Effects of traditional classroom and distance continuing education: a theory-driven evaluation of a vaccine-preventable diseases course

OBJECTIVES: This study evaluated the effects of a major federal immunization continuing education course, delivered in both traditional classroom and satellite broadcast versions, on public health professionals' knowledge, agreement, self-efficacy, and adherence in practice to recommendations. METHODS: The study used a comparative time series design to determine whether the course influenced participants' knowledge, agreement, self-efficacy, and adherence in practice to general and polio-specific recommendations as measured immediately and 3 months after the course. It also compared the effects of the classroom and satellite broadcast versions and used path analysis to show how the outcomes were related to one another. RESULTS: Both versions significantly improved knowledge, agreement, self-efficacy, and adherence. Knowledge and agreement were significant predictors of self-efficacy, which directly predicted adherence. Vaccine availability and supportive clinic policies were also important adherence predictors. CONCLUSIONS: A well-designed training update can change provider knowledge, agreement, self-efficacy, and adherence. Traditional classroom and distance training can have comparable effects. The findings support incorporation of distance learning in national public health training, if the distance learning is used wisely in relation to training needs, goals, and practice contexts.     

Evaluating the effectiveness of an emergency preparedness training programme for public health staff in China

BACKGROUND: The severe acute respiratory syndrome (SARS) crisis of 2003 provided a new urgency in China in terms of preparing public health staff to respond effectively to public health emergencies. Although the Chinese Government has already carried out a series of emergency education and training programmes to improve public health staff's capability of emergency preparedness, it remains unclear if these training programmes are effective and feasible. The purpose of this research was to evaluate an emergency preparedness training programme and to develop a participatory training approach for emergency response. METHODS: Seventy-six public health staff completed the emergency preparedness training programme. The effectiveness of the training was evaluated by questionnaire before training, immediately after training and 12 months after training (follow-up). Additionally, semi-structured interviews were conducted throughout the training period. RESULTS: The emergency preparedness training improved the knowledge levels and increased attitudinal and behavioural intention scores for emergency preparedness (P<0.01). The results at follow-up showed that the knowledge levels and attitudinal/behavioural intention scores of participants decreased slightly (P>0.05) compared with levels immediately after training (P<0.01). However, there was a significant increase compared with before training (P<0.01). Moreover, more than 80% of participants reported that the training process and resources were scientific and feasible. CONCLUSIONS: The emergency preparedness training programme met its aims and objectives satisfactorily, and resulted in positive shifts in knowledge and attitudinal/behavioural intentions for public health staff. This suggests that this emergency training strategy was effective and feasible in improving the capability of emergency preparedness.     

因子分析法的公众应急准备情况影响因素研究

摘要：目的　用因子分析方法探讨公众应急准备状态的影响因素。方法　随机选取４６８名黑龙江省哈尔滨
市居民为调查对象,调查可能影响公众应急准备状态的２３项因素,对２３项影响因素进行了初始因子分析
和方差最大旋转。结果　２３项影响因素间存在６个主要公因子,其中第１公因子主要反映的是公众学习应
急知识、参与应急培训演练、思考及探讨应急逃生计划等应急准备行为情况;第２公因子主要反映的是公
众对于突发事件、应急准备的认知情况;第３公因子主要反映的是公众对于生活工作学习的场所发生自然
灾害、事故灾难、公共卫生、社会安全类事件的可能性大小的判断情况;第４公因子主要反映的是公众对
增强风险意识、保持警惕、做好应急准备的重要性认识情况;第５公因子主要反映的是公众对应急内容、
掌握应急知识、技能以及探讨应急类话题的态度情况;第６公因子主要反映的是公众对于探讨应急类话题
的凶吉认识、应对突发事件责任认识等的应急心理情况。结论　加强公众的应急准备能力,需要从公众的
应急准备行为、应急认知、风险判断、风险意识、应急态度、应急心理等多个方面来进行干预。
关键词：因子分析;公众;应急准备情况;影响因素
中图分类号：Ｒ１９７　　文献标识码：Ａ　　文章编号：１００９ ６６３９ （２０１４）０３ ０１６６ ０４     

