浙江省三峡移民卫生服务与健康教育需求调查及综合干预项目基线调查

本次调查是为了了解和掌握三峡移民在卫生服务需求和健康相关知识、态度、行为等方面的情况以及与当地居民的差异,移民的迁入对当地社会经济、文化和卫生防病工作的影响,以便为下一步合理配置卫生资源,更好地开展卫生服务与健康教育工作提供理论依据。1 调查设计1.1 调查目的1.1.1 通过对浙江省2个试点县内三峡移民的基本情况包括社会、经济、文化等方面的调查,收集试点内三峡移民及当地居民的生活习惯、健康状况和卫生需求等有关方面的资料,     

客运列车从业人员预防性病／艾滋病综合干预效果

目的为了有效控制性病/艾滋病向客运列车从业人员的传播,在调查该人群预防性病/艾滋病相关认知情况的基础上,对该人群运用了一系列健康教育综合干预手段,旨在探索行之有效的健康促进方法。方法通过自行设计调查表,实施健康教育综合干预措施,干预前后对同一人群各调查一次,比较干预前后卫生知识认知改变情况。结果经综合干预后,客运列车从业人员在性病/艾滋病认知方面有了明显的改善,体现了综合干预的成效。结论对旅客列车从业人员实施适合其工作生活环境的健康教育综合干预措施,对促使他们最终树立正确的健康意识、培养良好的卫生行为有显著效果。     

重庆市开县实施“三峡移民健康教育”中期效果调查

目的对重庆市开县境内三峡移民开展《三峡移民健康保护、健康监测及生活饮用水监测项目》本底资料调查及项目中期评价。方法在开县全县14个涉及移民工作的乡镇中，按三峡库区开县段具体情况，分别抽取地处库首、库中、库尾的村民及居民，共计600人。结果三峡居民开县安置区人群的健康知识有所增长，其中，个人卫生为14．3％、饮水卫生为13．5％、饮食卫生为14。8％、环境卫生为28．9％、居室卫生为6．3％、重点传染病防治为38．6％、儿童计划免疫为22．3％；健康行为的形成率也有不同程度的上升，其中，个人卫生为17．2％、饮水卫生为15．6％、饮食卫生为19．3％、环境卫生为23．2％、居室卫生为6．4％、重点传染病防治为33．5％、儿童计划免疫为33．1％；有文化的中青年接受健康教育的能力明显优于文化程度较低的甚至是文盲的老年人。结论库区健康教育项目的实施有效提高了移民的卫生知晓率和健康行为形成率，促进了全县移民搬迁建设。但库区健康教育工作发展不平衡，相关部门干预力度还应加强。     

全国九亿农民健康教育行动河北省试点县实施效果评价研究

以准实验研究方法对“全国九亿农民健康教育行动”河北省试点县的实施情况进行的中期效果评价结果显示,实验组干预前后在农村居民的基本卫生知识、健康观念和健康行为方面都发生了积极变化,实验组与对照组干预后比较,差异具有显著性;不同干预方法间的比较显示,综合教育组较大众传播组的变化更加显著。因此,可以认为我省“行动”试点工作是成功的,在“行动”中采取的大众传播与综合教育相结合、“行动”实施与初保达标和小康建设相结合的农村健康教育工作模式取得了预期成效。     

对某化工厂工人实施健康教育干预的效果

目的 探讨健康教育对企业工人防治职业病知识水平和自我保护能力的效果.方法 以某家化工企业452名工人为研究对象,通过健康检查和集中进行教育干预,对实施健康教育前后工人对职业卫生知识的知晓率、一般卫生习惯的变化进行评价.结果 通过健康教育干预措施,职工职业卫生法规知识与职业病防治知识知晓率明显提高,干预前后差异有统计学意义(P＜0.05);一般卫生知识行为均有改善,吸烟、饮酒等不良嗜好下降了29.1％,饭前洗手增加了31.4％,下班后洗澡更衣增加了37.6％.结论 开展职业病健康教育,能提高企业职工的有关职业病防治知识水平与自我保护意识,是预防职业中毒的有效途径之一.     

健康教育对青年流动人口健康知识与行为以及对卫生服务利用影响的效果评价

目的对青年流动人口进行健康教育干预并对影响效果进行评价,为探索并完善青年流动人口健康干预策略,摸索适合输出地流动人口的健康促进模式提供科学依据。方法采用整群随机抽样方法,在河北省沧州市沧县抽取劳务输出培训地的354名15～24岁外出务工人员,在实施健康教育前后进行问卷调查。结果青年流动人口在健康教育实施后,健康知识知晓率提高30.2%;健康意识与行为有了明显提高,不利于健康的行为发生率从干预前的17.8%下降到干预后的11.3%;卫生服务利用率从干预前的42.0%上升到干预后的66.5%,提高了24.5%,实施干预前后差异有统计学意义(P<0.01)。结论以培训学校为中心,以多种亲青服务为手段,多部门协调配合的健康教育模式对于青年流动人口是适宜的,在提高健康知识知晓率和健康行为形成率以及提高卫生服务利用方面效果十分明显。     

