目的：了解西安市目标人群对碘缺乏病防治知识的认知情况，评估碘缺乏病健康教育的干预成效。方法2007-2011年，按照碘缺乏病防治项目实施方案要求，在西安市每个项目区县按随机数字表法抽取3个乡镇作为项目乡镇，在开展健康教育宣传前后，对项目乡镇中心小学5年级学生和所在地育龄妇女进行碘缺乏病知识知晓情况问卷调查。同时采用分层随机抽样法对城乡5年级学生和育龄妇女进行碘缺乏病防治知识认知情况及认知来源现况调查。结果2007-2011年度健康教育项目实施后，小学生碘缺乏病知识知晓率从基线调查的66.97%（13321/19890）提高到93.49%（18610/19905），二者比较差异有统计学意义（χ2＝4413.07，P<0.05）；育龄妇女从基线调查的62.27%（6193/9945）提高到93.96%（9361/9963），二者比较差异有统计学意义（χ2=2924.18，P<0.05）。现况调查结果显示，农村目标人群碘缺乏病相关认知行为比城区差。其中农村地区小学生对碘缺乏病预防措施、主要危害的知晓率仅为46.50%（239/514）和55.25%（284/514），对碘盐包装标志的识别仅为50.97%（262/514），均低于城区学生[61.44%（376/612）、65.69%（402/612）、70.59%（432/612）]。城区和农村小学生正确向父母讲述碘缺乏病知识的仅占36.93%（226/612）和35.60%（183/514）。农村育龄妇女对碘缺乏病主要危害、预防措施、碘缺乏病日的知晓率仅为49.25%（197/400）、50.75%（203/400）和36.50%（146/400），低于城区育龄妇女[75.44%（298/395）、80.25%（317/395）、57.95%（229/395）]；而购盐的正确选择、炒菜时放盐的时机行为持有率仅为51.75%（207/400）和36.75%（147/400），也低于城区育龄妇女[73.42%（290/395）、43.80%（173/395）]。结论西安市目标人群在健康教育干预前对碘缺乏病防治知识的认知情况较差，尤其是农村落后于城区。健康教育项目的开展促进了西安市目标人群对碘缺乏病防治知识的了解和掌握。%Objective To find out the cognition understanding of iodine deficiency disorders(IDD) of target population in Xi’an City, and evaluate the effectiveness of a health education project on prevention and control of IDD. Methods By using the random number table, three towns in each project county were selected. Obeying the requirements of the education program for IDD control, the health education activities were implemented during 2007 - 2011. Before and after intervention, questionnaire was used to investigate the intervention effect. The primary school grade 5 students and women of childbearing age were included in the survey of IDD knowledge. Hierarchical random sampling method was used to select pupils and childbearing women. Results After health education, the rate of knowledge on IDD increased from 66.97%(13 321/19 890) to 93.49%(18 610/19 905,χ2 = 4 413.07, P < 0.05) among pupils, and 62.27%(6 193/9 945) to 93.96%(9 361/ 9 963, χ2= 2 924.18, P<0.05) among childbearing women. And the awareness had reached the national standard. But the survey results showed that: the rate of IDD related knowledge in rural areas was lower than that in town areas. The awareness rates of IDD in precaution, main hazards, identification of iodized salt were 46.50%(239/514), 55.25%(284/514) and 50.97%(262/514) among pupils in rural areas and 61.44%(376/612), 65.69%(402/612) and 70.59%(432/612) among pupils in town areas, and the awareness rates of pupils in rural areas were lower than those of pupils in town areas. Thirty-six point ninety-three per cent(226/612) of the pupils in towns and 35.60%(183/514) of the pupils in rural areas told this information to their parents. The awareness rates of IDD in precaution, main hazards, IDD prevention day were 49.25%(197/400), 50.75%(203/400) and 36.50%(146/400) among women in rural areas and 75.44%(298/395), 80.25%(317/395) and 57.97%(229/395) among women in town areas, and the rates of women in rural areas were lower than those of women in town areas. The rate of consciously purchasing of qualified iodized salt was 51.75%(207/400) and the consumption rate of iodized salt was 36.75%(147/400) among women in rural areas, which were 73.42%(290/395) and 43.80%(173/395) among women in town areas, and the rates in rural areas were lower than those in town areas. Conclusions Before health education of IDD, the rate of IDD related knowledge in Xi’an City is poor, rural areas are lower than town areas. Health education project is effective in promoting the understanding and grasp of IDD knowledge.
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