中国西南极度贫困县基于社区的健康教育计划对健康素养的影响：准实验设计的结果。
The effect of community-based health education programs on health literacy in severely impoverished counties in Southwestern China: Results from a quasi-experimental design.
机构信息
School of Public Health, Kunming Medical University, Kunming, China.
Department of Health Insurance, The Second Affiliated Hospital of Kunming Medical University, Kunming, China.
出版信息
Front Public Health. 2023 Jan 10;10:1088934. doi: 10.3389/fpubh.2022.1088934. eCollection 2022.
BACKGROUND
A national health education program in impoverished counties to promote health literacy among rural populations was released by the Chinese government in 2018. Under this nationwide campaign, an integrated health education program was implemented in Yunnan province, which included additional culturally sensitive educational components for the severely impoverished prefectures.
OBJECTIVE
This study examined the differential effects of the health education program models on health literacy outcomes among residents in poverty-stricken areas.
METHODS
A quasi-experimental design was applied with two arms that included surveys at baseline (in October 2019) and endline (in June 2021) to collect a range of individual-level health information, including the Chinese Resident Health Literacy Scale. The intervention group received the national health education program with the additional Yunnan specific program; the control group received only the national program. Respondents were recruited a multi-stage stratified sampling, including 641 participants at baseline (261 from the intervention sites and 380 from the control sites) and 693 participants at endline (288 from the intervention sites and 405 from the control sites). Chi-square and logistic regression analyses were performed to examine the association between program intervention and health literacy outcomes.
RESULTS
The overall health literacy levels were low (1.87%) at baseline, and there was no statistically significant difference between two groups (1.92 vs. 1.84%, = 1.000). A significant increase (from 1.87 to 11.11%, < 0.001) in the health literacy level was observed at endline in both groups. The magnitude of increase was significantly greater in the intervention group relative to the control group (17.71 vs. 6.42%, < 0.001). Adjusting for the confounding factors of individual and household characteristics, results from multivariate logistic regression revealed that the odds of having adequate health literacy among participants who received both the National Program and the Yunnan Program were 3.92 times higher than those who only received the National Program (95% CI: 2.10-7.33).
CONCLUSION
The findings highlighted the importance of incorporating non-verbal visual aids and culturally-sensitive media tools in health literacy education to address healthy lifestyle and the living contexts of the populations in poverty-stricken areas.
背景
中国政府于 2018 年推出了一项在贫困县开展的全民健康教育培训计划，旨在提高农村居民的健康素养。在这项全国性的活动中，云南省实施了一项综合健康教育计划，其中包括为极度贫困的州增加了更具文化敏感性的教育内容。
目的
本研究旨在探讨健康教育计划模式对贫困地区居民健康素养结果的差异影响。
方法
采用准实验设计，分为两组，在基线（2019 年 10 月）和终线（2021 年 6 月）进行调查，收集一系列个人健康信息，包括中国居民健康素养量表。干预组接受了国家健康教育计划和云南特定项目；对照组仅接受国家计划。通过多阶段分层抽样招募了参与者，基线时有 641 名参与者（干预组 261 名，对照组 380 名），终线时有 693 名参与者（干预组 288 名，对照组 405 名）。采用卡方检验和逻辑回归分析检验了计划干预与健康素养结果之间的关系。
结果
基线时总体健康素养水平较低（1.87%），两组间无统计学差异（1.92%比 1.84%， = 1.000）。两组的健康素养水平在终线时均显著提高（从 1.87%提高到 11.11%， < 0.001）。干预组的增长幅度明显大于对照组（17.71%比 6.42%， < 0.001）。调整个体和家庭特征的混杂因素后，多元逻辑回归结果显示，同时接受国家计划和云南计划的参与者中，具有足够健康素养的可能性是仅接受国家计划的参与者的 3.92 倍（95%CI：2.10-7.33）。
结论
研究结果强调了在健康素养教育中纳入非言语视觉辅助和具有文化敏感性的媒体工具的重要性，以解决贫困地区居民的健康生活方式和生活环境问题。
Zotero 插件