重庆市社区居民对气候变化知识、态度、行为及其影响因素调查

目的了解重庆市社区居民对气候变化的知识、态度、行为情况及其影响因素。方法选择典型社区,采取多层次单纯随机抽样,抽取18岁及以上、无认知障碍、居住两年及两年以上的常住社区居民为调查对象。结果在最受关注的社会热点问题和公共卫生问题中,气候变化分别列第七位和第五位;气候变化知晓率72.49%;获取知识途径主要为电视(47.95%)、网络(24.20%)、报刊(17.50%);78.88%社区居民认为目前热浪给人类生产生活带来的影响严重,81.43%对获得气候变化与健康的相关知识感兴趣,84.63%愿意参加适应气候变化保护人群健康的活动,86.61%希望获得气候变化健康影响的预警预报;64.69%的社区居民能够主动向医疗卫生人员咨询天气变化对健康的影响,88.60%关注天气预报,99.09%使用空调,68.85%会注意适时开窗通风;影响气候变化知识、态度、行为因素为文化程度和平时是否经常锻炼。结论重庆市社区居民应对气候变化有良好的态度,但关注度、相关知识的认知正确率和对气候变化的适应能力有待提高。加强电视、网络等大众媒体的宣传力度是提高气候变化认识和适应能力的有效途径。     

哈尔滨市社区居民应对气候变化知识、态度、行为及相关因素调查

目的了解哈尔滨市社区居民对热浪等气候变化的知识、态度、行为情况及影响因素。方法采用多层次单纯随机抽样,抽取600名18岁及以上社区居民进行问卷调查。结果在受关注的社会热点问题和公共卫生问题中,气候变化分别列第6位和第5位;气候变化知晓率44.3%,获取知识途径主要为电视82.3%、广播43.2%、报纸24.0%;87.7%的居民对获得气候变化与健康的相关知识感兴趣,76.0%的居民愿意参加适应气候变化保护人群健康的活动,88.2%的居民希望获得气候变化健康影响的预警预报;15.8%的居民主动向卫生服务人员咨询天气变化对疾病的影响,13.0%的社区居民使用空调;影响气候变化KAP因素为年龄和文化程度。结论社区居民应对气候变化保护健康的态度非常好,然而对气候变化的认知以及正确的应对和适应能力有待提高,加强电视、广播、报纸等大众媒体的宣传是提高KAP的有效途径。     

卫生系统应对气候变化脆弱性减缓评估基线调查

目的了解卫生管理人员对气候变化的观点、态度和建议,评价卫生系统脆弱性和适应性,探索气候变化与健康相关研究方法。方法召开座谈会,采用参与式进行评价的方式,应用H表格,对回答结果进行分值量化和分析评估。结果被调查卫生管理人员认为气候变化背景下人群健康的脆弱性严重,卫生系统适应气候变化的障碍也比较严重,对卫生系统持续、有效应对气候变化所带来的健康风险尚未达到比较有信心的程度,认为目前适应气候变化,保护公众健康的措施可持续性一般。结论有些明显受气候影响的健康威胁所提出的挑战已超越了公共卫生的应对范畴,应建立多级防护系统,进行多学科、多领域综合研究,积极应对气候变化对人群健康的威胁。     

2014年高温热浪期间宁波市居民风险认知及适应性调查

目的 了解高温热浪期间宁波市居民中暑发生情况、居民对中暑的风险认知及适应性,为开展健康宣教及制定高温热浪灾害应对措施提供参考.方法 采用分层整群随机抽样方法,于2014年10--11月在宁波市2个县(市)各随机抽取2个乡(镇),每个乡(镇)随机抽取2个居委会(村),每个居委会(村)随机抽取120户进行调查.内容包括调查对象一般情况、中暑情况、中暑风险认知及适应性行为,分析中暑脆弱人群和风险认知情况.结果 共调查14岁及以上居民2 767人,2014年7-9月经医院诊断为中暑的发生率为6.3％(174/2 767),自我诊断中暑的发生率为8.9％(247/2 767).工人、初中文化程度人群的医院诊断中暑发生率较高,分别为7.8％和7.7％;吸烟人群和饮酒人群的医院诊断中暑发生率较高,分别为8.5％和9.1％.专业技术人员自我诊断中暑的发生率最高(13.4％);偶尔参加体育锻炼和经常午睡的居民更倾向于自我诊断中暑,发生率分别为10.6％和11.2％.总分为14分的高温热浪风险认知得分中,平均得分为(8.9±3.0)分,认知程度低(≤8分)的人群中暑发生率较高.调查对象在高温热浪期间采取的适应性行为以尽量减少外出(87.2％)、户外乘凉(78.0％)和改变出行方式(66.4％)为主.结论 高温热浪期间宁波市居民中暑发生率较高,需采取综合干预措施,以提高居民高温热浪风险认知水平并及时采取适应性行为.     

