基于结构方程模型的慢性病高危人群休闲类身体活动影响因素分析  

Determinants of recreational physical activity among residents with high risk of chronic diseases: Application of Structural Equation Modeling

作　　者：吴士艳 胡康[1] 张幸[1] 张旭熙 孙凯歌[1] 刘思佳[2] 孙昕霙[1] 

机构地区：[1]北京大学医学部公共卫生学院,北京100191 [2]北京市通州区疾病预防控制中心,北京101100

出　　处：《中国健康教育》2017年第7期587-591,共5页Chinese Journal of Health Education

基　　金：国家自然科学基金项目(71673009)

摘　　要：目的本研究旨在应用健康信念模式和结构方程模型探究北京市通州区慢性病高危人群休闲类身体活动的状况及其影响因素,为今后实施休闲类身体活动干预和相关政策的制定提供参考。方法数据来自"北京市通州区社区诊断(2015)"专项调查,按规模大小成比例的概率抽样(PPS抽样)和配额抽样的方法进行抽样。以2736例慢性病高危人群为研究对象,应用结构方程模型分析该人群休闲类身体活动的影响因素。结果本地区慢性病高危人群的流行率为37.4%。该人群休闲类身体活动的日均千步当量中位数为0.0(0.0,4.6)千步当量。结构方程模型显示客观障碍(β=-0.229)和自我效能(β=0.133)对休闲类身体活动的直接效应显著;客观障碍的直接效应最大且为负效应。模型中还广泛存在中介效应,自我效能和主观障碍是中介变量,其中自我效能是最主要的中介变量。结论慢性病高危人群流行率偏高,且该人群休闲类身体活动量不足。今后工作应该着重减少休闲类身体活动的客观障碍及主观障碍,提高该人群自我效能,进而提高该人群休闲类身体活动量。Objective Application of health belief model and structural equation modeling to identify the determinants of recreational physical activity among residents with high risk of chronic diseases, and to provide specific interventions on recreational physical activity and references for health relevant policy-making in future. Methods The data were from ＂Community Diagnosis Program of Tongzhou, Beijing （2015）＂ . Probability proportional to size （PPS） sampling and pro- portional quota sampling were conducted to select residents according to demographic characteristics such as age and gender. A total of 2736 residents with high risk of chronic diseases were involved. Structural equation modeling was conducted to explore the determinants of recreational physical activity. Results The median amount of recreational physical activity was 0. 0 thousand-step equivalent with quartile of （0. 0, 4. 6 ）. In the structural equation modeling, the direct effects of per- ceived objective barriers （β = -0. 229） and self-efficacy （β =0. 133） on recreational physical activity were significant and perceived objective barriers had the strongest and negative direct effects on recreational physical activity. Indirect effect existed widely in the structural equation modeling. Self-efficacy and perceived subjective barriers were important mediating variable, and self-efficacy was the most crucial mediator. Conclusion The prevalence of residents with high risk of chronic diseases is relatively high, and the recreational physical activity level is lower. To improve recreational physical activity a- mong residents with high risk of chronic diseases, much more attention should be paid to reduce the objective and subjective barriers of recreational physical activity and improve self-efficacy.

关 键 词：慢性病 高危人群 休闲类身体活动 结构方程模型 影响因素 

分 类 号：R193[医药卫生—卫生事业管理]