蚌埠市农村人群乙型肝炎疫苗接种影响因素研究

目的　调查影响农村居民接受乙肝疫苗接种的因素 ,探索能提高农村地区乙肝疫苗接种率的有效干预策略。方法　随机抽取蚌埠市郊区秦集乡、吴小街乡、怀远县梅桥乡、五岔乡的目标人群 4 0 0人 ,以问卷形式了解其对乙肝疫苗接种的知识、信念、行为现况。结果　 81.77%的目标人群知道有乙肝疫苗 ,6 8.90 %的人认识到其作用 ,但有一半的人不了解乙肝疫苗接种程序 ;获得乙肝疫苗知识的途径主要是医生和广播、电视 ;未给孩子接种乙肝疫苗主要原因是不知道相关知识和接种程序 ;目标人群乙肝疫苗全程接种知识贫乏。结论　当前农村提高乙肝疫苗接种率的主要策略是加大乙肝疫苗接种的健康教育力度 ,发挥孕期保健时医生的人际传播作用 ,继续加大广播电视媒体的大众传播作用     

Evaluation of mental health emergency preparedness among health professionals

The purpose of this study was to identify if health professionals report an increase in mental health preparedness abilities with having only two mental health components as part of a 2-day preparedness training conference. At each of three conferences, identical pretraining and posttraining surveys were administered to conference participants. A 3-month follow-up survey was administered to respondents who volunteered to complete them. At pretraining, respondents (n = 603) reported generally greater mental health preparedness abilities than non-mental health preparedness abilities. This trend continued at posttraining (n = 490) and at 3 months posttraining (n = 195). Participants reported significantly increased mental health preparedness abilities at immediate posttraining and at 3 months posttraining from pretraining. This current study suggests that even when mental health items are included as a secondary component of disaster preparedness training, significant and meaningful growth in participants' confidence in their abilities can occur.     

公众救灾防病知信行流行病学调查分析

目的了解浙江省公众对灾害和救灾防病知识、信念、行为和健康教育需求情况.方法对浙江省609名1990年8月30日前出生的城市、城镇和农村居民进行间卷调查.结果调查对象对灾害和救灾防病基本知识有一定的了解,但还需进一步加强救灾防病健康教育力度.重点人群是农民,重点内容为急救知识.电视得到了普遍欢迎;广播可作为农村健康教育的重要手段;文字材料适宜针对城市和城镇居民,表现形式可以文字为主,配些插图;宣传画也是一种公众喜欢的传播手段.结论针对城市和农村设计不同风格和表现手法的宣传资料,可取得最好的健康教育效果.     

鄂尔多斯市布鲁杆菌病干预效果评价

目的 评价在重点人群中开展布病宣传等干预措施对该人群布病知识知晓率、防护用品使用率及相关行为所产生的影响,为控制布病疫情提供科学依据.方法 分别予干预前后随机选取部分从事屠宰、养殖和皮毛加工人员,进行内容相同的问卷调查,比较布病患病率、知识知晓率、防护用品使用率以及相关行为的变化.结果 干预后布病知识知晓率显著提高,布...     

对职业中毒病人实施健康教育的效果评价

目的评价对职业中毒病人开展健康教育的效果,为完善教育模式提供依据。方法对125例职业中毒病人采取个别指导、集体讲座、文字宣传和收看录像、幻灯等形式开展规范、系统的健康教育。通过问卷调查比较病人在教育前后健康知识、态度和行为得分及对医疗服务满意度的变化。结果病人在健康教育前后知识、态度得分差异显著,行为得分总体变化不明显;在健康教育后,女性相关态度和行为改变均显著高于男性;高年龄组在教育前知识得分显著高于低年龄组,在教育后知信行指标也较高,但与教育前比较无显著性差异;不同文化程度的病人,知识得分在教育前后、态度得分在教育后差异显著,行为得分在教育前后组间差异均不明显。结论医院健康教育能够有效提高病人相关知识水平、改善对疾病的态度,但不能显著改变行为;教育效果受性别、年龄和文化程度的影响。因此,在健康教育中,应针对病人的具体情况,确定相应的教育方法、内容和强度,进行持续的教育和行为干预,以取得更好的效果。     