山西省大同市育龄妇女艾滋病母婴传播知识与相关态度干预效果分析

目的了解山西省大同市育龄妇女艾滋病母婴传播的相关知识与态度,评价健康教育的效果。方法选取在大同市妇幼保健机构进行体检的育龄妇女380名,按照“世界银行贷款卫生九预防艾滋病母婴传播项目”中的“预防艾滋病母婴传播重点人群相关知识、态度、行为调查问卷”,分别在健康教育讲座前后对同一人群进行调查。结果健康教育前,有84．2％的调查对象了解艾滋病母婴传播的途径,只有34．7％知道可以用药物阻断母婴传播。健康教育后,97．2％的调查对象了解艾滋病母婴传播途径,89．2％知道可以用药物阻断母婴传播,对预防艾滋病母婴传播相关态度的回答正确率也较健康教育前明显提高。结论城市育龄妇女对预防艾滋病母婴传播知识知晓率仍有待提高,妇幼保健机构开展健康教育是提高其知晓率的重要途径。     

热浪对健康的影响及其应对措施

随着气候变化引发极端天气事件发生频率和强度的增强,夏季热浪正在并将继续影响公共卫生安全。本文综述热浪造成的主要健康影响,热浪的易感人群以及如何应对热浪事件,保护人群健康。     

生活方式干预对农村居民慢病及相关知识、态度及行为的影响

目的了解生活方式干预对农村居民慢性非传染性疾病（简称慢病）及其相关知识、态度和行为改变的影响。方法在山东省中西部八个县（市、区）部分乡村,采取发放宣传材料、盐勺、油壶、制作宣传栏、举办健康教育课堂等形式对农村居民进行慢病防治知识宣传与行为生活方式干预,采取随机抽样方法进行人群干预效果调查。结果除高血压病防治基本知识外,干预人群对健康知识的知晓率均显著高于对照组（P〈0．01）。干预和对照人群在对待膳食中盐油与血压、血脂关系的态度差别最大,干预人群明显优于对照人群,相差20％～40％。干预人群盐、油摄入量分别为11．18、32．72g／（人·d）,低于对照人群[分别为12．67、38．57g／（人·d）,P〈0．01],盐、油摄入达标率（15．5％和53．3％）均高于对照人群（9．4％和36．6％）。结论生活方式干预显著提高了农村居民对慢病相关健康知识的知晓率,明显地改善了他们对待健康相关问题的态度,生活行为方式发生了一定程度的转变,但健康生活方式仍未形成,需要长期坚持不懈的健康教育和健康促进行动。     

热浪期间居民自发性适应行为与中暑的关系

为了解广东省居民高温热浪期间的适应行为现状,并进一步分析适应行为与中暑之间的关联,于2010年9--11月采用四阶段分层整群抽样方法随机抽取2 183名居民,进行入户面对面调查,调查内容包括一般人口学特征、对热浪的风险认知、高温热浪期间的自发性适应行为和过去1年是否发生过中暑.采用非条件Logistic回归分析适应行为与中暑之间的关联,并控制混杂因素.结果显示,2 183名研究对象平均(39.31±14.16)岁,其中男性1 165人,城市居民1 064人,从事农林牧渔业者507人,过去1年有中暑经历者149人,其中从事农林牧渔业、低收入水平和农村居民的中暑发生率较高(P＜0.05);热浪期间98.03％的调查对象至少采取1项适应行为防止中暑;中暑发生的保护因素在总样本和＜50岁者中为少出门、使用空调和穿浅色衣服;在男性中为少出门、使用空调、穿浅色衣服和减少活动;在女性中为穿浅色衣服;在农林牧渔业者中为减少活动、穿浅色衣服和使用防护品或太阳伞;在城市居民中为多饮水和穿浅色衣服;在农村居民中为减少活动和穿浅色衣服;发生中暑的风险随着居民采用适应行为数量增加而降低(P＜0.05).提示绝大多数居民在高温热浪期间采取了自发性适应行为,不同特征人群适应行为不同,并且采用的适应行为越多发生中暑的风险越低.     

