健康传播中健康素养和媒介素养的教育反思

针对健康传播现状,笔者以"大卫生"和"大传播"观为框架,从媒介素养与健康素养教育角度探讨我国健康传播的健康生态营造。     

武汉市农村居民健康素养干预效果评价

目的对农村居民存在的最突出的卫生及行为问题进行有针对性的干预,提高农村居民的健康素养水平,探索农村社区健康素养干预方式。方法采通过巡展、举办健康教育讲座、咨询、技能演示、视频教育等多种形式,对武汉市农村居民进行1年的干预,并对农村居民健康素养水平进行本底调查和干预评价。结果居民的总体健康知识知晓率提高了9.3%,健康行为形成率提高了4.8%,健康技能持有率提高了5.9%。结论农村居民在健康基本知识、行为生活方式与习惯及健康基本技能方面表现较干预前有较大提高。通过现场干预实践,提高了农村居民健康素养,干预效果显著。     

2012年中国居民健康素养影响因素分析

  目的  了解江苏省南京市居民慢性病防治素养水平状况及影响因素,为制定针对性的健康素养干预策略和措施提供依据。  方法  于2016年10 — 12月,采用多阶段分层与人口规模成比例抽样（PPS）方法,在南京市12个行政区随机抽取15～69岁居民9 168人进行问卷调查。  结果  2016年南京市居民慢性病防治健康素养水平为10.9 %（95 % CI = 8.8 %～13.4 %）,低于全国平均水平（11.5 %）。多因素logistic回归分析显示,白领人员慢性病防治健康素养水平高于蓝领人员（14.6 % vs. 9.6 %;OR = 1.35,95 % CI = 1.04～1.75）;与低收入人群比较,中、高收入人群的慢性病防治健康素养水平较高[（11.0 % vs. 7.3 %;OR = 1.42,95 % CI = 1.03～1.95）;（14.1 % vs. 7.3 %;OR = 1.74,95 % CI = 1.04～2.92）]。  结论  2016年南京市居民慢性病防治健康素养水平较低,应以蓝领工作者和家庭人均收入较低人群为重点干预对象,以提高全体居民慢性病防治健康素养水平。     

Promoting health literacy through the health education assessment project

BACKGROUND: The Council of Chief State School Officers' State Collaborative on Assessment and Student Standards Health Education Assessment Project (SCASS-HEAP) allows states to pool financial and human resources to develop effective ready-to-use health education assessment resources through a collaborative process. The purpose of this article is to describe the extensive ongoing development of the SCASS-HEAP and its benefits for important stakeholders in health and education. METHODS: A review of the products from the first decade of the SCASS-HEAP was undertaken. RESULTS: The SCASS-HEAP supports a comprehensive systems approach to helping educators focus effectively on the most important skills and issues in child and adolescent health and gives health education a place at the school reform table, providing visibility and credibility and promoting the essential links between health and learning. CONCLUSION: State education agencies and school districts can use SCASS-HEAP materials for assessment and, perhaps more importantly, to help teachers modify and improve instruction at the classroom level for increased student learning.     

Health literacy: addressing the health and education divide

Health literacy as a discrete form of literacy is becoming increasingly important for social, economic and health development. The positive and multiplier effects of education and general literacy on population health, particularly women's health, are well known and researched. However, a closer analysis of the current HIV/AIDS epidemics, especially in Africa, indicates a complex interface between general literacy and health literacy. While general literacy is an important determinant of health, it is not sufficient to address the major health challenges facing developing and developed societies. As a contribution to the health literacy forum in Health Promotion International, this paper reviews concepts and definitions of literacy and health literacy, and raises conceptual, measurement and strategic challenges. It proposes to develop a set of indicators to quantify health literacy using the experience gained in national literacy surveys around the world. A health literacy index could become an important composite measure of the outcome of health promotion and prevention activities, could document the health competence and capabilities of the population of a given country, community or group and relate it to a set of health, social and economic outcomes.     

