Article(id=1324077948080357566, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1324077868950631142, articleNumber=null, orderNo=null, doi=10.20043/j.cnki.MPM.202507307, pmid=null, cstr=null, oa=null, hot=null, price=null, onlineType=0, articleFormat=0, articleType=null, articleTypeStr=null, receivedDate=1753027200000, receivedDateStr=2025-07-21, revisedDate=null, revisedDateStr=null, acceptedDate=null, acceptedDateStr=null, onlineDate=1793614383000, onlineDateStr=2026-11-02, pubDate=1771948800000, pubDateStr=2026-02-25, doiRegisterDate=null, doiRegisterDateStr=null, onlineIssueDate=1793614383000, onlineIssueDateStr=2026-11-02, onlineJustAcceptDate=null, onlineJustAcceptDateStr=null, onlineFirstDate=null, onlineFirstDateStr=null, sourceXml=null, magXml=null, createTime=1793614383000, creator=13701087609, updateTime=1793614383000, updator=13701087609, issue=Issue{id=1324077868950631142, tenantId=1146029695717560320, journalId=1227665162245664772, year='2026', volume='53', issue='4', pageStart='577', pageEnd='768', issueExtLink='null', onlineDate='null', pubDate='1771948800000', pubDateStr='2026-02-25', beforeIssueId=null, nextIssueId=null, price=null, status=1, issueComplete=1, articleOrder=1, issueType=-1, specialIssue=0, createTime=1793614364134, creator='13701087609', updateTime=1793614446224, updator='13701087609', preIssue=null, nextIssue=null, articleTotal=null, ext={EN=IssueExt(id=1324078213328142371, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1324077868950631142, language=EN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=), CN=IssueExt(id=1324078213332336676, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1324077868950631142, language=CN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=)}, issueFiles=null, downloadFileDto=null}, startPage=623, endPage=629, ext={EN=ArticleExt(id=1324077949770662079, articleId=1324077948080357566, tenantId=1146029695717560320, journalId=1227665162245664772, language=EN, title=Analysis of influencing factors of correct dog-raising behavior in Xizang children and adolescents based on HAPA model, columnId=1228016568949474136, journalTitle=Modern Preventive Medicine, columnName=Child and Adolescent health, Maternal and Child Health, runingTitle=null, highlight=null, articleAbstract=
Objective

To explore the dog-raising behavior of children and adolescents and its influencing factors based on the health action process approach (HAPA), so as to provide reference for the prevention and control of echinococcosis.

Methods

A questionnaire based on HAPA was developed to investigate students in four schools in Nagqu City, Tibet from October 2024 to April 2025. The factors influencing dog-raising behavior were analyzed by structural equation model.

Results

Among the 942 children and adolescents with dog-raising at home included in this study, the unqualified rate of dog-raising behaviors was 69.9%. In the HAPA model, the intention of correct dog-raising behavior was influenced by outcome expectations [standard path coefficient (95% CI)=0.321 (0.224-0.411), P<0.001]. The intention of correct dog-raising behavior and maintenance self-efficacy directly affected the action plan, with standard path coefficients (95% CI) of 0.225 (0.138-0.314) and 0.560 (0.417-0.695) respectively, and P values were both <0.001. The action plan directly affected the correct dog-raising behavior [standard path coefficient (95% CI)=0.160 (0.013-0.341), P<0.05]. Social support had an indirect effect on correct dog-raising behavior by influencing the action plan [effect value (95% CI)=0.025 (0.003-0.037), P<0.05].

Conclusion

The correct dog-raising behaviors of children and adolescents are influenced by the action plan.The intention of correct dog-raising behavior and social support indirectly affect correct dog-raising behavior through the action plan. In health education strategies, the formulation of the action plan can be taken as the key intervention point to promote children and adolescents to form correct dog-raising behaviors.

, authors=Shu-yu YANG1, Danzengquzhen2, Sangji3, Cidandunzhu3, Rui-zhe SHANG1, Lan YU1, Zi-hao YUAN1, Zhi-wei CHEN4, Tuerxun Mudaikesi1, Qiao-lan LIU1, authorsList=Shu-yu YANG, Danzengquzhen, Sangji, Cidandunzhu, Rui-zhe SHANG, Lan YU, Zi-hao YUAN, Zhi-wei CHEN, Tuerxun Mudaikesi, Qiao-lan LIU, authorCompany=null, correspAuthors=Qiao-lan LIU, authorNote=null, correspAuthorsNote=null, copyrightStatement=null, copyrightOwner=null, extLink=null, articleAbsUrl=null, sourceXml=null, magXml=null, pdfUrl=null, pdf=null, pdfFileSize=null, pdfExtLink=null, richHtmlUrl=null, mobilePdfUrl=null, reviewReport=null, pdfFirstPage=null, abstractGraph=null, abstractGraphContent=null, abstractVideo=null, citation=null, cebUrl=null, magXmlContent=null, mapNumber=null, fund=null), CN=ArticleExt(id=1324077950827626694, articleId=1324077948080357566, tenantId=1146029695717560320, journalId=1227665162245664772, language=CN, title=基于HAPA模型的西藏儿童青少年正确养犬行为影响因素分析, columnId=1228016570031604578, journalTitle=现代预防医学, columnName=儿少卫生与妇幼保健, runingTitle=null, highlight=null, articleAbstract=
目的