哈尔滨市社区居民应对气候变化知识、态度、行为干预效果分析

目的了解气候变化健康干预前后社区居民对热浪等气候变化的知识、态度、行为(KAP)变化情况,评估干预效果。方法采用多层次单纯随机抽样的方法,分别于气候变化健康干预工作前后,抽取600余名18岁及以上社区居民进行问卷调查,对比干预前后社区居民对热浪知识、态度、行为等改变。应用多元线性回归分析知识、态度、行为的影响因素。结果干预前、后在知识知晓率、态度转变率、行为形成率方面差异均有统计学意义(均P0.05);年龄、文化程度、锻炼、干预对知识、态度、行为的影响差异均有统计学意义(均P0.05)。结论年龄、文化程度、是否注重自身健康、干预是知识、态度、行为的影响因素,开展有针对性的气候变化健康干预工作可有效提升高居民对于热浪的正确认知、改善其态度和相关行为。     

温州市公众艾滋病相关知识、态度、行为调查

目的了解温州市公众艾滋病相关知识知晓情况及其态度和行为。方法以自行设计的调查问卷随机调查市区公众585人。其中,男性344人,女性241人,平均年龄38.46岁。结果被调查对象预防艾滋病知识主要来自报纸、书刊、电视;被调查人员对艾滋病的可能传播途径回答的正确率在80%以上,非传播途径的回答正确率在70%以下;只有47.18%的人知道艾滋病目前是无法治愈的;36.27%的人对艾滋病病人感到害怕或恐惧;8.83%的人承认有性乱及不安全性行为。结论艾滋病健康教育应更加全面、科学,要注重有针对性健康教育,提高人群对艾滋病的认识与防治水平。     

城乡基层医疗人员对气候变化及其健康风险认知的差异

目的探究基层医疗人员对气候变化及其健康风险认知的城乡差异。方法采用分层随机整群抽样,抽取广东省21家城区和10家乡镇基层医疗卫生机构的医疗人员进行问卷调查,收集其基本信息和对气候变化及其健康风险的认知情况,通过卡方检验、秩和检验和logistic逐步回归分析探究气候变化认知的城乡差异。结果63.8%(468/733)的基层医疗卫生人员认同气候变化正在发生,55.4%(406/733)的人认为气候变化主要归因于人类活动。城区卫生人员对气候变化正在发生的认同程度高于乡镇,而城区与乡镇对气候变化发生原因的认知差异不明显。城区人员在高温热浪的健康风险认知上略高于乡镇,而对于气候变化与传染病关联的认知略低于乡镇,但差异不具有统计学意义。乡镇人员识别气候变化脆弱人群的能力略高于城区,差异具有统计学意义。此外,职称级别越高越能感知气候变化健康风险;临床医生相比于护士和公共卫生人员更认同气候变化正在发生且更能识别其发生原因。结论城区基层医疗卫生人员在气候变化正在发生的认同程度上略高于乡镇,但是乡镇医疗卫生人员比城区的更能识别脆弱人群。城区与乡镇基层医疗卫生人员对气候变化及其健康风险认知均不容乐观,应积极采取措施提升风险认知以增强其应对气候变化健康风险的能力。     

卫生新闻宣传与健康教育

卫生新闻宣传是卫生工作的重要组成部分,其工作目标是向群众传播卫生工作中的重要信息,使群众了解国家及当地的卫生工作重点及其相关的内容。健康教育以传播、教育、干预为手段,以帮助个体和群体改变不健康行为和建立健康行为为目标。卫生新闻与健康教育既有区别又密切相关。由于医疗卫生与大众传媒分属不同学科领域,长期以来存在交流障碍。如何结合重大卫生新闻事件,强化防病知识的宣传;结合突发性传染病的及时报道,引导公众正确应对公共卫生危机;结合慢性病患病率的升高,宣传健康的生活方式等内容,是目前从事卫生新闻报道值得研究的课题。     

