应用广义估计方程评估"农村义务教育学生营养改善计划"地区营养宣教实施效果  

Evaluation on the effectiveness of nutrition propaganda and education on Nutrition Improvement Program for Rural Compulsory Education Students,using Generalized Estimating Equation

作　　者：程茅伟[1] 戴诗玙 欧阳英英[1] 李菁菁[1] 龚晨睿[1] 

机构地区：[1]湖北省疾病预防控制中心,武汉430079

出　　处：《公共卫生与预防医学》2017年第3期6-10,共5页Journal of Public Health and Preventive Medicine

基　　金：2013年"达能营养中心膳食营养研究与宣教基金"资助项目(DIC2013-04)

摘　　要：目的运用广义估计方程(generalized estimating equation,GEE)评价湖北省"农村义务教育学生营养改善计划"(简称"计划")地区营养宣教干预效果,为在"计划"地区大规模开展营养宣教提供理论和实践依据。方法采取随机整群抽样法在湖北省恩施市"计划"地区4所中小学分别设立对照组和干预组。干预前对所有选择对象进行问卷调查;干预组营养宣教干预5个月后,对两组学生进行第2次调查。采用GEE分析结果得出统计学结论。结果干预组233人,对照组209人。控制其他协变量,干预组干预后营养知识、日常健康饮食行为相对于基线分别提高了0.82分(χ~2=24.31,P<0.001)、3.29分(χ~2=14.07,P<0.001);干预组干预后日常不良饮食行为(χ~2=0.12,P=0.773)、"计划"营养餐满意度及依从性(χ~2=2.44,P=0.118)得分改变相对于基线均无显著性。结论营养宣教能显著性提高"计划"地区中小学生营养知识知晓率并促进日常健康饮食行为水平,但未能有效改善其日常不良饮食行为、"计划"营养餐满意度和依从性水平。GEE方法处理营养干预纵向资料具有极大的实用性和灵活性。Objective Using generalized estimating equations （ GEE） to evaluate the effect of nutrition propaganda and education among rural students receiving Nutrition Improvement Program for Rural Compulsory Education Students （NIPRCES） , and provide the theory and practice basis for carrying out nutrition propaganda and education among NIPRCES in future. Methods The study design was under cluster - randomized controlled trial, with 233 students in the intervention and 209 students in the control groups. Repeated measurement data on nutrition propaganda and education in NIPRCES area were analyzed through GEE model. Results After the implementation of nutrition propaganda and education, by controlling other covariates, the average scores of nutrition knowledge and average scores of healthy diet behavior were 0. 82 and 3. 29 higher than the base line in the intervention group respectively （ P 〈 0. 001 ）. However, the unhealthy eating habits score, NIPRCES dining satisfaction and compliance remained unchanged （ P 〉 0. 05 ） . Conclusion Junior and primary students of NIPRCES obtained more nutrition knowledge and changed their healthy dietary behaviors through nutrition propaganda and education. However, there was no significant improvement in healthy dietary behaviors and NIPRCES dining satisfaction and compliance. GEE method had great practicability and flexibility to deal with longitudinal data of nutrition intervention.

关 键 词：广义估计方程 营养宣教 纵向资料 农村义务教育学生营养改善计划 中小学生 

分 类 号：R179[医药卫生—妇幼卫生保健]