本研究基于健康行动过程模型(health action process approach,HAPA)探究儿童青少年养犬行为及其影响因素,为包虫病防控提供参考依据。

方法

基于HAPA制定问卷,于2024年10月—2025年4月调查西藏那曲市4所学校(1所小学和3所初中)的学生。应用结构方程模型分析养犬行为影响因素。

结果

纳入本研究家中有养犬的942例儿童青少年中,养犬行为不合格率为69.9%。在HAPA模型中,正确养犬行为意向受结果预期的影响[标准路径系数(95% CI)=0.321(0.224~0.411),P值<0.001];正确养犬行为意向、维持自我效能直接影响行动计划,标准路径系数(95% CI)分别为0.225(0.138~0.314)、0.560(0.417~0.695),P值均<0.001;行动计划直接影响正确养犬行为[标准路径系数(95% CI)=0.160(0.013~0.341),P值<0.05];社会支持通过影响行动计划对正确养犬行为产生间接效应[效应值(95% CI)=0.025(0.003~0.037),P值<0.05]。

结论

儿童青少年正确养犬行为受到行动计划的影响,正确养犬行为意向和社会支持通过行动计划间接影响正确养犬行为。在健康教育策略中,可将行动计划的制定作为干预重点,促进儿童青少年形成正确的养犬行为。

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杨舒羽(2002—),女,硕士在读,研究方向:健康与社会行为学

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(In Chinese), articleTitle=Analysis of the status quo of exercise behavior in type 2 diabetic patients and the influencing factors analysis based on the health action process approach model, refAbstract=null)], funds=[Fund(id=1324077958410928404, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324077948080357566, awardId=2022WZK1007, language=CN, fundingSource=国家卫生健康委包虫病防治研究重点实验室项目(2022WZK1007), fundOrder=null, country=null)], companyList=[AuthorCompany(id=1324077951083479239, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324077948080357566, xref=1., ext=[AuthorCompanyExt(id=1324077951091867848, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324077948080357566, companyId=1324077951083479239, language=EN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=Department of Health Behavior and Social Medicine, West China School of Public Health/West China Fourth Hospital, Sichuan University, Chengdu, Sichuan 610041, China), AuthorCompanyExt(id=1324077951100256457, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324077948080357566, companyId=1324077951083479239, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=1.四川大学华西公共卫生学院/华西第四医院 健康行为与社会医学系,四川 成都 610041)]), AuthorCompany(id=1324077951175753930, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324077948080357566, xref=2., ext=[AuthorCompanyExt(id=1324077951188336843, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324077948080357566, companyId=1324077951175753930, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=2.西藏自治区疾病预防控制中心)]), AuthorCompany(id=1324077951259640012, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324077948080357566, xref=3., ext=[AuthorCompanyExt(id=1324077951268028621, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324077948080357566, companyId=1324077951259640012, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=3.那曲市疾病预防控制中心)]), AuthorCompany(id=1324077951343526094, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324077948080357566, xref=4, ext=[AuthorCompanyExt(id=1324077951351914703, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324077948080357566, companyId=1324077951343526094, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=4成都市郫都区疾病预防控制中心)])], figs=[ArticleFig(id=1324077956741595402, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324077948080357566, language=EN, label=Fig.1, caption=HAPA model of dog-raising behaviors (standardized path), figureFileSmall=2bh+SrMMUPn/n0TKvQf7lg==, figureFileBig=5QeaVzbLYWPhj7qIFyRVug==, tableContent=null), ArticleFig(id=1324077957056168203, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324077948080357566, language=CN, label=图1, caption=养犬行为HAPA模型(标准化路径)

注:路径中虚线表示P>0.05,实线表示P<0.05。

, figureFileSmall=2bh+SrMMUPn/n0TKvQf7lg==, figureFileBig=5QeaVzbLYWPhj7qIFyRVug==, tableContent=null), ArticleFig(id=1324077957496570124, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324077948080357566, language=EN, label=Table 1, caption=

