网络有奖竞答对居民肺结核防治核心信息的干预效果评估

doi:10.19982/j.issn.1000-6621.20260278

摘要/Abstract

摘要：

目的: 评估网络有奖竞答活动对居民肺结核防治核心信息知晓率的干预效果,为优化结核病健康教育策略提供依据。 方法: 于2022年和2023年通过“长沙疾控”官方微信公众号发布两轮肺结核防治知识网络有奖竞答活动,面向所有居民开展网络问卷调查。采用倾向性评分匹配控制混杂因素,以2023年参与者中曾参加2022年活动者为干预组(6638名),未参加者为对照组(6638名)。比较两组在2023年活动中的肺结核防治核心知识总知晓率及单项知识知晓率差异,同时比较干预组自身在2022年(干预前)与2023年(干预后)的肺结核防治核心知识总知晓率变化情况,运用广义估计方程中的对数二项回归模型计算风险比(risk ratio,RR)和风险比之比(ratio of risk ratio,RRR)。 结果: 横向比较显示,干预组总知晓率为89.18%(29598/33190),对照组为81.38%(27009/33190),干预组总知晓率是对照组的1.10倍(95%CI:1.09~1.10)。亚组分析显示,<20岁人群的干预效果最好(RR=1.37,95%CI:1.23~1.53)。各单项核心信息中,第2项核心信息(肺结核主要通过呼吸道传播,人人都有可能被感染)的干预效果最好(RR=1.14,95%CI:1.12~1.16),第3项核心信息(咳嗽、咳痰 2 周以上,应怀疑得了肺结核,要及时就诊)的干预效果相对较低(RR=1.06,95%CI:1.05~1.07)。干预组2023年总知晓率(89.18%)较其2022年基线水平(86.39%,28674/33190)有稳步提升(RR=1.03,95%CI:1.03~1.04),且提升幅度与答题次数和答题时长有关,答题次数≥2次、累计答题时间≥2min者的知晓率提升效果更好。 结论: 参与网络有奖竞答活动对居民肺结核防治核心知识具有显著的提升效应。建议将网络有奖竞答纳入结核病常态化健康教育手段,并针对不同人群进行差异化设计,同时引导参与者重复答题、延长有效学习时间以提升干预深度。

关键词: 结核, 健康教育, 问卷调查, 干预性研究

Abstract:

Objective: To evaluate the intervention effect of online prize-winning quiz activities on residents’ awareness rate of core knowledge on pulmonary tuberculosis (PTB) prevention and control, and to provide evidence for optimizing TB health education strategies. Methods: Two rounds of online prize-winning quizzes on PTB prevention and control knowledge were released via the official WeChat public account of Changsha Center for Disease Control and Prevention in 2022 and 2023, with online questionnaire surveys conducted among all residents. Propensity score matching was applied to control for confounding factors. Among participants of the 2023 activity, those who had joined the 2022 activity were assigned to the intervention group (n=6638), and those who had not were assigned to the control group (n=6638). The differences in the overall awareness rate and item-specific awareness rate of core PTB prevention and control knowledge in the 2023 activity were compared between the two groups. Meanwhile, changes in the overall awareness rate of core PTB prevention and control knowledge within the intervention group were compared between 2022 (pre-intervention) and 2023 (post-intervention). The log-binomial regression model based on generalized estimating equations was used to calculate the risk ratio (RR) and ratio of risk ratios (RRR). Results: Cross-sectional comparison showed that the overall awareness rate reached 89.18% (29598/33190) in the intervention group and 81.38% (27009/33190) in the control group; the overall awareness rate of the intervention group was 1.10 times (95%CI: 1.09-1.10) that of the control group. Subgroup analysis revealed that the intervention effect was optimal among populations aged under 20 years (RR=1.37, 95%CI: 1.23-1.53). Among all core information items, the second core item (“Pulmonary tuberculosis is mainly transmitted through the respiratory tract, and everyone is susceptible to infection”) achieved the best intervention effect (RR=1.14, 95%CI: 1.12-1.16), while the third core item (“Those with cough and expectoration for more than 2 weeks should be suspected of pulmonary tuberculosis and seek medical care promptly”) had a relatively lower intervention effect (RR=1.06, 95%CI: 1.05-1.07). The overall awareness rate of the intervention group in 2023 (89.18%) was steadily elevated compared with its baseline level in 2022 (86.39%, 28674/33190)(RR=1.03, 95%CI: 1.03-1.04). The improvement magnitude was correlated with the number of quiz attempts and total quiz duration: participants with ≥2 attempts and cumulative quiz duration ≥2 minutes presented better improvement in awareness rate. Conclusion: Participation in online prize-winning quiz activities exerts a significant enhancement effect on residents’ mastery of core knowledge on PTB prevention and control. It is recommended to incorporate online prize-winning quizzes into routine TB health education approaches, adopt differentiated designs for different populations, and guide participants to take quizzes repeatedly and extend effective learning time to deepen the intervention effect.

