健康促进对北领地偏远原住民社区三个工作场所工作人员沙眼知识、态度和行为的影响。
The impact of health promotion on trachoma knowledge, attitudes and practice (KAP) of staff in three work settings in remote Indigenous communities in the Northern Territory.
作者信息
Lange Fiona D, Jones Kelly, Ritte Rebecca, Brown Haley E, Taylor Hugh R
机构信息
Indigenous Eye Health, Indigenous Health Equity Unit, Centre for Health Equity, Melbourne School of Population and Global Health, The University of Melbourne, Victoria, Australia.
Indigenous Health Equity Unit, Centre for Health Equity, Melbourne School of Population and Global Health, The University of Melbourne, Victoria, Australia.
出版信息
PLoS Negl Trop Dis. 2017 May 24;11(5):e0005503. doi: 10.1371/journal.pntd.0005503. eCollection 2017 May.
BACKGROUND
Globally, trachoma is the leading cause of infectious blindness and Australia is the only developed country with endemic trachoma. It is found in remote Indigenous communities burdened with poverty, overcrowding and poor hygiene. Lack of culturally appropriate health promotion, a small trachoma workforce and lack of awareness and support for trachoma elimination in general, were early barriers.
METHODS
A cross-sectional pre-post study using a convenience sample, was conducted in clinics, schools and community work-settings from 63 of the 82 remote Aboriginal communities identified as being at risk of trachoma in the Northern Territory (NT). The study assessed the effect of a multi-component health promotion strategy aimed at increasing knowledge, attitude and practice amongst health, education and community support settings staff. Data were collected between 2010 and 2012. The health promotion initiatives were introduced in communities in staggered delivery over a one-year period; 272 participants were surveyed at baseline and 261 at follow-up.
RESULTS
Trachoma related knowledge, attitudes and practice increased across all settings and for all primary outcome measures. Across all settings, there was a significant increase in the proportion of participants reporting the most important thing to do if a child has a 'dirty' face is to 'wash it every time its dirty' (61.6% cf 69.7%; X2p = 0.047), a significant reduction in the proportion of respondents answering 'no' to the question "Is it normal for kids to have dirty faces in your community' (40.5% cf 29.6%; X2p = 0.009) and a significant increase in reported capacity to teach others about trachoma prevention (70.8% cf 83.3%; X2p <0.001).
CONCLUSION
Health promotion was associated with increased trachoma knowledge, attitude and practice amongst health, education and community support staff working with children and in remote NT communities. In the early stages of the trachoma health promotion program, this increased trachoma awareness and improved local workforce capacity and support for trachoma elimination in three health promotion settings in remote communities in the NT.
背景
在全球范围内，沙眼是传染性失明的主要原因，而澳大利亚是唯一一个沙眼流行的发达国家。沙眼在偏远的原住民社区中出现，这些社区面临着贫困、过度拥挤和卫生条件差的问题。早期的障碍包括缺乏符合文化背景的健康促进措施、沙眼防治工作人员数量少以及总体上对消除沙眼缺乏认识和支持。
方法
采用便利抽样的横断面前后对照研究，在北领地（NT）82个被确定有沙眼风险的偏远原住民社区中的63个社区的诊所、学校和社区工作场所进行。该研究评估了一项多成分健康促进策略的效果，该策略旨在提高卫生、教育和社区支持机构工作人员的知识、态度和实践水平。数据收集于2010年至2012年期间。健康促进举措在一年的时间里分阶段在各社区推行；272名参与者在基线时接受了调查，261名在随访时接受了调查。
结果
在所有机构以及所有主要结局指标方面，与沙眼相关的知识、态度和实践均有所增加。在所有机构中，报告如果孩子脸“脏”最重要的做法是“每次脏了都洗”的参与者比例显著增加（61.6%对比69.7%；X2p = 0.047），对“在你们社区孩子脸脏是正常的吗”这个问题回答“否”的受访者比例显著降低（40.5%对比29.6%；X2p = 0.009），并且报告向他人传授沙眼预防知识能力的比例显著增加（70.8%对比83.3%；X2p <0.001）。
结论
健康促进与在北领地偏远社区中与儿童打交道的卫生、教育和社区支持工作人员对沙眼的知识、态度和实践增加相关。在沙眼健康促进项目的早期阶段，这提高了对沙眼的认识，改善了当地工作人员的能力，并在北领地偏远社区的三个健康促进机构中为消除沙眼提供了支持。
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