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Objective:To investigate the status of satisfaction of postgraduates majoring in public health with the teaching material of The prevention and control of chronic non- communicable disease, so as to provide the basis for promoting the teaching and optimizing the reprint of the teaching material. Methods:An online survey was conducted among 180 public health postgraduates of Batch 2018 to Batch 2020 from China CDC who took the selective course of "prevention and control of chronic non-communicable diseases". The survey content included the overall satisfaction of the respondents with the teaching material and such four levels of satisfaction as primary indicators at the content level, thinking level, motivation level and arrangement level and 20 secondary indicators. The statistical analysis was made by SPSS 25.0.Results:The effective response rate was 90.56% (163/180), and the overall satisfaction of postgraduates with the teaching material was 88.96%. The satisfaction of "scientificity", "comprehensiveness", "internal coordination" and "hierarchy" at the content level, "systematic thinking" and "quality education" at the thinking level, "deepening the understanding and application of relevant knowledge in the field of chronic disease prevention and control" and "the content is convenient for self-study and helps guide the construction of new knowledge" at the motivation level, and "accurate words, fluent language and easy to read and understand" and "firm binding, good paper quality and clear printing" at the arrangement level of the teaching material was more than 90.00%. Only the satisfaction of "the critical thinking" at the thinking level and "stimulating learning enthusiasm" at the motivation level was less than 85.00%.Conclusion:The teaching material of The prevention and control of chronic non- communicable disease meets the learning needs of postgraduates majoring in public health, and students have high overall satisfaction evaluation on the teaching material. It is necessary to further optimize the two aspects of "the critical thinking" and "stimulating learning enthusiasm" in the revision of the teaching material.
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2018 witnessed the 40th anniversary of the Alma-Ata Declaration. On October 25, 2018, the World Health Organization issued a new Astana Declaration, which reiterates and further develops the concept and core elements of primary health care. It is also proposes that the implementation of the primary health care concept will facilitate to cope with the increasing burden of non-communicable diseases in different countries. Based on the analysis on the policies and practices of the prevention and control of non-communicable diseases in China, this paper points out that the "government-leading, multi-sectoral collaboration, social mobilization and participation by all people" which we have always emphasized is just the application of this primary health care concept, and the Astana Declaration also brings a new and important inspiration to the prevention and control of non-communicable diseases in China.
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Objective@#To evaluate the effect of a community-based intervention supporting type 2 diabetes mellitus patients in their self-management of the disease.@*Methods@#This research was a randomized controlled trial conducted in communities in Fangshan District, Beijing, China. Adult patients with type 2 diabetes from 17 communities in 4 sub-district of Fangshan District were randomly assigned to either the intervention or control group. Participants in the intervention group participated in a three-month group-based diabetes self-management intervention service. Data were collected both in intervention and control group at baseline and after the intervention to evaluate the effect of the intervention. A questionnaire survey was completed by all participants to collect their demographic information, diabetes related health behaviors and skills. A physical examination and lab testing including height, weight, blood pressure, and waist circumference as well as HbA1c, fasting blood glucose, lipid profile were conducted before and after the intervention.@*Results@#A total of 500 valid questionnaires were received, including 259 in the intervention group and 241 in the control group. Patients in the intervention group who learned how to conduct the self-monitoring of blood glucose increased from 56.76% (n=147) to 87.26% (n=226) after the intervention, higher than that of control group (63.07%, n=152) (P<0.001). 69.50% (n=180) patients in intervention group had blood glucose monitor at home, which was 60.62% (n=157) prior to the intervention and higher than that of control group (57.68%, n=139) (P=0.004). After the intervention, 3.09% (n=8) patients in intervention group ceased to take medicine by themselves, which was 16.22% (n=42) before the intervention, while the control group was 8.30% (n=20) after the intervention (P=0.009). Patients in the intervention group made significant improvements in implementing self monitoring on blood glucose (SMBG), which was increased from one day per week to 2 days per week, and foot self-examination, which increased from 2 days per week to 7 days per week. The body weight of patients in the intervention group reduced 1.62 kg on average after the intervention, while it increased 0.88 kg in the control group. Similar improvement was found in waist circumstance between the intervention and control group (-0.83 cm vs -0.16 m). There was a significant reduction on body weight and waist circumstance in the intervention group (P<0.05).@*Conclusion@#The group activities focusing on people with type 2 diabetes resulted in improvement in their lifestyle and self management behaviors, as well as their body weight and waist circumstance.