Model variable range, definition and Cronbach α coefficient

, figureFileSmall=null, figureFileBig=null, tableContent=
变量条目数定义α系数
行动自效3发起正确养犬行为的自我效能0.720
风险感知3对不良养犬行为引起的疾病发生概率及危害程度的认识0.720
结果预期5对正确养犬行为可能产生的结果的利弊权衡0.813
行为意向2为正确养犬行为制定的目标0.719
维持自效3维持正确养犬行为的自我效能0.739
行动计划2为正确养犬行为制定计划0.752
社会支持3支持正确养犬行为的因素0.782
合计210.899
), ArticleFig(id=1324077957601427725, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324077948080357566, language=CN, label=表1, caption=

模型变量范围、定义及Cronbach α系数

, figureFileSmall=null, figureFileBig=null, tableContent=
变量条目数定义α系数
行动自效3发起正确养犬行为的自我效能0.720
风险感知3对不良养犬行为引起的疾病发生概率及危害程度的认识0.720
结果预期5对正确养犬行为可能产生的结果的利弊权衡0.813
行为意向2为正确养犬行为制定的目标0.719
维持自效3维持正确养犬行为的自我效能0.739
行动计划2为正确养犬行为制定计划0.752
社会支持3支持正确养犬行为的因素0.782
合计210.899
), ArticleFig(id=1324077957668536590, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324077948080357566, language=EN, label=Table 2, caption=

Description of general situation and results of single factor analysis

, figureFileSmall=null, figureFileBig=null, tableContent=
变量n(%)养犬行为正确率χ2P
不合格合格(%)
年级6.4610.091
5127(13.5)79(12.0)48(16.9)
7235(24.9)158(24.0)77(27.1)
8318(33.8)229(34.8)89(31.3)
9262(27.8)192(29.2)70(24.6)
性别0.2900.590
男520(55.3)367(55.8)153(54.1)
女422(44.7)291(44.2)130(45.9)
本人及家属既往包虫病患病情况19.496<0.001
有35(3.8)28(4.3)7(2.5)
无812(87.6)547(84.5)265(94.6)
不清楚80(8.6)72(11.1)8(2.9)
母亲文化8.1360.043
文盲或半文盲340(37.5)255(40.5)85(30.7)
小学397(43.8)265(42.1)132(47.7)
初中92(10.1)59(9.4)33(11.9)
高中及以上78(8.6)51(8.1)27(9.7)
父亲文化6.5520.088
文盲或半文盲277(30.7)207(33.1)70(25.3)
小学443(49.1)298(47.7)145(52.3)
初中114(12.6)78(12.5)36(13.0)
高中及以上68(7.5)42(6.7)26(9.4)
经济状况11.290.004
低191(21.4)114(18.4)77(28.4)
中629(70.6)454(73.2)175(64.6)
高71(8.0)52(8.4)19(7.0)
总计942(100.0)284(30.1)658(69.9)
), ArticleFig(id=1324077957760811279, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324077948080357566, language=CN, label=表2, caption=

一般情况描述及单因素分析结果

, figureFileSmall=null, figureFileBig=null, tableContent=
变量n(%)养犬行为正确率χ2P
不合格合格(%)
年级6.4610.091
5127(13.5)79(12.0)48(16.9)
7235(24.9)158(24.0)77(27.1)
8318(33.8)229(34.8)89(31.3)
9262(27.8)192(29.2)70(24.6)
性别0.2900.590
男520(55.3)367(55.8)153(54.1)
女422(44.7)291(44.2)130(45.9)
本人及家属既往包虫病患病情况19.496<0.001
有35(3.8)28(4.3)7(2.5)
无812(87.6)547(84.5)265(94.6)
不清楚80(8.6)72(11.1)8(2.9)
母亲文化8.1360.043
文盲或半文盲340(37.5)255(40.5)85(30.7)
小学397(43.8)265(42.1)132(47.7)
初中92(10.1)59(9.4)33(11.9)
高中及以上78(8.6)51(8.1)27(9.7)
父亲文化6.5520.088
文盲或半文盲277(30.7)207(33.1)70(25.3)
小学443(49.1)298(47.7)145(52.3)
初中114(12.6)78(12.5)36(13.0)
高中及以上68(7.5)42(6.7)26(9.4)
经济状况11.290.004
低191(21.4)114(18.4)77(28.4)
中629(70.6)454(73.2)175(64.6)
高71(8.0)52(8.4)19(7.0)
总计942(100.0)284(30.1)658(69.9)
), ArticleFig(id=1324077957903417616, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324077948080357566, language=EN, label=Table 3, caption=

