $900,000, yet does not address the causative issues. The authors recommend that schools teach comprehensive school health from kindergarten to grade 12 and employ health educators to support teachers teach health promotion and education.

Clustering of Multiple Risk Behaviors among Ethnically Diverse Adolescents Living in Hawaii

The current study examined the prevalence and clustering of 5 health-risk behaviors among adolescents in Hawaii, including physical inactivity, low fruit and vegetable consumption, junk food consumption, excessive television time, and inadequate sleep. High school students were recruited from 5 classrooms in Oahu Hawaii. Data were collected in the spring semester of 2011. Proportions were used to describe the prevalence of single and multiple health risk behaviors. Significant health behavior clusters were revealed using an observed-to-expected (O/E) ratio method. Participating adolescents (n = 114) were 11th and 12th grade students with a mean age of 16.28 (SD = 0.62). Participants were predominantly female (75%) and Filipino-American (68%). Seventy-seven percent of adolescents were physically inactive, 90% watched excessive TV, 66% consumed inadequate fruits and vegetables, 94% reported inadequate levels of sleep, and 80% consumed excessive junk food. Overall, 94% reported at least 3 risk factors, 73% reported at least 4 risk factors, and 37% reported all 5 risk factors. No significant clusters were found. Conclusion: Health-risk behaviors cluster and occur more often than expected among adolescents living in Hawaii. Non-significant clustering may be due to insufficient variability within the sample data;future examinations of this highly understudied population are necessary.

Perception and prevalence of behavioral risk factors: the lifestyle risk scale (LRS)

Objective: To develop a lifestyle risk scale (LRS) of health-related behaviors based on risk assessments of study participants. Method: By means of pairwise comparisons of assessed risks associated with tobacco, alcohol, obesity, fast-food, physical inactivity, and lack of sleep, each at four levels, 24 behaviors were ranked on a unidimensional risk scale. Results: Overall, use of tobacco was assigned the highest risk score (3.7), consumption of fast-food and lack of sleep the lowest (1.7, 1.6). Minor risk factors (lack of sleep and fast-food) were, at their highest levels, assigned similar risk values as major risk factors (tobacco, alcohol, obesity) at their lowest levels. Lifestyles of female participants were less hazardous than those of male participants, as measured with the LRS. In contrast, perception of behavioral health risks was more precise in men. Conclusions: The LRS provides a practical quantification to identify and compare groups with different risk behavior patterns as well as clusters of risky health behaviors in and across populations. It can also support the communication of behavioral health risks.

Health behavior after intrahepatic cholestasis of pregnancy

Background: Pregnancy is an opportunity to adopt favorable health behaviors. We studied whether intrahepatic cholestasis of pregnancy (ICP) promotes favorable health behavior in later life. Design: A prospective controlled cohort study. The method was a questionnaire survey in 2010 among 575 women with ICP and 1374 controls, all having delivered between the years 1969 and 1988 in Tampere University Hospital in Finland. Questionnaires were sent to 544 ICP patients and 1235 controls. Responses were received from 1178 (response rate 66.2%). The main outcome measures concerning recent or current health behavior were smoking, alcohol consumption, physical activity, body mass index (BMI) and special diet. Results: Current smoking was less common in the ICP group than among controls (10.5% vs 15.7%, p = 0.017). Assessed by smoking pack years there was a similar difference: in the ICP group 11.7% of women had at least 10 smoking pack years compared to 18.0% of the controls (p = 0.006). Recent alcohol consumption did not separate the two groups. The groups did not differ as to reported physical activity assessed in MET units. Fewer ICP women had had BMIs of 30 or more during pregnancy compared with controls (18.8% vs 25.1%, p = 0.023). In other points of life the BMI differences were not statistically significant. Weight-loss diet and gallbladder diet were more common in the ICP group (6.3% vs 3.6%, p = 0.044, and 3.0% vs 1.3%, p = 0.038). Conclusions: Having developed ICP two to four decades earlier seemed to constitute an effective intervention for smoking habits but not for other aspects of health behavior.