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Objective To analyze the effect of intervention programs and influencing factors regarding the community “5 + 1” staged diabetes target management on patients with type 2 diabetes mellitus (T2DM) and to provide evidence for improving the quality of life (QOL).Methods A total of 12 community health service centers from Shanxi province,Jiangsu province,and Ningxia Hui autonomous region were selected as intervention group and control group,by stratified cluster sampling method.“5 + 1” model was used in intervention groups and basic public health services model was applied in control groups for this two-year follow-up.Data was collected through a questionnaire on demographic and disease-related information,while the QOL was measured with SF-36.Multiple linear regression and conducted by SAS 9.4.Results A total of 2 467 subjects were included at baseline and 1 924 had completed a two-year-long management service.After intervention programs being implemented,the net effect of PCS score between the intervention and the control groups was 13.6,with the net effect of MCS score as 29.8.Results from the multiple linear regression showed that the main factors affecting PCS scores included age,type of medical insurance,baseline PCS score and regions of residency.Main factors related to MCS score included age,type of medical insurance,baseline MCS score,hypertension,and region of residency.Conclusion Community “5 + 1” staged diabetes target management model presented favorable effect of improving the QOL on T2DM patients.
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Objective To analyze the burden of disease (BOD) on diabetes attributable to high BMI in China from 1990 to 2016.Methods Data based on population of the 2016 Global Burden of Disease Study for China were used to analyze the attributable fractions (PAF) of BOD for diabetes attributable to high BMI.Measurements for attributable BOD of diabetes included disability adjusted life years (DALY),years of lost life (YLL),years living with disability (YLD),death number and mortality rate.The average world population from 2010 to 2035 was used as a reference.Results In 2016,death number of diabetes attributable to high BMI was 40 310,which was significantly higher than that in 1990 (15 008).Age-standardized death rate of diabetes attributable to high BMI increased from 2.01/100 000 in 1990 to 2.60/100 000 in 2016,which showed a more significant increasing trend in both males and people aged 15-49 years.DALYs of diabetes attributable to high BMI increased from 1.09 million person years to 3.30 million person years.YLL and YLD also showed increasing trends.The highest increasing rate of YLD was in people aged 15-49 years.High BMI was responsible for 26.01％ of the diabetes deaths in 2016 in China,an increase of 39.39％ compared with that in 1990 (18.66％).Most provinces in China experienced a sharp increase of DALY of diabetes attributable to high BMI from 1990 to 2016.Inner Mongolia,Xinjiang,Zhejiang,Macao SAR,Sichuan and Qinghai had the most significant increase tendency in terms of DALY rate during this period.Conclusions There was a rapid increase of the deaths and mortality rate of diabetes attributable to high BMI,causing a heavy disease burden,in China from 1990 to 2016.The BOD varied in both different age and gender groups.More attention should be paid to males and people aged 15-49 years in the prevention and control programs of diabetes.
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Objective To analyze the effect of intervention programs and influencing factors regarding the community “5 + 1” staged diabetes target management on patients with type 2 diabetes mellitus (T2DM) and to provide evidence for improving the quality of life (QOL).Methods A total of 12 community health service centers from Shanxi province,Jiangsu province,and Ningxia Hui autonomous region were selected as intervention group and control group,by stratified cluster sampling method.“5 + 1” model was used in intervention groups and basic public health services model was applied in control groups for this two-year follow-up.Data was collected through a questionnaire on demographic and disease-related information,while the QOL was measured with SF-36.Multiple linear regression and conducted by SAS 9.4.Results A total of 2 467 subjects were included at baseline and 1 924 had completed a two-year-long management service.After intervention programs being implemented,the net effect of PCS score between the intervention and the control groups was 13.6,with the net effect of MCS score as 29.8.Results from the multiple linear regression showed that the main factors affecting PCS scores included age,type of medical insurance,baseline PCS score and regions of residency.Main factors related to MCS score included age,type of medical insurance,baseline MCS score,hypertension,and region of residency.Conclusion Community “5 + 1” staged diabetes target management model presented favorable effect of improving the QOL on T2DM patients.
