摘要目的 了解城乡居民干预后健康素养水平变化情况,评价健康素养促进行动效果,为进一步调整温州市公民健康素养提升策略提供参考依据.方法 采用分层多阶段简单随机抽样方法,从全市11个县(市、区)中抽取鹿城区和泰顺县,再从鹿城区和泰顺县中各抽取2个街道/乡镇,再从抽中的街道/乡镇中各抽取2个社区,于2012年7月至2013年9月在这8个社区开展以《健康素养66条》为核心内容的综合性健康素养宣传及干预活动,并于干预前、后采用统一的《公民健康素养调查问卷》,分别在干预前后调查了该8个社区的880名和840名15～69岁居民,分析比较干预前、后城乡居民健康素养总具备率、3方面健康素养和5大类健康问题素养的具备率变化情况,并作相关率的x2检验.结果 温州市城乡居民健康素养具备比例从干预前的11.8％ (104/880)提高到干预后的16.3％(137/840)(x2=7.20,P＜0.01);具备基本知识和理念、生活方式与行为、基本技能方面素养的比例分别从18.5％(163/880)、9.4％(83/880)、23.5％(207/880)提高到28.0％(235/840)、14.6％(123/840)、33.5％(281/840),差异有统计学意义(x2依次为21.60、11.07、20.85,P均＜0.01);具备健康科学观、传染病预防、慢性病预防、安全与急救、基本医疗素养的比例为40.4％(339/840)、31.8％(267/840)、22.4％(188/840) 、58.2％(489/840)、33.8％(284/840),比干预前分别提高了12.1％、7.5％、5.5％、15.8％、8.1％,差异有统计学意义(x2依次为27.79、34.95、8.10、43.07、13.61,P均＜0.01).结论 采取健康传播、参与式干预的健康促进与健康教育对提升居民健康素养是有效果的,城市与农村居民、不同特征居民之间的干预效果不同.应以健康生活方式与行为素养和慢性病预防素养为重点内容,以农村居民、老年居民、低教育程度居民以及低收入居民为重点对象,实行有侧重性、分类指导的健康素养干预策略.

abstractsObjective To investigate health literacy before and after the medical intervention and its influencing factors so as to provide evidence for public health promotion.Methods Stratified multi-stage random sampling method was applied for residents aged 15-69 years from 8 urban or rural communities of Taishun County of Lucheng District.The comprehensive health literacy promotion and intervention was carried out,and a unified citizen health literacy questionnaire was designed.Residents' health literacy,the three aspects of health literature and five categories of health literacy issues levels were compared before and after the intervention,and Chi-square test was used for data analysis.Results The overall rate of having health literacy was 11.8％ and 16.3％ in 2012 and 2013,respectively (x2=7.20,P＜ 0.01).The rate of basic health concept and knowledge,health lifestyles and behaviors,and medical skills were significantly raised from 18.5％,9.4％ and 23.5％ to 28.0％,14.6％ and 33.5％,respectively (x2 values were 21.60,11.07 and 20.85,respectively; all P＜0.01).As to the five issues of health literacy,the level of the scientific healthy literacy,the chronic disease literacy,the literacy of infectious disease,the safety and first aid literacy and the basic health literacy were significantly inclined (52.4％ vs.40.4％,39.3％ vs.31.8％,27.8％ vs.22.4％,74.0 ％ vs.58.2％ and 41.9％ vs.33.8％,respectively; x2 values were 27.79,34.95,8.10,43.07 and 13.61,respectively; all P＜0.01).Conclusion Health education was helpful in the promotion of healthy literacy.Healthy lifestyles and behavior literacy and chronic disease prevention literacy should be important for the rural,elderly,low-education level and low-income populations.