中国四城市社区居民应对高温热浪的干预措施效果评估  

Intervention effect assessment of response to heatwave in communities of four cities, China

作　　者：李永红[1] 汪庆庆[2] 兰莉 罗书全[6] 方道奎[3] 和晋渝[6] 杨超[4] 丁震[2] 程义斌[1] 李成橙[1] 吴珍[1] 余淑苑[3] 金银龙[1] Li Yonghong, Wang Qingqing, Lan Li, Luo Shuquan, Fang Daokui, He Jinyu, Yang Chao, Ding Zhen, Cheng Yibin, Li Chengcheng, Wu Zhen, Yu Shuyuan, Jin Yinlong(National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Belting 100021, Chin)

机构地区：[1]中国疾病预防控制中心环境与健康相关产品安全所,北京100021 [2]江苏省疾病预防控制中心环境疾病防制所 [3]深圳市疾病预防控制中心 [4]哈尔滨市疾病预防控制中心 [5]哈尔滨市慢病预防控制所 [6]重庆市疾病预防控制中心公共卫生与安全监测所

出　　处：《中华预防医学杂志》2018年第4期424-429,共6页Chinese Journal of Preventive Medicine

基　　金：GEF/UNDP/WHO气候变化专项基金项目（PIMS3248）;国家重点基础研究发展计划（2012CB955502）

摘　　要：目的 评估四城市社区居民应对高温热浪的干预措施效果。方法 2011年11月至2013年11月，通过面对面问卷调查的方式在哈尔滨、南京、深圳和重庆试点社区进行高温热浪和气候变化相关知识、态度和行为（KAP）基线调查，共调查1 604名对象。2013—2014年夏季通过发布高温热浪健康风险预警、开展健康教育和健康促进活动对人群进行干预性教育，2014年11月同一社区采用同样的方法和问卷再次进行抽样调查，调查社区居民1 640名。采用χ2检验比较干预前后居民一般人口学特征及KAP的改变情况，并通过logistic多元逐步回归模型分析干预效果的相关因素。结果 干预前、后调查对象的年龄分别为（46.4±15.5）和（45.0±15.9）岁。四城市社区居民在干预前、后热浪知晓率分别为70.5%（1 131/1 604）、82.9%（1 359/1 640）（χ2=69.40，P〈0.001），希望获得高温预警预报的居民由干预前的88.3%（1 416/1 604）增加到了94.6%（1 551/1 604），增加了6.3%（χ2=41.11，P〈0.001）。高温风险预警和健康教育也产生了很大影响，1 192名接收到预警信息的调查对象中，92.7%（1 105名）居民根据预警信息调整作息时间，在1 323名知道社区开展过宣传活动的调查对象中，93.0%（1 231名）的居民认为宣传活动对应对高温保护健康起到积极作用。干预后，南京、重庆的男性热浪知晓情况高于女性，OR（95%CI）值分别为1.48（1.02~2.16）、1.45（1.04~2.03）。4城市大学以上文化程度热浪KAP均高于小学及以下文化程度（OR为1.18~2.05，P〈0.05）；与不经常锻炼身体者相比，四城市经常锻炼身体（OR为1.39~2.70）是影响热浪KAP干预效果的主要相关因素（P〈0.05）。结论 早期预警和健康教育是提高社区居民高温热浪和气候变化应对能力的有效手段。Objective To evaluate the intervention effects of response to heatwave in communities of four cities, China.Methods Baseline survey on heatwave and climate change related knowledge, attitude and practice （KAP） was conducted in the pilot communities in Harbin, Nanjing, Shenzhen and Chongqing, using face-to-face questionnaire interview in November, 2011 to November, 2013. Finally, 1 604 residents were interviewed. Intervention measures were implemented in summers of 2013 and 2014, including delivering early warning information of heatwave health risk and launching health education and promotion. The second survey was conducted in same communities using the same questionnaire and sampling method as baseline survey in November, 2014, and 1 640 residents were interviewed. The Chi-square test was used to compare the demographic characteristics and KAP of community residents between before and after intervention, and the factors that affected the intervention effect were selected by logistic multiple stepwise regression model.Results The age of the residents interviewed before and after intervention was （46.4 ± 15.5） years and （45.0 ± 15.9） years, respectively. Overall, the residents＇ awareness rates of heatwave before and after intervention were 70.5% （1 131/1 604） and 82.9% （1 359/1 640） （χ2=69.40, P〈0.001）. The rate of residents who had wished to receive early warning information increased 6.3% （χ2=41.11, P〈0.001）, which reached 94.6% （1 551/1 604） after intervention from 88.3% （1 416/1 604） in baseline survey. Both heatwave health risk early warning and health education had big impacts to residents. There were 92.7% （1 105 residents） among the 1 192 residents who had received the early warning information arrange work and rest time according to the early warning information and 93.0% （1 231 residents） among the 1 323 residents who knew about health education activities being conducted in community thought that the community health education activities had made

关 键 词：气候变化 干预性研究 高温热浪 社区干预 效果评估 

分 类 号：R122[医药卫生—环境卫生学]