School of Public Health, Ningxia Medical University, Ningxia, China.
Sci Rep. 2024 Jun 6;14(1):13071. doi: 10.1038/s41598-024-63961-5.
Knowledge, Attitude, and Practice (KAP) survey, as an effective measure tool, is of practical significance for identifying the susceptible population in high-incidence regions of tuberculosis (TB). We aim to identify the health education targeted susceptible population of TB and discuss the acting pathway of KAP in Ningxia. A multistage random sampling method was used to conduct a face-to-face questionnaire survey for residents. The latent class analysis (LCA) model was used to classify susceptible populations of TB, and the structural equation modeling (SEM) model was also employed to investigate the interaction mechanisms of KAP (mediation analysis). We further applied the ordered logistic regression model to explore the associated factors. A total of 973 residents were enrolled, 70.6% were male, aged from 16 to 89. The LCA analysis demonstrated that 3 categories of susceptible populations of TB ("overall good", "positive attitude" and "overall poor") have optimal goodness of fit (BIC = 7889.5, Entropy = 0.923). SEM model indicated that the attitude plays a significant mediation effect from knowledge to practice toward TB (an indirect effect of 0.038, and a direct effect of 0.138). The ordered logistic regression results found that age, sex, marital status, education level, occupation, family income, self-perceived health status, having a family member or friend with TB, and knowing the DOTS strategy were significantly associated with classifications of KAP level towards TB. Based on the LCA model, we accurately classified the susceptible population of TB into 3 groups with different degrees of KAP. We found that TB attitude plays a mediating role between knowledge and practice. Therefore, we should pay more attention and carry out targeted health education in the community to these populations with overall poor KAP towards TB, and develop effective strategies and measures to realize the End TB Plan.
知识、态度和实践（KAP）调查作为一种有效的衡量工具，对于确定结核病（TB）高发地区的易感人群具有实际意义。我们旨在确定结核病有针对性的易感人群的健康教育，并探讨 KAP 在宁夏的作用途径。采用多阶段随机抽样方法对居民进行面对面问卷调查。采用潜在类别分析（LCA）模型对结核病易感人群进行分类，并采用结构方程模型（SEM）模型探讨 KAP 的相互作用机制（中介分析）。我们进一步应用有序逻辑回归模型探讨相关因素。共纳入 973 名居民，男性占 70.6%，年龄 16-89 岁。LCA 分析表明，3 类结核病易感人群（“总体良好”、“态度积极”和“总体较差”）具有最佳拟合优度（BIC=7889.5，熵=0.923）。SEM 模型表明，态度对知识向 TB 实践的传递具有显著的中介作用（间接效应为 0.038，直接效应为 0.138）。有序逻辑回归结果发现，年龄、性别、婚姻状况、教育程度、职业、家庭收入、自我感知健康状况、有家庭成员或朋友患有 TB、了解 DOTS 策略与 KAP 对 TB 的分类显著相关。基于 LCA 模型，我们将结核病易感人群准确地分为 3 组，具有不同程度的 KAP。我们发现，TB 态度在知识和实践之间起着中介作用。因此，我们应该更加关注和开展针对这些对结核病的 KAP 总体较差的人群的社区针对性健康教育，并制定有效的策略和措施来实现终结结核病计划。