黑龙江省宾县平坊镇农村部分家庭主妇健康教育效果评价

目的了解实施健康教育后,农村家庭主妇卫生知识知晓率、卫生行为形成率,总结、探索科学的工作方法,为普及农村健康教育提供参考。方法随机抽取黑龙江省宾县科研村和民庆村200名家庭主妇为研究对象,对其进行为期1年的多种形式健康教育活动,采用同一问卷,于干预前后进行问卷调查。比较实施健康教育前后,家庭主妇卫生知识、卫生行为及环境卫生状况的改变。结果卫生知识知晓率平均由教育前的35.6%提高到55.1%;卫生行为形成率平均由教育前的58.8%提高到73.6%;家庭环境卫生状况好转率平均由教育前的24.7%提高到61.8%,三者的改变均呈显著性差异(P<0.01),实施健康教育后明显好于教育前。结论通过一定形式的健康教育干预措施,对于帮助农村家庭主妇掌握基本卫生知识,改变不良卫生行为有积极的促进作用。     

某市50家生产企业职业卫生管理人员的职业卫生知信行调查及干预效果评估

目的了解某市部分生产企业中卫生管理人员的职业病防治知识、职业卫生态度和职业卫生行为,提高生产企业职业卫生管理人员服务水平,探索适合生产企业的预防控制职业危害的综合干预模式。方法自拟调查表,用整群抽样方法选取该市50家生产企业各1名职业卫生服务管理人员进行相关职业病预防知识的问卷调查。继而对调查结果采取综合干预措施。结果干预后50家企业职业卫生服务管理人员对职业卫生服务知识内容知晓有较大程度的提高,干预后知晓率均达到100%,差异有统计学意义(P0.05)。结论通过健康教育促进了所调查的部分企业职业卫生管理人员职业卫生服务的知信行行为。综合干预模式行之有效。     

南通市钢丝绳行业铅作业农民工健康促进及效果分析

目的通过制定和实施一系列干预措施,对铅作业农民工的卫生行为进行干预,并评价干预效果。方法以南通市铅作业农民工218名为调查对象,制定和实施干预措施,并比较干预前后职业卫生知识、态度、行为的变化,企业作业场所有毒有害因素检测结果等的变化,以评价干预措施的效果。结果通过干预措施的制定和实施,铅作业农民工基本职业卫生知识认识程度都超过了80%,较干预前有明显提高(P<0.01),职业卫生态度干预后均达到86%以上,职业健康行为方式也明显提高。企业职业病危害因素检测总合格率由干预前45.83%提高到干预后70.00%。有半数以上的人都希望知道本次调查所涉及的职业卫生需求内容及得到有关知识教育。其中81.65%的工人选择通过传媒咨询(网络、电视等)的方式获得职业健康知识。结论开展职业健康促进,加强健康教育,改善卫生行为,是预防铅作业农民工慢性铅中毒的有效途径。     

北京市大兴区农民工职业卫生健康教育干预效果评价

目的评价北京市大兴区农民工职业卫生健康教育干预效果。方法通过现场培训、资料发放、播放DVD等活动对大兴区13家企业的1500名农民工进行为期6个月的职业卫生行为干预,并调查干预前后农民工职业卫生知识、态度和相关行为状况。结果干预后,农民工对职业卫生知识的知晓率有了一定提高,知识得分由干预前的9．83±2．939提高到10．97±2．740,二者差异有统计学意义（P〈0．05）;态度得分与行为得分健康教育前后差异无统计学意义（P〉0．05）。结论现场培训、资料发放等职业卫生健康教育干预活动对提高农民工职业卫生知识水平、改变其职业卫生态度和职业行为习惯有着重要作用。     

陕西省山区县农村居民口腔保健健康教育效果分析

目的了解健康教育与健康促进对农村居民口腔保健知识提高率和健康行为形成率的影响,总结农村居民口腔保健的有效方法。方法在充分查阅资料的基础上,抽取口腔疾病高发的2个山区农村县,干预前后分别将2个县按经济好、中、差分类,每类随机抽取1个乡,每个乡按照相同的方法随机抽取1个村,每村随机调查10岁以上常住居民240人,2个县共调查1440人。结果健康教育与健康促进策略的综合运用使农村居民口腔保健认知水平和口腔保健行为形成率显著提高（P〈0.001）。结论提出农村开展健康教育与健康促进工作的有效方法与策略。     

Health Promotion and the Preventative Health Taskforce

The release in October of the Preventative Health Taskforce's discussion paper, ‘Australia: the healthiest country by 2020’ offers health promotion practitioners their greatest opportunity to participate in national policy development for many years. The Taskforce, which was established by the Federal Health Minister Nicola Roxon in March, has been asked to develop a National Preventative Health Strategy for the Government by mid‐2009, focusing initially on obesity, smoking and alcohol. The Taskforce has proposed the following targets to be achieved by 2020:

• halt and reverse the rise in overweight and obesity;
• reduce the prevalence of daily smoking to 9% or less;
• reduce the prevalence of harmful drinking for all Australians by 30%; and
• contribute to the ‘Close the Gap’ target for Indigenous people, reducing the 17‐year life expectancy gap between Indigenous and non‐Indigenous Australians.