Partial correlation analysis results of each variable

, figureFileSmall=null, figureFileBig=null, tableContent=
变量风险感知结果预期行动自我效能正确养犬行为意向维持自我效能行动计划社会支持
风险感知1.000
结果预期0.0171.000
行动自我效能0.0370.553a1.000
正确养犬行为意向0.0400.472a0.575a1.000
维持自我效能0.0040.494a0.515a0.523a1.000
行动计划0.0370.520a0.540a0.574a0.545a1.000
社会支持0.0310.514a0.527a0.521a0.534a0.535a1.000
), ArticleFig(id=1324077958012469521, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324077948080357566, language=CN, label=表3, caption=

各变量偏相关分析结果

, figureFileSmall=null, figureFileBig=null, tableContent=
变量风险感知结果预期行动自我效能正确养犬行为意向维持自我效能行动计划社会支持
风险感知1.000
结果预期0.0171.000
行动自我效能0.0370.553a1.000
正确养犬行为意向0.0400.472a0.575a1.000
维持自我效能0.0040.494a0.515a0.523a1.000
行动计划0.0370.520a0.540a0.574a0.545a1.000
社会支持0.0310.514a0.527a0.521a0.534a0.535a1.000
), ArticleFig(id=1324077958104744210, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324077948080357566, language=EN, label=Table 4, caption=

The main path coefficients in the HAPA model and the effects of each variable on dog-raising behaviors

, figureFileSmall=null, figureFileBig=null, tableContent=
路径未标准化系数
(标准误)
标准化系数
(95%CI)
P
直接效应
社会支持→行动自我效能0.203(0.011)0.654(0.597~0.708)<0.001
行动自我效能→结果预期0.680(0.044)0.785(0.715~0.844)<0.001
风险感知→结果预期0.006(0.024)0.009(-0.60~0.80)0.788
行动自我效能→维持自我效能0.683(0.058)0.662(0.544~0.777)<0.001
风险感知→正确养犬行为意向0.052(0.036)0.049(-0.19~0.116)0.145
结果预期→正确养犬行为意向0.482(0.059)0.321(0.224~0.411)<0.001
社会支持→维持自我效能0.067(0.014)0.209(0.087~0317)<0.001
社会支持→正确养犬行为意向0.107(0.014)0.265(0.184~0.351)<0.001
维持自我效能→行动计划0.614(0.059)0.560(0.417~0.695)<0.001
社会支持→行动计划0.054(0.015)0.155(0.037~0.271)<0.001
正确养犬行为意向→行动计划0.195(0.028)0.225(0.138~0.314)<0.001
行动计划→正确养犬行为0.043(0.020)0.160(0.013~0.341)0.032a
社会支持→正确养犬行为0.009(0.006)0.009(-0.125~0.128)0.888
间接效应
路径10.018(0.011)0.059(0.006~0.139)0.028a
路径20.001(0.001)0.002(0.000~0.007)0.074
路径30.004(0.003)0.012(0.002~0.031)0.021a
路径40.002(0.001)0.025(0.003~0.037)0.023a
总效应0.025(0.015)0.098(0.010~0.204)0.026a
), ArticleFig(id=1324077958251544851, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324077948080357566, language=CN, label=表4, caption=

HAPA模型中主要路径系数及各变量对养犬行为的效应

, figureFileSmall=null, figureFileBig=null, tableContent=
路径未标准化系数
(标准误)
标准化系数
(95%CI)
P
直接效应
社会支持→行动自我效能0.203(0.011)0.654(0.597~0.708)<0.001
行动自我效能→结果预期0.680(0.044)0.785(0.715~0.844)<0.001
风险感知→结果预期0.006(0.024)0.009(-0.60~0.80)0.788
行动自我效能→维持自我效能0.683(0.058)0.662(0.544~0.777)<0.001
风险感知→正确养犬行为意向0.052(0.036)0.049(-0.19~0.116)0.145
结果预期→正确养犬行为意向0.482(0.059)0.321(0.224~0.411)<0.001
社会支持→维持自我效能0.067(0.014)0.209(0.087~0317)<0.001
社会支持→正确养犬行为意向0.107(0.014)0.265(0.184~0.351)<0.001
维持自我效能→行动计划0.614(0.059)0.560(0.417~0.695)<0.001
社会支持→行动计划0.054(0.015)0.155(0.037~0.271)<0.001
正确养犬行为意向→行动计划0.195(0.028)0.225(0.138~0.314)<0.001
行动计划→正确养犬行为0.043(0.020)0.160(0.013~0.341)0.032a
社会支持→正确养犬行为0.009(0.006)0.009(-0.125~0.128)0.888
间接效应
路径10.018(0.011)0.059(0.006~0.139)0.028a
路径20.001(0.001)0.002(0.000~0.007)0.074
路径30.004(0.003)0.012(0.002~0.031)0.021a
路径40.002(0.001)0.025(0.003~0.037)0.023a
总效应0.025(0.015)0.098(0.010~0.204)0.026a
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基于HAPA模型的西藏儿童青少年正确养犬行为影响因素分析
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杨舒羽 1 , 旦增曲珍 2 , 桑吉 3 , 次旦顿珠 3 , 尚睿哲 1 , 喻斓 1 , 袁梓皓 1 , 陈志伟 4 , 木克代斯·吐尔逊 1 , 刘巧兰 1
现代预防医学 | 儿少卫生与妇幼保健 2026,53(4): 623-629
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现代预防医学 |儿少卫生与妇幼保健 2026 , 53 (4) : 623 -629
基于HAPA模型的西藏儿童青少年正确养犬行为影响因素分析
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杨舒羽1, 旦增曲珍2, 桑吉3, 次旦顿珠3, 尚睿哲1, 喻斓1, 袁梓皓1, 陈志伟4, 木克代斯·吐尔逊1, 刘巧兰1
作者信息
  • 1.四川大学华西公共卫生学院/华西第四医院 健康行为与社会医学系,四川 成都 610041
  • 2.西藏自治区疾病预防控制中心
  • 3.那曲市疾病预防控制中心
  • 4成都市郫都区疾病预防控制中心
通讯作者:
刘巧兰,E-mail:
作者简介:

