Article(id=1324078268919456093, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1324078175000605624, articleNumber=null, orderNo=null, doi=10.20043/j.cnki.MPM.202510029, pmid=null, cstr=null, oa=null, hot=null, price=null, onlineType=0, articleFormat=0, articleType=null, articleTypeStr=null, receivedDate=1759939200000, receivedDateStr=2025-10-09, revisedDate=null, revisedDateStr=null, acceptedDate=null, acceptedDateStr=null, onlineDate=1793614459494, onlineDateStr=2026-11-02, pubDate=1769270400000, pubDateStr=2026-01-25, doiRegisterDate=null, doiRegisterDateStr=null, onlineIssueDate=1793614459494, onlineIssueDateStr=2026-11-02, onlineJustAcceptDate=null, onlineJustAcceptDateStr=null, onlineFirstDate=null, onlineFirstDateStr=null, sourceXml=null, magXml=null, createTime=1793614459494, creator=13701087609, updateTime=1793614459494, updator=13701087609, issue=Issue{id=1324078175000605624, tenantId=1146029695717560320, journalId=1227665162245664772, year='2026', volume='53', issue='2', pageStart='193', pageEnd='384', issueExtLink='null', onlineDate='null', pubDate='1769270400000', pubDateStr='2026-01-25', beforeIssueId=null, nextIssueId=null, price=null, status=1, issueComplete=1, articleOrder=1, issueType=-1, specialIssue=0, createTime=1793614437103, creator='13701087609', updateTime=1793614526046, updator='13701087609', preIssue=null, nextIssue=null, articleTotal=null, ext={EN=IssueExt(id=1324078548130082942, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1324078175000605624, language=EN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=), CN=IssueExt(id=1324078548130082943, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1324078175000605624, language=CN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=)}, issueFiles=null, downloadFileDto=null}, startPage=200, endPage=204, ext={EN=ArticleExt(id=1324078269129171294, articleId=1324078268919456093, tenantId=1146029695717560320, journalId=1227665162245664772, language=EN, title=Analysis of the current status of knowledge,attitude,and practice regarding H.pylori infection prevention and control, and the influencing factors of practices among H.pylori-positive individuals in rural China, columnId=1228016567443718970, journalTitle=Modern Preventive Medicine, columnName=Epidemiology and Statistical Methods Advances, runingTitle=null, highlight=null, articleAbstract=
Objective

To investigate the current status of knowledge, attitudes, and practices (KAP) and influencing factors of practices among Helicobacter pylori (H. pylori)-positive populations in rural China, and to provide a reference basis for adopting effective health education and health promotion strategies.

Methods

From October to December 2024, a multistage stratified cluster random sampling method was employed to select 168 administrative villages (neighborhood committees) from 27 rural counties across four provinces (Jiangsu, Anhui, Shandong, and Henan) as the study areas. All rural residents underwent H. pylori infection testing via the 13C-urea breath test, and a questionnaire survey was conducted among 16 144 individuals who were identified as H. pylori-positive. Cluster analysis and Logistic regression were utilized to assess the current status of knowledge, attitudes, and practices (KAP) and to identify behavioral influencing factors among the H. pylori-positive population.

Results

The standardized scores for the knowledge, attitude, and practice dimensions among the H. pylori-positive population were (0.69±0.29), (0.91±0.15), and (0.73±0.15) points, respectively. K-means cluster analysis revealed that 27.99%, 5.49%, and 15.59% of the surveyed participants exhibited low levels in the knowledge, attitude, and practice dimensions, respectively. Based on knowledge and attitude levels, the population was categorized into four distinct characteristic groups: high knowledge-high attitude, low knowledge-high attitude, high knowledge-low attitude, and low knowledge-low attitude. The multivariate analysis results indicated that compared to the low knowledge-low attitude level group, the high knowledge-high attitude level group had a higher behavioral dimension level (OR=6.45, 95% CI: 5.45-6.83), followed by the low knowledge-high attitude level group (OR=2.48, 95% CI: 2.09-2.95). Compared to males, females had a higher behavioral dimension level (OR=1.46, 95% CI: 1.33-1.60). Compared to farmers, non-farmer occupational groups had a higher behavioral dimension level (OR=1.30, 95% CI: 1.18-1.44).

Conclusion

The H. pylori-positive population in rural areas demonstrates relatively positive attitudes but suboptimal knowledge and health practices. It is recommended to implement precise stratified intervention strategies tailored to different population characteristics. Emphasis should be placed on groups with low knowledge-low attitude and high knowledge-low attitude to enhance their cognitive levels and risk awareness. This approach provides evidence-based strategic support for the comprehensive prevention and control of H. pylori infection and gastric cancer in rural areas.