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Objective To analyze the burden of disease (BOD) on diabetes attributable to high BMI in China from 1990 to 2016.Methods Data based on population of the 2016 Global Burden of Disease Study for China were used to analyze the attributable fractions (PAF) of BOD for diabetes attributable to high BMI.Measurements for attributable BOD of diabetes included disability adjusted life years (DALY),years of lost life (YLL),years living with disability (YLD),death number and mortality rate.The average world population from 2010 to 2035 was used as a reference.Results In 2016,death number of diabetes attributable to high BMI was 40 310,which was significantly higher than that in 1990 (15 008).Age-standardized death rate of diabetes attributable to high BMI increased from 2.01/100 000 in 1990 to 2.60/100 000 in 2016,which showed a more significant increasing trend in both males and people aged 15-49 years.DALYs of diabetes attributable to high BMI increased from 1.09 million person years to 3.30 million person years.YLL and YLD also showed increasing trends.The highest increasing rate of YLD was in people aged 15-49 years.High BMI was responsible for 26.01％ of the diabetes deaths in 2016 in China,an increase of 39.39％ compared with that in 1990 (18.66％).Most provinces in China experienced a sharp increase of DALY of diabetes attributable to high BMI from 1990 to 2016.Inner Mongolia,Xinjiang,Zhejiang,Macao SAR,Sichuan and Qinghai had the most significant increase tendency in terms of DALY rate during this period.Conclusions There was a rapid increase of the deaths and mortality rate of diabetes attributable to high BMI,causing a heavy disease burden,in China from 1990 to 2016.The BOD varied in both different age and gender groups.More attention should be paid to males and people aged 15-49 years in the prevention and control programs of diabetes.
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Objective To assess the disease burden for gynecological disease in China in 2016. Methods Data were extracted from the global burden of disease study 2016(GBD 2016). The burden of gynecological disease among age groups and provinces groups was assessed by prevalence rate, mortality rate, years lived with disability (YLD), years of life lost due to premature mortality (YLL) and disability-adjusted life years(DALY). An average world population age-structure for the period 2010-2035 was adopted to calculate age-standardized rates. Results In 2016, the prevalence rate of gynecological disease in women aged 15 years and above in China was 24.94%, of which was 36.71%to women of childbearing age. The number of DALY from gynecological disease was 2727637.82 life years in 2016, with the DALY rate was 411.12/100000 and standardized DALY rate was 341.80/100000. The first three gynecological diseases with highest DALY and DALY rate among Chinese women aged ≥15 years were premenstrual syndrome(815004.64 life years, 122.84/100000), uterine fibroids(281976.67 life years, 42.5/100000) and endometriosis (154792.89 life years, 23.33/100000). The DALY caused by gynecological disease in Guangdong (220871.19 life years), Shandong (190968.72 life years), Henan (171273.92 life years), Jiangsu(168404.27 life years)and Sichuan(144358.5 life years)were higher than other provinces. The standardized DALY rate attributable to gynecological disease were highest in Xinjiang Uygur Autonomous Region(404.00/100000), Shanghai(394.90/100000), Heilongjiang(382.00/100000), Beijing(365.70/100000)and Jiangsu (357.50/100000). Conclusions Gynecological disease is a great threat to women' s reproductive health. Effective measures should be taken to address the issue, especially to women of childbearing age.