杨舒羽(2002—),女,硕士在读,研究方向:健康与社会行为学

Analysis of influencing factors of correct dog-raising behavior in Xizang children and adolescents based on HAPA model
Shu-yu YANG1, Danzengquzhen2, Sangji3, Cidandunzhu3, Rui-zhe SHANG1, Lan YU1, Zi-hao YUAN1, Zhi-wei CHEN4, Tuerxun Mudaikesi1, Qiao-lan LIU1
Affiliations
  • Department of Health Behavior and Social Medicine, West China School of Public Health/West China Fourth Hospital, Sichuan University, Chengdu, Sichuan 610041, China
出版时间: 2026-02-25 doi: 10.20043/j.cnki.MPM.202507307
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目的

本研究基于健康行动过程模型(health action process approach,HAPA)探究儿童青少年养犬行为及其影响因素,为包虫病防控提供参考依据。

方法

基于HAPA制定问卷,于2024年10月—2025年4月调查西藏那曲市4所学校(1所小学和3所初中)的学生。应用结构方程模型分析养犬行为影响因素。

结果

纳入本研究家中有养犬的942例儿童青少年中,养犬行为不合格率为69.9%。在HAPA模型中,正确养犬行为意向受结果预期的影响[标准路径系数(95% CI)=0.321(0.224~0.411),P值<0.001];正确养犬行为意向、维持自我效能直接影响行动计划,标准路径系数(95% CI)分别为0.225(0.138~0.314)、0.560(0.417~0.695),P值均<0.001;行动计划直接影响正确养犬行为[标准路径系数(95% CI)=0.160(0.013~0.341),P值<0.05];社会支持通过影响行动计划对正确养犬行为产生间接效应[效应值(95% CI)=0.025(0.003~0.037),P值<0.05]。

结论

儿童青少年正确养犬行为受到行动计划的影响,正确养犬行为意向和社会支持通过行动计划间接影响正确养犬行为。在健康教育策略中,可将行动计划的制定作为干预重点,促进儿童青少年形成正确的养犬行为。

包虫病  /  养犬行为  /  健康行动过程模型  /  结构方程模型
Objective

To explore the dog-raising behavior of children and adolescents and its influencing factors based on the health action process approach (HAPA), so as to provide reference for the prevention and control of echinococcosis.

Methods

A questionnaire based on HAPA was developed to investigate students in four schools in Nagqu City, Tibet from October 2024 to April 2025. The factors influencing dog-raising behavior were analyzed by structural equation model.

Results

Among the 942 children and adolescents with dog-raising at home included in this study, the unqualified rate of dog-raising behaviors was 69.9%. In the HAPA model, the intention of correct dog-raising behavior was influenced by outcome expectations [standard path coefficient (95% CI)=0.321 (0.224-0.411), P<0.001]. The intention of correct dog-raising behavior and maintenance self-efficacy directly affected the action plan, with standard path coefficients (95% CI) of 0.225 (0.138-0.314) and 0.560 (0.417-0.695) respectively, and P values were both <0.001. The action plan directly affected the correct dog-raising behavior [standard path coefficient (95% CI)=0.160 (0.013-0.341), P<0.05]. Social support had an indirect effect on correct dog-raising behavior by influencing the action plan [effect value (95% CI)=0.025 (0.003-0.037), P<0.05].

Conclusion

The correct dog-raising behaviors of children and adolescents are influenced by the action plan.The intention of correct dog-raising behavior and social support indirectly affect correct dog-raising behavior through the action plan. In health education strategies, the formulation of the action plan can be taken as the key intervention point to promote children and adolescents to form correct dog-raising behaviors.