, authors=Xiang-yi RUI1, Ya-rong HAN2, Xin-yi YANG1, Xue-fei FENG1, yu-qi WANG2, Ning WANG1, Bao-hua WANG1, authorsList=Xiang-yi RUI, Ya-rong HAN, Xin-yi YANG, Xue-fei FENG, yu-qi WANG, Ning WANG, Bao-hua WANG, authorCompany=null, correspAuthors=Bao-hua WANG, 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=1324078269817037153, articleId=1324078268919456093, tenantId=1146029695717560320, journalId=1227665162245664772, language=CN, title=农村幽门螺杆菌阳性人群对H.pylori感染防治知信行现状及行为影响因素分析, columnId=1228016567632462653, journalTitle=现代预防医学, columnName=流行病与统计方法, runingTitle=null, highlight=null, articleAbstract=
目的

探讨我国农村幽门螺杆菌(Helicobacter pylori,H.pylori)阳性人群H. pylori防治相关知识、态度、行为现状及行为影响因素,为采取有效的健康教育及健康促进策略提供参考。

方法

于2024年10月—12月,采用多阶段分层整群随机抽样法,选取江苏、安徽、山东和河南4省的27个农村县区的168个行政村(居委会),对全体农村居民采用13C尿素呼气试验进行H. pylori感染检测,对16 144名已确定为H. pylori阳性人群开展问卷调查。利用聚类分析确定H.pylori阳性人群知信行现状,并采用logistic回归分析H.pylori相关健康行为影响因素。

结果

H.pylori阳性人群的知识、态度、行为维度的标准分分别为(0.69±0.29)、(0.91±0.15)、(0.73±0.15)分。K-means聚类分析结果显示,27.99%、5.49%和15.59%的调查对象分别在知识、态度、行为维度处于低水平。根据知识和态度水平划分为高知识—高态度、低知识—高态度、高知识—低态度及低知识—低态度四类特征人群。多因素分析结果显示,与低知识—低态度水平的人群相比,高知识—高态度水平的人群行为维度水平高(OR=6.45,95% CI:5.45~6.83),其次是低知识—高态度水平的人群(OR=2.48,95% CI:2.09~2.95);与男性相比,女性的行为维度水平高(OR=1.46,95% CI:1.33~1.60);与农民相比,非农民职业的人群的行为维度水平高(OR=1.30,95% CI:1.18~1.44)。

结论

农村地区H. pylori阳性人群态度水平较高,但知识与健康行为水平偏低,建议对不同特征人群实施精准分层干预策略,重点针对低知识—低态度和高知识—低态度的人群,强化其认知水平及风险意识,为农村地区H.pylori感染及胃癌的综合防控提供循证策略支持。

, authors=芮向依1, 韩亚蓉2, 杨心仪1, 冯雪菲1, 王宇琦2, 王宁1, 王宝华1, authorsList=芮向依, 韩亚蓉, 杨心仪, 冯雪菲, 王宇琦, 王宁, 王宝华, authorCompany=null, correspAuthors=王宝华, authorNote=

