Health literacy on infectious disease prevention and its influential factors among residents in Hebei province
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摘要:
目的 掌握河北省居民传染病防治素养水平及其影响因素,为制定卫生健康政策、提升居民传染病防控能力提供科学依据。 方法 采用分层、多阶段、PPS与简单随机相结合的抽样方法抽取河北省84个县(市、区)的20 535名15~69周岁的城乡常住居民作为调查对象,于2020年7—9月对抽中居民进行问卷调查。 统计分析采用复杂抽样模块下的描述性分析、χ2检验、logistic回归分析方法,研究不同特征人群传染病防治素养水平及影响因素。 结果 经权重调整,河北省城乡居民传染病防治素养水平为28.80%。 多因素logistic回归分析结果显示:河北省城乡居民传染病防治素养水平受性别、年龄、文化程度的影响。 与女性相比,男性传染病防治素养水平较低(OR=0.809,95%CI:0.722~0.906);与65~岁年龄组相比,15~、25~、35~、45~年龄组居民传染病防治素养水平更高,OR值分别为1.600(95%CI:1.105~2.316)、2.088(95%CI:1.608~2.711)、2.055(95%CI:1.675~2.521)、1.568(95%CI:1.299~1.893);以本科及以上学历为参照,文化程度越低,传染病防治素养水平越低,大专、高中/职高/中专、初中、小学、不识字或识字很少的OR值分别为0.667(95%CI:0.503~0.885)、0.594(95%CI:0.461~0.765)、0.427(95%CI:0.330~0.552)、0.216(95%CI:0.162~0.290)、0.135(95%CI:0.080~0.226)。 结论 河北省居民传染病防治素养水平仍较低,有待提升。 今后工作应从老年人、学历较低者、男性等低素养人群以及薄弱环节入手,有针对性地开展传染病防治宣教和干预。 Abstract:Objective To know about the status of health literacy on infectious disease prevention and its influential factors, and to provide evidence for prevention and control on infectious disease. Methods By using stratified,multi-stage, simple random and PPS sampling method,the investigation extracted the sample from Hebei province. The respondents were 20 535 urban and rural residents of 15–69 years old who were selected to complete a health literacy questionnaire. Descriptive analysis, chi-square test and logistic regression analysis under complex sampling module were used to study the literacy level and influencing factors of infectious disease prevention and control in populations with different characteristics. Results After weighted adjustment,the level of literacy of infectious disease prevention in Hebei province was 28.80%. Compared with the females as the reference,the males had lower literacy of infectious disease prevention (OR=0.809, 95%CI: 0.722–0.906); Compared with the group 65–69 year-old,the group 15–24 year-old ,the group 25–34 year-old ,the group 35–44 year-old and the group 45–54 year-old were more likely to have the literacy of infectious disease prevention, and their ORs were 1.600 (95%CI: 1.105–2.316), 2.088 (95%CI: 1.608–2.711), 2.055 (95%CI: 1.675–2.521) and 1.568 (95%CI: 1.299–1.893) respectively; The residents with undergraduate and above were used as a reference,the lower the level of education,the lower the level of literacy of infectious disease prevention. The junior college,high school/higher/secondary,junior high school,primary school, illiterate/ less literate ORs (95%CI) were 0.667 (95%CI: 0.503–0.885), 0.594 (95%CI: 0.461–0.765), 0.427 (95%CI: 0.330–0.552), 0.216 (95%CI: 0.162–0.290) and 0.135 (95%CI: 0.080–0.226) respectively. Conclusion The level of literacy of infectious disease prevention in Hebei province is still low.When the health promotion work is carried out,it is necessary to focus on the elderly,the lower educational level of the population and the males as the key intervention group. Different strategies should be developed on literacy on infectious disease prevention promotion according to the characteristics of populations. -
表 1 调查对象的一般人口学特征
Table 1. General demographic characteristics of the respondents