中国居民传染病健康素养量表编制与信效度检验

目的 筛选中国农村居民健康素养评价指标,为编制农村居民健康素养测评工具奠定基础。 方法 2017年10月,通过文献检索和专家咨询,提出农村居民健康素养评价指标初稿,采用德尔菲专家咨询法遴选中国农村卫生、环境卫生、食品卫生、健康教育与健康促进等领域的专家30名,采用函询的办法,邀请专家就指标的重要性、敏感性和特异性进行评分。 结果 两轮咨询问卷回收率均 > 90 %,专家权威程度0.85。经过两轮咨询,专家意见趋于一致。专家协调系数为0.322,且有统计学差异（P < 0.01）。最终筛选出43个条目,分别从健康意识和观念（16个条目）、健康知识（21个条目）、健康技能（3个条目）和健康信息认知与应用（3个条目）4方面对农村居民健康素养进行评价。 结论 专家代表性强、积极性高、权威程度和协调性较好,此次咨询筛选出的条目符合构建农村居民健康素养评价指标体系的需要。     

Early adolescents perceptions of health and health literacy

BACKGROUND: Health illiteracy is a societal issue that, if addressed successfully, may help to reduce health disparities. It has been associated with increased rates of hospital admission, health care expenditures, and poor health outcomes. Because of this, much of the research in the United States has focused on adults in the health care system. This study investigated the effect of aspects of health literacy on the motivation to practice health-enhancing behaviors among early adolescents. METHODS: Measures were generally based on 3 National Health Education Standards for grades 5-8. Data were obtained from 1178 9- to 13-year-old students visiting 11 health education centers in 7 states. Students responded via individual electronic keypads. RESULTS: Multivariate logistic regression revealed that, in addition to age, difficulty understanding health information and belief that kids can do little to affect their future health, decreased the likelihood for interest in and desire to follow what they were taught about health. Further, low interest independently decreased motivation to follow what was taught. Girls were more likely to turn to school, parents, and medical personnel for health information. Older students were more likely to turn to school and to the Internet. CONCLUSIONS: Programs and curricula should be designed to increase student interest in health issues and their self-efficacy in controlling their own health destinies. Educators should also teach students to more effectively use nonconventional health information sources such as the Internet, parents, and medical professionals.     

Lay beliefs about the preventability of major health conditions.

Beliefs about the extent to which health problems can be prevented reflect an understanding that preventive measures can reduce adverse health events and the level of control individuals perceive that they hold over the factors that affect their health. A population survey of 1659 people conducted in 1995 in south western Sydney, Australia, found that only child drownings, tooth decay, skin cancer, and burns and scalds were considered all or mostly preventable by more than 50% of the sample. The majority of respondents did not believe that heart attacks, cervical cancer, high blood pressure, serious road injury, lung cancer and asthma deaths were all or mostly preventable. Logistic regression analysis showed that people born in an English speaking country, those with more than 10 years of education and men were significantly more likely to recognize a number of key conditions as highly preventable. The findings suggest that, in spite of the range of prevention efforts in Australia to date, these are not matched by strong beliefs within the community that prevention is possible. Communication of the opportunities and methods for prevention needs to be improved, particularly among certain population groups. The findings also indicate a need to examine social and environmental factors which are potentially reducing confidence, and subsequently and adoption of preventive behaviours.     

2008年北京市顺义区健康素养监测

目的了解北京市顺义区农村居民健康素养水平,为今后的健康教育工作提供指导性方向。方法采用整群随机抽样方法 ,抽取顺义区农村地区两个行政村,采用北京市健康教育所统一的调查问卷进行入户调查。结果该地区居民健康素养总体水平为18.1%,具备基本知识和理念、健康生活方式与行为、基本健康素养的人口比例分别是42.5%、16.2%和28.5%;具备相关健康素养的人口比例由高到低分别是:安全与急救素养69.4%、科学健康观素养48.5%、传染病预防素养32.3%、慢性病预防素养9.2%、基本医疗素养5.8%。结论该区居民整体健康素养较低,健康教育工作任重道远。     

