【作者】 李淑玲；

【导师】 王束玫；

【作者基本信息】 山东大学 ， 公共卫生（专业学位）， 2013， 硕士

【摘要】 研究背景健康是一项基本人权,是人类发展的一项重要组成部分。与中国高速增长的经济和令人羡慕的发展成果不一致的是,中国在人类健康方面却长期落后于世界经济发达国家。影响中国人健康,导致其过早死亡和残疾的首要原因是慢性非传染性疾病。心脏病、中风、癌症、慢性呼吸系统疾病和糖尿病等慢性病是迄今世界上最主要的死因。2010和2011连续两个年度,全球经济论坛建议各国政府应制定切实有效的政策和国家规划,应对这一经济和社会发展风险。2005年世界卫生组织《预防慢性病：一项至关重要的投资》和2006年中国疾病预防控制中心的中国慢性病报告均指出,膳食不合理、身体活动不足、吸烟是造成多种慢性病的三大行为危险因素。不合理膳食属于健康相关行为中危害健康行为。营养健康教育是改变不合理膳食行为的有效手段。日本通过营养教育,日本人均寿命居世界首位,男女少年的身高均有大幅度提高。美国的学校营养教育,使美国因心脏病死亡人数下降了29%。发达国家的经验证明：健康教育是经济有效的营养干预措施。我国亦于1996开始进行学校营养教育,但受多种因素的影响,健康教育效果并不显著,学生中不良饮食行为发生率极高。知-信-行(KAP)模式是二十世纪七十年代初在医学领域出现的研究方法,并已应用于营养学。该模式,行为转变的过程是知识→态度→行为的转变。人们通过学习,获得相关的营养健康知识和技能,逐步形成健康的信念和态度,从而促成健康膳食行为的产生。目前大量研究表明我国大学生不良饮食行为发生率很高,与普通大学生比,高职生入学水平较差,学业负担轻,自由支配时间更多,经济相对独立,饮食受约束机会小,其不良饮食行为发生率也很高,而针对高职生的营养干预较少,本研究旨在了解高职生营养知识态度行为现状,找出影响因素,有针对性的开展营养干预,提高其营养知识水平,转变健康营养观念,改变不良饮食行为,对提高全民的健康素质防治慢性病有非常重要的意义。目的了解山东省某高职院校学生营养知识态度行为现况,分析影响高职生营养知识态度行为水平的主要因素,研究能提高高职生营养知识态度行水平的方法并评价干预效果,为在高职生中开展营养健康教育和慢性病教育提供依据。方法以“知-信-行”理论为指导,利用自制的《高职生营养知识、态度和行为调查问卷》,采用横断面调查法对山东省某高职院校980名高职生营养知识、态度和行为现状进行调查；通过两样本均数比较的t检验、方差分析及多元线性回归等分析方法分析影响高职生营养知识、态度和行为的主要因素；制定“营养知识态度行为干预方案”,运用平行对照设计,选取320名高职生随机分为对照组与干预组,每组160名；比较干预前后两组间营养知识、态度和行为的变化。结果1在980名高职生中,营养知识得分范围为0～42分,平均得分8.50分,其中基础营养知识平均得分6.17分,疾病营养知识平均得分2.33分；营养态度得分范围为0～13分,平均得分5.89分：营养行为得分范围为0～68分,平均得分为30.33分。2母亲文化程度、饮食支出是影响高职生营养知识、态度和行为的主要因素(P<0.05)。3干预前对照组和干预组的一般资料、营养知识、态度和行为得分差异无统计学意义(P>0.05)。干预3个月后,对照组与干预组的营养知识、态度和行为各维度得分和总得分均存在显著性差异(P<0.01)；对照组与干预组的营养知识、态度各题目回答结果存在显著性差异(P<0.01)；对照组与干预组的饮食行为部分题目回答结果无显著性差异(P>0.05)；干预组自身前后的营养知识态度行为各维度得分和总得分均存在显著性差异(P<0.01)；对照组自身前后的营养知识态度行为各维度得分和总得分无显著性差异(P>0.05)。结论1高职生营养知识态度行为水平很低,但有较强烈的获取知识的愿望。2母亲文化程度、饮食支出是影响高职生营养知识态度行为的主要因素。3以知-信-行理论为指导的多种健康教育方法能大幅提高高职生营养知识水平、明显提高高职生营养健康态度养成率,但部分饮食行为改变不明显。更多还原

