Knowledge, attitude and behavior of drinking water and associated factors among primary school students in rural China
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摘要:
目的 了解农村地区小学生饮水知信行现状及其相关因素，为农村地区开展饮水健康行为干预提供实证依据。 方法 2023年3月1日至4月27日，采用目的抽样方法，在河北省、河南省、山东省和山西省选取23所学校乡镇中心校和村教学点，对2 173名三至六年级在校小学生利用自编问卷开展调查，了解小学生饮水知信行现状。采用多元Logistic回归分析小学生饮水知信行的相关因素。 结果 抽样学校小学生饮水知识、态度和行为水平达标率分别为20.02%，26.65%和31.20%。小学生日饮水量中位数为1 000 mL，日饮水量均值为(1 172.99 ±771.89)mL，66.31%的小学生日饮水量达到800 mL推荐量的最低标准。多元Logistic回归分析显示，学校饮水可及性、饮水健康课程及个体自我控制能力与小学生饮水知识(OR值分别为1.31，1.57，1.58)、态度(OR值分别为2.07，1.65，1.73)、行为(OR值分别为1.40，1.49，1.91)及日饮水量(OR值分别为1.41，1.38，1.20)呈正相关(P值均<0.05)。 结论 小学生总体饮水知识、态度、行为及日饮水量达标率较低。学校应采取针对性措施，注重学生自我控制能力培养，提升学生饮水知识、态度，助力学生饮水健康行为形成。 -
关键词:
- 饮水 /
- 健康知识, 态度, 实践 /
- 回归分析 /
- 学生
Abstract:Objective To investigate the status quo and associated factors of drinking water knowledge, attitude and behavior among primary school students in rural areas, so as to provide evidence for health behavioral intervention of drinking water in primary school. Methods Twenty-three primary schools in rural area from Hebei, Henan, Shandong and Shanxi provinces were selected by using purposive sampling method from March 1 to April 27 in 2023. Self-designed questionnaires regarding knowledge, attitude and behavior of drinking water were distributed to all students in grade 3-6, and 2 173 valid questionnaires were obtained. Multivariate Logistic regression was used to analyze the influencing factors of drinking water knowledge, attitude and behavior of primary school students. Results The attainment rates of drinking water knowledge, attitude and behavior level were 20.02%, 26.65%, and 31.20%, respectively, among primary school students. The median of daily water intake was 1 000 mL, and the average daily water intake was (1 172.99±771.89)mL. In addition, 66.31% of students water intake reached the minimum standard of 800 mL recommended. The results of multiple Logistic regression indicated that drinking water accessibility in school, health education of drinking water, and individual self-control ability were positively correlated with the knowledge (OR=1.31, 1.57, 1.58), attitude (OR=2.07, 1.65, 1.73), behavior (OR=1.40, 1.49, 1.91) of drinking water and daily water intake (OR=1.41, 1.38, 1.20) (P<0.05). Conclusions Primary school students in rural areas are generally lack of appropriate health awareness on drinking water including knowledge, attitude and behavior. Schools should take targeted measures to focus on the cultivation of students' self-control ability, so as to improve students' knowledge and attitudes of drinking water, and furthermore help students shape their healthy behaviors of drinking water. -
Key words:
- Drinking /
- Health knowledge, attitudes, practice /
- Regression analysis /
- Students
1) 利益冲突声明 所有作者声明无利益冲突。2) 秦胜杰和刘思语为共同第一作者。 -
表 1 不同组别小学生饮水知识态度行为达标情况比较
Table 1. Comparison of drinking water KAP attainment of primary school students in different groups
