不同健康教育模式对黄浦区建筑工人艾滋病知信行干预效果评价
Evaluation of the Effects on KAP for AIDS Prevention among Construction Workers in Huangpu District after Intervention with Different Health Education Measures
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摘要:
目的 探索不同艾滋病健康教育干预模式应用在建筑工人中的干预效果,为制定针对此人群干预教育策略提供参考。 方法 采取随机抽样的方法抽取上海市黄浦区工期长且人员相对稳定的6个建筑工地,按随机方法分成低、中、高3个等级的干预组实施不同模式的干预;健康教育方法随干预等级提高趋于多样、专业。干预后6个月随访分析干预前后建筑工人艾滋病知信行的变化。 结果 干预前调查594人,干预后6个月随访到352人,随访率59.3%。在干预前对艾滋病知识有一定了解的建筑工人,干预后的得分与干预前比较,差异无统计学意义;而在干预前对艾滋病知识了解较少的建筑工人,干预后的得分与干预前比较,差异有统计学意义(3个干预等级P均≤ 0.001)。建筑工人干预前艾滋病知识知晓率仅62.2%,各干预等级之间差异无统计学意义;干预后知晓率提高,各干预等级差异有统计学意义(F=20.3,P < 0.001),高度干预工地建筑工人艾滋病知识知晓率提高最多,达73.6%。在干预前多数建筑工人对艾滋病病人持"同情"态度,但也有"害怕"、"厌恶"的看法,各工地间差异无统计学意义;干预后建筑工人对艾滋病病人持"同情"态度有增加,持"害怕"、"厌恶"态度有所降低,工地间各干预等级差异有统计学意义(认可率: "同情" χ2=17.7,P<0.05; "害怕" χ2=16.8,P < 0.05; "厌恶" χ2=16.2,P < 0.05),高度和中度干预工地变化较大。但发生性关系时经常使用安全套者的比例各干预组干预前后差异无统计学意义。 讨论 对建筑工人开展形式多样的艾滋病健康教育对提高艾滋病知识和信念可行有效;健康教育的开展不仅要针对性强而且要坚持反复强化,使受教育者知行一致。 Abstract:Objective To explore the application of different levels of health education measures among construction workers, to study its intervention effect and to provide evidence for focused health education policy. Methods A face-to-face questionnaire survey was conducted among construction workers in 6 construction sites of Huangpu District of Shanghai by random sampling, and different levels of health education measures were applied (the higher the intervention level was, the more multiform and professionalized intervention measures were applied). After 6 months, a follow-up was conducted to analyze the variation of KAP status among construction workers. Results A group of 594 workers were surveyed before intervention, and 352 workers were followed-up after 6 months, with the follow-up rate of 59.3%. Among the construction workers with some pre-intervention knowledge, the variation of HIV-related knowledge showed no statistical difference, but among those with less pre-intervention knowledge, the variation showed statistical difference in construction sites with three intervention levels (P ≤ 0.001). Before intervention the awareness rate of HIV-related knowledge was as low as 62.2%, with no statistical difference among different intervention levels. After intervention the rates rose and showed statistical differences (F=20.3, P < 0.001), with the highest rate of 73.6% in the construction sites with high intervention level. Before intervention there was no statistical difference of the attitudes toward HIV carriers among different intervention levels. After intervention the acceptance rate of "sympathetic" view increased and that of "afraid" and "disgusting" views decreased, with statistical differences ("sympathetic":χ2=17.7, P < 0.05; "afraid":χ2=16.8, P < 0.05; "disgusting":χ2=16.2, P < 0.05). The views between construction sites with high and medium intervention levels had more changes. However, the proportion of people using condoms every time they had sex did not change much. Conclusion It's feasible and effective to influence the knowledge and attitude of construction workers by using multiple health education measures. We should apply strongly focused interventions, and intervene repeatedly to improve the HIV-related knowledge as well as attitude and perception, and to protect the health of construction workers.
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