青年学生艾滋病警示性教育量表及课程的开发应用与评估

发布时间：2017-12-27 21:11

本文关键词：青年学生艾滋病警示性教育量表及课程的开发应用与评估　出处：《中国疾病预防控制中心》2017年博士论文　论文类型：学位论文

【摘要】：背景:目前,我国青年学生中艾滋病感染人数呈逐年快速上升趋势,且感染方式多为性传播途径。近年来,卫计委多次强调要加强青年学生艾滋病健康教育的警示性。然而我国有关警示性教育的应用研究几乎空白,其应用效果及推广意义有待考证。因此,开发青年学生艾滋病警示性教育量表及课程并对其进行应用评估,具有深远的理论意义和重要的实用价值。目的:开发针对青年学生的艾滋病警示性教育量表与课程,并在广州、哈尔滨两市青年学生中对其应用效果展开评估,以期为今后青年学生艾滋病防控提供科学依据与实用参考工具。方法:1.以恐惧诉求理论的新平行过程模型(Extended Parallel Process Model—EPPM)为理论基础,依据文献分析法和定性访谈法编制青年学生艾滋病警示性教育量表和课程。量表包括8个维度,22个条目,涉及艾滋病有关知识、认知态度等维度。开发的课程按照警示性力度分为三组:对照课程、低警示力度课程与高警示力度课程。2.选择广州与哈尔滨两市作为本研究的调查现场,通过小样本预调查和大样本现况研究,应用探索性因子分析和结构方程模型等统计学方法考核量表的测量学性能。3.使用编制的量表调查青年学生艾滋病相关知识、认知等情况,同时利用单因素分析、多因素分析及路径分析检验学生艾滋病知识的认知、态度行为的影响因素。4.使用警示性教育课程对学生进行艾滋病健康教育,并利用重复测量资料方差分析对课程应用的近期和中期效果进行评估。结果:1.量表具有较好的信度与效度,各维度信度考核指标均大于0.6。其中Cronbach's α系数介于0.698～0.885之间,分半系数介于0.604～0.889之间;因子分析结果显示各公因子与预先设计各维度相符。除婚前性行为外,所有条目因子载荷均大于0.5,量表结构效度较好。路径分析显示严重性认知对安全套使用效能的总效应为0.40;易感性认知对安全套使用自我效能的总效应为-0.06;此外,学生对艾滋病教育态度及婚前性行为意向均对自我效能有较大的直接效应,分别为 0.49 与-0.31。2.基线调查:两市学生艾滋病基本知识掌握程度相对较低(66.3%;57.2%),性别、调查城市、学校类别及是否接受过教育是学生艾滋病知晓率的影响因素;两市青年学生对艾滋病严重性认知较高而易感性认知不足,同时严重性认知、易感性认知、安全套使用自我效能及婚前性行为倾向之间存在明显的性别差异、学校差异及地区差异;广州学生性行为发生率(6.6%)低于哈尔滨学生(13.5%),性别、地区、学校类别、是否接受过艾滋病教育是学生性行为发生的影响因素。3.警示性教育课程应用近期效果:艾滋病警示性教育后学生知晓率显著提高,由63.6%上升至90.2%,差异具有统计学意义(P0.001)。三组课程对学生艾滋病基本知识的提升效果不具有差异,但对严重性认知、易感性认知、安全套使用自我效能、对艾滋病教育的态度及艾滋病感染者的态度的改善效果存在显著差异(P0.001)。其中,以高力度组教育效果明显。此外,三组课程均未影响学生的婚前性行为意向。4.警示性教育课程应用中期效果:接受艾滋病警示性教育半年后学生艾滋病基本知识为81.8%,整体低于教育后的效果;三组课程对学生艾滋病基本知识知晓率、易感性认知、对艾滋病教育的态度的影响随时间变化前呈先升高后降低的趋势,且均以高警示力度组效果好;三组课程对学生艾滋病严重性认知影响的变化趋势不一致,低力度组与高力度组呈先升高后降低的趋势,对照组呈持续降低的趋势;三组课程均未影响学生的婚前性行为意向及性行为发生率,这两个维度均随时间变化呈逐渐升高的趋势。结论:1.本研究编制的量表具有良好的信度和效度,不但能够全面反映学生艾滋病相关知识、认知与态度等具体情况,并且为青年学生艾滋病警示性教育课程的近期与中期教育效果提供了有效的评价手段。2.本研究开发的三组课程均在一定程度改善了青年学生艾滋病相关知识、认知和态度,且近中期应用效果均证实三组课程在警示力度上具有一定的区分度。三组课程的近期效果理想,其中以高力度组课程作用效果最为显著。三组课程的远期效果整体较近期有所下降,中期效果仍以高力度组最佳。此外,三组课程均未影响学生的婚前性行为意向,其时间的变化趋势呈持续升高的状态。
[Abstract]:Background: at present, the number of AIDS infection among young students in China is increasing rapidly year by year, and most of the ways of infection are sexually transmitted. In recent years, the Wei Planning Commission has repeatedly stressed the need to strengthen the warning of young students' AIDS health education. However, the application of warning sex education in China is almost blank, and its application effect and popularization need to be tested. Therefore, it is of profound theoretical significance and important practical value to develop the AIDS warning education scale and curriculum for young students and to evaluate them. Objective: to develop AIDS alert education scale and curriculum for young students, and to evaluate the application effect of young students in two cities of Guangzhou and Harbin, in order to provide scientific basis and practical reference tools for future AIDS prevention and control for young students. Methods: 1.. Based on the Extended Parallel Process Model EPPM theory, based on literature analysis and qualitative interview, we draw up the AIDS alert education scale and curriculum for young students. The scale includes 8 dimensions and 22 items, which are related to AIDS related knowledge, cognitive attitude and other dimensions. The developed curriculum is divided into three groups according to the warning intensity: the control course, the low warning intensity course and the high warning intensity course. 2., select two cities in Guangzhou and Harbin as the research sites. Through small sample pre survey and large sample current research, exploratory factor analysis and structural equation modeling were applied to assess the measurement performance of the scale. 3., using compiled scale to investigate AIDS related knowledge and cognition among young students. Meanwhile, univariate analysis, multivariate analysis and path analysis were used to test students' cognition, attitude and behavior of AIDS knowledge. 