Factors associated with smoking and the intention to smoke in secondary school pupils: results of the ESFA project in Barcelona, Spain

Objective: To describe the factors asssociated with smoking and intention to smoke among a representative sample of first-grade pupils of secondary education (12-13 years old) in Barcelona.Subjects and methods: 37 secondary schools were randomly selected to evaluate the impact of a European-wide smoking prevention program (European Smoking prevention Frame Approach, ESFA project). In these schools, 1041 pupils of first grade of secondary education responded to a questionnaire designed at the University of Maastricht to study life-style attitudes and behaviours, mainly smoking.Results: 9.8% of boys and 12.6% of girls declared to smoke either regulary or ocasionally. Among the no-smokers, 61.4% of the boys and 73.3% of the girls reported to have the intention to smoke in the future. Among the boys, factors associated with smoking included social norms (odds ratio [OR] = 2.5; 95% confidence interval [CI]: 1.2-5.2), smoking by siblings (OR = 2.4; 95% CI, 1.1-5.2), attitudes against smoking (OR = 0.3; 95% CI, 0.1-0.6), practicing some sports in the leisure time (OR = 0.3; 95% CI, 0.1-0.7) and having more available pocket money (OR = 3.2; 95% CI, 1.5-6.8). Intention to smoke was only related to attitudes (OR = 0.3; 95% CI, 0.2-0.5). Among girls, smoking was associated to perceived pressure to smoke (OR = 2.5; 95% CI, 1.2-5.0), consumption by friends (OR = 6.0; 95% CI, 2.4-15.4) and attitudes against smoking (OR = 0.2; 95% CI, 0.1-0.4), while intention was only associated to attitudes (OR = 0.4; 95% CI, 0.2-0.6) and hanging out in the street in the leisure time (OR = 2.2; 95% CI, 0.3-3.5).Conclusions: The results stress the need to deal simultaneoulsy with the different factors associated to smoking initiation and attitude shaping, including cognitive factors, environmental factors, and patterns of leisure time utilization.     

Female victims of intimate partner physical domestic violence (IPP-DV), California 1998

BACKGROUND: This study was conducted to identify factors associated with adult female victims of intimate partner physical domestic violence (IPP-DV) in California and to estimate statewide IPP-DV prevalence. METHODS: We analyzed data from the 1998 California Women's Health Survey, a random, computer-assisted telephone interview (CATI) survey of 4006 California women aged > or = 18, conducted by the California Department of Health Services. RESULTS: Data from the survey indicated that 6% of the women reported that in the previous 12 months, their intimate partners threw objects at them, or hit them with an object, or kicked, pushed, slapped, choked, beat up, or threatened them with a gun or a knife. Odds ratio (OR) analyses controlling for age and race/ethnicity suggest that a large number of factors are associated statistically with IPP-DV victims. These factors include feelings of ill physical and mental health; pregnancies at early age; smoking status; nutritional needs; low income; participation in the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) program; having children aged < 18 in the household; and limited access to health care. Among the non-U.S.-born respondents, IPP-DV victims were significantly younger when they entered the United States than their nonvictim counterparts. A multiple logistic regression model identified the following factors as main correlates with IPP-DV: feelings of being overwhelmed in the past 30 days (OR = 3.4, 95% confidence interval [CI] = 2.5-4.6); aged 18 to 44 (OR = 2.8, 95% CI = 1.9-4.1); current smoking status (OR = 2.1, 95% CI = 1.5-2.9); participation in WIC in the previous 2 years (OR = 1.8, 95% CI = 1.2-2.6); and being out of work (OR = 1.4, 95% CI = 1.1-1.9). CONCLUSIONS: The above findings suggest that a variety of venues (e.g., schools, mental and physical health care providers, WIC, immigration programs, and social services) will be needed in order to identify/gain access to IPP-DV victims, provide referral resources, and implement any future prevention efforts.     

