基于健康信念模式的四川省农村地区婴幼儿看护人营养包喂服行为研究  

Caregivers’micronutrient powder(Ying Yang Bao)feeding behavior in rural areas of Sichuan Province:based on the health belief model

作　　者：姚秀春 孙畅[1] 廖颖 叶睿雪 杜艳 吴玉菊[2] 沈丽琴[2] 周欢[1] Yao Xiuchun;Sun Chang;Liao Ying;Ye Ruixue;Du Yan;Wu Yuju;Shen Liqin;Zhou Huan(Department of Health Behavior and Social Medicine,West China School of Public Health and West China Fourth Hospital,Sichuan University,Chengdu 610041,China;Department of Child and Adolescent Health and Maternal and Child Health Care,West China School of Public Health and West China Fourth Hospital,Sichuan University,Chengdu 610041,China)

机构地区：[1]四川大学华西公共卫生学院/四川大学华西第四医院健康行为与社会医学系,成都610041 [2]四川大学华西公共卫生学院/四川大学华西第四医院儿少卫生与妇幼保健学系,成都610041

出　　处：《卫生研究》2022年第2期216-221,共6页Journal of Hygiene Research

基　　金：国家自然科学基金(No.71874114);应用新媒体及社会网络探索贫困农村地区儿童营养改善的健康教育与健康促进创新模式(No.19PJ072);基于微型学习的偏远农村地区母婴健康促进科普培训(No.2021JDKP0042)。

摘　　要：目的评估四川省农村地区6~24月龄婴幼儿看护人营养包喂服现状,以健康信念模式为理论框架,探索婴幼儿看护人营养包喂服行为的影响因素。方法2019年10月,采用多阶段随机整群抽样方法抽取四川省6个县(2个汉族县,2个藏族县,2个彝族县)的36个乡的108个村,整群纳入6~24月龄婴幼儿的看护人进行面对面问卷访谈,获取看护人对营养包的认知和态度、看护人营养包喂服情况等信息。共纳入830名婴幼儿看护人,男孩446人(53.73%),女孩384人(46.27%),6~12月龄209人(25.18%),13~18月龄295人(35.54%),19~24月龄326人(39.28%)。基于健康信念模式,采用路径分析探究婴幼儿看护人营养包喂服行为的影响因素。结果四川省农村地区6~24月龄婴幼儿看护人营养包有效喂服率为48.80%。路径分析结果显示,健康信念模式中知觉障碍对看护人营养包喂服行为有直接(β=-0.145,P<0.001)和通过自我效能中介的间接(β=-0.066,P<0.001)负向影响,总效应大小为-0.211;知觉益处对看护人营养包喂服行为有直接(β=0.130,P<0.001)和通过自我效能中介的间接(β=0.055,P<0.001)正向影响,总效应大小为0.185;自我效能对看护人营养包喂服行为有直接正向影响(β=0.183,P<0.001)。结论四川省农村地区6~24月龄婴幼儿看护人营养包喂服情况不理想,健康信念模式中知觉障碍、知觉益处、自我效能影响婴幼儿看护人营养包喂服行为。OBJECTIVE To evaluate the status of caregivers’micronutrient powder feeding behavior among 6-24 months infants and young children in rural areas of Sichuan Province.To explore the influencing factors of caregivers’micronutrient powder feeding behavior based on the health belief model(HBM).METHODS In October 2019,a total of six counties consisting of two Han counties,two Tibetan counties and two Yi counties were selected by multi-stage random cluster sampling in Sichuan Province.A total of 830 caregivers were eligible.There were 446 boys(53.73%)and 384 girls(46.27%)participated the program and 25.18%of them were 6-12 months,35.54%were 13-18 months,39.28%were 19-24 months.A structured questionnaire based on the health belief model was designed to collect data which includes caregivers’perception,attitude and feeding behavior of micronutrient powder.The data was collected by face-to-face interviews.Furthermore,a path analysis was used to determine the influence of health belief model constructs on caregivers’micronutrient powder feeding behavior.RESULTS The effective micronutrient powder feeding rate was 48.80%.Path analysis result suggested that constructs of health belief model that influencing caregivers’micronutrient powder feeding behavior included perceived barrier,perceived benefit and self-efficacy.Specifically,perceived barrier had both direct(β=-0.145,P<0.001)effect and indirect(β=-0.066,P<0.001)effect mediated by self-efficacy,and its total effect was-0.211;perceived benefit similarily had both direct effect(β=0.130,P<0.001)and indirect(β=0.055,P<0.001)effect mediated by self-efficacy,and its total effect was 0.185;self-efficacy only had direct(β=0.183,P<0.001)effect.CONCLUSION The effective micronutrient powder feeding rate in rural areas of Sichuan Province is significantly low.Three health belief model constructs which included perceived barrier,perceived benefit and self-efficacy could influence caregivers’micronutrient powder feeding behavior.

关 键 词：营养包喂服行为 健康信念模式 路径分析 

分 类 号：R153.2[医药卫生—营养与食品卫生学] R174[医药卫生—公共卫生与预防医学]