摘要目的:观察和评价甘肃省克山病健康教育效果，为科学制定克山病健康教育干预（简称干预）策略提供依据。方法:2017年10月至2018年4月选择甘肃省10个克山病病区县（区）作为项目县（区），每个县（区）选择3个乡（镇），在每个乡（镇）中心小学校4~6年级开展克山病健康教育活动；在每个乡（镇）选择3个村，开展社区健康教育活动。进行为期6个月的克山病防治知识宣传，发放健康教育材料和举办讲座等干预方法，在干预前和干预后对目标人群（50岁以下居民和5年级小学生）进行健康教育问卷调查，评价克山病知识知晓率及干预效果。结果:干预前和干预后调查50岁以下居民分别为450和451人，居民克山病防治知识知晓率由干预前的45.4%（2 041/4 500）上升到干预后的79.5%（3 583/4 510），干预前后比较差异有统计学意义（χ 2 = 1 115.9， P < 0.05）；干预前和干预后调查5年级小学生分别为948和906人，小学生克山病防治知识知晓率由干预前的50.8%（4 818/9 480）上升到干预后的84.2%（7 631/9 060），干预前后比较差异有统计学意义（χ 2 = 2 343.3， P < 0.05）。 结论:以健康教育为主的综合干预手段能够显著提高小学生和居民克山病防治知识知晓率，改善其不良生活行为方式，对克山病的防治有着重要意义。

abstractsObjective:To spread the knowledge of Keshan disease prevention and control, enhance the awareness of disease prevention among the population in the diseased areas, and provide the basis for formulating scientific intervention strategies for health education of Keshan disease.Methods:From October 2017 to April 2018, 10 counties (districts) with Keshan disease were selected as project counties(districts) in Gansu Province, and 3 towns were selected in each project county (district). To carry out Keshan disease health education activities in grade 4 - 6 of each township (town) central primary school, 3 villages were selected in each township to carry out community health education activities. We carried out 6-month propaganda on knowledge of Keshan disease prevention and control among pupils and residents, distributed health education materials and held lectures. Before and after the intervention, we conducted a questionnaire survey on health education among the target population (residents under 50 and primary school students in Grade 5), evaluated the improvement level of knowledge about keshan disease, and made statistical analysis.Results:Four hundred and fifty residents were investigated pre intervention and 451 residents post intervention, the awareness rate of Keshan disease prevention and control knowledge among residents in the diseased areas increased from 45.4% (2 041/4 500) before intervention to 79.5% (3 584/4 510) after intervention (χ 2 = 1 115.9, P < 0.05). Nine hundred and forty-eight pupils were investigated before intervention and 906 pupils (primary school students in Grade 5) after intervention, the awareness rate of Keshan disease prevention and control knowledge among pupils increased from 50.8% (4 818/9 480) before intervention to 84.2% (7 631/9 060) after intervention (χ 2 = 2 343.3, P < 0.05). Conclusion:The comprehensive intervention mainly based on health education can significantly improve the awareness rate of prevention and treatment knowledge of Keshan disease among primary school students and residents, and improve their bad life style, which is of great significance to the prevention and treatment of Keshan disease.