Key words: Tuberculosis, Health education, Questionnaires, Intervention studies

中图分类号:

谢赐福, 宋丽新, 尹鹏亮, 熊姿. 网络有奖竞答对居民肺结核防治核心信息的干预效果评估[J]. 中国防痨杂志, 2026, 48(9): 1356-1363. doi: 10.19982/j.issn.1000-6621.20260278

Xie Cifu, Song Lixin, Yin Pengliang, Xiong Zi. Evaluation of the intervention effect of an online prize-winning quiz on residents’ core knowledge of pulmonary tuberculosis prevention and control[J]. Chinese Journal of Antituberculosis, 2026, 48(9): 1356-1363. doi: 10.19982/j.issn.1000-6621.20260278

图/表 4

表1

表2

网络有奖竞答对不同特征人群的肺结核防治核心知识总知晓率干预效果分析

特征	干预组^a	对照组^a	RR^b (95%CI)值	Z值	P值	RRR^b (95%CI)值	Z值	P值
性别
男性	88.32 (14220/16100)	79.62 (12943/16255)	1.11 (1.10~1.12)	16.899	<0.001	参照组	参照组	参照组
女性	89.98 (15378/17090)	83.06 (14066/16935)	1.08 (1.07~1.09)	14.800	<0.001	0.98 (0.96~0.99)	-3.022	<0.003
年龄组(岁)
<20	86.34 (354/410)	63.08 (287/455)	1.37 (1.23~1.53)	5.613	<0.001	参照组	参照组	参照组
20~39	89.48 (26848/30005)	82.22 (24556/29865)	1.09 (1.08~1.10)	20.225	<0.001	0.80 (0.71~0.89)	-4.087	<0.001
40~59	86.18 (2232/2590)	75.20 (2038/2710)	1.14 (1.11~1.18)	8.252	<0.001	0.84 (0.75~0.94)	-3.066	<0.002
≥60	88.65 (164/185)	80.00 (128/160)	1.11 (0.96~1.27)	1.430	0.153	0.81 (0.68~0.96)	-2.376	0.018
文化程度
小学及以下	87.06 (1097/1260)	75.97 (961/1265)	1.15 (1.09~1.21)	5.154	<0.001	参照组	参照组	参照组
初中	88.38 (3862/4370)	79.73 (3512/4405)	1.11 (1.08~1.14)	7.805	<0.001	0.97 (0.91~1.02)	-1.164	0.245
高中	88.92 (7812/8785)	81.83 (7361/8995)	1.09 (1.07~1.11)	10.715	<0.001	0.95 (0.90~1.00)	-1.870	0.061
本科及以上	89.62 (16827/18775)	81.92 (15175/18525)	1.09 (1.08~1.10)	17.454	<0.001	0.95 (0.91~1.01)	-1.727	0.084
职业
农牧渔船民	86.31 (889/1030)	79.63 (864/1085)	1.09 (1.04~1.14)	3.581	<0.001	参照组	参照组	参照组
机关/事业单位	87.40 (4702/5380)	81.32 (4363/5365)	1.08 (1.05~1.10)	7.072	<0.001	0.99 (0.94~1.04)	-0.400	0.689
医务人员	88.65 (6454/7280)	78.84 (6130/7775)	1.12 (1.10~1.14)	11.900	<0.001	1.03 (0.98~1.08)	1.217	0.224
企业	91.05 (10566/11605)	83.23 (9230/11090)	1.09 (1.08~1.11)	13.806	<0.001	1.01 (0.96~1.06)	0.263	0.793
商业/服务业	88.78 (5593/6300)	82.78 (5244/6335)	1.07 (1.06~1.09)	8.334	<0.001	0.99 (0.94~1.04)	-0.448	0.654
在校学生	89.56 (806/900)	78.74 (689/875)	1.14 (1.09~1.19)	5.654	<0.001	1.05 (0.98~1.12)	1.435	0.151
军人	90.00 (45/50)	90.00 (36/40)	1.02 (0.81~1.30)	0.194	0.846	0.94 (0.74~1.20)	-0.482	0.630
离退休	84.55 (93/110)	81.05 (77/95)	1.04 (0.87~1.24)	0.418	0.676	0.96 (0.80~1.15)	-0.496	0.620
其他	84.11 (450/535)	70.94 (376/530)	1.19 (1.10~1.28)	4.235	<0.001	1.09 (1.00~1.20)	1.877	0.060
合计	89.18 (29598/33190)	81.38 (27009/33190)	1.10 (1.09~1.10)	22.499	<0.001	-	-	-