Promoting Health Behavior Change in Canada: A Quality Improvement Project Integrating Prevention and Wellness in Frontline Care

Background: The critical need for Health Behaviour Change (HBC) for preventative care has been highlighted by the COVID-19 pandemic. This quality improvement project assessed the effectiveness and acceptability of Fountain of Health HBC tools as a minimal intervention for primary and secondary prevention among Canadian clinicians and their patients. Methods: Clinicians received HBC education and tools (paper tools and app-based) to assist their patients in setting a S.M.A.R.T (Specific, Measurable, Action-oriented, Realistic, Time-limited) goal at baseline and assessed four weeks later. Primary outcome measures were: 1) patient self-report of success at goal attainment;2) patient self-reported evaluation of change in well-being and health attitudes;and 3) clinician experience and engagement. Results: A total of 2184 clinicians received HBC education. Of these, 759 clinicians registered to participate in the project. 961 patients set S.M.A.R.T. HBC goals using either the paper tools (PT) or the app format. Patient data revealed nearly all patients (89% of PT users and 90% of app users) at least partially succeeded in attaining their goal at a four-week follow-up. Most patients (85% of PT and 80% of app users) also reported improvement in their well-being. A significant difference in health beliefs and attitudes was found in both PT (p < 0.001) and app users (p = 0.003). Conclusions: HBC is challenging. Educating and providing clinicians with HBC tools as a minimal intervention was found to be a successful health prevention strategy to improve patient well-being and health attitudes, and achieve S.M.A.R.T. goals. Results show HBC tools, education, and support for clinicians are both acceptable and effective for HBC in frontline care. These findings are relevant and timely given greater reliance on virtual care in the wake of the COVID-19 pandemic. Further research with rigorous methodology is needed to implement programs to achieve sustainable HBC to promote health on a large scale.

Integrated Behavioral Healthcare in Thailand:A Case Study from Chiang Mai

Purpose:This study aims to examine the level of behavioral health integration in primary care clinics among patients with hypertension and type 2 diabetes in Chiang Mai,Thailand.It also aims to explore the provider perceived prevalence of behavioral problems and need for an expert behavioral health consultant on the primary care team and the risk and protective factors of the patients’psychological and cardio-metabolic health outcomes.Methodology:Using survey data between 2017 and 2018 regarding the level of integration as measured by a Practice Integration Profile,provider ratings of prevalence and need based on a Provider Survey,and patient lifestyle and behavioral problems with a Health Risk Assessment in six primary health care settings in Chiang Mai,Thailand(n=335).We conducted ordinary least squares regressions to explore the relationship between each of the patient psychological and cardio-metabolic health outcomes and physical,mental health and substance abuse variables while controlling for the demographics.Results:The results showed overall high levels of integration,but significant variability across clinics.Providers rated prevalence of health risk and need for a Behavioral Health Consultant as moderate.Results of the patient health risk assessment were variable,with some problems high severity,others low.Conclusion:The results reflect a need for integrated behavioral health into the health care system in Thailand especially for those who are in the chronic illness condition.Recommendations for future study include an evaluation of the translation quality and validity and reliability of the study measures under the Thai context.This study fills the research gap of lacking research on the level of integrated care in clinics in Thailand.

Impact of Risk Perception about COVID-19 on the Coping Behavior of the Elderly:Mediating Role of Self-Efficacy

Objective:This study aimed to explore the mediating role of self-efficacy on the relationship between risk perception and the coping behavior of the elderly during the coronavirus disease 2019(COVID-19)pandemic.Methods:The study employed the convenience sampling method to select a total of 550 elderly from Chongqing,Chengdu and Luohe in China.A questionnaire composed of the perception scale,self-efficacy scale,and coping behavior scale was used to collect data.Results:Risk perception exerted a significantly direct effect on positive coping behavior and avoidant coping behavior.Moreover,it positively predicted the components of self-efficacy.In turn,self-efficacy positively predicted the components of positive coping behavior,which confirm that it plays a partial mediating role in the relationship between risk perception and positive coping behavior.Moreover,self-efficacy negatively predicted the components of avoidant coping behavior,which confirms that it also plays a partial mediating role in the relationship between risk perception and avoidant coping behavior.Conclusion:A simple mediation model revealed that self-efficacy partially mediated the direct and indirect effects of risk perception on coping behavior.Based on the results,the study recommended several countermeasures and suggestions for enhancing the positive coping behavior of the elderly during the COVID-19 pandemic.

