Study The Promoting Model Of Circumcision Among Migrant Population In Chongqing

Objective: To know the rate of wllingness to accepting circumcisionand influence factors among migrant population in Chongqing, develophealth education materials of circumcision, as well as evaluate the effects ofthree health education models, and study the fit models of promotingcircumcision among migrant population in Chongqing.Methods:1. Cross-sectional study: The stratified multi-stage and cluster randomsampling methods were adopted in the investigation.Two districts wereselected from main cities of Chongqing randomly,then eight factorieswhich included many migrant worker were selected from themrangomly.The study investigated the knowledge level of circumcision、thewllingness to accepting circumcision and influence factors、the knowledgelevel of AIDS and high-risk sexual behavior which adopted the qualitativestudy and quantitative research study method among migrant populationwhose age are between18and45in Chongqing from Oct2009to Jan2010.2. Community trial: The respondents divided in three groups which used cluster randomization.The inclusion criteria are: the HIV/syphilisserology antibody detection are negative、the age are between18and45and not been circumcised.Baseline survery、the intervation of healtheducation and follow-up(two times, finished the follow-up every6months)study were carried out among migrant population from Mar2010to Jun2011. The three health education model are:①Model1,three timesintervention were carried out in group1,the first intervention used generalpaper materials+general video materials, the second intervention usedparticular paper materials+particular video materials,the third interventionused college students health education+expert lessons;②Model2,twotimes intervention were carried out in group2, the first intervention usedparticular paper materials+particular video materials,the secondintervention used particular paper materials+particular video materials+college students health education+expert lessons;③Model3,one timeintervention was carried out in group3,the intervention used particularpaper materials+particular video materials+college students healtheducation+expert lessons.3. Scoring method: Used scores of circumcision to reflect theknowledge level of circumcision, there questionare had13subjects withcircumcision related knowledge,one point for the right answer,zero pointfor the wrong or no answer,the accumulated scores are the scores of circumcision knowledge level.Used scores of AIDS to reflect theknowledge level of AIDS, there questionare had10subjects with AIDSrelated knowledge,one point for the right answer,zero point for the wrongor no answer,the accumulated scores are the scores of AIDS knowledgelevel.4. The date entry and analysis: Used the EpiDate3.02software toestablish the data base, adopted double check and logical check to finishedthe date entry.The statistical analysis are based SPSS13.0,the analysismethod included descriptive analysis、2test、One-way ANOVA、multivariate logistical regression analysis and so on.Results:1. The knowledge level of circumcision:83.60%participants hadheard about circumcision，the awareness of people whose age between27~35and education over junior college are higher than other people（2=23.000,P<0.001）.The average score of circumcision knowledge was4.260+0.101, the circumcision knowledge level of people whose educationover junior college are higher than other people (F=24.671，P<0.001).Theawareness of circumcision benefit、best time and so on were low,forexample,only16.00%participants know that circumcision can preventAIDS and other STDs.2. The wllingness to accept of circumcision and influence factor: There are41.07%of migrant population are willing to acceptcircumcision, logistical regression analysis showed that the followingfactors can incease the wllingness to accept of circumcision: knowedundant prepuce should be circumcisied(OR=1.797,95%CI:1.039～3.109);have any friends or relatives have been circumcised(OR=1.668,95%CI:1.072～2.074);have redundant prepuce or capistration(OR=23.288,95%CI:12.017～45.130).The main reason of that respondents won’t acceptthe circumcision are: it isn’t necessary, don’t effect health (57.69%);don’tknow the benefit of circumcision(20.36%);warry about the risk ofcircumcision(20.36%);warry about effect sexual function(18.55%); warryabout the expensive cost(14.03%).78.96%population are not willing tocircumcison decided by himself;13.35%population are opposed by mateor girlfriend;12.44%population warry about be made fun by friends;5.20%population are opposed by eldership.3. The health service demond of circumcision:66.56%、17.53%、12.99%、1.62%population choose male specialized subject hospital、country-level hospital、 province-level hospital and private hospitalrespectively.69.80%、26.30%、2.60%、1.30%population choose attendingphysician、chief physician、resident physician and associate chief physicianrespectively.34.74%population can’t spend money to accept circumcision,43.50%population can’t afford about1000cost. 4. Qualitative research results: The respondents’s willingness to acceptcircumcision is34.00%,the main reason of that they won’t accept thecircumcision are:“it isn’t necessary, don’t effect health”(50.00%)、“warryabout the dangerous”(25.00%)、“have no time”(20.00%),A few said “theywant to accept the circumcision if it is free”.The perferred hospital are malespecialized subject hospital and regual general hospital, the perferreddoctor are attending physician and chief physician.The reasonable expensesof operation is about300～500. The main consideration factors are: thesafety problems、time problems and cost problems.5. The results of i community trial: The circumcision cognitive levelof migrant population in Chongqing is low, the average score ofcircumcision knowledge was(5.120+0.127)and(6.490+0.093) before andafter intervention respectively,with significant increase trend (F=88.210,P<0.001),the score of3times intervention group is higher than2times and1times intervention group. After intervention, the willing to acceptcircumcision of3times intervention group is higher than2times and1times intervention group. The actual circumcision rate of3timesintervention group is higher than2and1times intervention group, thecircumcision rate of each group is25.00%、8.42%、4.44%respectively.Logistical regression analysis showed that the following factors can inceasethe circumcision rate: Intervention model(OR=0.242,95%CI:0.102～ 0.574；OR=0.093,95%CI:0.028～0.310);Have redundant prepuce orcapistration(OR=3.274,95%CI:1.045～10.252); Have friends or relativesbeen circumcised(OR=2.638,95%CI:1.160～5.999);Have homosexualbehavior(OR=31.261,95%CI:2.882～39.121).Conclusion:1. The cognitive level of circumcision is in the“widely heard but lackof understanding”stage.We should develop nichetargeting health educationto increase the circumcision rate.The respondents’s willingness to acceptcircumcision is high.The rate of willingness to accept circumcision ofpeople who have redundant prepuce is highest. The main reason of thatthey won’t accept the circumcision are: don’t know the benefit ofcircumcision、warry about the safety and cost problem、opposition of mateand eldership、taese of friends.2. Three intervention models can increase the knowledge level ofcircumcision effectively.The model1is better than model2and model3,the respondents’s willingness to accept circumcision and knowledge levelof circumcision is the highest which adopted model1to intervent.Thewillingness to accept circumcision of people who have relative or friendhad accepted circumcision is high, it is illustrate that companion educationcan applicable to the migrants population’s circumcision health education. 3. It is necessary to improve the circumcison knowledge level ofdifferent age, gender, educational of the population.Adopting model1todevelop circumcison health education and increas the circumcison rate.Useing male specialized subject hospital and county-level hospital whichare reviewed and approved to carry out circumcision by technicallyqualified doctors. Reduce the surgery cost and develop free circumcision insome financial trouble areas.