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目的运用广义估计方程(generalized estimating equation,GEE)评价湖北省“农村义务教育学生营养改善计划”(简称“计划”)地区营养宣教干预效果,为在“计划”地区大规模开展营养宣教提供理论和实践依据。方法采取随机整群抽样法在湖北省恩施市“计划”地区4所中小学分别设立对照组和干预组。干预前对所有选择对象进行问卷调查;干预组营养宣教干预5个月后,对两组学生进行第2次调查。采用GEE分析结果得出统计学结论。结果干预组233人,对照组209人。控制其他协变量,干预组干预后营养知识、日常健康饮食行为相对于基线分别提高了0.82分(χ~2=24.31,P<0.001)、3.29分(χ~2=14.07,P<0.001);干预组干预后日常不良饮食行为(χ~2=0.12,P=0.773)、“计划”营养餐满意度及依从性(χ~2=2.44,P=0.118)得分改变相对于基线均无显著性。结论营养宣教能显著性提高“计划”地区中小学生营养知识知晓率并促进日常健康饮食行为水平,但未能有效改善其日常不良饮食行为、“计划”营养餐满意度和依从性水平。GEE方法处理营养干预纵向资料具有极大的实用性和灵活性。
Objective To evaluate the effect of nutrition education intervention in the “Compulsory Education for Rural Compulsory Education (PSB)” in Hubei Province by means of the Generalized Estimation Equation (GEE) To carry out nutrition education to provide theoretical and practical basis. Methods A randomized cluster sampling method was used to establish the control group and the intervention group in 4 primary and secondary schools in Enshi City, Hubei Province. Before intervention, all the selected subjects were surveyed; after intervention of nutrition education intervention group for 5 months, the second survey was conducted on both groups of students. Using GEE analysis results come to statistical conclusions. Results Intervention group 233 people, control group 209 people. (Χ ~ 2 = 24.31, P <0.001), 3.29 (χ ~ 2 = 14.07, P <0.001), respectively; The scores of daily dietary adverse reactions (χ ~ 2 = 0.12, P = 0.773), satisfaction and compliance (χ ~ 2 = 2.44, P = 0.118) of intervention in the intervention group were significantly lower than those in the baseline Significance. Conclusion Nutrition education can significantly improve the nutrition awareness of primary and secondary school students in the “plan” area and promote the daily healthy eating behavior, but they can not effectively improve their daily bad eating behavior, satisfaction and compliance with the “plan” nutritional meal Level. The GEE method has great practicality and flexibility in dealing with longitudinal information of nutrition intervention.