     

Health Care Coverage and the Health Care Industry

Objectives. We examined rates of uninsurance among workers in the US health care workforce by health care industry subtype and workforce category.Methods. We used 2004 to 2006 National Health Interview Survey data to assess health insurance coverage rates. Multivariate logistic regression analyses were conducted to estimate the odds of uninsurance among health care workers by industry subtype.Results. Overall, 11% of the US health care workforce is uninsured. Ambulatory care workers were 3.1 times as likely as hospital workers (95% confidence interval [CI] = 2.3, 4.3) to be uninsured, and residential care workers were 4.3 times as likely to be uninsured (95% CI = 3.0, 6.1). Health service workers had 50% greater odds of being uninsured relative to workers in health diagnosing and treating occupations (odds ratio [OR] = 1.5; 95% CI = 1.0, 2.4).Conclusions. Because uninsurance leads to delays in seeking care, fewer prevention visits, and poorer health status, the fact that nearly 1 in 8 health care workers lacks insurance coverage is cause for concern.For complex socioeconomic reasons, private health insurance, typically provided by an employer, is “the dominant mechanism for paying for health services” in the United States.^1(p79) According to the Kaiser Commission on Medicaid and the Uninsured and the Urban Institute, analyses of data from the Current Population Survey (CPS) show that, in 2006, 54% of the US civilian, noninstitutionalized population had employer-sponsored health insurance; 5% had private, nongroup health insurance; and 26% had public health insurance coverage. Approximately 46 million US residents (16% of the population) are currently uninsured.² Numerous studies have shown that, relative to people with health insurance, uninsured people receive less preventive care, are diagnosed at more advanced disease stages, and, once diagnosed, tend to receive less therapeutic care and have higher mortality rates.^3–8Although national uninsurance trends are well-documented, the rate of uninsurance within the health care workforce has received scant attention. Given that health care employment rates are increasing at a more rapid pace than overall employment rates, this lack of attention is especially worrisome. According to the Bureau of Labor Statistics, nearly half of the 30 occupations in which employment opportunities are growing fastest are health care occupations. For example, whereas the Bureau of Labor Statistics projects that overall employment will increase about 10% from 2006 to 2016, employment opportunities for personal and home care aides are projected to increase nearly 51%, and opportunities for physical therapist assistants are expected to increase by a third. The Bureau of Labor Statistics also projects that, by 2016, new job opportunities for registered nurses will increase by approximately 24% (approximately 587 000 new jobs).⁹Although the overall employment outlook for health care workers is promising, what is less clear is to what degree employment in health care is associated with health insurance coverage. A 2001 General Accounting Office report suggested that one fourth of nursing home aides and one third of home health care aides were uninsured.¹⁰ The Kaiser Family Foundation reported that the uninsured rate among workers in the health and social services industry was 23% in 2007.¹¹ On the basis of a review of the literature in the health and human services occupations, Ebenstein concluded that the health insurance plans offered to direct care workers in the developmental disabilities field are “inferior … with less coverage and more out-of-pocket expenses” and that fewer direct care workers “are able to afford health coverage even if they are eligible.”^12(p132)Taking a more comprehensive look at the US health care workforce, Himmelstein and Woolhandler¹³ used 1991 CPS data to estimate uninsurance rates among physicians and other health care personnel. They reported that, overall, 9% of health care workers were uninsured, along with more than 20% of nursing home workers. Examining CPS data from 1988 to 1998, Case et al. found that uninsurance rates among all health care workers rose from 8% to 12%, that rates increased more for health care workers than for workers in other industries, and that rates differed according to occupation and place of employment.¹⁴ For example, occupation-specific uninsurance rates were 23.8% among health aides, 14.5% among licensed practical nurses, and 5% among registered nurses, whereas place-specific rates were 20% among nursing home workers, 8.7% among medical office workers, and 8.2% among hospital workers.¹⁵In their studies, Himmelstein and Woolhandler¹³ and Case et al.¹⁴ used national-level data to estimate uninsurance trends among health care workers. However, these trends were not adjusted for health care workers'' social, demographic, or economic characteristics, which would have helped explain variation across categories or over time. Moreover, with the growth of the health care workforce, estimates from these older studies probably do not reflect the current situation. As a result, the picture of uninsurance as it pertains to the health care workforce lacks the precision and currentness necessary for sound policy decisions. In an effort to expand knowledge in this area, produce more up-to-date estimates, and provide support for possible policy decisions, we used data from the National Health Interview Survey (NHIS) to examine uninsurance among workers in the health care industry.