芮向依(2001—),女,硕士在读,研究方向:肿瘤等慢性病预防与控制

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王宝华,E-mail:
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Analysis of helicobacter pylori infection status and related influencing factors among middle-aged and young adults undergoing physical examinations[J]. Journal of Parasitic Biology, 2025, 20(4): 481-485. (In Chinese), articleTitle=Analysis of helicobacter pylori infection status and related influencing factors among middle-aged and young adults undergoing physical examinations, refAbstract=null), Reference(id=1324078276712473016, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324078268919456093, doi=null, pmid=null, pmcid=null, year=2019, volume=37, issue=1, pageStart=70, pageEnd=75, url=null, language=null, rfNumber=[21], rfOrder=29, authorNames=徐月娥, 李淑湘, 高鑫, journalName=华西口腔医学杂志, refType=null, unstructuredReference=徐月娥,李淑湘,高鑫,等.苏州两所幼儿园儿童感染幽门螺杆菌的危险因素及口腔清洁措施对降低口腔幽门螺杆菌感染的作用[J].华西口腔医学杂志,2019,37(1):70-75., articleTitle=苏州两所幼儿园儿童感染幽门螺杆菌的危险因素及口腔清洁措施对降低口腔幽门螺杆菌感染的作用, refAbstract=null), Reference(id=1324078276787970489, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324078268919456093, doi=null, pmid=null, pmcid=null, year=2019, volume=37, issue=1, pageStart=70, pageEnd=75, url=null, language=null, rfNumber=[21], rfOrder=30, authorNames=Xu YE, Li SX, Gao X, journalName=West China Journal of Stomatology, refType=null, unstructuredReference=Xu YE, Li SX, Gao X, et al. 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(In Chinese), articleTitle=Risk factors of oral Helicobacter pylori infection among children in two kindergartens in Suzhou and the effects of oral cleaning on reducing oral Helicobacter pylori infection, refAbstract=null)], funds=[Fund(id=1324078274200084890, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324078268919456093, awardId=2024YFC3607800, language=CN, fundingSource=国家重点研发计划(2024YFC3607800), fundOrder=null, country=null)], companyList=[AuthorCompany(id=1324078270072889698, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324078268919456093, xref=1., ext=[AuthorCompanyExt(id=1324078270081278307, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324078268919456093, companyId=1324078270072889698, language=EN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=National Center for Chronic and Non-communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 100050, China), AuthorCompanyExt(id=1324078270089666916, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324078268919456093, companyId=1324078270072889698, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=1.中国疾病预防控制中心慢性非传染性疾病预防控制中心,北京 100050)]), AuthorCompany(id=1324078270198718821, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324078268919456093, xref=2., ext=[AuthorCompanyExt(id=1324078270215496038, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324078268919456093, companyId=1324078270198718821, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=2.南通市疾病预防控制中心健康教育与慢性病防治科)])], figs=[ArticleFig(id=1324078273034068370, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324078268919456093, language=EN, label=Table 1, caption=

Basic characteristics of respondents(n=16 144)

, figureFileSmall=null, figureFileBig=null, tableContent=
变量人数(n)构成比(%)
年龄
18~40岁(青年)3 84223.80
41~60岁(中年)7 50246.47
≥61岁(老年)4 80029.73
性别
男6 79942.11
女9 34557.89
文化程度
初中及以下11 63072.04
高中或中专2 24513.91
大专及以上2 26914.05
职业
农民7 94749.23
其他8 19750.77
婚姻状况
已婚/同居14 70991.11
其他(未婚/丧偶/离婚/分居)1 4358.89
), ArticleFig(id=1324078273185063315, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324078268919456093, language=CN, label=表1, caption=

调查对象一般情况(n=16 144)

, figureFileSmall=null, figureFileBig=null, tableContent=
变量人数(n)构成比(%)
年龄
18~40岁(青年)3 84223.80
41~60岁(中年)7 50246.47
≥61岁(老年)4 80029.73
性别
男6 79942.11
女9 34557.89
文化程度
初中及以下11 63072.04
高中或中专2 24513.91
大专及以上2 26914.05
职业
农民7 94749.23
其他8 19750.77
婚姻状况
已婚/同居14 70991.11
其他(未婚/丧偶/离婚/分居)1 4358.89
), ArticleFig(id=1324078273281532308, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324078268919456093, language=EN, label=Table 2, caption=

Scores and classification criteria of the H.pylori KAP questionnaire

, figureFileSmall=null, figureFileBig=null, tableContent=
项目得分范围问卷得分(分)程度划分[例(%)]
总分标准分高低
知识维度0~2718.66±7.740.69±0.2911 626(72.01)4 518(27.99)
H.pylori一般知识0~96.01±3.000.67±0.33
H.pylori传染性知识0~42.19±1.800.55±0.45
H.pylori诊断与治疗知识0~75.01±2.030.72±0.29
H.pylori预防知识0~75.44±2.080.78±0.30
态度维度5~5046.11±6.850.91±0.1515 258(94.51)886(5.49)
胃部出现不适症状,愿意去医院检测H.pylori1~109.03±2.070.89±0.23
愿意听从医生建议进行药物治疗1~109.38±1.560.93±0.17
对自己能按时按量服药有多大的信心1~109.11±1.860.90±0.21
愿意在体检项目中增加H.pylori 检测1~109.23±1.840.91±0.20
愿意接受H.pylori 相关知识的宣教1~109.35±1.630.93±0.18
行为维度7~3225.14±3.670.73±0.1513 627(84.41)2 517(15.59)
用药行为0~64.38±1.530.73±0.26
就餐行为2~1410.64±1.910.72±0.16
日常行为0~1210.12±1.870.84±0.16
), ArticleFig(id=1324078273386389909, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324078268919456093, language=CN, label=表2, caption=