Factors associated with gastric cancer screening of Koreans based on a socio-ecological model

OBJECTIVES: We measured behavioral factors associated with Koreans receiving gastric cancer screening based on a socio-ecological model, in part to develop strategies to improve cancer screening rates. METHODS: A telephone survey was conducted with 2,576 people chosen through stratified random sampling from April 1--May 31, 2004. Collected information included gastric cancer screening, socio-demographic factors, and socio-ecological factors at intrapersonal, interpersonal, community, and public policy levels. RESULTS: Among 985 survey respondents (380 men and 605 women), 402 had received gastric cancer screening. Logistic analysis was performed to compare those screened and unscreened. 'Age' was the only demographic factor that showed a statistically significant association with getting screening. People in their fifties (OR=1.731, 95% CI=1.190-2.520) and sixties (OR=2.098, 95% CI=1.301-3.385) showed a higher likelihood of getting screened, compared to those in the forties. 'Accessibility to a medical institution' was a significant factor related to having gastric cancer screening at the intrapersonal level. At the interpersonal level, recommendations by family members to be screened and a family practice of routine cancer screening were significantly related. People with frequent education about cancer screening or with stronger social feelings that cancer screening is necessary also demonstrated significantly higher tendencies to be screened. CONCLUSIONS: In conclusion, a socio-ecological model seems appropriate for explaining gastric cancer screening behavior and associated factors. Health planners should develop integrated strategies to improve cancer screening rates based on socio-ecological factors, especially at the interpersonal and community levels.     

Predisposing and Enabling Factors Associated with Mammography Use Among Hispanic and Non-Hispanic White Women Living in a Rural Area

ABSTRACT:  Context: Women who do not receive regular mammograms are more likely than others to have breast cancer diagnosed at an advanced stage. Purpose: To examine predisposing and enabling factors associated with mammography use among Hispanic and non-Hispanic White women. Methods: Baseline data were used from a larger study on cancer prevention in rural Washington state. In a sample of 20 communities, 537 women formed the sample for this study. The main outcomes were ever having had a mammogram and having had a mammogram within the past 2 years. Findings: Reporting ever having had a mammogram was inversely associated with lack of health insurance (OR = 0.37, 95% CI: 0.16-0.84), ages under 50 years (OR = 0.23, 95% CI: 0.12-0.45), high cost of exams (OR = 0.48, 95% CI: 0.27-0.87), and lack of mammography knowledge (OR = 0.16, 95% CI: 0.07-0.37), while increasing education levels were positively associated (OR = 1.72, 95% CI: 1.09-2.70). Reporting mammography use within the past 2 years was inversely associated with ages under 50 years (OR = 0.49, 95% CI: 0.27-0.88) and over 70 years (OR = 0.47, 95% CI: 0.24-0.94), lack of health insurance (OR = 0.23, 95% CI: 0.10-0.50), and high cost of exams (OR = 0.55, 95% CI: 0.35-0.87). Conclusions: Continued resources and programs for cancer screening are needed to improve mammography participation among women without health insurance or low levels of education.     

One- and two-year predictors of decline in physical activity among inner-city schoolchildren

BACKGROUND: Alarming secular declines in physical activity (PA) have been observed among youth over the last decade. A better understanding of the predictors of these declines is crucial to identifying those children most at risk and to developing interventions that target youth before the onset of decline. This report identifies 1- and 2-year predictors of decline in PA among fourth- and fifth-grade students from inner-city neighborhoods in Montreal, Canada. METHODS: Data for this study were collected in classroom questionnaires each May/June from 1993 to 1997. Analyses for this paper were completed in 2001. The cohort included active (at least one PA per day) children with baseline and 1-year (n =1873) or 2-year (n =509) follow-up data. RESULTS: In boys, 1-year predictors of decline to an inactive status identified in generalized estimating equations analysis included moderate (vs high) baseline PA (odds ratio [OR]=1.66, 95% confidence interval [CI]=0.91-3.05); low PA self-efficacy (OR=1.67, 95% CI=1.03-2.71); born outside Canada (OR=2.13; 95% CI=1.31-3.46); Asian origin (OR=1.81; 95% CI=1.03-3.16) and no participation in school teams (OR=1.81, 95% CI=0.93-3.55). In girls, these 1-year predictors included moderate PA (OR=1.91, 95% CI=1.10-3.32); low PA self-efficacy (OR=1.70, 95% CI=1.15-2.49); watching four or more TV programs per day (OR=1.40, 95% CI=0.97-2.02); mother unemployed (OR=1.54, 95% CI=1.07-2.23); and grade five (vs grade four) (OR=1.35, 95% CI=0.94-1.93). Two-year predictors in boys included moderate baseline PA (OR=2.52, 95% CI=0.84-7.50), and born outside Canada (OR=1.96, 95% CI=0.91-4.20). In girls, these 2-year predictors included moderate baseline PA (OR=2.75, 95% CI=1.01-7.49); no participation in school teams (OR=2.14, 95% CI=0.92-5.00); watching four or more TV programs per day (OR=1.93, 95% CI=0.99-3.74); and born outside Canada (OR=1.85, 95% CI=0.96-3.55). CONCLUSIONS: Reduced TV viewing among girls and increased participation in school sports teams in boys and girls may prevent declines in PA among pre-adolescents from inner-city neighborhoods.     