Health impacts of climate change and health and social inequalities in the UK

This article examines how social and health inequalities shape the health impacts of climate change in the UK, and what the implications are for climate change adaptation and health care provision. The evidence generated by the other articles of the special issue were interpreted using social justice reasoning in light of additional literature, to draw out the key implications of health and social inequalities for health outcomes of climate change. Exposure to heat and cold, air pollution, pollen, food safety risks, disruptions to access to and functioning of health services and facilities, emerging infections and flooding are examined as the key impacts of climate change influencing health outcomes. Age, pre-existing medical conditions and social deprivation are found to be the key (but not only) factors that make people vulnerable and to experience more adverse health outcomes related to climate change impacts. In the future, climate change, aging population and decreasing public spending on health and social care may aggravate inequality of health outcomes related to climate change. Health education and public preparedness measures that take into account differential exposure, sensitivity and adaptive capacity of different groups help address health and social inequalities to do with climate change. Adaptation strategies based on individual preparedness, action and behaviour change may aggravate health and social inequalities due to their selective uptake, unless they are coupled with broad public information campaigns and financial support for undertaking adaptive measures.     

Protecting Health from Climate Change: Preparedness of Medical Interns

Context:

Climate change is a significant and emerging threat to public health and to meet the challenge, health systems require qualified staff.

Aims:

To study the preparedness of medical interns to meet the challenge of protecting health from climate change.

Settings and Design:

Medical colleges in a coastal town. Cross-sectional study.

Materials and Methods:

A proportionate number of medical interns from five medical colleges were included in the study. Level of awareness was used as a criterion to judge the preparedness. A self-administered, pretested, open-ended questionnaire was used. Responses were evaluated and graded.

Statistical Analysis Used:

Proportions, percentage, Chi-test.

Results:

About 90% of the medical interns were aware of the climate change and human activities that were playing a major role. Ninety-four percent were aware of the direct health impacts due to higher temperature and depletion in ozone concentration, and about 78% of the respondents were aware about the change in frequency / distribution of vector-borne diseases, water borne / related diseases, malnutrition, and health impact of population displacement. Knowledge regarding health protection was limited to mitigation of climate change and training / education. Options like adaptation, establishing / strengthening climate and disease surveillance systems, and health action in emergency were known to only nine (7%), eight (6%), and 17 (13%), respectively. Collegewise difference was statistically insignificant. Extra / co-curricular activities were the major source of knowledge.

Conclusions:

Majority of medical interns were aware of the causes and health impacts of climate change, but their knowledge regarding health protection measures was limited.     

Local heat stroke prevention plans in Japan: characteristics and elements for public health adaptation to climate change

The adverse health effects from hot weather and heat waves represent significant public health risks in vulnerable areas worldwide. Rising temperatures due to climate change are aggravating these risks in a context of fast urbanization, population growth and societal ageing. However, environmental heat-related health effects are largely preventable through adequate preparedness and responses. Public health adaptation to climate change will often require the implementation of heat wave warning systems and targeted preventive activities at different levels. While several national governments have established such systems at the country level, municipalities do not generally play a major role in the prevention of heat disorders. This paper analyzes selected examples of locally operated heat-health prevention plans in Japan. The analysis of these plans highlights their strengths, but also the need of local institutions for assistance to make the transition towards an effective public health management of high temperatures and heat waves. It can also provide useful elements for municipal governments in vulnerable areas, both in planning their climate change and health adaptation activities or to better protect their communities against current health effects from heat.     

公共卫生专业人员参与健康科普现状及需求调查分析

目的 了解我国公共卫生专业人员参与健康科普活动现状及其健康科普能力培训需求。方法 选取2017年11月参加中华预防医学会第五届学术交流会的全国公共卫生专业人员进行问卷调查，分析健康科普活动参与率及其影响因素、健康科普能力建设需求以及面临的主要问题。结果 本研究共纳入499名调查对象，314名（62.9%）参与过健康科普活动；女性、中级以及副高及以上职称（OR = 2.086，95%CI:1.362～6.879，P = 0.001；OR = 0.514，95%CI:0.290～0.908，P = 0.022；OR = 0.325 95%CI:0.145～0.729，P = 0.006）是影响公共卫生专业人员参与健康科普活动的影响因素。在479名调查对象中希望获得“综合性专业科普知识”“专业表达、沟通和演讲技巧”“多媒体应用技能”分别占66.2%、51.8%、37.4%。在476名调查对象中认为开展健康科普活动面临策划、资金、组织、实施困难分别占56.9%、46.8%、28.4%、25.6%。结论 我国半数以上公共卫生专业人员参与过健康科普活动，公共卫生专业人员尤其是30岁以下或职称较低者的健康科普活动参与率较低。开展健康科普的主要动因与工作岗位相关，因兴趣爱好参与健康科普活动的比例低于科技工作者的整体水平。需健全公共卫生专业人员参与健康科普的激励机制，加大培训力度，加强专业人员健康科普能力建设。     