H.pylori知信行问卷得分情况及程度划分

, figureFileSmall=null, figureFileBig=null, tableContent=
项目得分范围问卷得分(分)程度划分[例(%)]
总分标准分高低
知识维度0~2718.66±7.740.69±0.2911 626(72.01)4 518(27.99)
H.pylori一般知识0~96.01±3.000.67±0.33
H.pylori传染性知识0~42.19±1.800.55±0.45
H.pylori诊断与治疗知识0~75.01±2.030.72±0.29
H.pylori预防知识0~75.44±2.080.78±0.30
态度维度5~5046.11±6.850.91±0.1515 258(94.51)886(5.49)
胃部出现不适症状,愿意去医院检测H.pylori1~109.03±2.070.89±0.23
愿意听从医生建议进行药物治疗1~109.38±1.560.93±0.17
对自己能按时按量服药有多大的信心1~109.11±1.860.90±0.21
愿意在体检项目中增加H.pylori 检测1~109.23±1.840.91±0.20
愿意接受H.pylori 相关知识的宣教1~109.35±1.630.93±0.18
行为维度7~3225.14±3.670.73±0.1513 627(84.41)2 517(15.59)
用药行为0~64.38±1.530.73±0.26
就餐行为2~1410.64±1.910.72±0.16
日常行为0~1210.12±1.870.84±0.16
), ArticleFig(id=1324078273583522198, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324078268919456093, language=EN, label=Table 3, caption=

Current status of the H.pylori Knowledge-Attitude dimension (n=16 144)

, figureFileSmall=null, figureFileBig=null, tableContent=
变量人数
(n)
构成比
(%)
χ2值P值
知识—态度维度996.31<0.001
低—低6584.08
低—高3 86023.91
高—低2281.41
高—高11 39870.60
), ArticleFig(id=1324078273814208919, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324078268919456093, language=CN, label=表3, caption=

H.pylori知识—态度维度现状(n=16 144)

, figureFileSmall=null, figureFileBig=null, tableContent=
变量人数
(n)
构成比
(%)
χ2值P值
知识—态度维度996.31<0.001
低—低6584.08
低—高3 86023.91
高—低2281.41
高—高11 39870.60
), ArticleFig(id=1324078274023924120, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324078268919456093, language=EN, label=Table 4, caption=

Univariate and multivariate analysis of practices factors influencing H.pylori-infection (n=16 144)

, figureFileSmall=null, figureFileBig=null, tableContent=
变量单因素分析多因素分析
OR值(95%CI)P值OR值(95%CI)P值
性别
男Ref.-Ref.-
女1.41(1.30~1.54)<0.0011.46(1.33~1.60)<0.001
年龄
18~40岁(青年)Ref.---
41~60岁(中年)0.83(0.74~0.93)0.001--
≥61岁(老年)0.59(0.52~0.66)<0.001--
文化程度
初中及以下Ref.-
高中或中专1.40(1.23~1.60)<0.001--
大专及以上1.67(1.45~1.92)<0.001--
职业
农民Ref.-Ref.-
其他1.58(1.45~1.72)<0.0011.30(1.18~1.44)<0.001
婚姻状况
已婚/同居Ref.---
其他(未婚/丧偶/离婚/分居)1.03(0.88~1.20)0.721--
知识-态度维度水平
低-低Ref.-Ref.-
高-高6.74(5.72~7.95)<0.0016.45(5.45~6.83)<0.001
高-低1.40(1.03~1.92)0.0331.34(0.98~1.83)0.071
低-高2.41(2.03~2.86)<0.0012.48(2.09~2.95)<0.001
), ArticleFig(id=1324078274103615897, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324078268919456093, language=CN, label=表4, caption=

H.pylori感染行为影响因素的单因素和多因素分析(n=16 144)