A cross-sectional survey of environmental health in remote Aboriginal communities in Western Australia

Introduction: The Australian Aboriginal population experiences significantly poorer health than the non-Aboriginal population. The contribution of environmental risk factors in remote communities to this health disparity is poorly understood.

Objective: To describe and quantify major environmental risk factors and associated health outcomes in remote Aboriginal communities in Western Australia.

Methods: The association between environmental health indicators, community infrastructure and reported health outcomes was analysed using linear and logistic regression of survey data.

Results: Housing/overcrowding was significantly associated with increased reports of hearing/eyesight (OR 3.01 95?% CI 1.58–5.73), skin (OR 2.71 95?% CI 1.31–5.60), gastrointestinal (OR 3.51 95 % CI 1.49–8.26) and flu/colds (OR 2.47 95 % CI 1.27–4.78) as health concerns. Dust was significantly associated with hearing/eyesight (OR 3.16 95 % CI 1.82–5.48), asthma/respiratory (OR 2.48 95 % CI 1.43–4.29) and flu/colds (OR 3.31 95 % CI 1.88–5.86) as health concerns.

Conclusion: Poor environmental health is prevalent in remote Aboriginal communities and requires further delineation to inform environmental health policy.     

Physical activity promotion in schools: which strategies do schools (not) implement and which socioecological factors are associated with implementation?

We studied the implementation and associated factors of strategies (e.g. sports after school and during lunch break, active schoolyards, active school commuting) and organizational principles (e.g. safe bike racks, pupil involvement) that facilitate the physical activity (PA)-promoting role of schools. Key representatives of 111 elementary and 125 secondary schools filled out an online survey. Less than half of the elementary schools organized sports during lunch-break or after school. In secondary schools the least implemented strategies were the promotion of active school commuting and after-school sports. In general pupil, parental and community involvement scored low. Better knowledge of community schools and having attended in-service training were associated with higher implementation scores in elementary and secondary schools. Better implementation of the strategies was found in larger schools. Participation in activities from the School Sports Association and more perceived interest from parents and the school board were also associated with higher implementation scores. In conclusion, knowledge of community schools and in-service training next to sufficient human resources are potential key factors to promote PA. Efforts are needed to convince and help schools to increase parental and pupil involvement and to build a policy on school-community partnerships.     

Absence from childcare for respiratory illness

BACKGROUND: This population-based study investigated prospectively collected absence for respiratory illness data in two types of formal childcare (centre day care and family day care) in Perth, Western Australia, and factors associated with such absence. METHODS: All centres (n = 11) and 95% of family day care caregivers (n = 130) selected at random from licensing lists agreed to participate. Demographic details were obtained from a parental questionnaire and absences were recorded prospectively. Characteristics of the child and family were described using univariate odds ratios (OR) with 95% confidence intervals (CI). Multivariable analysis including generalized estimating equations was used to investigate having at least one absence for respiratory illness, having two or more absences, and having six or more absences. RESULTS: No statistically significant difference between care types for having had at least one absence episode for respiratory illness (OR 1.37, 95% CI 0.92-2.04) was found. Children who attended care for more days per week (OR 1.40, 95% CI 1.26-1.56) and those in the study for more weeks (OR 1.03, 95% CI 1.01-1.05) were more likely to be absent for respiratory illness. Those children in care for a greater number of hours per day were less likely to be absent (OR 0.88, 95% CI 0.80-0.97). Family history of bronchitis was also associated with absence for respiratory illness (OR 1.86, 95% CI 1.32-2.63). CONCLUSIONS: Statistically significant factors which had an impact on absence for respiratory illness were primarily those relating to the time spent in childcare and to family history of bronchitis.     