Preparedness and response to terrorism: a framework for public health action

Political group violence in the form of terrorist actions has become a reality worldwide, affecting the health and economies of populations. As a consequence, preparedness and response are becoming an integral part of public health action. Risk appraisal, preservation of human and civil rights and communications within and between countries are all issues to be considered in the process. The combination of the natural history of terrorist actions and the epidemiological triangle model has been adapted in this paper and suggested as a comprehensive approach for preparedness and action. It covers preparedness (pre-event), response (event) and the consequences (post-event) of a terrorist attack. It takes into account the human factor, vectors and environment involved in each one of the phases. KEY POINTS: Terrorism is a global reality with varying underlying causes, manifestations and impact on the health of the public. Preparedness, response and rehabilitation are an integral part of public health action. Consideration of the pre-event, event and post-event phases in terrorist actions, together with the human factor, vector/agent and environment in each of these phases, offers a framework for public health preparedness, response and rehabilitation. Planning should consider risk assessment, risk communication, inter-sectorial cooperation, enactment of laws and regulations which consider protection of the public's health and civil liberties. Allocation of resources would need to make allowance for maintenance and development of ongoing public health activities.     

2018年上海市闵行区儿童家长预防接种知识和满意度调查

目的了解上海市闵行区儿童家长对预防接种知识知晓度和对接种门诊的服务满意度,并探讨其影响因素。方法采用随机抽样的方法,对上海市闵行区13个社区卫生服务中心接种门诊的1380名儿童家长进行预防接种知识知晓情况及接种门诊服务满意度的问卷调查,并分析其影响因素。结果被调查儿童家长为母亲、常住人口、本科及以上、28~35岁、机关事业单位职员和家庭年收入在10~20万元者预防接种知识知晓率高于其他人群。多因素分析显示,母亲和本区常住人口的预防接种知识知晓情况显著较高。此外,儿童家长对预防接种门诊环境卫生情况、医务人员的工作态度及健康宣教(禁忌症筛查、注意事项、接种后留观等)的满意度分别为96.09%、96.23%和95.80%,总满意度(满意和很满意)为95.07%。结论应加强对重点人群(如儿童父亲及其他亲属、外来流动人口、从事家务农业及待业人群等)的预防接种知识的宣教工作,不断改善接种门诊的环境和服务质量,从而进一步提高儿童预防接种知识的知晓率和满意度。     

北京市某高校大学生生殖健康教育干预效果评价

目的了解北京市某高校大学生生殖健康相关知识、态度和行为状况,评价健康教育效果。方法采用随机整群抽样方法,对某高校1027名大学生健康教育干预前后进行相同匿名问卷调查。结果干预后大学生对生殖健康基本知识、避孕知识、预防知识的正确认知均有所提高。大学生"宿舍留宿异性"、"多性伴"、"交易性行为"正向态度分别上升到68.6%、82.8%和86.0%(P<0.05或P<0.01),29.4%的大学生认可在校发生性行为。干预后,登陆色情网站(33.4%)、看色情书籍(36.6%)、看色情影碟(44.3%)等与性有关的行为均有所降低。结论在大学生中开展生殖健康教育是必要的,广播宣传、网络宣传、展板展示、发放宣传资料等综合干预,是有效的健康教育形式。     

The effectiveness of nutrition education programme for primary school children

This study was conducted to determine changes in nutrition knowledge, attitude and practice of 8-year-old school children after receiving a nutrition education package. A total of 418 school children from urban and rural areas participated in this study. The intervention group consisted of 237 children while 181 children who did not receive the nutrition education package acted as controls. The nutrition education programme that was conducted for 3 weeks comprised of a video viewing session and a comic reading session followed by exercise questions as reinforcement for each session, and also classroom activities. Knowledge, attitude and practice questionnaires were distributed to the children before (pre-intervention) and after (postintervention) receiving the nutrition education programme. A follow-up visit was conducted six months after the programme had elapsed. The results obtained indicated that the nutrition knowledge score increased significantly in the intervention group from 48.3±13.2 at pre-test to 54.6±16.2 in post-test and 55.0±14.3 in follow-up test (p<0.05). The nutrition attitude score also increased significantly from 68.7±15.5 at pre-intervention to 72.6±15.0 and 74.7±15.8 during post-test and follow-up test respectively (p<0.05). However, the nutrition practice score had no significant improvement in both groups throughout the study period. There were no significant changes in the control group in knowledge, attitude and practice scores at pre, post and follow-up tests. In conclusion, this study showed that a good nutrition education programme had a positive impact whereby better nutrition knowledge, attitude and healthy eating habits in children were seen. It is hoped that the improvements would be sustained throughout their lives.     

The Management Academy for Public Health: the South Carolina experience.