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Objective To analyze the trends on mortalities of all-cause and deaths caused by chronic and non-communicable diseases (NCDs) among Chinese labor force population during 2007 to 2016.Methods Data on cause-of-death that collected from the National Mortality Surveillance System was used to analyze the age and area-related specific crude mortality rates,age-standardized mortality rates and component ratios of NCDs,among the Chinese labor force population,during 2007 to 2016.Trend of crude mortality rates and mortality component ratios of the three major diseases (infectious diseases,maternal and infant diseases,nutritional deficiency diseases;NCDs;injuries) were analyzed.Age-standardized mortality of cancer,COPD,cardiovascular and cerebrovascular diseases were also analyzed by gender.Age-standardized mortality was calculated based on the Year 2010 Population Census of China.Joinpoint regression model was used to obtain annual percentage change and 95％CI was set for assessing the trend.Results In 2016,the age-standardized all-cause mortality rate was 217.23 per 100 000 among the Chinese labor force population,but decreased by-2.8％ (95％CI:-3.8％--1.7％) annually from 2007 to 2016.The gap between different gender and regions gradually narrowed.The proportion of deaths caused by NCDs increased annually by 0.8％ (95％CI:0.7％-0.9％).The age-standardized mortality rate of NCDs appeared as 171.89/100 000,among the Chinese labor force population in 2016,showing a downward trend by-2.4％ (95％CI:-3.3％--1.4％).However,in females,there appeared the greatest decrease,with an average annual change of-3.3％ (95％CI:-4.0％--2.5％).Diseases as cancer,COPD,cardiovascular and cerebrovascular diseases all showed downward trends in the whole country,with an average range of-2.0％ (95％CI:-2.6％--1.3％),-8.0％ (95％CI:-8.9％--7.1％),-1.5％ (95％CI:-2.9％--0.1％),-2.3％ (95％CI:-2.8％--1.8％)in a ten-year period,respectively.Conclusion All-cause and age-standardized mortality rates caused by NCDs among Chinese labor force population were decreasing during 2007 to 2016.However,the constituent ratios appeared increasing,year by year.Close attention needs to be paid on NCDs which affecting the health of the labor force population in China.
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Objective To analyze the trends on mortalities of all-cause and deaths caused by chronic and non-communicable diseases (NCDs) among Chinese labor force population during 2007 to 2016.Methods Data on cause-of-death that collected from the National Mortality Surveillance System was used to analyze the age and area-related specific crude mortality rates,age-standardized mortality rates and component ratios of NCDs,among the Chinese labor force population,during 2007 to 2016.Trend of crude mortality rates and mortality component ratios of the three major diseases (infectious diseases,maternal and infant diseases,nutritional deficiency diseases;NCDs;injuries) were analyzed.Age-standardized mortality of cancer,COPD,cardiovascular and cerebrovascular diseases were also analyzed by gender.Age-standardized mortality was calculated based on the Year 2010 Population Census of China.Joinpoint regression model was used to obtain annual percentage change and 95％CI was set for assessing the trend.Results In 2016,the age-standardized all-cause mortality rate was 217.23 per 100 000 among the Chinese labor force population,but decreased by-2.8％ (95％CI:-3.8％--1.7％) annually from 2007 to 2016.The gap between different gender and regions gradually narrowed.The proportion of deaths caused by NCDs increased annually by 0.8％ (95％CI:0.7％-0.9％).The age-standardized mortality rate of NCDs appeared as 171.89/100 000,among the Chinese labor force population in 2016,showing a downward trend by-2.4％ (95％CI:-3.3％--1.4％).However,in females,there appeared the greatest decrease,with an average annual change of-3.3％ (95％CI:-4.0％--2.5％).Diseases as cancer,COPD,cardiovascular and cerebrovascular diseases all showed downward trends in the whole country,with an average range of-2.0％ (95％CI:-2.6％--1.3％),-8.0％ (95％CI:-8.9％--7.1％),-1.5％ (95％CI:-2.9％--0.1％),-2.3％ (95％CI:-2.8％--1.8％)in a ten-year period,respectively.Conclusion All-cause and age-standardized mortality rates caused by NCDs among Chinese labor force population were decreasing during 2007 to 2016.However,the constituent ratios appeared increasing,year by year.Close attention needs to be paid on NCDs which affecting the health of the labor force population in China.