石家庄市社区医疗卫生人员伤害及安全社区知信行情况调查

目的了解石家庄市社区医疗卫生人员伤害及安全社区的认知水平、态度、行为情况,为开展伤害健康教育及建设安全社区工作提供依据。方法选取社区卫生服务机构医疗卫生人员612人,采用自填式问卷进行集中调查,其中资料完整的596人。结果接受调查的社区医疗卫生人员伤害及安全社区总知晓率为79.43%,其中能准确回答伤害定义的仅有8.89%,知晓安全社区的有25.38%,1年内有过不安全行为经历的有97.15%,男性医务人员知识知晓情况高于女性,但伤害行为发生率高于女性。认同应由社区医务人员对居民进行伤害防治教育的有45.77%,曾在日常工作中参与居民伤害防治教育工作的只有0.13%。结论该市社区医疗卫生人员对伤害的认知水平较高,但对伤害定义和安全社区缺乏了解,应加强对其进行伤害及安全社区知识培训。     

Managing the Health Effects of Temperature in Response to Climate Change: Challenges Ahead

Background: Although many studies have shown that high temperatures are associated with an increased risk of mortality and morbidity, there has been little research on managing the process of planned adaptation to alleviate the health effects of heat events and climate change. In particular, economic evaluation of public health adaptation strategies has been largely absent from both the scientific literature and public policy discussion.Objectives: We examined how public health organizations should implement adaptation strategies and, second, how to improve the evidence base required to make an economic case for policies that will protect the public’s health from heat events and climate change.Discussion: Public health adaptation strategies to cope with heat events and climate change fall into two categories: reducing the heat exposure and managing the health risks. Strategies require a range of actions, including timely public health and medical advice, improvements to housing and urban planning, early warning systems, and assurance that health care and social systems are ready to act. Some of these actions are costly, and given scarce financial resources the implementation should be based on the cost-effectiveness analysis. Therefore, research is required not only on the temperature-related health costs, but also on the costs and benefits of adaptation options. The scientific community must ensure that the health co-benefits of climate change policies are recognized, understood, and quantified.Conclusions: The integration of climate change adaptation into current public health practice is needed to ensure the adaptation strategies increase future resilience. The economic evaluation of temperature-related health costs and public health adaptation strategies are particularly important for policy decisions.     

昆山市成年女性心理健康状况调查分析

目的了解昆山市成年女性心理健康状况水平,并为其提供合适的心理健康知识和心理援助,以提高其心理健康素质。方法采用分层随机抽样方法,通过标准化设计的问卷进行匿名调查,调查人群年龄为18～85岁。数据应用SPSS13.0软件进行统计分析。结果共调查599位女性,其中84.4%认为自己的心理很健康;56.1%认为自己能够正确的评价自己,接纳自己;54.9%认为自己的情绪稳定;55.2%认为自己的意志健全;76.1%认为自己有良好的人际关系。结论从整体情况来看,昆山市女性的心理健康状况处在正常的水平,但是在接纳自我、情绪稳定、意志健全这三个方面的心理健康问题比较突出,值得关注。     

Community of practice: an effective mechanism to strengthen capacity in climate change and health

SettingClimate change is one of the greatest threats to global health in the twenty-first century and has recently been declared a health emergency. The lack of effective dissemination of emerging evidence on climate change health risks, effects, and innovative interventions to health professionals presents one of the greatest challenges to climate action today.InterventionTo identify and address the knowledge gaps at the intersection of health and climate change, the Canadian Coalition for Global Health Research (CCGHR) established a Working Group on Climate Change and Health (WGCCH). WGCCH is evolving organically into a community of practice (CoP) that aims to elevate knowledge brokering on climate change and health and expand to global multi-, inter-, and transdisciplinary realms.OutcomesTo date, the WGCCH established a regular webinar series to share expert knowledge from around the world on intersections between climate change and health, developed short summaries on climate change impacts on broad health challenges, supported young professional training, and enhanced climate health research capacity and skills through collegial network development and other collaborative projects that emerged from CoP activities.ImplicationsThis paper proposes that WGCCH may serve as an example of an effective strategy to address the lack of opportunities for collaborative engagement and mutual learning between health researchers and practitioners, other disciplines, and the general public. Our experiences and lessons learned provide opportunities to learn from the growing pains and successes of an emerging climate change and health-focused CoP.