In the late 1990s, the South Carolina Department of Health and Environmental Control (SCDHEC) was faced with the challenges of a workforce that was not prepared in public health; the impending loss of significant agency expertise, leadership, and institutional knowledge through retirement; the lack of available and accessible training; and continuing state budget cuts. Preparedness for bioterrorism and other public health emergencies was also of concern, a need made more urgent after 2001. To respond to current and emerging public health challenges, the SCDHEC had to have a workforce with the knowledge and skills necessary for the delivery of essential public health services. To address these challenges, the department partnered with the University of North Carolina in the pilot of the Management Academy for Public Health. The Management Academy is now integrated into the South Carolina workforce development strategy, and 199 staff members and 22 community partners have graduated from the program. Along with increased knowledge, skills, and abilities of individual staff and increased organizational and community capacity, a significant result of South Carolina's experience with the Management Academy for Public Health is the development of a training program for emergency preparedness modeled on the Management Academy. This highly successful program illustrates the replicability of the Management Academy model.     

Using principles of community-based participatory research to enhance health data skills among local public health community partners.

In a prior statewide health disparities assessment, local community public health and social service professionals indicated a need for technical capacity growth in order to understand and effectively utilize health data. Using a community-based participatory research approach in addressing this need, health data training was provided to 26 individuals with the primary goals being to provide capacity to identify health disparities that result in higher morbidity and mortality, and to provide the skills needed to access, interpret, and utilize health data. Satisfaction surveys showed that an overwhelming majority of participants were extremely pleased with the training. Follow-up telephone interviews (100% response rate) conducted 2 months after the training indicated positive results, with participants discussing how they felt empowered to find, interpret, and use data as a result of the training. Results of a 6-month follow-up questionnaire (54% response rate) further supported the program's desired outcome to expand participants' knowledge and use of health data. This pilot project illustrated how utilizing a community-level partnership approach to program development not only enhances the utilization of such programs but also helps sustain participants' knowledge and skills.     

Core competencies for disaster medicine and public health

Effective preparedness, response, and recovery from disasters require a well-planned, integrated effort with experienced professionals who can apply specialized knowledge and skills in critical situations. While some professionals are trained for this, others may lack the critical knowledge and experience needed to effectively perform under stressful disaster conditions. A set of clear, concise, and precise training standards that may be used to ensure workforce competency in such situations has been developed. The competency set has been defined by a broad and diverse set of leaders in the field and like-minded professionals through a series of Web-based surveys and expert working group meetings. The results may provide a useful starting point for delineating expected competency levels of health professionals in disaster medicine and public health.     

Difficulties in the prevention of cervical cancer: adults' attitudes towards HPV vaccination 3 years after introducing the vaccine in Hungary

Cervical cancer is one of the most prevalent gynaecological malignancies worldwide. The Hungarian incidence and mortality of this disease take the 4th-5th places within the European Union. A survey including 785 male and female adults was conducted to assess the knowledge and attitudes concerning HPV vaccination. We focused on the difficulties of the primary and secondary prevention of cervical cancer and examined some potential sociodemographic predictors of HPV vaccine acceptability.Our findings have identified some important issues like: incomplete knowledge, intense distrust and financial concerns. Almost half of the college students (45.6%) are unaware of HPV infections. We confirmed previous findings that older age and female gender correlates with better knowledge on STDs, including HPV. We found that greater exposure to health information comes with better knowledge and more positive attitudes towards vaccination.One quarter of survey respondents do not believe that cervical cancer may be prevented by vaccination. More than half of the adults do not trust national health care system and the preparedness of Hungarian doctors. General attitudes towards vaccination are broadly positive, 80% of survey participants had expressed desire towards HPV vaccination, however if there was a need to pay for the vaccination the willingness would decrease by half.Primary prevention through HPV-focused educational programs, clear communication and financial support would be important for public health to reduce the high incidence and mortality of cervical cancer in Hungary in the future.     

