本土化健康教育对提高农村中老年人群营养与慢性病防治认知水平的效果分析
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摘要
目的通过采取“本土化”健康教育模式对农村中老年人进行健康教育,评价该教育模式对提高农村中老年人群膳食营养和慢性病防治知识水平的影响,为在农村社区有效地开展公共卫生服务,预防和控制疾病的发生发展提供科学依据。
方法采用随机整群抽样的方法,在某地农村30个自然村选取了1631名50岁及以上的中老年人作为研究对象,进行面对面的问卷调查及医学体检。以村为单位,将30个自然村随机分为教育组(15个村)和对照组(15个村)。在教育组各村选取一名妇联主任或积极性高、威望高的村干部作为健康联络员,对其进行多次集中的膳食营养与慢性病专业知识和技能培训,采用本土传播方式,充分利用当地的食物资源和卫生资源,在教育组的15个村对757位农村中老年人进行为期7个月的“本土化”健康教育,对照组人群未作干预。遵照干预前后调查对象、方法、内容不变以及自愿的原则,于干预前后分别对30个村969名50岁及以上的中老年人进行抽样调查。
结果干预前农村中老年人的营养知识知晓率较低,仅为3.7%。仅有48人(3%)知道人体所需要的全部五类营养素；调查对象对人体所需要的能量的主要来源和哪种常见食物中含蛋白质较多知晓率较高,分别为32.9%和26.3%；对精白米面中哪种营养素丢失最多和哪些蔬菜的水溶性维生素含量较高知晓率较低,分别为2.7%和7.9%；有80%左右的农村中老年人完全不知道高血压、糖尿病的危险因素及防治方法；57.8%的受检者不知道怎样能控制体重。有一种或一种以上危险行为因素的农村中老年人高达80.1%。年收入,文化程度,活动水平,膳食多样化程度与营养和慢性病知识知晓率呈正相关。性别,年龄,婚姻状况,吃盐过多,饮酒与营养和慢性病知识知晓率呈负相关。高血压和或糖尿病患者营养与慢性病知识知晓情况与未患病人群之间无显著性差异(P>0.05)。
干预后教育组营养及慢性病知识知晓率由4.3%提高至85.4%,对照组由2.9%提高至7.1%,教育组受教育人群的知识知晓率提高幅度远大于对照组(p<0.01)。干预后教育组中99.3%的人认为查体和营养与慢性病知识学习对健康很重要；93.3%受教育的中老年人能够根据学到的健康知识主动改变不良生活习惯,求知意识得到提高。
结论本土化健康教育模式使农村中老年人更容易接受和掌握基本的营养健康知识,积极实践健康的生活方式,取得了令人满意的效果,建议创造条件开展更大范围的试点和推广。
Objectives To evaluate effects of the local health education on improving cognitive level of chronic disease knowledge in rural middle-aged and old people. To provide scientific basis for community public health services and preventing and controlling of chronic diseases.
Methods 1631 people aged 50 and older were randomly selected as subjects by Cluster random sampling from 30 villages in a countryside. Each subject accepted a face-to-face questionnaire and body check. All the 30 villages were divided into an education group (15 villages) and a control group (15 villages). A women director or a prestigious leader was chosen as a health instructor. A number of training courses were conducted to these health instructors, which focused on nutrition and chronic disease knowledge and skill training. Local food and health resources were sued to carry out dietary nutrition and chronic disease education following guidance in each village through local means of communication. The education group followed the direction of diet, nutrition and health education and guidance interventions for 7 months. There were no interventions for the control group. Following the same respondent, method and content principle, sample survey was conducted to the 969 people aged 50 and older in 30 villages before and after the trial.
Results Before the intervention, the awareness rate of nutrition knowledge of the subjects was very low(only 3.7%). Only 48 persons (3%) knew all the five nutrients the body needs. The awareness rate of the main source of energy the body needs and which food contains more protein was higher(32.9% and 26.3% respectively). The awareness rate of which nutrient lost the most in fine rice and flour and which vegetable contains more water-soluble nutrients was 2.7% and 7.9% respectively. There were 80% of the subjects did not know the risk factors and prevention knowledge of chronic diseases. 57.8% of the subjects did not know how to control body weight. There were 80.1% subjects who had one or more than one risk behavior factors. Education, physical exercise, annual income and dietary diversity score were positively correlated with knowledge awareness rate. Gender, age, marriage status, high salt intake and drink were negatively correlated with knowledge. There was no significant difference in nutrition and health knowledge awareness rate between those who had hypertension and (or) diabetes and those who had not.
After the intervention, the awareness rate of nutrition and chronic disease knowledge of the education group raised from 4.3% to 85.4%, while the control group increased only from 2.9% to 7.1%. The health knowledge awareness rate of the education group increased more than that of the control group (p<0.01). After the intervention,99.3% of the people in the education group believed that body check and the nutrition and health knowledge was useful for their health,93.3% of the subjects were willing to adhere to health behaviors according to the knowledge they acquired.