表2

表3

表4

参考文献 22

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特征	干预组(6638名)	对照组(6638名)	合计(13276名)	χ²值	P值
性别				0.290	0.590
男性	3251(49.0)	3220(48.5)	6471(48.7)
女性	3387(51.0)	3418(51.5)	6805(51.3)
年龄组(岁)				1.439	0.696
<20	91(1.4)	82(1.2)	173(1.3)
20~39	5973(90.0)	6001(90.4)	11974(90.2)
40~59	542(8.1)	518(7.8)	1060(8.0)
≥60	32(0.5)	37(0.6)	69(0.5)
文化程度				0.861	0.835
小学及以下	253(3.8)	252(3.8)	505(3.8)
初中	881(13.3)	874(13.2)	1755(13.2)
高中	1799(27.1)	1757(26.5)	3556(26.8)
本科及以上	3705(55.8)	3755(56.5)	7460(56.2)
职业				6.419	0.600
农牧渔船民	217(3.3)	206(3.1)	423(3.2)
机关/事业单位	1073(16.2)	1076(16.2)	2149(16.2)
医务人员	1555(23.4)	1456(21.9)	3011(22.7)
企业	2218(33.4)	2321(35.0)	4539(34.2)
商业/服务业	1267(19.1)	1260(19.0)	2527(19.0)
在校学生	175(2.6)	180(2.7)	355(2.7)
军人	8(0.1)	10(0.2)	18(0.1)
离退休	19(0.3)	22(0.3)	41(0.3)
其他	106(1.6)	107(1.6)	213(1.6)

题目	干预组 (6638名)^a	对照组 (6638名)^a	RR^b (95%CI)值	Z值	P值	RRR^b (95%CI)值	Z值	P值
第1项	5034(75.84)	4612(69.48)	1.09(1.07~1.11)	8.226	<0.001	参照组	参照组	参照组
第2项	5896(88.82)	5168(77.85)	1.14(1.12~1.16)	16.950	<0.001	1.05(1.02~1.07)	3.651	<0.001
第3项	6480(97.62)	6112(92.08)	1.06(1.05~1.07)	14.322	<0.001	0.97(0.95~0.99)	-2.653	0.008
第4项	5853(88.17)	5376(80.99)	1.09(1.07~1.10)	11.331	<0.001	1.00(0.97~1.02)	-0.212	0.832
第5项	6335(95.44)	5741(86.49)	1.10(1.09~1.12)	17.822	<0.001	1.01(0.99~1.03)	0.972	0.331

项目	干预后 (2023年)^a	干预前 (2022年)^a	RR^b (95%CI)值	Z值	P值	RRR^b (95%CI)值	Z值	P值
答题次数(次)
1	93.77 (4032/4300)	93.07 (4002/4300)	1.00 (0.99~1.01)	-0.522	0.602	参照组	参照组	参照组
2	90.87 (6638/7305)	90.09 (6581/7305)	1.04 (1.02~1.05)	5.962	<0.001	1.04 (1.02~1.05)	4.782	<0.001
3	89.17 (5952/6675)	86.55 (5777/6675)	1.04 (1.02~1.05)	5.434	<0.001	1.04 (1.02~1.06)	4.666	<0.001
4	88.07 (3985/4525)	83.36 (3772/4525)	1.06 (1.04~1.08)	6.340	<0.001	1.06 (1.04~1.08)	5.705	<0.001
≥5	86.58 (8991/10385)	82.25 (8542/10385)	1.06 (1.04~1.07)	7.559	<0.001	1.06 (1.04~1.08)	6.408	<0.001
累计答题时间(min)
<1	91.08 (7687/8440)	91.33 (7708/8440)	1.01 (0.99~1.02)	1.159	0.246	参照组	参照组	参照组
1~<2	90.30 (6574/7280)	87.23 (6350/7280)	1.01 (1.00~1.02)	1.547	0.122	1.00 (0.98~1.02)	0.136	0.892
2~<3	87.88 (5866/6675)	84.60 (5647/6675)	1.03 (1.02~1.04)	4.511	<0.001	1.02 (1.00~1.04)	2.423	0.015
3~<4	88.94 (3442/3870)	84.16 (3257/3870)	1.06 (1.04~1.07)	6.587	<0.001	1.05 (1.03~1.07)	4.504	<0.001
≥4	87.06 (6029/6925)	82.48 (5712/6925)	1.05 (1.04~1.06)	8.633	<0.001	1.04 (1.03~1.06)	4.996	<0.001
合计	89.18 (29598/33190)	86.39 (28674/33190)	1.03 (1.03~1.04)	10.795	<0.001	-	-	-