吸毒严重地区的暗娼HIV和梅毒新发感染及队列保持研究

目的 了解吸毒严重地区暗娼HIV和梅毒新发感染及队列保持情况。方法 2004年12月至2005年1月，在四川省西昌市以社区为基础招募343名暗娼开展前瞻性队列研究，在6个月随访时进行HIV和梅毒血清抗体检测，估算HIV和梅毒血清抗体阳转率，以及分析队列本底的社会人口学和高危行为特征与队列6个月保持率的关系。结果 暗娼队列6个月的HIV和梅毒血清抗体阳转率分别为1．00／100人年和6，23／100人年。队列6个月保持率为53．6％（184／343），在队列保持率影响因素的多因素logistic回归模型分析中，少数民族（OR=0．36，95％CI：0．18～0．74）、参加过艾滋病防治项目（OR：1，83，95％CI：1．17～2．86）、近6个月嫖客人数≥50人（OR=1．75，95％CI：1．11～2．77）和住所或工作场所变化（OR=0．56，95％CI：0．33～0．94）与6个月仍旧能随访的关系有统计学意义。结论 该地区有高的暗娼梅毒新发感染率和高危性行为，汉族、参加过艾滋病防治项目及住所或工作场所稳定的暗娼队列保持率高。     

Contraceptive usage, knowledge and correlates of usage among female emergency department patients

OBJECTIVES: For female emergency department (ED) patients, we sought to assess the prevalence of contraceptive usage as well as the extent of contraceptive knowledge and to determine if demographic and sexual health history factors, comprehension of contraceptive methods and moral/religious opinions on contraception were associated with current usage of birth control pills (BCPs), prior usage of emergency contraception (EC) and frequency of condom usage. METHODS: English-speaking female ED patients aged between 18 and 55 years at a northeastern United States urban ED were surveyed on their usage, comprehension and opinions regarding BCPs, EC and condoms. RESULTS: Of the 539 respondents (64.6% were aged 相似文献   

Physician Assistants and Nurse Practitioners as a Usual Source of Care

ABSTRACT:  Purpose: To identify characteristics and outcomes of patients who use physician assistants and nurse practitioners (PA/NPs) as a usual source of care. Methods: Cross sectional analysis using the telephone and mail surveys of the Wisconsin Longitudinal Study (WLS), a prospective cohort study of Wisconsin high school graduates and selected siblings (n = 6,803). Findings: Individuals from metropolitan (OR = 0.40, 95% CI = 0.29-0.54) and micropolitan (OR = 0.65, 95% CI = 0.44-0.95) areas were less likely to utilize PA/NPs than participants from rural locations. Participants without insurance or with public insurance other than Medicare were more likely than those with private insurance to utilize PA/NPs (OR = 1.71, 95% CI = 1.02-2.86). Patients of PA/NPs were more likely to be women (OR = 1.77, 95% CI = 1.34-2.34), younger (OR = 0.95, 95% CI = 0.92-0.98) and have lower extroversion scores (OR = 0.81, 95% CI = 0.68-0.96). Participants utilizing PA/NPs reported lower perceived access (β=−0.22, 95% CI =−0.35-0.09) than those utilizing doctors. PA/NP utilization was associated with an increased likelihood of chiropractor visits (OR = 1.57, 95% CI = 1.15-2.15) and decreased likelihood of a complete health exams (OR = 0.74, 95% CI = 0.55-0.99) or mammograms (OR = 0.65, 95% CI = 0.45-0.93). There were no significant differences in self-rated health or difficulties/delays in receiving care. Conclusions: Populations served by PA/NPs and doctors differ demographically but not in complexity. Though perceived access to care was lower for patients of PA/NPs, there were few differences in utilization and no differences in difficulties/delays in care or outcomes. This suggests that PA/NPs are acting as primary care providers to underserved patients with a range of disease severity, findings which have important implications for policy, including clinician workforce and reimbursement issues.     

