上海市儿童跌倒伤害干预项目效果评价

目的 探讨综合性干预措施对儿童跌倒伤害预防的效果，为将来进行推广项目提供经验。方法 采用分层抽样方法在上海市范围内随机抽取11所小学，干预前选取1~3年级学生，干预后选取3~5年级相同对象，进行问卷调查，了解其跌倒伤害发生的相关情况。结果 干预组学生家长跌倒伤害预防知晓率从77.53%提高到92.78%（χ2=354.50，P<0.001），倍差法（difference in differences，DID）显示净效果相对提升了45%（Z=4.08，P<0.001）；运动前热身的知晓率从91.26%提高到98.65%（χ2=174.73，P<0.001），净效果显示相对提升了46%；游乐设施的识别行为从83.32%提高到90.55%（χ2=70.89，P<0.001），净效果相对提升了44%；危险环境改善从87.62%提高到89.42%（χ2=4.97，P=0.022），净效果相对提升了34%。干预前跌倒伤害发生率对照组为6.32%，干预组为6.15%，差异无统计学意义（χ2=0.08，P=0.770）；干预实施后干预组的跌倒发生率降为4.33%，对照组为8.56%，净效果显示跌倒伤害发生率比干预前相对下降了69%。结论 跌倒伤害预防工作是一个多领域多层次的干预工作，应采取包括健康教育、环境改造、制度完善等综合性的干预手段才能有效地降低跌倒伤害的发生。

An evaluation on effectiveness of intervention for children fall injury in Shanghai

Objective To explore the effect of comprehensive intervention measures on children fall injury prevention,so as to provide experience for the future fall injury prevention promotion programs.Methods Using stratified sampling method,11 primary schools were randomly selected in Shanghai,then students of 1 th grade to 3 th grade were recruited from these schools,two years later,questionnaire survey was conducted among these students to understand the condition of their knowledge of children's fall injury.Results After intervention,fall injury prevention awareness rate of the intervention group was increased from 77.53 ％ to 92.78 ％ (x2 =354.50,P ＜ 0.001),difference in differences (DID) analysis showed net effect was relatively increased by 45 ％ (Z =4.08,P ＜ 0.001),awareness rate warming up before exercise increased from 91.26％ to 98.65％ (x2 =174.73,P ＜0.001),the net effect was relatively increased by 46％.Rides risk identify behavior increased from 83.32％ to 90.55％ (x2 =70.89,P ＜ 0.001),the net effect was relatively increased by 44％,dangerous environment improvement increased from 87.62％ to 89.42％ (x2 =4.97,P =0.022),the net effect was relatively increased by 34％.Before intervention,the fall injury incidence of control group and intervention group was 6.32％ and 6.15％ respectively,there was no significant difference (x2 =0.08,P =0.770).The fall injury incidence of control group was 8.56％ after the intervention,the incidence of intervention group fell to 4.33％,the net effect relatively dropped by 69％.Conclusions It is multi-field and multi-level to effectively reduce the incidence of fall injury,which needs comprehensive interventions,such as health education,environmental transformation,policy innovation,etc.