【Abstract】 BackgroundHealth is a fundamental human right, which is an important part of human development. With the development of China’s high-speed economic growth and enviable achievements is inconsistent, but human health in China lags behind the economic developed countries for a long time. The leading cause of premature death and disability was chronic non-communicable diseases in China. And heart disease, stroke, cancer, chronic respiratory diseases and diabetes were so far the most important causes of death in the world. Two consecutive years in2010and2011, the World Economic Forum recommended that governments should develop effective policies and national plannings and response to reduce the economic and social development risk.In2005the world health organization "preventing chronic diseases:a vital investment" and report of chronic disease in China in2006pointed out that three main behavioral risk factors for chronic diseases are unreasonable diet, lacking of physical activity, smoking.Unreasonable dietary health risk behaviors are health-related behavior. Nutritional health education is an effective mean to change the irrational dietary behavior. Through nutrition education in Japan, Japanese life expectancy is the highest in the world, the height of young men and women improved greatly. School nutrition education in the United States reduced29%of deaths due to heart disease. The experience of developed countries proved:health education is economic and effective nutritional interventions. School nutrition education also began in1996in China, but the impact of health education is not significant due to a variety of factors, the incidence of unhealthy dietary behaviors in students is high.Knowledge-attitude-belief-practice (KAP) model appeared in the field of medical research method in the early1970’s, and has been applied in nutrition. The model indicates that the process of behavioral change is the transformation of knowledge→attitude→behavior. Through learning, nutrition and health related knowledge and skills will gradually form health beliefs and attitudes, which will lead to the generation of healthy dietary behavior. At present, a large number of studies have shown a high incidence of bad behavior of college students in China. Compared with ordinary college students, the low entry level of higher vocational students with lighter academic burden, more free time, relatively independent economy, and eating small chance constrained, the prevalence of poor eating behaviors is also high. And in view of the higher vocational students of nutrition education intervention is less, This study aims to understand the nutrition knowledge, attitude and practice of higher vocational students present situation, affecting factors, targeted to carry out the nutrition intervention, to improve the nutritional knowledge level, to change the concept of health and bad eating behavior. Thus, it has very important significance to improve the health quality of the prevention and control of chronic diseasesObjectivesTo investigate and analyze the status of nutrition knowledge-attitude-behavior in Shandong province at some higher vocational college, and to analyze the main factors influencing the level of nutrition knowledge attitude behavior of higher vocational students, the study can improve their nutrition knowledge attitude line level method and evaluate the efficacy of the intervention, chronic disease for nutritional health education in higher vocational students and education provides the basis.MethodsAccording to "KAP" theory, using a home-made vocational students nutrition knowledge, attitudes and behavior questionnaire, we carried out a cross-sectional survey of980vocational students in Shandong Province; through two sample t-test, one-way ANOVA and multiple linear regression to analyse the main factors of vocational students nutrition knowledge, attitudes and behavior; enactment of nutritional knowledge, attitude and behavior intervention programs, and we conducted a parallel control design with320vocational students were randomly selected and were divided into control group and intervention group (n=160)to compare intervention between the two groups before and after the nutrition knowledge, attitudes and behavior change.Main Results1Of980students, the nutrition knowledge score range of0-42points, scored an average of8.50points, scored an average of6.17points, including basic nutrition knowledge, disease nutritional knowledge scored an average of2.33points; Nutritional attitude score range0～13points, scored an average of5.89points; Nutrition behavior score range of0～68, scored an average of30.33points.2Mother culture degree and spending on food are the main influence factors for nutrition knowledge attitude behavior of higher vocational students.(P<0.05).3Before intervention in the control group and intervention group general materials, nutrition knowledge, attitude and behavior of score difference are not significant (P>0.05);Three months after the intervention, the difference between control group and intervention group the nutrition knowledge, attitude and behavior of each dimension score and total score were significant (P<0.01);The difference between control group and intervention group of nutritional knowledge, attitude toward the subject to answer the result there is significant (P<0.01); The difference between control group and intervention group the eating behavior of some topic answer results was not significant (P>0.05);Intervention group before and after their nutrition knowledge attitude behavior that each dimension score and total score were significant difference (P<0.01);Control group before and after their nutrition knowledge attitude behavior each dimension score and total score have no significant difference (P>0.05).Conclusions1The level of nutrition knowledge attitude behavior of higher vocational students is low, but they also have a strong desire to acquire knowledge.2Mother culture degree and food costs into the regression equation are the main influencing factors for nutrition knowledge attitude behavior of higher vocational students.3In a variety of methods of health education KAP theory can effectively improve the level of nutrition knowledge attitude and behavior of college students, in which knowledge level improvement, health behavior has improved significantly, but some dietary behavior change is not obvious, further studies should explore more effective health education method.更多还原