Correlates of falling during 24 h among elderly Danish community residents

OBJECTIVES: To identify dietary, medical, and environmental correlates of falling during the last 24 h among elderly community residents. The limited accuracy of recall of falls in the elderly in previous studies was the reason for a 24-h time frame. METHODS: The study composes 4281 community residents aged 66+ years. The statistical analyses included Pearson's chi(2) test and multiple logistic regression. RESULTS: Mutually independent correlates of falls were a family history of fracture (OR, 3.0; 95% CI: 1.3-7.1); osteoarthrosis of the knee (OR, 2.9; 95% CI: 1.3-6.2); dizziness (OR, 4.1; 95% CI: 1.9-8.9); a diet not including sour dairy products (OR, 3.0; 95% CI: 1.4-6.3) or fish (OR, 3.4; 95% CI: 1.5-7.5); drinking tea (OR, 5.8; 95% CI 2.15-15.30); needing help for shopping (OR, 3.9; 95% CI: 1.6-9.3); and for administration of medicine (OR, 9.0; 95% CI: 2.0-40.6). Independent environmental correlates were vinyl on the floor in the bathroom (OR, 6.6; 95% CI: 2.1-20.9) and using indoor footwear without soles (OR, 5.5; 95% CI: 2.3-13.4). CONCLUSION: The present analyses suggest that several factors are associated to the risk of falling among elderly community residents. It appears relevant for further studies to test if modifications of the potential risk factors identified may reduce falls among community dwelling older persons.     

A multilevel analysis of neighbourhood built and social environments and adult self-reported physical activity and body mass index in Ottawa, Canada

Canadian research examining the combined effects of social and built environments on physical activity (PA) and obesity is limited. The purpose of this study was to determine the relationships among built and social environments and PA and overweight/obesity in 85 Ottawa neighbourhoods. Self-reported PA, height and weight were collected from 3,883 adults using the International PA Questionnaire from the 2003-2007 samples of the Rapid Risk Factor Surveillance System. Data on neighbourhood characteristics were obtained from the Ottawa Neighbourhood Study; a large study of neighbourhoods and health in Ottawa. Two-level binomial logistic regression models stratified by sex were used to examine the relationships of environmental and individual variables with PA and overweight/obesity while using survey weights. Results identified that approximately half of the adults were insufficiently active or overweight/obese. Multilevel models identified that for every additional convenience store, men were two times more likely to be physically active (OR = 2.08, 95% CI: 1.72, 2.43) and with every additional specialty food store women were almost two times more likely to be overweight or obese (OR = 1.77, 95% CI: 1.33, 2.20). Higher green space was associated with a reduced likelihood of PA (OR = 0.93, 95% CI: 0.86, 0.99) and increased odds of overweight and obesity in men (OR = 1.10, 95% CI: 1.01, 1.19), and decreased odds of overweight/obesity in women (OR = 0.66, 95% CI: 0.44, 0.89). In men, neighbourhood socioeconomic scores, voting rates and sense of community belonging were all significantly associated with overweight/obesity. Intraclass coefficients were low, but identified that the majority of neighbourhood variation in outcomes was explained by the models. Findings identified that green space, food landscapes and social cohesiveness may play different roles on PA and overweight/obesity in men and women and future prospective studies are needed.     

江西农村地区传染病症状监测数据报告质量及其影响因素研究

目的 分析农村地区传染病症状监测系统中不同数据源数据上报质量及其影响因素。方法 采用多阶段整群抽样和目的抽样的方法在江西省两县抽取162家医疗机构、62家小学和30家药店作为监测点。连续两年收集患者主诉、非处方药物销量和小学生因病缺勤记录并进行质量控制,采用自行设计的调查表对数据报告员开展上报数据质量及影响因素的调查。结果 监测期间共收集到医疗机构门诊症状报告记录504 082条,药店非处方药物销售记录916 669条,小学缺勤记录18 402人次。医疗机构、药店、小学的及时报告率从第1个月的78.38%、71.27%和81.52%上升到了第24个月的99.50%、94.94%和99.00%。村级数据报告员及时上报率增幅为57.4%高于县乡级报告员的38.6%（OR=2.90,95%CI:1.28～6.57）;学历较低的数据报告员及时上报率改善明显（OR=2.36,95%CI:1.07～5.21）。参与计算机技术培训可以提高报告人员的及时上报率（OR=2.72,95%CI:1.41～5.24）。结论 在中国农村建立多数据源症状监测系统有一定的可行性,症状监测系统数据报告质量随时间推移逐步提升并稳定。常规数据报告的质量控制、必要的计算机操作技术培训有助于改善数据报告质量。     