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Objective@#To assess the disease burden for low back pain in China in 2013 and analyzed the change of it between 1990 and 2013.@*Methods@#Data was from the Global Burden of Disease Study 2013 (GBD 2013). The burden of low back pain (LBP) among age groups, gender groups, provinces (excluding Taiwan China) groups was assessed by years lived with disability (YLD), including YLD, YLD rate, proportion of YLD due to LBP. The change of the YLD for LBP was analyzed between 1990 and 2013 by age-standardized YLD rate using the world standard population of 2000-2025 WHO.@*Results@#In 2013, The YLD for LBP was 16 347 thousand (the leading cause of YLD in China), and the proportion of YLD in age group 30-59 years old was 54.6% (8 929/16 347) . The age-standardized rate in China was 1 072.6/100 000, and the rates in Guangdong (1 742.2/100 000) , Shanghai (1 227.8/100 000) and Beijing (1 136.6/100 000) were higher than in other provinces. The proportion of YLD due to LBP was 11.8%. LBP was the leading cause of YLD in China. Compared with 1990, the growth rates of age-standardized rate, proportion of YLD and YLD, were 5.6%, 25.5% and 72.1%, desperately.@*Conclusion@#Low back pain was the leading cause of YLD in China in 2013. Compared with 1990, the disease burden for low back pain increased rapidly.
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Objective To understand the'backward'provinces and the relatively poor work among the construction of National Demonstration Area,so as to promote communication and future visions among different regions.Methods Methods on Cluster analysis were used to compare the development of National Demonstration Area in different provinces,including the coverage of National Demonstration Area and the scores of non-communicable disease (NCDs) prevention and control work based on a standardized indicating system.Results According to the results from the construction of National Demonstration Area,all the 29 provinces and the Xinjiang Production and Construction Corps (except Tibet and Qinghai) were classified into 6 categories:Shanghai;Beijing,Zhejiang,Chongqing;Tianjin,Shandong,Guangdong and Xinjiang Production and Construction Corps;Hebei,Fujian,Hubei,Jiangsu,Liaoning,Xinjiang,Hunan and Guangxi;Shanxi,Jilin,Henan,Hainan,Sichuan,Anhui and Jiangxi;Inner Mongolia,Shaanxi,Ningxia,Guizhou,Yunnan,Gansu and Heilongjiang.Based on the scores gathered from this study,24 items that representing the achievements from the NCDs prevention and control endeavor were classified into 4 categories:Manpower,special day on NCD,information materials development,policy/strategy support,financial support,mass media,enabled environment,community fitness campaign,health promotion for children and teenage,institutional structure and patient self-management;healthy diet,risk factors on NCDs surveillance,tobacco control and community diagnosis;intervention of high-risk groups,identification of high-risk groups,reporting system on cardiovascular and cerebrovascular events,popularization of basic public health service,workplace intervention programs,construction of demonstration units and mortality surveillance;oral hygiene and tumor registration.Contents including oral hygiene,tumor registration,intervention on high-risk groups,identification of high-risk population,reporting system on cardiovascular and cerebrovascular events,popularization of basic public health service,workplace intervention programs,construction of demonstration units and mortality surveillance were discerned as the relatively weak areas in the construction programs of National Demonstration Area.Conclusions Western regions,especially in some remote provinces had the poorest performance during the construction of National Demonstration Area.Programs regarding chronic disease surveillance,identification and intervention on high-risk groups showed the lowest scores and these outcome-oriented tasks should be further focused on,during the next term of review,in these areas.
