Abstract:

Objective To provide scientific evidence for health education activities on tuberculosis (TB) control, through the nationwide investigation of health education channels for conveying TB key messages among residents in China. Methods Multi-stage stratified cluster sampling method was applied to select 181 survey sites in 31 provinces, including 84 urban survey sites and 97 rural survey sites. Of all 33357 subjects who were 15 years and above, 18156 (54.43%) subjects and 15201 (45.57%) subjects were from urban and rural areas respectively. Subjects were divided into 12 population groups to compare their different preferences of health education channels and choice of propaganda materials. These 12 groups were population groups of 15-60 years old from eastern urban area (5311 subjects) and eastern rural area (3561 subjects), groups of 60 years old and above from eastern urban area (1618 subjects) and eastern rural area (1106 subjects); groups of 15-60 years old from central urban area (6055 subjects) and central rural area (4476 subjects), groups of 60 years old and above from central urban area (1560 subjects) and central rural area (974 subjects); and groups of 15-60 years old from western urban area (2791 subjects) and western rural area (3789 subjects), groups of 60 years old and above from western urban area (732 subjects) and western rural area (1218 subjects). All subjects were interviewed face to face using the awareness questionnaire of TB key messages designed by experts. General information on their socioeconomical characteristics and information about their channels of receiving health education were collected. Finally, 33191 questionnaires were calculated as valid, thus the retrieve rate was 99.50%. Among whom 21296 subjects (64.16%) confirmed they had received at least some sort of health education before this survey. Results Out of the 21296 subjects who had received health education from the 12 population groups, the first 3 mostly preferred media were television (17.46%, 11087/63510), broadcasting (14.54%, 9237/63510), and leaflet/flyer/poster (13.60%, 8635/63510). Group with highest preference for television and broadcasting was group of 60 years old and above from central urban area (23.07%, 314/1361 for TV and 19.62%, 267/1361 for broadcasting). As well, group of >60 years old from central rural area preferred leaflet/flyer/poster (14.97%, 299/1998) best. The group of 15-60 years old in eastern urban area had the highest preference rate (5.89%, 577/9792) for website/Mini-blog/WeChat, whereas the group of 60 years old and above from western rural area got the lowest (0.30%, 5/1639). The best 3 channels for all 33357 subjects as ideal channel for obtaining TB control information were broadcasting/television/film/internet/audio and video materials (26.76%, 15517/57978), doctor propaganda (18.21%, 10559/57978), and poster/bulletin board/blackboard newspaper/exhibition panel (16.06%, 9311/57978). For the choices of propaganda materials, they loved picture-oriented (25.76%, 9549/37074) and mainly text products (24.57%, 9110/37074) best. For the acceptance level about internet, the highest one (9.16%, 163/1779) was the group of 60 years old and above from eastern urban area, the lower ones (2.60%, 27/1037 and 2.71%, 25/923 respectively) were the ≥60 groups from central and western rural areas. The most favorable online consultation or enquiry approaches were “consulting a medical professional online” (27. 89%, 9653/34608), “viewing professional medical websites” (21.86%, 7563/34608), “searching by Baidu or Google” (15.74%, 5448/34608), etc. The way of online knowledge dissemination preferred by the public were mainly text + pictures (29.14%,11268/38672) and text + videos (26.20%,10131/38672). Conclusion Different health education channels and approaches should be taken as per the characteristics of different regions, areas and age group populations. Key TB control information should be effectively conveyed to specific targeted groups, especially to the elderly population and the western rural population with relatively low awareness rate.

Key words: Tuberculosis, Health education, Questionnaires, Information access, Data interpretation, statistical