武汉市中学生教育与防止艾滋病扩散的政策和措施研究
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摘要
研究目的
     本研究旨在了解武汉市中学生艾滋病知识健康促进和健康教育相关政策及实施措施的基本现状;了解目前中学生对预防艾滋病的态度、认知程度及行为改变;探讨适合青少年各年龄段的预防艾滋病学校健康促进和健康教育模式。
     研究方法
     采用随机分层整群抽样的方法,对武汉市3所初级中学(初中)和2所高级中学(高中)的1500名中学生进行艾滋病知识健康教育,并在教育前后进行问卷调查;对目标学校全体教师进行艾滋病学校健康教育问卷调查;对所调查学生的家长进行艾滋病家庭教育问卷调查;对武汉市教育部门相关负责人、目标学校校长、校医进行个人访谈;对目标学校年级组负责人和任课教师、每个学校8-10名中学生进行专题小组讨论。定量资料进行百分率、构成比计算;定性资料进行卡方检验、多因素Logistic回归分析。
     研究结果
     艾滋病知识健康教育对象中,初中生年龄范围为11-14岁,高中生年龄范围为15-18岁。健康教育前,95.00%以上的中学生听说过艾滋病,但对艾滋病是由什么引起的、是否传染等问题知晓率在30.00-90.00%之间。初中生对艾滋病三大传播途径知晓程度在70.00-90.00%之间,高中生对部分知识点知晓率可达90.00%以上。对于艾滋病非传播途径,30.00-40.00%的中学生认为日常生活接触可以传播艾滋病病毒。教育后,中学生对艾滋病基本知识、传播途径和非传播途径知识知晓率比教育前有所提高,部分题目知晓率可达95.00%以上(P<0.05)。多元回归结果显示学生家庭经济情况、年级和对艾滋病的相关态度是艾滋病知识掌握程度的影响因素。
     定性访谈:教育部门对高中艾滋病健康教育有明确课时规定,对初中未做硬性规定,学校基本未针对艾滋病健康教育制定教学计划并安排课时,教师和学生较为赞成开展艾滋病健康教育。
     本研究共对1158名家长进行了问卷调查,对艾滋病的知晓程度大部分可达80.00%以上,接近90.00%的家长赞成学校安排艾滋病健康教育课程。问卷调查教师331名,艾滋病相关知识知晓率大部分在90.00%以上,88.52%的教师赞成学校开展艾滋病健康教育课程。
     研究结论
     艾滋病健康教育干预是提高中学生艾滋病知识知晓率、改变艾滋病相关态度的有效手段,学校教师和学生家长对于开展以学校教育为基础的艾滋病防治工作持支持态度。学校应根据教学实际,在教育部门相关政策的指导下制定教学计划,落实教学任务,培训教学人员,切实保障艾滋病健康教育和健康促进的顺利进行。教育部门应做好政策支持和监督工作,积极探索适应本地教育现状的干预模式。
Objectives
     The aim of this study was to understand the policies on HIV/AIDS knowledge health education and promotion as well as its implementation situation among secondary school students in Wuhan. Secondary school students'attitude, knowledge, and behaviors of HIV/AIDS were also need be understood at present. To explore school health education and promotion model fitting to every age step of adolescence.
     Methods
     Random stratified cluster sampling was used in this study. HIV/AIDS knowledge education was conducted in three middle schools and two high schools with a number of 1,500 students in Wuhan. After education there was a questionnaire survey for them. Questionnaire survey was also designed for teachers and parents. Personal interviews were used to interview education sector manager, principal, and school doctor. Focus group discussion was used among grade group managers, teachers and eight to ten students. Quantitative data were analyzed by percentage and constituent ratio.χ2 test and multi-factor logistic regression analysis were used to analyze qualitative data.
     Results
     Middle school students'age range was from eleven to fourteen and high school students'age range was from fifteen to eighteen. Before education, about 95.00% students heard HIV/AIDS. About what caused the disease and whether it is infectious disease, the awareness rate was between 30.00-90.00%. Awareness rate about AIDS three ways of transmission of middle school students was between 70.00-90.00% while up to 90.00% for high school students in some point. As to AIDS transmission ways, about 30.00-40.00% students think that daily contraction can spread the virus. After education, awareness rate was higher than before education of HIV/AIDS basic knowledge, transmission ways, and non-transmission ways. Parts of questions can reach a rate higher than 95.00%(P<0.05). Multi-factor analysis results indicated that students'family economic level, grade as well as attitude to AIDS were the influence factors to HIV/AIDS knowledge.
     Qualitative interview results show that education sector had clearly provision of HIV/AIDS education lessons for high school but none for middle school. Schools we investigated had no education plan and lesson arrangement for HIV/AIDS. Teacher and students agreed to conduct HIV/AIDS health education at school.
     A number of 1158 parents were asked to participant a questionnaire survey and the results suggested that parents'HIV/AIDS awareness rate was higher than 80.00%, particularly, almost 90.00% parents agree to improve HIV/AIDS education at school. There were 331 teachers participated questionnaire survey and their HIV/AIDS awareness rate was higher than 90.00%. Moreover, about 88.52% teachers agree secondary school develop HIV/AIDS education.
     Conclusions
     HIV/AIDS health education prevention was an effective way to improve secondary students'HIV/AIDS knowledge, attitude and behavior change. Teachers and parents are all agree to participate HIV/AIDS education at school. Schools should formulate teaching plan, train teachers, and implement teaching task according to actual situation and related policies from education sector to guarantee health education and health promotion. Education sectors should strength supporting strategies and supervision, meanwhile, explore education prevention model fit for local education situation.
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