Impact of health educators' intervention on non-communicable diseases-related knowledge, attitude and behavior among rural residents / 中华预防医学杂志

ABSTRACT

<p><b>OBJECTIVE</b>To evaluate the impact of health educators' intervention on knowledge, attitude and behavior among rural residents and the feasibility of this intervention mode.</p><p><b>METHODS</b>Using stratified cluster random sampling method, three towns and five villages in Yongchuan district, Chongqing municipality were selected from February to November, 2013. One or two health educators from each village were recruited by recommendation or voluntary registration. A total of 30 health educators were recruited and trained. Health educators who passed the exam of the training conducted the intervention and training of knowledge and skill about non-communicable disease (NCD) prevention and control for over 30 rural residents who lived nearby aged over 18 years old, could take care of themselves and complete questionnaire independently. 900 residents were selected as the study samples before and after the intervention. Questionnaire surveys were conducted before and after the intervention to evaluate the effect. Changes of knowledge and behavior among participants were compared by Chi-square test. Changes of attitude towards NCD prevention and control among participants were compared by two independent t-test.</p><p><b>RESULTS</b>Before and after the intervention, the cognition rate about diagnostic criteria of hypertension among rural adults was 29.8% (268/900) and 67.9% (611/900), respectively(χ(2)=261.58, P<0.001). The cognition rate about risk factors of hypertension was 22.9% (206/900) and 78.2% (704/900), respectively(χ(2)=551.19, P<0.001). The cognition rate about the prevention measure of hypertension was 37.2% (335/900) and 88.0% (792/900) , respectively(χ(2)=495.64, P<0.001). The cognition rate about complications of hypertension was 15.4% (139/900) and 68.9% (620/900), respectively(χ(2)=527.07, P<0.001). The cognition rate about diagnostic criteria of diabetes was 12.9% (116/900) and 50.3% (453/900), respectively(χ(2)=291.85, P<0.001). The cognition rate about the criteria of risk population of diabetes was 8.6% (77/900) and 62.0% (558/900), respectively(χ(2)=562.94, P<0.001). The cognition rate about the symptom of diabetes was 29.8% (268/900) and 83.3% (750/900), respectively(χ(2)=525.31, P<0.001). The cognition about the preventive measure of diabetes was 44.7% (402/900) and 89.3% (804/900), respectively(χ(2)=406.06, P<0.001). The cognition rate about 6 g salt intake per person per day among rural adults was 28.0% (252/900) and 84.3% (759/900), respectively(χ(2)=580.04, P<0.001). The cognition about 25 g oil intake per person per day among rural adults was 26.7% (240/900) and 71.4% (643/900), respectively(χ(2)=361.04, P<0.001). The cognition about self-perception of body weight among rural adults was 62.9% (566/900) and 91.9% (827/900), respectively (χ(2)=216.28, P<0.001). The cognition about self-circumference among rural adult was 54.8% (493/900) and 87.7% (789/900), respectively(χ(2)=237.49, P<0.001). The cognition rate of self-blood pressure was 60.5% (544/900) and 70.4% (634/900), respectively(χ(2)=14.92, P<0.001). Before and after the intervention, the scores of the necessity about conducting health education for the public among rural adults was (3.1±0.9 ) and (3.7±0.5 ), respectively(t=20.09, P<0.001). The score of the necessity about unhealthy lifestyle change among rural adults was (3.0±0.9 ) and (3.7±0.6), respectively(t=20.84, P<0.001). The score of the necessity about testing blood pressure and blood glucose regularly among rural adults was (3.0±0.9) and (3.7±0.6), respectively(t=21.07, P<0.001). The score of the necessity about body weight control was (2.9±1.0) and (3.6± 0.8), respectively(t=20.04, P<0.001). The score of the necessity about conducting hypertension screen among high risk population was (3.0±0.9) and (3.7±0.5), respectively(t=22.99, P<0.001). The score of the necessity about conducting diabetes screen among high risk population was (3.0 ± 0.9) and (3.7 ± 0.5), respectively(t=23.22, P<0.001). The score of the necessity about providing instruction service of diet and physical activity for high risk population was (3.0±0.9) and (3.7±0.5), respectively(t=22.41 and 22.87, P< 0.001). Before and after the intervention, the proportion of rural adults seeking counseling service about NCD was 44.0% (396/900) and 64.9% (584/900), respectively(χ(2)=79.17, P<0.001). The proportion of rural adults testing blood pressure in the recent six months was 43.4% (391/900) and 63.1% (568/900), respectively(χ(2)=69.92, P<0.001). The proportion of rural adults who tested blood glucose in the recent six months was 28.6%(257/900) and 48.1% (433/900), respectively(χ(2)=72.80,P<0.001). The proportion of rural adults who controlled body weight consciously was 34.7%(312/900) and 29.3% (264/900), respectively(χ(2)= 5.88,P<0.05).</p><p><b>CONCLUSION</b>Health educators' intervention could raise rural participants' awareness and confidence about NCD significantly, but this intervention mode might have little impact on healthy behaviors change in a short time.</p>