Maternal risk factors and major associated defects in infants with Down syndrome

More than 50% of infants with Down syndrome have associated defects that cause considerable morbidity and mortality. We evaluated the hypothesis that the trisomic genome interacts with environmental factors to increase the risk for specific associated defects. We evaluated risk factors present during early pregnancy in a multiracial population of 687 infants with Down syndrome. Mother's cigarette smoking was associated with the grouped cardiac defects [odds ratio (OR)=2.0; 95% confidence interval (CI) = 1.2-3.2]. When adjusted for other cardiac defects and maternal race, the following specific defects were associated with smoking: atrioventricular canal (OR = 2.3; 95% CI = 1.2-4.5), tetralogy of Fallot (OR = 4.6; 95% CI = 1.2-17.0), and atrial septal defects without ventricular septal defect (OR = 2.2; 95% CI = 1.1-4.3). Hirschsprung disease was associated with mother's daily consumption of more than three cups of coffee (OR = 6.02; 95% CI = 1.2-29.7) and with mother's fever (OR = 3.4; 95% CI = 0.7-16.4), but the number of cases was small. Use of alcohol was not associated with any defect. Mother's race, age, parity, income, or education did not confound the associations. Results suggest that environmental factors can modify the occurrence of associated anomalies in the embryo with Down syndrome.     

Danish pupils' perceived satisfaction with the health dialogue: Associations with the office and work procedure of the school health nurse

The aim is to identify how environmental factors, perceivedby the pupils, are associated with the pupils' perceived satisfactionwith a good health dialogue. This article focuses on the pupils'perception of the health office and the work procedure of theschool health nurses. The present article is based on data fromthe 1994 Danish part of the WHO-collaborative study Health Behaviourin School-aged Children. A nation-wide random sample of pupils11, 13 and 15 years old (n = 4046) answered a standardized questionnaireabout perceived health, health behaviour, social situation,the school as a workplace and the health dialogue. The finalmodel of the multivariate logistic regression analysis revealedeight predictor variables of perceived satisfaction with thehealth dialogue and three confounder variables. The predictorswere: comfortable health office OR = 1.20 (95% CI 1.11–1.30),pupils sat by the desk OR = 1.12 (95% CI 1.03–1.23), pupilsinfluenced the content of the dialogue yes/no: OR = 1.43 (95%CI 1.27–1.60), yes/don't know: OR = 0.80 (95% CI 0.72–0.89),sufficient time OR = 1.33 (95% CI 1.23–1.44), the schoolhealth nurse listened carefully OR = 1.24 (95% CI 1.13–1.35),the school health nurse talked a lot OR = 0.91 (95% CI 0.85–0.98),gave good advice OR = 1.28 (95% CI 1.18–1.43), let thepupils talk OR = 1.17 (95% CI 1.07–1.28). The confounderswere: pupils' sex: female OR = 1.23 (95% CI 1.14–1.33);and age: low age OR = 1.20 (95% CI 1.07–1.35) or highage OR = 0.84 (95% CI 0.76–0.93), but not medium age,high school satisfaction OR = 1.53 (95% CI 1.31–1.77),and low school satisfaction OR = 0.74 (95% CI 0.63–0.87).     