中国农村职业人群健康素养现状及影响因素分析

目的 分析中国农村职业人群健康素养(adequate health literacy,AHL)现况及主要影响因素,为相关政策的制定提供依据。方法 2008年5—8月,采取多阶段分层随机抽样方法,调查全国31个省(自治区、直辖市)及新疆生产建设兵团(未含香港、澳门和台湾)32 987名农村15～69岁脑力劳动者、轻体力劳动者、农林牧副渔生产运输者和农民工的AHL水平。结果 调查地区农村职业人群具备AHL的比例为3.98%,其中脑力劳动者、轻体力劳动者、农林牧副渔和农民工分别为16.90%、16.20%、2.14%、4.50%;农村职业人群具备基本知识和理念、健康生活方式和行为、基本技能素养的人口比例分别是10.14%、4.09%、13.05%;具备科学健康观、传染病预防素养、慢性病预防素养、安全与急救素养、基本医疗素养的人口比例分别是23.35%、11.35%、2.77%、12.33%、4.76%;logistic回归模型发现,对农村职业人群AHL影响因素从高到底依次为文化程度(OR=0.497)、职业性质(OR=-0.222)、民族(OR=-0.175)、地域(OR=-0.167～0.071)、年龄(OR=-0.094)和婚姻状况(OR=0.049);文化程度越高、年龄越轻、汉族、已婚者AHL相对较高,中部高于东部,西部最低。结论 文化程度、职业性质、民族、地域、年龄、婚姻是我国农村职业人群AHL的主要影响因素,应采取相应的干预措施,改善农村居民AHL现况。     

中国城乡居民基本医疗素养现状调查及其影响因素研究

  目的  了解中国居民2012 — 2017年慢性病防治素养（慢病素养）水平变化趋势及影响因素,为进一步提高居民慢病素养提供参考依据。  方法  采用单纯随机抽样方法在2012 — 2017年全国居民健康素养监测数据库中抽取89153名居民作为研究对象并收集相关数据,采用层次年龄 – 时期 – 队列（APC）法构建多水平固定效应模型分析中国居民慢病素养水平变化趋势及其影响因素。  结果  中国居民2012、2013、2014、2015、2016和2017年慢病素养持有率分别为8.52 %、11.01 %、9.01 %、10.05 %、10.25 %和13.96 %,中国居民慢病素养持有率总体呈上升趋势（χ²_趋势 = 118.69,P < 0.001）;居民慢病素养水平时期净效应与时期粗效应的变化大体趋势一致,均表现为2012 — 2016年上下波动,2016 — 2017年快速增长。在控制了人口学变量和健康情况影响后,多水平固定效应模型分析结果显示,文化程度小学及以上、医务人员、自觉健康状况比较好的中国居民慢病素养水平较高,少数民族、农民、工人、中部地区、西部地区和居住在农村的中国居民慢病素养水平较低;将每一年的慢病素养水平与前一年相比,慢病素养水平在2013年、2015年和2017年均较前一年有所上升（OR = 1.200、1.116、1.535,均P < 0.01）。居民慢病素养水平的变化具有明显的时期效应,但中国居民2012 — 2017年慢病素养水平变化未见显著的年龄效应和队列效应（均P > 0.05）。  结论  中国居民2012 — 2017年慢病素养水平的时期净效应呈现总体增长趋势,以2016 — 2017年增长速度最快,由政策或健康促进项目带来的时期效应和一些人口学因素对慢病素养水平变化的影响值得重视。     

住户调查中户内样本抽样方法的比较研究

  目的  了解甘肃省农民健康素养现状,为开展农民健康教育与健康促进工作提供参考依据。  方法  于2018年10 — 12月采用多阶段分层随机抽样方法在甘肃省抽取16 349名18～69岁农民进行健康素养问卷调查。  结果  甘肃省16 349名农民中,具备健康素养者1 587人,总体健康素养水平为9.7 %;具备基本知识和理念、健康生活方式与行为和基本健康技能3个方面健康素养者依次为3 019、1 959和1 905人,此3个方面素养水平依次为18.9 %、12.4 %和11.9 %;具备科学健康观、传染病防治、慢性病防治、安全与急救、基本医疗和健康信息6类健康问题健康素养者分别为5 149、2 579、2 499、4 853、2 492和2 677人,此6类健康问题健康素养水平依次为31.7 %、17.0 %、15.1 %、29.6 %、15.8 %和16.4 %。  结论  甘肃省农民健康素养水平较低,尤其是基本健康技能和慢性病防治素养水平较低,应采取有针对性地措施大力开展农民健康素养促进行动。     

句容市农村居民健康素养干预效果分析

目的:了解干预前后农村居民健康素养相关知识、理念、行为、技能的改变,评价全民健康教育对公众健康素养的影响,为探寻农村居民健康素养提高策略提供依据.方法:采用现场流行病学的方法,在基线调查的基础上,以健康知识资料入户、健康咨询巡展巡讲、媒体宣传密集覆盖等方式,开展8个月的集中干预,以及再常规性宣传干预1年后分别进行效果评...