一般人口学特征 调查人数 构成比(%) 监测点性质 城市 3143 15.31 农村 17392 84.69 性别 男性 8972 43.69 女性 11563 56.31 年龄组(岁) 15~ 1057 5.15 25~ 2252 10.97 35~ 3310 16.12 45~ 5307 25.84 55~ 5860 28.54 65~69 2749 13.39 民族 汉族 19212 93.56 少数民族 1323 6.44 文化程度 不识字或识字很少 1454 7.08 小学 5303 25.82 初中 9103 44.33 高中/职高/中专 3089 15.04 大专 917 4.47 本科及以上 669 3.26 户籍 本地 20042 97.60 外地 493 2.40 职业 机关事业单位人员 1154 5.62 学生 798 3.89 工人 1396 6.80 其他企业人员 930 4.53 其他 713 3.47 农民 15536 75.69 家庭人均年收入(元) <3 000 2458 24.76 3 000~ 1213 12.22 5 000~ 2783 28.03 10 000~ 2279 22.96 20 000~ 662 6.67 >30 000 533 5.37 患慢性病 是 5250 25.57 否 15285 74.43 注:由于少数变量存在部分缺失值,变量各频数之和与总人数不完全一致 表 2 传染病防治素养测评题目知晓率(%)
Table 2. Awareness rate of infectious disease prevention literacy assessment questions (%)
传染病防治测评题目 答对
人数知晓率
(样本率)知晓率
(加权率)预防流感知识 11951 58.20 63.14 乙肝的传播途径 10949 53.32 59.08 肺结核治疗优惠政策 14025 68.30 73.80 儿童免疫接种知识 17233 83.92 86.16 对开窗通风的理解 13616 66.31 69.16 咳嗽、打喷嚏的处理方式 7347 35.78 42.48 表 3 不同特征人群传染病防治素养水平
Table 3. The level of literacy of infectious disease prevention among people with different characteristics
人口学特征 具备素养人数 样本率(%) 加权率
(%)χ2值 P值 监测点性质 2.674 0.106 城市 872 27.74 31.14 农村 3780 21.73 28.12 性别 8.321 0.005 男性 1922 21.42 27.21 女性 2730 23.61 30.41 年龄组(岁) 45.514 <0.001 15~ 369 34.91 35.60 25~ 778 34.55 35.12 35~ 1053 31.81 32.29 45~ 1180 22.23 23.14 55~ 931 15.89 16.29 65~69 341 12.40 12.61 民族 3.521 0.064 汉族 4302 22.39 28.45 少数民族 350 26.46 34.03 文化程度 51.664 <0.001 不识字或识字很少 100 6.88 8.19 小学 722 13.61 14.19 初中 2221 24.40 26.91 高中/职高/中专 933 30.20 33.70 大专 357 38.93 37.97 本科及以上 319 47.68 48.74 户籍 1.063 0.306 本地 4519 22.55 28.70 外地 133 26.98 31.65 职业 24.667 <0.001 机关事业单位人员 461 39.95 38.88 学生 288 36.09 38.83 工人 332 23.78 28.11 其他企业人员 318 34.19 36.41 其他 183 25.67 30.25 农民 3069 19.75 23.57 家庭人均年收入(元) 2.191 0.065 <3 000 444 18.06 24.04 3 000~ 234 19.29 28.79 5 000~ 628 22.57 30.13 10 000~ 565 24.79 30.09 20 000~ 182 27.49 31.98 >30 000 166 31.14 33.35 患慢性病 61.773 <0.001 是 852 16.23 19.32 否 3800 24.86 30.29 合计 4652 22.65 28.80 表 4 居民传染病防治素养水平的多因素logistic回归分析
Table 4. Multiple logistic regression analysis of influencing factors of residents' infectious disease prevention literacy level
变量 β $s _{ \bar x} $ t值 P值 OR值(95%CI) 常数 −0.565 0.171 −3.310 0.001 0.568(0.404~0.798) 性别(参考:女性) 男性 −0.212 0.057 −3.718 <0.001 0.809(0.722~0.906) 年龄组(岁,参考:65) 15~ 0.470 0.186 2.526 0.013 1.600(1.105~2.316) 25~ 0.736 0.131 5.603 <0.001 2.088(1.608~2.711) 35~ 0.720 0.103 7.015 <0.001 2.055(1.675~2.521) 45~ 0.450 0.095 4.753 <0.001 1.568(1.299~1.893) 55~ 0.063 0.083 0.760 0.450 1.065(0.903~1.256) 文化程度(参考:本科及以上) 不识字或识字很少 −2.006 0.261 −7.683 <0.001 0.135(0.080~0.226) 小学 −1.530 0.147 −10.441 <0.001 0.216(0.162~0.290) 初中 −0.851 0.129 −6.581 <0.001 0.427(0.330~0.552) 高中/职高/中专 −0.521 0.127 −4.098 <0.001 0.594(0.461~0.765) 大专 −0.404 0.142 −2.853 0.005 0.667(0.503~0.885) 职业(参考:农民) 机关事业单位人员 −0.016 0.128 −0.125 0.901 0.984(0.763~1.270) 学生 0.124 0.184 0.673 0.503 1.132(0.785~1.632) 工人 −0.106 0.110 −0.965 0.337 0.900(0.723~1.119) 其他企业人员 0.014 0.116 0.116 0.908 1.014(0.804~1.277) 其他 −0.095 0.127 −0.752 0.454 0.909(0.707~1.170) 患慢性病(参考:未患慢性病) 是 −0.001 0.068 −0.010 0.992 0.999(0.874~1.143) -
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