Study On Shandong Rural Residents' Cognition To Chronic Diseases And Related Risk Factors: Evidence From Six Project Counties

In order to reduce the hazards of common chronic diseases such as hypertension, diabetes, to improve the health status of Shandong rural residents, and to explore effective models and methods for Solving chronic disease problems in Shandong rural areas, the Health Department of Shandong Province officially launched the WHO-Luxembourg -Shandong project which was about rural health personnel training and chronic disease control in the first half of 2007, with the technical support provided by WHO and funding support provided by Luxembourg Government.In order to make the project counties' rural residents come to know chronic diseases' hazards, early manifestations, treatment and prevention methods, and its related risk factors, the Provincial Center for Disease Control and Prevention has organized a series of chronic disease-related health education and health promotion activities, on the basis of 2007 baseline survey.The main content of this study is to analyze the project counties' rural residents' cognition to chronic diseases (mainly for hypertension and diabetes) and their related risk factors after one year intervention, and to analyze the factors which can influence the rural residents' cognition. The purpose is to provide some basic adjustment advice for the next phase of health promotion and health education.Methods: In this study, samples are selected from basic library which is formed at baseline survey in 2007. From basic library, one sample township is selected from each project county by the principle of random sampling. This time we sample six townships from six project counties which are Shanghe, Lingxian, Yiyuan, Laicheng, Guangrao, Shouguang. From the sample townships' household database, one family member is random selected from each household, and composes the survey sample library and replacement library. The member in replacement library is used to replace sample people who can't be surveyed at the time. One-way and multi-way statistical methods are used in the analysis of rural residents' cognition to chronic diseases and their risk factors.The major findings of the study are as follows. 1) The project counties' rural residents have medium cognition rate to the basic knowledge about meal nutrition, however, they don't know very well about the deeper nutrition knowledge such as the correct daily intake of salt and cooking oil. Especially those who are aged 65 and above elderly, illiterate or semi-illiterate have much less awareness about nutrition knowledge.2) The project counties' rural residents have better awareness of the general hazards of smoking, but they are lack of depth and breadth about knowing the diseases which smokers are susceptible to. Smokers and non-smokers attitudes towards smoking have statistical difference.3) The project counties' rural residents have medium cognition rate to the basic knowledge about exercises, however, they don't know very well about the deeper exercise knowledge such as the appropriate number of exercise training every week, the benefits of exercise, etc. In addition, many targets of the survey agree that exercises can be replaced by the manual, which is misunderstanding. There are more than half of the survey who don't exercise in peacetime.4) Most of the survey do not know how to correctly judge whether a person is obese, especially those aged 65 and above elderly, illiterate and semi-illiterate, engaged in forestry, animal husbandry and aquaculture and fishery production. The project counties' rural residents are lack of accurate, comprehensive, in-depth understanding about the causes of obesity and the dangers of obesity.5) The investigation objects' cognition to high-risk groups for diabetes, diabetes patients' symptoms, complications of diabetes isn't comprehensive, and has misunderstandings. The cognition to what the diabetes patients should notice in daily life is relatively better, but has Misunderstandings too.6) The investigation objects' cognition to high-risk groups for hypertension is not comprehensive. The objects know well that high blood pressure can lead to stroke, heart disease, but they are lack of understanding about other complications of hypertension, or have wrong cognition. The investigation objects know better about how a hypertension patient to control blood pressure. Most of the objects are agreed with the opinion that more than 35-year-old age people should measure blood pressure at least one time every year.7) Television and broadcasting, medical personnel are the important ways for rural residents in project counties to acquire health knowledge. By the Restriction of education level and other factors, the rural residents don't utilize other ways very well to acquire health knowledge.Policy recommendations: 1) To establish proper health behavior, it is necessary to correct the erroneous and fuzzy cognition. When conducting health education, we should aim at the rural residents' health knowledge errors, and strengthen education.2) Focus on strengthening the health promotion activities aim at the low-educational-level people and the elderly people, and create supportive social and physical environment for them. 3) Carry out targeted health promotion activities depending on the different characteristics of the crowd. Reform and improve the assessment and compensation mechanisms for primary medical institutions and their staff, and encourage them to develop health education and health promotion activities actively.