湖北省某市农村中学生性侵犯防范能力调查

了解农村中学生性侵犯的防范能力现状及其影响因素,为预防农村中学生性侵犯教育提供科学依据.方法 随机整群抽取湖北省某市农村2所初中学校的初一、初二年级和1所高中学校高一、高二年级共1 658名在校学生,采用不记名自填式问卷调查中学生性侵犯防范能力的现状,并对影响因素进行非条件Logistic回归分析.结果 有关中学生性侵犯防范能力的7个问题中,男生回答“有时”或者“经常”的频率更高,其中5个条目性别间差异均有统计学意义.中学生性侵犯防范能力得分合格(性侵犯防范能力得分≥12)的危险因素为男生(OR=1.509,95% CI=1.230~1.852)和亲密度得分低(OR=1.259,95%CI=1.138~1.393);保护因素为非留守(OR=0.774,95% CI=0.627~0.956)、非住校(OR=0.558,95%CI=0.455~0.686)、≤12岁(OR=0.363,95%CI=0.268~0.493)和13~16岁(OR=0.160,95% CI=0.101~0.254).结论 农村中学生预防性侵犯的能力相对不足,需要开展加强农村中学生性侵犯防范能力的学校教育和家庭教育.     

上海和苏州两地男男性行为者HIV自我检测行为、检测模式及影响因素研究

  目的  评估上海和苏州两地MSM的HIV自我检测行为、检测模式及影响因素。  方法  2021年2-5月间通过社交软件招募上海市、苏州市两地≥18岁且未被诊断为HIV/AIDS的MSM开展网络问卷现况调查,用频率描述自检行为及检测模式,用χ2检验和Logistic回归分析模型分析影响因素。  结果  759名研究对象中,542例有HIV自检史,占比71.4%。其中148例报告既往自检出现过阳性结果,140人经复测确认为假阳性。检测模式包括不检测、传统检测和自检/自检+传统检测三种,各占20.6%、10.0%、69.4%。与含自检模式相比,长居苏州(OR=1.85, 95% CI:1.08~3.17)、性角色插入方(OR=0.34, 95% CI:0.14~0.80)、近1年性伴数2~4人(OR=0.51, 95% CI:0.32~0.81)或5~9人(OR=0.31, 95% CI:0.14~0.68)、线下(OR=0.44, 95% CI:0.23~0.86)或“线下+线上”(OR=0.51, 95% CI:0.31~0.84)寻找性伴、近1年使用毒品/兴奋剂(OR=0.54, 95% CI:0.36~0.83)、有性病史(OR=0.41, 95% CI:0.24~0.69)、试剂获取困难(OR=2.52, 95% CI:1.53~4.15)、试剂使用困难(OR=1.93, 95% CI:1.22~3.07)是MSM选择未检测模式的影响因素;年龄18~＜25岁(OR=0.26, 95% CI:0.10~0.71)或25~＜45岁(OR=0.38, 95% CI:0.15~0.95)、近1年性伴数2~4人(OR=0.42, 95% CI:0.23~0.78)、试剂获取困难(OR=2.58, 95% CI:1.33~4.99)是MSM选择传统检测模式的影响因素(均有P < 0.05)。  结论  上海和苏州两地的MSM具有较高的自检使用率和支持服务需求,年龄、居住地、性行为特征、药物滥用、自检试剂可及性和可操作性影响MSM对检测模式的选择。     

健康生态学视角下我国60岁及以上老年人自评健康的影响因素研究

目的 基于健康生态学视角,探讨我国60岁及以上老年人群自评健康的影响因素。方法 采用横断面调查的方法,以CHARLS 2015的387例60岁以上老年人为研究对象。采用logistic回归分析老年人自评健康的影响因素。结果 老年人自评健康比例仅28.2%。童年健康状况不好（OR=2.928, 95%CI: 2.298~3.826）、住宅商用（OR=1.528, 95%CI: 1.024~2.281）、居住地为农村（OR=1.467, 95%CI: 1.164~1.85）、夜间睡眠时间（OR=0.862, 95%CI: 0.828~0.91）、饮酒（OR=0.735, 95%CI: 0.583~0.927）、戒酒（OR=1.862, 95%CI: 1.301~2.665）、人际交往（OR=0.791, 95%CI: 0.651~0.962）、工作类型非农业（OR=0.608, 95%CI: 0.44~0.84）、住房有洗澡设施（OR=0.817, 95%CI: 0.669~0.999）与老年人自评健康有关。结论 需要将老年健康干预时间前移,并从个体到环境因素加强对老年健康的干预。