组别 选项 人数 饮水知识 饮水态度 饮水行为 达标人数 χ2值 P值 达标人数 χ2值 P值 达标人数 χ2值 P值 性别 男 1 057 176(16.65) 14.58 < 0.01 281(26.58) < 0.01 0.95 250(23.65) 54.64 < 0.01 女 1 116 259(23.21) 298(26.70) 428(38.35) 年级 三 688 67(9.74) 96.40 < 0.01 232(33.72) 59.68 < 0.01 209(30.38) 12.73 < 0.01 四 685 128(18.69) 183(26.72) 200(29.20) 五 518 159(30.69) 137(26.45) 193(37.26) 六 282 81(28.72) 27(9.57) 76(26.95) 是否住校 否 1 479 265(17.92) 12.77 < 0.01 347(23.46) 24.01 < 0.01 366(24.75) 89.88 < 0.01 是 694 170(24.50) 232(33.43) 312(44.96) 超重肥胖 否 1 605 312(24.13) 1.29 0.26 445(27.73) 3.67 0.06 530(33.02) 9.48 < 0.01 是 568 123(21.65) 134(23.59) 148(26.06) 是否上过饮水健康课程 否 1 168 193(16.52) 19.26 < 0.01 253(21.66) 32.10 < 0.01 312(26.71) 23.71 < 0.01 是 1 005 242(24.08) 326(32.44) 366(36.42) 学校饮水可及性 不方便 427 63(14.75) 9.20 < 0.01 63(14.75) 38.45 < 0.01 93(21.78) 21.97 < 0.01 方便 1 746 372(21.31) 516(29.55) 585(33.51) 所在省人均GDP/元 ≤85 698 2 041 396(19.40) 7.97 < 0.01 545(26.70) 0.06 0.81 641(31.41) 0.66 0.42 >85 698 132 39(29.55) 34(25.76) 37(28.03) 注：()内数字为达标率/%。 
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表 2 农村地区小学生饮水知识、态度、行为相关因素的多因素Logistic回归分析(n=2 173)
Table 2. Multivariate Logistic regression analysis of drinking water KAP level of primary school students in rural areas(n=2 173)
自变量 选项 知识 态度 行为 标准误 Wald χ2值 P值 OR值(95%CI) 标准误 Wald χ2值 P值 OR值(95%CI) 标准误 Wald χ2值 P值 OR值(95%CI) 性别 男 1.00 1.00 1.00 女 0.12 11.07 < 0.01 1.48(1.17~1.86) 0.10 1.15 0.28 0.90(0.73~1.10) 0.10 38.92 < 0.01 1.89(1.55~2.30) 年级 三 1.00 1.00 1.00 四 0.17 22.92 <0.01 2.21(1.60~3.06) 0.12 9.20 <0.01 0.69(0.54~0.88) 0.13 0.17 0.68 0.95(0.74~1.22) 五 0.17 75.46 < 0.01 4.18(3.03~5.77) 0.13 11.26 < 0.01 0.64(0.49~0.83) 0.13 5.80 0.02 1.37(1.06~1.78) 六 0.19 67.77 <0.01 4.88(3.35~7.12) 0.22 43.57 <0.01 0.23(0.15~0.36) 0.17 0.01 0.91 0.98(0.70~1.37) 是否住校 否 1.00 1.00 1.00 是 0.12 19.13 < 0.01 1.68(1.33~2.13) 0.11 20.60 < 0.01 1.63(1.32~2.01) 0.10 87.15 < 0.01 2.63(2.14~3.22) 超重肥胖 否 1.00 1.00 1.00 是 0.13 2.76 0.10 1.24(0.96~1.59) 0.12 2.40 0.12 0.83(0.66~1.05) 0.12 2.31 0.13 0.84(0.67~1.05) 自我控制能力得分 0.10 21.80 < 0.01 1.58(1.30~1.91) 0.09 37.97 < 0.01 1.73(1.45~2.05) 0.09 55.92 < 0.01 1.91(1.61~2.27) 是否上过饮水健康 否 1.00 1.00 1.00 课程 是 0.12 15.50 < 0.01 1.57(1.26~1.97) 0.10 23.65 < 0.01 1.65(1.35~2.02) 0.10 15.94 < 0.01 1.49(1.23~1.81) 学校饮水可及性 不方便 1.00 1.00 1.00 方便 0.16 2.91 0.09 1.31(0.96~1.77) 0.15 23.15 < 0.01 2.07(1.54~2.79) 0.14 6.06 0.01 1.40(1.07~1.82) 所在省人均GDP ≤85 698 1.00 1.00 1.00 /元 >85 698 0.22 18.59 < 0.01 2.58(1.68~3.97) 0.22 0.01 0.91 1.02(0.67~1.56) 0.21 0.11 0.74 1.07(0.71~1.63) 注：自我控制能力得分为连续型变量。
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表 3 农村地区小学生日饮水量的多因素Logistic回归分析(n=2 173)
Table 3. Multivariate Logistic regression analysis of daily drinking water volume of primary schools in rural areas(n=2 173)
自变量 选项 标准误 Wald χ2值 P值 OR值(95%CI) 性别 男 1.00 女 0.09 3.82 0.05 0.83(0.69~1.00) 年级 三 1.00 四 0.12 0.01 0.91 0.99(0.78~1.24) 五 0.13 2.16 0.14 0.83(0.65~1.06) 六 0.15 1.64 0.20 0.83(0.62~1.11) 是否住校 否 1.00 是 0.10 0.08 0.77 0.97(0.80~1.18) 超重肥胖 否 1.00 是 0.11 4.31 0.04 1.25(1.01~1.55) 自我控制能力得分 0.08 5.70 0.02 1.20(1.03~1.39) 是否上过饮水健康 否 1.00 课程 是 0.09 11.51 < 0.01 1.38(1.14~1.66) 学校饮水可及性 不方便 1.00 方便 0.11 8.83 < 0.01 1.41(1.12~1.76) 所在省人均GDP ≤85 698 1.00 /元 >85 698 0.21 5.91 0.02 1.68(1.11~2.56)
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