上海市闵行区11~18岁学生健康危险行为的潜在剖面分析

目的探索上海市闵行区11~18岁学生健康危险行为的潜在类别,明确不同类别学生健康危险行为的影响因素。方法采用分层整群抽样方法选取上海市闵行区1690名中学生作为研究对象,运用“上海市青少年健康危险行为监测问卷”收集数据,评估参与者在6类健康危险行为上的得分。通过潜在剖面分析(latent profile analysis,LPA)方法对学生的健康危险行为进行聚类,运用多因素Logistic回归模型分析相关影响因素。结果上海市闵行区11~18岁学生健康危险行为可分为3个类别:第一类别组915人(54.14%),健康危险行为得分均处于中低水平,命名为“以各类行为中低危为突出表现的不健康行为组”;第二类别组539人(31.89%),精神成瘾得分较高,命名为“以精神成瘾为突出表现的不健康行为组”;第三类别组236人(13.97%),在物质成瘾行为上得分较高,命名为“以物质成瘾为突出表现的不健康行为组”。单因素分析结果显示,不同学校、年龄、民族、寄宿情况的学生健康危险行为3个潜在类别差异均有统计学意义(P<0.05)。多因素Logistic回归分析结果显示,普高学生和职高学生相比于初中生,表现出以精神成瘾和物质成瘾为特征的不健康行为的风险更高,差异均有统计学意义(P<0.05)。结论上海市闵行区11~18岁学生健康危险行为存在3个潜在类别,且不同背景的学生在这些类别上的分布存在显著差异。建议针对具有不同学校属性和处于不同学习阶段的学生实施定制化的健康教育及干预措施。

泡泡水玩具儿童玩耍行为特征分析及防腐剂暴露健康风险评估

为评估泡泡水玩具中防腐剂对中国儿童健康的风险,本文对儿童玩耍泡泡水玩具的行为特征进行问卷调研,并对80款市售泡泡水玩具中防腐剂的含量进行测定.基于调研和检测结果,对泡泡水玩具的甲醛暴露进行风险评估.结果表明,甲醛和异噻唑啉酮这两类有害防腐剂均在部分泡泡水玩具中有检出,苯酚未检出,甲醛的检出率为60%,不合格率56%,质量比范围为8—444 mg·kg^(−1),异噻唑啉酮类防腐剂的检出率和不合格率均为5%,其中1,2-苄基异噻唑啉-3-酮(BIT)最高达到122 mg·kg^(−1),2-甲基-4-异噻唑啉-3-酮(MIT)含量最高为3.5 mg·kg^(−1),CMIT:MIT(3:1)混合物含量最高为14 mg·kg^(−1).非致癌风险评价结果显示,低龄儿童的健康风险稍高于大龄儿童.正常使用时,1—6岁儿童的风险指数(H)范围为0.011—0.354,6—14岁儿童风险指数(H)范围为0.008—0.260,风险指数均小于1;当长时间(60 min·次^(−1))高频率(0.43次·d^(−1))使用泡泡水时,风险明显增大,1—6岁儿童的风险指数范围为0.067—2.171,6—14岁儿童的风险指数范围为0.052—1.674,风险指数范围最大值均大于1.泡泡水玩具中的甲醛非致癌风险在正常使用时对儿童健康为可容许风险,但长时间高频率使用时,风险明显升高.

职业院校学生性与生殖健康知识和不安全性行为风险的关系

目的探讨职业院校学生性与生殖健康知识和不安全性行为风险的关系。方法2023年9月至10月采用整体随机抽样法对扎兰屯职业学院2023年新入学的1601名学生进行问卷调查,调查工具为性与生殖健康知识问卷和不安全性行为风险评估量表。采用潜变量剖面分析,将样本分成特征不同的类别,采用多因素线性回归分析不同类别与性风险评分的关系。结果性与生殖健康知识主要分为3类,Q1组以高艾滋病和低性病知识为主,Q2组以高避孕和低性病知识为主,Q3组以高性病知识为主。三组女生占比均高于男生(P<0.05);与Q1组比较,Q2和Q3组医学系、高职、城市户口、父母文化程度较高及父母婚姻关系较不和睦的青少年占比较高(P<0.05);Q1组不安全性行为风险评分高于Q2组和Q3组(P<0.05);Q1组性与生殖健康知识评分低于Q2和Q3组(P<0.05);三组婚前性行为态度评分比较,差异具有统计学意义(P<0.05)。随着生殖健康知识水平的增加,模型1、模型2、模型3不安全性行为风险均降低(P<0.05)。结论性与生殖健康知识分类对降低学生不安全性行为风险具有重要价值,设计性健康教育和干预方案时,需要充分考虑不同性知识分类的差异性。