Echinococcosis  /  Dog-raising behavior  /  Health action process model  /  Structural equation model
杨舒羽, 旦增曲珍, 桑吉, 次旦顿珠, 尚睿哲, 喻斓, 袁梓皓, 陈志伟, 木克代斯·吐尔逊, 刘巧兰. 基于HAPA模型的西藏儿童青少年正确养犬行为影响因素分析. 现代预防医学, 2026 , 53 (4) : 623 -629 . DOI: 10.20043/j.cnki.MPM.202507307
Shu-yu YANG, Danzengquzhen, Sangji, Cidandunzhu, Rui-zhe SHANG, Lan YU, Zi-hao YUAN, Zhi-wei CHEN, Tuerxun Mudaikesi, Qiao-lan LIU. Analysis of influencing factors of correct dog-raising behavior in Xizang children and adolescents based on HAPA model[J]. Modern Preventive Medicine, 2026 , 53 (4) : 623 -629 . DOI: 10.20043/j.cnki.MPM.202507307
包虫病(Hydatidosis/Echinococcosis),又称棘球蚴病,是由棘球绦虫的幼虫(棘球蚴)引起的慢性、消耗性人畜共患传染病,是我国重要的公共卫生问题之一[1]。西藏地区自然环境及生产生活方式特殊,是人畜包虫病高度流行区[2-3]。西藏部分地区犬只细粒棘球蚴阳性感染率达10.3%[4],犬科动物是棘球绦虫的终宿主,犬粪中包含大量包虫卵,为主要传染源。一项meta分析结果显示[5],影响西部地区居民包虫病的最主要因素为犬相关因素,如“密切接触犬”“自家养犬”等。包虫病作为人畜共患传染病,感染的高峰期主要在儿童青少年期,可长达数年的无症状期,常发病于成人,感染包虫病亦会直接影响其生长发育。既往研究中,儿童青少年时期正确养犬行为合格率较低,大约在29%~40%之间[6-7],提示儿童青少年包虫病的健康教育更应引起重视,但目前对包虫病相关的研究中,从行为理论模型的角度去探讨儿童青少年养犬行为影响因素的研究目前是空白。
健康行动过程模型(health action process approach,HAPA)[8]旨在解释个体从行为意向到健康行为的有效转化,它不仅可以解释个体行为意向产生的各种因素,同时也可以解释从行为意向到促进健康行为的路径,其中,行动计划弥合了行为意向和健康行为之间的鸿沟[9]。传统HAPA模型主要集中在个体水平的健康行为改变,而个体的健康行为始终受环境及群体行为的影响。社会支持[10]作为健康行为的重要因素,可以提供情感、信息、工具和评价支持,促进健康行为的形成。
本研究基于HAPA模型,探索性分析其在儿童青少年的正确养犬行为中的适用性,并将社会支持融入HAPA模型,重点关注影响正确养犬行为的意向到形成行动计划这一路径,为促进高牧区包虫病防控提供实践策略和措施。
本研究于2024年9月—2025年4月,采用整群随机抽样的方式,考虑当地社会经济发展的不平衡状况,整群抽取西藏那曲地区4所学校(1所小学的全体五年级学生和3所初中的七、八、九年级学生),共发放问卷2 976份,剔除无效样本后,总样本量2 966,有效回收率99.7%。通过询问“你家中养犬吗”,回答为“是”则满足本研究纳入标准,回答为“否”则排除。参照随机抽样样本量计算公式(π为正确养犬行为率,在29%~40%之间,取40%[6-7],相对误差δ控制在4%),所需样本量为577人。整群样本再增加20%,则计算样本量为693人。本研究纳入家中养犬学生共942人,满足研究需要。研究方案已通过四川大学华西第四医院/华西公共卫生学院伦理委员会审查(伦理号:Gwll2023116)。
调查方法 基于HAPA模型自行设计调查问卷,经专家论证后正式使用。问卷主要包含两部分:(1)一般人口学特征问卷,含性别、年龄、经济状况、父母文化程度等,其中经济状况分为较好、一般和较差;(2)HAPA模型量表,该量表遵循Schwarzer [11]编制HAPA模型条目的原则进行编制,同时根据研究具体问题进行适当的添加、修改和删除。除风险感知中三个条目的评分从1(远低于平均水平)到5(远高于平均水平)外,其它变量条目均采用Likert 4分制,评分从1(非常不同意)到4(非常同意);其余问卷总体信、效度较好。进行Kaiser-Meyer-Olkin(KMO)检验和Bartlett’s球形检验,KMO值为0.887,Bartlett检验P值<0.001,进行探索性因子分析,累计方差解释率为63.45%。总Cronbach α系数为0.899,各因子Cronbach α系数均>0.7,见表1。