公众对公共场所新冠病毒感染个人防护的知识态度行为调查

目的 了解我国公众对公共场所场景下新冠病毒感染个人防护的知识态度行为现状。方法 2022年7至9月依托全国公共场所健康危害监测网络面向我国城市成年人开展公共场所相关的新冠病毒感染个人防护知识、态度及行为问卷星在线调查。共收集有效问卷6 723份。采用χ¹检验对分类资料进行比较分析。结果 5项新冠病毒感染防护基本知识中，公众对“新冠病毒感染传播途径”和“疫苗接种目的”的知晓率最低，分别为50.22%和76.45%。9种态度及行为中，“经常对手机进行消毒”、“接触公共场所及交通工具内物品后，马上洗手或手部消毒”和“触摸公共场所及交通工具内物品后，做到不接触口、鼻、眼部”三种行为的正确率最低，分别为17.03%、23.87%和33.50%。此外，女性对新冠病毒感染防控知识的知晓率、态度及行为正确率均高于男性；高年龄段人群新冠病毒感染防控行为的正确率高于低年龄段，差异均具有统计学意义(P <0.05)。结论 公众对公共场所新冠病毒感染个人防护知识的掌握程度总体不高，个人防护态度和行为有待提高，提示应加强面向公众的公共场所卫生宣传教育。     

Barriers to at-home-preparedness in public health employees: implications for disaster preparedness training

OBJECTIVES: To assess "at-home" preparedness and barriers to preparedness in a cohort of public health employees. METHOD: Conducted a cross-sectional survey involving 100 employees attending emergency preparedness training that emphasized incident command training and included a segment on "at-home" preparedness. RESULTS: Fifteen percent of participants were rated as "better prepared," and only 8% of participants would be considered "most prepared." There was no relationship between the concern for bioterrorism and other disasters and preparedness. The principal barrier involved challenges in getting the task done versus lack of desire or knowledge. CONCLUSIONS: There is great potential for distraction of public health workers during an emergent event if they are not prepared at home and have concern for family members. At-home preparedness training efforts that emphasize what should be done and why are likely to have limited impact on changing behavior. Strategies that ensure that small steps are taken are likely to be more successful.     

天津市孕期妇女预防接种知识现状及干预效果研究

目的:了解天津市孕期妇女预防接种知识现状,探索对该人群开展健康干预方式。方法:对分层随机抽取的孕3个月到分娩在本市居住3个月及以上的孕妇在干预前后开展问卷调查,健康干预采用发放光盘和宣传手册2种方式。数据用χ2检验等方法分析。结果:干预前后分别调查714例和706例孕妇,随访率98.88%。干预前疫苗知晓率12.89%,干预后为42.72%(P<0.01)。干预前光盘和宣传手册组疫苗知晓率无差别,干预后光盘组高于宣传手册组(P<0.01);孕37周及以上人群干预后低于其他组(P<0.01)。95.52%的孕妇希望获得预防接种知识,最希望获取途径前3位为医生(56.72%)、专业书籍(31.23%)、专题讲座(26.61%)。结论:孕期妇女疫苗知晓率不高,该人群希望获取预防接种知识且健康干预效果明显。健康干预可以采取对孕20～36周孕妇发放宣传光盘和孕妇学校医生讲解相结合的方式。     

基于微信平台的自我管理干预对COPD患者 肺功能及生活质量的影响*

目的研究基于微信平台的自我管理干预对慢性阻塞性肺疾病(COPD)患者肺功能及生活质量的影响。方法选择2017年1月至2018年12月在我院治疗的COPD患者80例,采用随机数字表法随机分为对照组和观察组,每组各40例。对照组患者参照《COPD自我管理知识手册》进行自我管理,观察组患者采用基于微信平台的自我管理干预,比较两组患者的肺功能、生活质量、焦虑抑郁及运动耐力等指标。结果干预前,两组患者的第1秒用力呼气容积(FEV1)、第1秒用力呼气容积/用力肺活量(FEV1/FVC)、6分钟步行试验(6 MWT)和Borg评分相近(P0.05);干预后,两组患者的肺功能和运动耐力均明显提高,观察组患者的FEV1、FEV1/FVC和6 MWD均高于对照组,Borg评分低于对照组(P0.05)。干预后,观察组的呼吸症状、活动受限、疾病影响和圣乔治呼吸问卷(SGRQ)总分均低于对照组(P0.05)。干预前,两组患者的医院焦虑抑郁情绪测量表(HAD)评分和抑郁自评量表(SDS)评分相近(P0.05);干预后,观察组的HAD评分和SDS评分均低于对照组(P0.05)。结论基于微信平台的自我管理干预可以明显提高COPD患者的肺功能,提高运动耐力和生活质量,缓解患者的焦虑抑郁情绪和呼吸困难症状,值得在临床推广应用。