东莞市滨海湾新区梅毒感染者梅毒防治知识知晓情况调查

目的调查东莞市滨海湾新区梅毒感染者梅毒防治知识的知晓率,并分析其健康教育的需求。方法选取东莞市滨海湾中心医院2022年6月—2023年6月接诊的1000例梅毒感染者作为研究对象。通过问卷调查的方式对研究对象的梅毒防治知识知晓情况展开调查,观察不同高危人群、不同年龄层、不同性别与不同文化程度群体对梅毒防治知识知晓情况,并分析研究对象的健康教育需求。结果1000例梅毒高危患者中,男男性行为者对梅毒防治知识知晓率最高(83.87%),在校大学生群体对梅毒防治知识知晓率最低(29.92%)。在年龄上,>30~40岁患者对梅毒防治知识知晓率最高(80.41%),16~20岁患者对梅毒防治知识知晓率最低(4.76%)。在性别上,男性患者与女性患者梅毒防治知识知晓率分别为56.08%与58.80%。在文化程度上,高中及中专文化水平患者梅毒防治知识知晓率最高(76.35%),小学文化程度患者梅毒防治知识知晓率最低(34.91%)。在梅毒高危行为意向上,以性行为中从不使用安全套问题最突出。结论东莞市滨海湾新区梅毒感染者的疾病防治知识知晓率仍然处于相对较低的水平,有待采取更具有针对性的健康教育方案对当地梅毒感染者的梅毒防治知识知晓水平加以改善。

Association between Cardiovascular Disease Risk Factor Knowledge and Lifestyle

Objective: To relate cardiovascular risk factor knowledge to lifestyle. Methods: In this cross-sectional study, food consumption and lifestyle characteristics were recorded using mailed questionnaires. The dietary pattern was described using the Mediterranean Diet Score (MDS). An open ended questionnaire without predefined choices or answers was used to capture cardiovascular knowledge. Results: Lack of physical activity, smoking and eating too much fat were the 3 most cited potential cardiovascular risk factors, while being overweight, eating too much salt and a low consumption of fruits and vegetables were the least cited risk factors. Age, Body Mass Index, physical activity, smoking, income and dietary habits were not consistently associated with knowledge of risk factors. A low socioeconomic position as measured by the indicator education was associated with a lower knowledge of established and modifiable cardiovascular risk factors. Conclusions: Risk factor knowledge, an essential step in prevention of CVD, is not systematically associated with a healthier lifestyle. The findings of this study confirm that there is a gap between risk factor knowledge and lifestyle.

Incorporating HPS Model into Lebanese Public Schools: Comparison of Adolescents’ Smoking, Alcohol and Drug Use Behavior in HPS versus Other Public and Private Schools in Lebanon

In 2010, the World Health Organization supported the Lebanese Ministry of Education and Higher Education to establish a network of 10 Health Promoting Schools (HPS). This study was undertaken to address the extent to which the HPS model was able to produce changes in the risk behaviors of adolescents (Smoking, Drinking, and Drug Use) and prepare them to respond to evolving health challenges. A cross-sectional survey was carried out during 2011-2012 and compared Grade 6 - 9 students in HPS, and 10 other public and private schools. The Youth Risk Behavior Survey [1], and Carbon Monoxide measurements in adolescent breaths were used for data collection. Findings revealed that the current School Health Program failed to address issues of concern to adolescents with no significant differences in risk behaviors: smoking, alcohol and drug use. The HPS network needs reassessment to upgrade the outcomes of health education curricula. Expected learning outcomes and healthy practices must be designed to match students’ age, grade level, and developmental milestones.

Managing cardiovascular disease risk in South Asian kidney transplant recipients

South Asians(SA)are at higher cardiovascular risk than other ethnic groups,and SA kidney transplant recipients(SA KTR)are no exception.SA KTR experience increased major adverse cardiovascular events both early and late posttransplantation.Cardiovascular risk management should therefore begin well before transplantation.SA candidates may require aggressive screening for pretransplant cardiovascular disease(CVD)due to their ethnicity and comorbidities.Recording SA ethnicity during the pre-transplant evaluation may enable programs to better assess cardiovascular risk,thus allowing for earlier targeted periand post-transplant intervention to improve cardiovascular outcomes.Diabetes remains the most prominent post-transplant cardiovascular risk factor in SA KTR.Diabetes also clusters with other metabolic syndrome components including lower high-density lipoprotein cholesterol,higher triglycerides,hypertension,and central obesity in this population.Dyslipidemia,metabolic syndrome,and obesity are all significant CVD risk factors in SA KTR,and contribute to increased insulin resistance.Novel biomarkers such as adiponectin,apolipoprotein B,and lipoprotein(a)may be especially important to study in SA KTR.Focused interventions to improve health behaviors involving diet and exercise may especially benefit SA KTR.However,there are few interventional clinical trials specific to the SA population,and none are specific to SA KTR.In all cases,understanding the nuances of managing SA KTR as a distinct post-transplant group,while still screening for and managing each CVD risk factor individually in all patients may help improve the long-term success of all kidney transplant programs catering to multi-ethnic populations.

