Quantitative analysis of policies aimed at the prevention and control of myopia in Chinese children and adolescents
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摘要:
目的 分析中国儿童青少年近视防控政策,为儿童青少年近视防控领域政策制定及优化提供参考。 方法 基于政策工具理论,采用内容分析法,构建“政策工具—政策对象”二维框架,对中国中央政府层面发布的与儿童青少年近视防控密切相关的43份政策文件进行量化分析。 结果 从政策工具维度看,环境型政策工具使用较多(48.36%),供给型工具(26.39%)和需求型工具(25.25%)使用频次接近。从政策对象维度看,中国儿童青少年近视防控政策在学校方面(26.15%)提出的要求最多,在社会方面(6.18%)提出的要求最少。 结论 儿童青少年近视防控政策应适当提升供给型政策工具的使用效益,提高需求型政策工具的使用频率,以科研成果优化环境型政策工具的使用手段。 Abstract:Objective To analyze the policies that are aimed at the prevention and control of myopia in children and adolescents, and to provide a reference for the adjustment and optimization of follow-up policies. Methods Based on policy tool theory, content analysis was performed to construct a two-dimensional framework of "policy tools-policy objects" and a quantitative analysis of 43 national-level policy texts related to the prevention and control of myopia in children and adolescents. Results From the perspective of policy tools, environment-oriented policy tools were the most widely applied (48.36%), followed by supply-oriented tools (26.39%) and demand-oriented tools (25.25%) which were used closely in frequency. From the perspective of policy objects, the texts put forward requirements in schools (26.15%) were the most and in society the least (6.18%). Conclusion The policies for the prevention and control of myopia in children and adolescents should aim to improve the efficacy of supply-based policy tools and increase the frequency with which demand-based policy tools are adopted, while scientific research should be applied to optimize the quality of environment-based policy tools. -
Key words:
- Health policy /
- Myopia /
- Child /
- Adolescent
1) 利益冲突声明 所有作者声明无利益冲突。 -
表 1 儿童青少年近视防控政策工具类型及解释(n=43)
Table 1. The types and interpretations of policy tools for the prevention and control of myopia in children and adolescents(n=43)
政策工具类型 具体政策工具 政策工具解释 供给型 监测与卫生服务 对儿童青少年视力进行监测,对医疗卫生机构提出的要求(如近视矫正和心理治疗等方面) 人才保障 加快视力监测机构、医疗机构以及眼镜店等专业优秀人才的培养和配备 硬件改造 政府、学校、家庭置换合格的书桌、照明设备,构建合格的光暴露环境以及户外基础设施建设 资金投入 政府财政拨款,加强医院、学校、体育场所的资金支持力度 需求型 组织协同 家校联动、校医联动、学校和政府部门联动以及多单位联合行动 试点示范 遴选和推行试点示范区域,做好试点示范工作 环境型 策略性措施 依据相关的法律法规而采取的行动,制定相应的策略,采取相应的措施 监督管制 政策内容涉及加强对医疗机构、监测机构、学校、眼镜店等机构的监管 卫生运动 对医疗机构、家庭、学校、学生本人以及社会层面等进行卫生运动,如发放科普手册、专家讲座等 目标规划 政府部门对建设近视防控体系提出的目标,对近视防控工作作出规划 表 2 儿童青少年近视防控不同年份政策工具使用率/%
Table 2. The use rate of policy tools for the prevention and control of myopia in children and adolescents with different years/%
年份 监测与卫生服务 人才保障 硬件改造 资金投入 策略性措施 监督管制 目标规划 卫生运动 试点示范 组织协同 2018 9.20 4.60 8.05 2.30 8.05 18.39 3.45 13.79 14.94 17.23 2019 12.00 1.33 2.67 0 2.67 5.33 0 56.00 0 20.00 2020 11.57 1.65 9.09 0.83 7.44 6.61 1.65 35.54 14.05 11.57 2021 15.08 3.91 8.38 0.56 7.82 7.82 1.12 33.52 1.68 20.11 2022 16.36 5.14 6.54 1.87 7.01 10.28 3.27 20.56 7.48 21.50 表 3 儿童青少年近视防控各类政策工具分布
Table 3. The distribution of policy tools for the prevention and control of myopia in children and adolescents
工具类型 工具名称 频数 构成比/% 供给型 监测与卫生服务 94 50.81 (n=185) 人才保障 26 14.05 硬件改造 56 30.27 资金投入 9 4.86 需求型 组织协同 128 72.32 (n=177) 试点示范 49 27.68 环境型 卫生运动 202 59.59 (n=339) 策略性措施 51 15.04 监督管制 71 20.94 目标规划 15 4.42 表 4 儿童青少年近视防控政策工具类型(X维度)与政策对象(Y维度)的交叉列联分布
Table 4. The cross contingency table of the types (X dimension) and targets (Y dimension) of the policy tools for prevention and control of myopia in children and adolescents
政策工具类型 条数 家庭 学校 政府部门 医疗机构 学生 社会 监测与卫生服务 156 13(8.33) 35(22.44) 36(23.08) 62(39.74) 6(3.85) 4(2.56) 人才保障 44 1(2.27) 7(15.91) 15(34.09) 16(36.36) 0 5(11.36) 硬件改造 97 13(13.40) 30(30.93) 27(27.84) 19(19.59) 2(2.06) 6(6.19) 资金投入 14 1(7.14) 3(21.43) 6(42.86) 2(14.29) 0 2(14.29) 策略性措施 77 7(9.09) 27(35.06) 21(27.27) 15(19.48) 1(1.30) 6(7.79) 监督管制 101 7(6.93) 15(14.85) 57(56.44) 17(16.83) 1(0.99) 4(3.96) 目标规划 12 1(8.33) 1(8.33) 6(50.00) 2(16.67) 1(8.33) 1(8.33) 卫生运动 294 60(20.41) 83(28.23) 39(13.27) 40(13.61) 48(16.33) 24(8.16) 试点示范 54 5(9.26) 10(18.52) 28(51.85) 7(12.96) 1(1.85) 3(5.56) 组织协同 258 42(16.28) 73(28.29) 69(26.74) 46(17.83) 9(3.49) 19(7.36) 注: ()内数字为构成比/%。 -
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