Craig Brett J, Engstrom Martha C
Department of Communication, Nazarbayev University, Kazakhstan.
Cent Asian J Glob Health. 2016 Mar 29;4(2):191. doi: 10.5195/cajgh.2015.191. eCollection 2015.
As the Republic of Kazakhstan undertakes new public health efforts to promote healthy lifestyles among its citizens, the local perceptions of health and health behaviors need to be examined and understood from the sociocultural and historical perspectives. The primary aim of this study is to examine the association between perception of control on one's health and engagement in good and bad health behaviors.
Students enrolled in a health communication course surveyed 310 citizens of Kazakhstan on their perceptions of control over their own health and multiple health behaviors (i.e. smoking status, physical activity, etc.). Twenty-seven students were divided into groups and approached every third passerby as a potential participant during common shopping hours in nine popular marketplaces in Astana, Kazakhstan. Perception of control on one's health was measured using a validated measure of health control: the multidimensional health locus of control scale (MHLC), developed by Wallston and colleagues. The MHLC measures three separate loci of control: internal, chance, and powerful others.
Participants perceived themselves as having highest control over their health (MHLC subscale internal: 29.70±0.64), powerful others had second highest control (MHLC subscale power others: 23.72±0.77), and chance had the lowest but still some control on their health (MHLC subscale chance: 20.82±0.85). Most participants rated their current health as very good (18.1%), good (45.0%), or moderate (32.3%). Approximately 23.4% of participants were smokers, and 22.2% consumed alcohol. Physical activity averaged 3.63 days in the past week, and fruit and vegetable consumption averaged 2 servings of each per day. Tobacco and the powerful others subscale were significantly negatively correlated (r=-0.17, <0.05).
Participant reports regarding personal health behaviors and lifestyle did not reflect the national reports regarding lifestyle behaviors. The relationship between powerful others subscale and tobacco smoking indicate that using healthcare providers may open up avenues to lowering tobacco use through patient education; however, social desirability is a notable concern for public health interventions. More importantly, the surveys uncovered future questions for conducting public health research with the general public, including issues of trust in the healthcare system and social desirability bias. Additional factors such as distrust in healthcare and government also may play a role in the public's participation in social scientific research. The students who conducted the surveys reported a general skepticism from the public ranging from unfamiliarity with survey research to explicit distrust in the intentions and purpose of the research itself.
随着哈萨克斯坦共和国为促进公民养成健康生活方式而开展新的公共卫生工作，需要从社会文化和历史角度审视和理解当地对健康及健康行为的认知。本研究的主要目的是考察对自身健康的控制感与参与良好和不良健康行为之间的关联。
参加健康传播课程的学生对310名哈萨克斯坦公民进行了调查，了解他们对自身健康的控制感以及多种健康行为（如吸烟状况、体育活动等）。27名学生被分成小组，在哈萨克斯坦阿斯塔纳的九个热门市场的普通购物时段，每隔两个路人作为潜在参与者进行询问。使用一种经过验证的健康控制测量方法：由沃尔斯顿及其同事开发的多维健康控制点量表（MHLC）来测量对自身健康的控制感。MHLC测量三个不同的控制点：内控、机遇和他人的力量。
参与者认为自己对健康的控制感最强（MHLC分量表内控：29.70±0.64），他人的力量次之（MHLC分量表他人的力量：23.72±0.77），机遇对健康的控制感最低但仍有一定控制（MHLC分量表机遇：20.82±0.85）。大多数参与者将自己目前的健康状况评为非常好（18.1%）、好（45.0%）或中等（32.3%）。约23.4%的参与者吸烟，22.2%饮酒。过去一周体育活动平均为3.63天每天，水果和蔬菜摄入量平均每天各2份。烟草与他人的力量分量表呈显著负相关（r=-0.17，<0.05）。
参与者关于个人健康行为和生活方式的报告与国家关于生活方式行为的报告不符。他人的力量分量表与吸烟之间的关系表明，利用医疗服务提供者可能为通过患者教育降低烟草使用开辟途径；然而，社会期望是公共卫生干预的一个显著问题。更重要的是，这些调查揭示了在与普通公众进行公共卫生研究时未来的问题，包括对医疗保健系统的信任问题和社会期望偏差。对医疗保健和政府的不信任等其他因素也可能在公众参与社会科学研究中起作用。进行调查的学生报告说，公众普遍持怀疑态度，从对调查研究不熟悉到对研究本身的意图和目的明确不信任。