儿童青少年养犬行为赋值及判断标准养犬行为包括是否将狗栓养、定期喂驱虫药、犬粪掩埋、与狗玩耍及玩耍后是否洗手五个重要行为[12-14],总分0~15分,得分越高,表示养犬正确行为率越高。参照Qucuo, N等关于包虫病知识、态度、行为的综合评估准则[15],养犬行为正确率80%(本研究大于或等于12分)则视为合格,否则为不合格。
质量控制 调查前对调查员进行统一培训,明确调查流程与指标释义;现场调查时,提前说明研究目的及问卷填写事项,被调查对象以班级为单位在教室里进行问卷自填,以确保调查环境的统一和隐私的保护;问卷由调查员当场收集与检查;采用EpiData 3.1软件进行数据录入和查验,对于无效问卷进行剔除,抽查5 %的问卷重复录入,以确保数据的准确性。
使用SPSS 21.0软件进行统计分析,用Amos 24软件构建结构方程模型,样本量与结构方程模型变量数比值超过20∶1,满足经验原则的需要。计量资料用()表示,计数资料用频数和频率表示;计量资料进行单因素方差分析,计数资料进行χ2检验;HAPA模型中各要素的少量缺失变量采用均值填补法进行填补。用偏相关系数矩阵探索各变量关系,用Cronbach α信度系数法检验问卷信度,探索性因子分析检验问卷效度。基于HAPA模型的正确养犬行为影响因素分析采用结构方程模型,模型拟合度良好(CFI=0.932,RMSEA=0.037<0.08,GFI=0.945>0.9,TLI=0.942>0.9)。采用最大似然法进行参数估计,bootstrap法5 000次抽样获得95%置信区间。检验水准设定为α=0.05。
本次纳入分析的家中养犬学生中,男性520人(55.2%),女性422人(44.8%);年龄(13.93±1.70)岁;详见表2。养犬行为不合格率为69.9%。HAPA总得分为(23.36±4.65)分,其中风险感知为(2.33±0.92)分、结果预期为(2.69 ±0.67)分、意向为(2.55±0.78)分、行动计划为(2.66±0.77)分、社会支持为(2.77±0.69)分、行动自我效能为(2.66±0.69)分、维持自我效能为(2.57±0.72)分;养犬行为总分为(11.24±1.95)分。
偏相关结果(表3)显示,行动自我效能、结果预期、正确养犬行为意向、维持自我效能、行动计划和社会支持之间均存在显著的相关关系(P<0.001),风险感知与其他变量之间的相关性无统计学意义(P>0.05)。
本研究基于HAPA模型,采用最大似然法进行参数估计。除年龄外,将表2中有统计学意义的调整变量加入模型。本研究为横断面研究,而恢复自我效能处于行动阶段,基于以往研究经验[16-17],去掉恢复自我效能这一变量,重点关注影响正确养犬行为的意向到形成行动计划这一路径后获得模型。模型具体路径显示各主要路径比较见表4、图1。
其中正确养犬行为意向受结果预期(β=0.321)的影响,正确养犬行为意向(β=0.225)和维持自我效能(β=0.560)直接影响行动计划,行动计划(β=0.160)直接影响正确养犬行为。这一过程中,行动自我效能也可影响维持自我效能(β=0.662),但风险感知对行为意向的影响无统计学意义(P>0.05)。
社会支持对行动自我效能(β=0.654)、维持自我效能能(β=0.209)、正确养犬行为意向(β=0.265)、行动计划(β=0. 155)都具有直接的正向影响。但社会支持对正确养犬行为的直接影响无统计学意义(P>0.05)。
模型的效应分为直接效应与间接效应。行动计划到正确养犬行为、行为意向到行动计划、结果预期到行为意向、社会支持到行动计划的直接效应均有统计学意义,直接效应值分别为0.160、0.225、0.321、0.155。社会支持到正确养犬行为的直接效应无统计学意义(P>0.05),但可以通过影响行动计划间接对正确养犬行为产生作用,间接效应值为0.025。模型中各变量对正确养犬行为潜变量的总效应见表4。
本研究结果表明,对包虫病的结果预期会使儿童青少年产生正确养犬行为意向;而在正确养犬意向形成后会促使其制定相应的养犬行动计划;行动自我效能、维持自我效能和社会支持也是正确养犬行为的重要促进因素。
近年来,随着健康教育的普及,人群包虫病防治知识知晓率和健康行为合格率逐渐提高,但在本研究中,儿童青少年养犬行为不合格率仍较高(69.9%),与边巴卓玛等[18]包虫病行为不合格率及Rui-Ou, Wang等[19]养犬行为正确率结果基本一致。这提示我们,包虫病健康教育对象不仅是成年人,儿童青少年的健康教育更应引起重视,以促进正确养犬行为的形成。汤晓佳等[6]也提出针对儿童青少年人群的有关包虫病的健康教育应成为政府工作的重点。