Conclusion The local health education can make the middle-aged and old people in rural areas more likely to accept the nutrition and health knowledge, as well as positive healthy lifestyle and practice. Results of this study suggests that the local health education mode should be practiced in more rural areas.
方法采用随机整群抽样的方法,在某地农村30个自然村选取了1631名50岁及以上的中老年人作为研究对象,进行面对面的问卷调查及医学体检。以村为单位,将30个自然村随机分为教育组(15个村)和对照组(15个村)。在教育组各村选取一名妇联主任或积极性高、威望高的村干部作为健康联络员,对其进行多次集中的膳食营养与慢性病专业知识和技能培训,采用本土传播方式,充分利用当地的食物资源和卫生资源,在教育组的15个村对757位农村中老年人进行为期7个月的“本土化”健康教育,对照组人群未作干预。遵照干预前后调查对象、方法、内容不变以及自愿的原则,于干预前后分别对30个村969名50岁及以上的中老年人进行抽样调查。
结果干预前农村中老年人的营养知识知晓率较低,仅为3.7%。仅有48人(3%)知道人体所需要的全部五类营养素；调查对象对人体所需要的能量的主要来源和哪种常见食物中含蛋白质较多知晓率较高,分别为32.9%和26.3%；对精白米面中哪种营养素丢失最多和哪些蔬菜的水溶性维生素含量较高知晓率较低,分别为2.7%和7.9%；有80%左右的农村中老年人完全不知道高血压、糖尿病的危险因素及防治方法；57.8%的受检者不知道怎样能控制体重。有一种或一种以上危险行为因素的农村中老年人高达80.1%。年收入,文化程度,活动水平,膳食多样化程度与营养和慢性病知识知晓率呈正相关。性别,年龄,婚姻状况,吃盐过多,饮酒与营养和慢性病知识知晓率呈负相关。高血压和或糖尿病患者营养与慢性病知识知晓情况与未患病人群之间无显著性差异(P>0.05)。
干预后教育组营养及慢性病知识知晓率由4.3%提高至85.4%,对照组由2.9%提高至7.1%,教育组受教育人群的知识知晓率提高幅度远大于对照组(p<0.01)。干预后教育组中99.3%的人认为查体和营养与慢性病知识学习对健康很重要；93.3%受教育的中老年人能够根据学到的健康知识主动改变不良生活习惯,求知意识得到提高。
结论本土化健康教育模式使农村中老年人更容易接受和掌握基本的营养健康知识,积极实践健康的生活方式,取得了令人满意的效果,建议创造条件开展更大范围的试点和推广。
Objectives To evaluate effects of the local health education on improving cognitive level of chronic disease knowledge in rural middle-aged and old people. To provide scientific basis for community public health services and preventing and controlling of chronic diseases.
Methods 1631 people aged 50 and older were randomly selected as subjects by Cluster random sampling from 30 villages in a countryside. Each subject accepted a face-to-face questionnaire and body check. All the 30 villages were divided into an education group (15 villages) and a control group (15 villages). A women director or a prestigious leader was chosen as a health instructor. A number of training courses were conducted to these health instructors, which focused on nutrition and chronic disease knowledge and skill training. Local food and health resources were sued to carry out dietary nutrition and chronic disease education following guidance in each village through local means of communication. The education group followed the direction of diet, nutrition and health education and guidance interventions for 7 months. There were no interventions for the control group. Following the same respondent, method and content principle, sample survey was conducted to the 969 people aged 50 and older in 30 villages before and after the trial.
Results Before the intervention, the awareness rate of nutrition knowledge of the subjects was very low(only 3.7%). Only 48 persons (3%) knew all the five nutrients the body needs. The awareness rate of the main source of energy the body needs and which food contains more protein was higher(32.9% and 26.3% respectively). The awareness rate of which nutrient lost the most in fine rice and flour and which vegetable contains more water-soluble nutrients was 2.7% and 7.9% respectively. There were 80% of the subjects did not know the risk factors and prevention knowledge of chronic diseases. 57.8% of the subjects did not know how to control body weight. There were 80.1% subjects who had one or more than one risk behavior factors. Education, physical exercise, annual income and dietary diversity score were positively correlated with knowledge awareness rate. Gender, age, marriage status, high salt intake and drink were negatively correlated with knowledge. There was no significant difference in nutrition and health knowledge awareness rate between those who had hypertension and (or) diabetes and those who had not.
After the intervention, the awareness rate of nutrition and chronic disease knowledge of the education group raised from 4.3% to 85.4%, while the control group increased only from 2.9% to 7.1%. The health knowledge awareness rate of the education group increased more than that of the control group (p<0.01). After the intervention,99.3% of the people in the education group believed that body check and the nutrition and health knowledge was useful for their health,93.3% of the subjects were willing to adhere to health behaviors according to the knowledge they acquired.
Conclusion The local health education can make the middle-aged and old people in rural areas more likely to accept the nutrition and health knowledge, as well as positive healthy lifestyle and practice. Results of this study suggests that the local health education mode should be practiced in more rural areas.
引文
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