复发风险感知对首发缺血性脑卒中患者健康行为的影响

目的 探讨首发缺血性脑卒中患者复发风险感知对其健康行为的影响,为促进脑卒中患者健康管理提供依据。方法 于2022-03—2023-05采用一般资料调查表、缺血性脑卒中患者复发风险感知量表、脑卒中患者健康行为量表对238例首发缺血性脑卒中患者进行问卷调查。结果 238例首发缺血性脑卒中患者复发风险感知量表得分(91.58±15.23)分,健康行为量表得分(68.27±14.05)分。分层回归分析显示,复发风险感知是首发缺血性脑卒中患者健康行为的重要预测因子,可独立解释健康行为16.5%的变异。结论 复发风险感知是首发缺血性脑卒中患者健康行为的重要影响因素,提高脑卒中患者复发风险感知水平有助于促进患者健康行为。

基于福格行为模型的社区主要不良心脏事件高危者的健康干预

目的探讨基于福格行为模型的健康干预对社区主要不良心脏事件高危者生活方式、用药依从性及院前延迟行为意向的影响。方法将不良心脏事件高危者按照社区分为对照组和干预组各66人。对照组采用常规健康管理,干预组在对照组的基础上依据福格行为模型从动机、能力和提示3个关键要素进行健康干预6个月并随访3个月。在干预前、干预后和随访后对两组健康促进生活方式、院前延迟行为意向、用药依从性进行评价。结果对照组60人、干预组57人完成干预及随访。干预及随访后,干预组健康促进生活方式、用药依从性评分显著高于对照组,院前延迟行为意向评分显著低于对照组(均P<0.05)。结论基于福格行为模型的健康干预有利于提高社区不良心脏事件高危者的健康促进生活方式和用药依从性,降低院前延迟行为意向。

新冠疫情下的儿童青少年健康危险行为:基于家庭风险的视角

新冠疫情期间儿童青少年健康危险行为激增,但随着生活逐渐恢复,其影响仍在持续。新冠疫情期间儿童青少年健康危险行为的变化主要体现在屏幕使用时间过长、身体活动骤减、久坐时间增加、饮食单一、饮食不规律、晚睡更晚起等方面,本文构建疫情背景下儿童青少年健康危险行为的家庭风险框架以解释健康危险行为变化的内在机制,这一框架结合生命史理论可为儿童青少年后疫情时代健康危险行为的持续提供解释。未来研究需长期追踪儿童青少年健康危险行为的发展轨迹,并加强家庭风险、生命史理论与儿童青少年健康风险行为关系的实证研究,为类似重大突发性事件、自然灾害等提供处理儿童青少年健康问题的普遍解决思路。

健康生活方式指导员健康科普分享意愿影响因素研究

目的 探索健康生活方式指导员通过在线平台分享健康科普意愿的影响因素,为更好地发挥指导员的健康传播与促进作用提供依据。方法 基于计划行为理论(Theory of Planned Behavior,TPB)和益处与风险评价理论(Theory of Benefit and Risk Assessment,BRA),2022年9月在南京市健康生活方式指导员中进行实证研究,分析感知风险、感知益处、分享态度、主观规范和感知行为控制对分享意愿的影响及机制。结果 参与调查的指导员1665名,模型解释了分享意愿87%的变化(R^(2)=0.87)和分享行为;32%的变化(R^(2)=0.32)。分享态度(β=0.388)、主观规范(β=0.596)、感知行为控制(β=0.105)和感知益处(β=0.081)正向影响指导员分享健康科普意愿(P<0.05)。分享态度在感知益处和分享意愿间起部分中介作用,中介效应为0.205 (95%CI:0.180~0.235);分享态度在感知风险和分享意愿间起完全中介作用,中介效应为0.076 (95%CI:0.064~0.091)。结论 基于TPB和BRA的整合模型可以较好地解释南京市指导员通过在线平台分享健康科普意愿的影响因素,为开展指导员培训和实施干预措施提供依据。