4., we should use alert education curriculum to carry out AIDS health education for students, and evaluate the short-term and medium-term effects of curriculum application by repeated measurement data ANOVA. Results: the 1. scale had good reliability and validity, and all the reliability indexes of each dimension were more than 0.6. Among them, the Cronbach's alpha coefficient is between 0.698 and 0.885, and the half coefficient is between 0.604 and 0.889. Except for premarital sex, all items of factor load were more than 0.5, and the structure validity of the scale was better. The path analysis showed that the total effect of perceived severity of condom use efficiency was 0.40; the perceived susceptibility of condom use self-efficacy total effect is -0.06; in addition, all the students' intention for AIDS education attitude and premarital sexual behavior has a direct effect on the higher self-efficacy, respectively is 0.49 and -0.31. 2. baseline survey: two students master the basic knowledge of AIDS is relatively low (66.3%; 57.2%), gender, school type, city investigation and whether education is students' AIDS awareness rate influence factors; two, young students on AIDS cognition of severity and higher susceptibility to cognitive deficiencies, and perceived severity, perceived susceptibility the use of condoms, self-efficacy and premarital sexual behavior tendency existed significant gender differences and school differences and regional differences; the incidence of sexual behavior among students in Guangzhou (6.6%) is lower than that of students in Harbin (13.5%), sex, area, school type and HIV / AIDS education are risk factors of students' behavior. 3., the short-term effect of the warning education curriculum is: after the AIDS alert education, the awareness rate of students increased significantly from 63.6% to 90.2%, the difference was statistically significant (P0.001). Three groups of courses had no difference in improving students' basic knowledge of AIDS, but there was a significant difference in the effect of severity cognition, susceptibility cognition, condom use self-efficacy, attitude towards AIDS education and attitude of AIDS infected people (P0.001). Among them, the effect of the high strength group was obvious. In addition, the three groups of courses did not affect the students' Premarital Sexual intention. The application effect of 4. mid warning education course: AIDS to receive warning education after the first half of the students basic knowledge of AIDS was 81.8%, lower than the effect of education; three groups of courses to students basic knowledge of AIDS awareness rate, perceived susceptibility of AIDS, education attitude change with the time before the first increased and then decreased, and the the effect of high intensity warning group; the change trend of AIDS is a serious cognitive effects of three courses to students is not the same, the trend of decrease after the first rise group showed low intensity and high intensity group, the control group was continuously decreased; the three group did not affect the course of premarital sexual behavior intention and behavior of students occurrence rate. These two dimensions are changing with the time was gradually increased. Conclusion: 1. this study scale has good reliability and validity, which can not only reflect the students' cognition and attitude of AIDS related knowledge, specific circumstances, and provides an effective means for the evaluation of AIDS / HIV warning education course in short and middle period of education. 2., three groups of courses developed to improve the AIDS related knowledge, cognition and attitude of young students to some extent, and the application results in the near and middle period all confirmed that the three groups had a certain degree of warning intensity. The recent effect of the three groups of courses is ideal, of which the effect of the high strength group is the most significant. The long-term effect of the three groups was lower than that in the near future, and the middle term effect was still the best in the high strength group. In addition, the three groups of courses did not affect the students' Premarital Sexual intention, and the change trend of the time showed a continuous rising state.
【学位授予单位】：中国疾病预防控制中心
【学位级别】：博士
【学位授予年份】：2017
【分类号】：G479;R-4

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