在前意向阶段,结果预期促使青少年产生了正确养犬行为意向。结果预期包括人们对将要开始的某种健康行为所带来结果的判断,也包括对改变一些疾病诱发因素的信心程度。当儿童青少年认识到通过自身正确的养犬行为(如与狗玩耍后洗手、掩埋犬粪、定期喂驱虫药等)便可减少包虫病及其他疾病的发生概率时,就会形成积极的结果预期,从而产生正确养犬行为意向。行动自我效能对维持自我效能有正向影响,研究学生锻炼行为[20]也得到了类似的结果。自我效能是指个体对自己执行某一特定行为的能力大小的一种主观判断,是个体能够坚持健康行为的自信。对儿童青少年日常生活中的养犬行为进行合理指导,增加自信心,有利于提高其正确养犬行为率。风险感知对正确养犬行为影响无意义,与其他健康行为中使用HAPA模型的研究类似[21-22]。
在意志阶段,儿童青少年产生正确养犬行为意向后,行动计划可为养犬行为提供明确可行的具体措施,如在什么时间、不同场景中如何做到正确管理犬,从而对正确养犬行为产生影响。模型结果显示,“维持自我效能→行动计划”“正确养犬行为意向→行动计划”“行动计划→养犬行为”均为正向影响。除路径2(风险感知→正确养犬行为意向→行动计划→正确养犬行为)外,路径1、路径3、路径4(行动自我效能→维持自我效能→行动计划→正确养犬行为、结果预期→正确养犬行为意向→行动计划→正确养犬行为、社会支持→行动计划→正确养犬行为)都作用于行动计划从而对养犬行为产生间接影响。说明行动计划既可以直接影响养犬行为,也作为其他变量影响儿童青少年正确养犬行为的中介因素。因此,在促进儿童青少年正确养犬行为的干预中,应注重提高正确管理犬的行动计划。
社会支持作为一个重要的要素加入HAPA模型。社会支持可以来自不同的来源,比如家庭、朋友或同学,其对行动自我效能、维持自我效能、正确养犬行为意向、行动计划均有直接影响。社会支持对于正确养犬行为虽无直接影响,但可以通过路径4(社会支持→行动计划→正确养犬行为)影响儿童青少年的养犬行为,再次说明行动计划对于儿童青少年养犬行为的重要性。由此可以得出,注重家人、朋友等对儿童青少年的正确养犬行为的支持作用,从而更易激发其行为改变的内在动机,主动促进健康行为的形成。
本研究为横断面研究,模型自变量和因变量在同一时点采集,很难满足因果关系中“因在前果在后”的先行后续关系,研究结果仅揭示了变量间的相关关系,其因果关联有待未来采用纵向设计或干预研究进一步验证;数据采集为自我报告,可能存在回忆偏倚。尽管本研究有这些缺陷,但本研究首次从行为理论模型的角度去探讨儿童青少年养犬行为,证实了HAPA模型应用于儿童青少年养犬行为影响因素的分析是适用的。
  • 国家卫生健康委包虫病防治研究重点实验室项目(2022WZK1007)
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doi: 10.20043/j.cnki.MPM.202507307
  • 接收时间:2025-07-21
  • 首发时间:2026-11-02
  • 出版时间:2026-02-25
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  • 收稿日期:2025-07-21
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国家卫生健康委包虫病防治研究重点实验室项目(2022WZK1007)
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    1.四川大学华西公共卫生学院/华西第四医院 健康行为与社会医学系,四川 成都 610041
    2.西藏自治区疾病预防控制中心
    3.那曲市疾病预防控制中心
    4成都市郫都区疾病预防控制中心

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2种不同金属材料的力学参数
科
Family
属数
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genus
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species
占总种数比例
Percentage of
total species (%)
属
Genus
种数
Number of
species
占总种数比例
Percentage of total
species (%)
鹅膏菌科Amanitaceae 2 11 5.26 鹅膏菌属 Amanita 10 4.78
小菇科 Mycenaceae 2 12 5.74 丝盖伞属 Inocybe 5 2.39
多孔菌科 Polyporaceae 8 14 6.70 蜡蘑属 Laccaria 5 2.39
红菇科 Russulaceae 3 23 11.00 小皮伞属 Marasmius 6 2.87
小菇属 Mycena 11 5.26
光柄菇属 Pluteus 5 2.39
红菇属 Russula 17 8.13
栓菌属 Trametes 5 2.39
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