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Objective To understand the'backward'provinces and the relatively poor work among the construction of National Demonstration Area,so as to promote communication and future visions among different regions.Methods Methods on Cluster analysis were used to compare the development of National Demonstration Area in different provinces,including the coverage of National Demonstration Area and the scores of non-communicable disease (NCDs) prevention and control work based on a standardized indicating system.Results According to the results from the construction of National Demonstration Area,all the 29 provinces and the Xinjiang Production and Construction Corps (except Tibet and Qinghai) were classified into 6 categories:Shanghai;Beijing,Zhejiang,Chongqing;Tianjin,Shandong,Guangdong and Xinjiang Production and Construction Corps;Hebei,Fujian,Hubei,Jiangsu,Liaoning,Xinjiang,Hunan and Guangxi;Shanxi,Jilin,Henan,Hainan,Sichuan,Anhui and Jiangxi;Inner Mongolia,Shaanxi,Ningxia,Guizhou,Yunnan,Gansu and Heilongjiang.Based on the scores gathered from this study,24 items that representing the achievements from the NCDs prevention and control endeavor were classified into 4 categories:Manpower,special day on NCD,information materials development,policy/strategy support,financial support,mass media,enabled environment,community fitness campaign,health promotion for children and teenage,institutional structure and patient self-management;healthy diet,risk factors on NCDs surveillance,tobacco control and community diagnosis;intervention of high-risk groups,identification of high-risk groups,reporting system on cardiovascular and cerebrovascular events,popularization of basic public health service,workplace intervention programs,construction of demonstration units and mortality surveillance;oral hygiene and tumor registration.Contents including oral hygiene,tumor registration,intervention on high-risk groups,identification of high-risk population,reporting system on cardiovascular and cerebrovascular events,popularization of basic public health service,workplace intervention programs,construction of demonstration units and mortality surveillance were discerned as the relatively weak areas in the construction programs of National Demonstration Area.Conclusions Western regions,especially in some remote provinces had the poorest performance during the construction of National Demonstration Area.Programs regarding chronic disease surveillance,identification and intervention on high-risk groups showed the lowest scores and these outcome-oriented tasks should be further focused on,during the next term of review,in these areas.
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<p><b>OBJECTIVE</b>To investigate the status quo and influence factors of self monitoring of blood glucose (SMBG) and self-efficacy of diabetes patients' that participated in community diabetes self management group.</p><p><b>METHODS</b>Beijing, Shanghai, Chongqing, Jiangsu, Guangdong, and Zhejiang were selected as the study sites considering patients management experiences they had. 1 401 adult diabetes patients were recruited from communities via health records system screening, telephone notification, poster advertisement, letters invitation ways. Face to face questionnaire survey was applied to obtain patients' general information, diabetes history, diabetes knowledge awareness, SMBG, and self-efficacy information. Multiple linear regression was used to analyze the relationship between factors and self efficacy.</p><p><b>RESULTS</b>There were 519 male patients (37.0%) and 882 female patients (63.0%) with an average age of (64.9 ± 8.9) years old. Patients lived in city accounted for 48.0% (672/1 401) and rural patients accounted for 52.0% (729/1 401). Patients who conducted SMBG accounted for 79.9% (1 120/1 401) and 33.3% (446/1 401) patients conducted blood glucose monitoring 1-3 times per month. Rural patients, primary school educated, and new rural cooperative medical system (NCMS) covered patients had a higher proportion of never conducting SMBG which were 21.9% (160/729), 24.2% (160/662), and 26.3% (125/475) , respectively. Scores of self-efficacy was (69.24 ± 16.30) (hundred-mark system) with a relative lower score in monitoring of blood glucose (64.09 ± 20.08) and foot care (63.63 ± 21.40), as well as a highest score in taking medicine and insulin injections (76.10 ± 22.00). Multiple regression analysis on self-efficacy and its related factors show a negative correlation between patients' place of residence and self-efficacy (β' = -0.076) and a positive correlation between education and self-efficacy (β' = 0.114) as well as between diabetes knowledge awareness and self-efficacy (β' = 0.193)(t = -2.46, 3.71, 7.18, P < 0.05).</p><p><b>CONCLUSION</b>Community diabetes patients had a low self-efficacy and it was even lower among low economic and education degree patients. The worst parts were SMBG and foot care. Place of residence, education, and diabetes knowledge awareness are factors that influence patients' self efficacy.</p>