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国家慢性病综合防控示范区实施效果研究

Study on the effectiveness of implementation: the National Demonstration Areas for Comprehensive Prevention and Control of Non-communicable Diseases

摘要:

目的 通过分析国家慢性病综合防控示范区(示范区)机构参与示范区创建的数据及10个示范区横断面调查数据,评价示范区建设工作开展情况和实施效果.方法 2016年11-12月,采用定量和定性相结合、流行病学和社会学方法并用进行过程评估、效果评估和典型案例分析.结果 示范区建设各项工作总体进展良好.其中,健康教育和健康促进、监测、保障措施这3项活动开展较好,实际得分占满分的比例均高于75%.已初步建立政府重视,多部门协作的慢性病防控格局,参与示范区创建的非卫生部门多达16个以上.示范区居民慢性病防治知识知晓率为28.7%,居民健康行为养成比例明显增加,72.1%的居民每天摄入蔬菜,53.6%的居民每天摄入水果,且居民的步行参与率达到86.9%.示范区居民的高血压和糖尿病的自报管理率均达到70%,规范化管理率均为50%以上.实施得分较高的示范区居民具有较高的慢性病防治知识知晓率(OR=6.591,95% CI:5.188~8.373)、较高的食盐摄入减少比例(OR=1.352,95%CI:1.151~1.589)、较高的食油摄入变少比例(OR=1.477,95%CI:1.249 ~ 1.746)和较高的身体活动达标比例(OR=1.975,95%CI:1.623 ~ 2.403).结论 国家慢性病综合防控示范区创建已成为各地开展慢性病防控的平台和抓手,成为我国慢性病防控工作的重要载体.

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Objective To assess the implementation and impact of programs carried out by the National Demonstration Areas for Comprehensive Prevention and Control of Non-communicable Diseases.Methods Both sociological and epidemiological methods were used to collect qualitative and quantitative data in November and December,2016 in order to conduct on process and outcome evaluation of the above mentioned objective.In the meantime,case study was also conducted.Results All the National Demonstration Areas for Comprehensive Prevention and Control of Non-communicable Diseases were found well implemented across the country,with health education and health promotion,surveillance and safeguard measures in particular.A government-led and inter-sector coordination and communication mechanism had been well established,with more than 16 non-health departments actively involved.28.7% of the residents living in the National Demonstration Areas for Comprehensive Prevention and Control of Non-communicable Diseases were aware of the key messages related to chronic diseases.Among the residents,72.1% of them consumed vegetables and 53.6% consumed fruits daily,with another 86.9% walked at least 10 minutes per day.Over 70% of the patients with hypertension or diabetes reported that they were taken care of by the Community Health Centers,and above 50% of them were under standardized management.Residents,living in the National Demonstration Areas under higher ranking of implementation scores,were more likely to be aware of relevant knowledge on chronic disease control and prevention (OR=6.591,95%CI:5.188-8.373),salt reduction (OR=1.352,95%CI:1.151-1.589),oil reduction (OR=1.477,95%CI:1.249-1.746) and recommendation on physical activities (OR =1.975,95% CI:1.623-2.403).Conclusion The implementation of programs carried out by the National Demonstration Areas for Comprehensive Prevention and Control of Non-communicable Diseases had served a local platform for the control and prevention of non-communicable diseases,and thus become an important'carrier'for chronic disease prevention and control programs in China.

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