, figureFileSmall=null, figureFileBig=null, tableContent=
变量单因素分析多因素分析
OR值(95%CI)P值OR值(95%CI)P值
性别
男Ref.-Ref.-
女1.41(1.30~1.54)<0.0011.46(1.33~1.60)<0.001
年龄
18~40岁(青年)Ref.---
41~60岁(中年)0.83(0.74~0.93)0.001--
≥61岁(老年)0.59(0.52~0.66)<0.001--
文化程度
初中及以下Ref.-
高中或中专1.40(1.23~1.60)<0.001--
大专及以上1.67(1.45~1.92)<0.001--
职业
农民Ref.-Ref.-
其他1.58(1.45~1.72)<0.0011.30(1.18~1.44)<0.001
婚姻状况
已婚/同居Ref.---
其他(未婚/丧偶/离婚/分居)1.03(0.88~1.20)0.721--
知识-态度维度水平
低-低Ref.-Ref.-
高-高6.74(5.72~7.95)<0.0016.45(5.45~6.83)<0.001
高-低1.40(1.03~1.92)0.0331.34(0.98~1.83)0.071
低-高2.41(2.03~2.86)<0.0012.48(2.09~2.95)<0.001
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农村幽门螺杆菌阳性人群对H.pylori感染防治知信行现状及行为影响因素分析
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芮向依 1 , 韩亚蓉 2 , 杨心仪 1 , 冯雪菲 1 , 王宇琦 2 , 王宁 1 , 王宝华 1
现代预防医学 | 流行病与统计方法 2026,53(2): 200-204
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现代预防医学 |流行病与统计方法 2026 , 53 (2) : 200 -204
农村幽门螺杆菌阳性人群对H.pylori感染防治知信行现状及行为影响因素分析
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芮向依1, 韩亚蓉2, 杨心仪1, 冯雪菲1, 王宇琦2, 王宁1, 王宝华1
作者信息
  • 1.中国疾病预防控制中心慢性非传染性疾病预防控制中心,北京 100050
  • 2.南通市疾病预防控制中心健康教育与慢性病防治科
通讯作者:
王宝华,E-mail:
作者简介:

芮向依(2001—),女,硕士在读,研究方向:肿瘤等慢性病预防与控制

Analysis of the current status of knowledge,attitude,and practice regarding H.pylori infection prevention and control, and the influencing factors of practices among H.pylori-positive individuals in rural China
Xiang-yi RUI1, Ya-rong HAN2, Xin-yi YANG1, Xue-fei FENG1, yu-qi WANG2, Ning WANG1, Bao-hua WANG1
Affiliations
  • National Center for Chronic and Non-communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 100050, China
出版时间: 2026-01-25 doi: 10.20043/j.cnki.MPM.202510029
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目的

探讨我国农村幽门螺杆菌(Helicobacter pylori,H.pylori)阳性人群H. pylori防治相关知识、态度、行为现状及行为影响因素,为采取有效的健康教育及健康促进策略提供参考。

方法

于2024年10月—12月,采用多阶段分层整群随机抽样法,选取江苏、安徽、山东和河南4省的27个农村县区的168个行政村(居委会),对全体农村居民采用13C尿素呼气试验进行H. pylori感染检测,对16 144名已确定为H. pylori阳性人群开展问卷调查。利用聚类分析确定H.pylori阳性人群知信行现状,并采用logistic回归分析H.pylori相关健康行为影响因素。

结果

H.pylori阳性人群的知识、态度、行为维度的标准分分别为(0.69±0.29)、(0.91±0.15)、(0.73±0.15)分。K-means聚类分析结果显示,27.99%、5.49%和15.59%的调查对象分别在知识、态度、行为维度处于低水平。根据知识和态度水平划分为高知识—高态度、低知识—高态度、高知识—低态度及低知识—低态度四类特征人群。多因素分析结果显示,与低知识—低态度水平的人群相比,高知识—高态度水平的人群行为维度水平高(OR=6.45,95% CI:5.45~6.83),其次是低知识—高态度水平的人群(OR=2.48,95% CI:2.09~2.95);与男性相比,女性的行为维度水平高(OR=1.46,95% CI:1.33~1.60);与农民相比,非农民职业的人群的行为维度水平高(OR=1.30,95% CI:1.18~1.44)。

结论

农村地区H. pylori阳性人群态度水平较高,但知识与健康行为水平偏低,建议对不同特征人群实施精准分层干预策略,重点针对低知识—低态度和高知识—低态度的人群,强化其认知水平及风险意识,为农村地区H.pylori感染及胃癌的综合防控提供循证策略支持。

幽门螺杆菌  /  知信行  /  健康教育  /  聚类分析
Objective

To investigate the current status of knowledge, attitudes, and practices (KAP) and influencing factors of practices among Helicobacter pylori (H. pylori)-positive populations in rural China, and to provide a reference basis for adopting effective health education and health promotion strategies.

Methods

From October to December 2024, a multistage stratified cluster random sampling method was employed to select 168 administrative villages (neighborhood committees) from 27 rural counties across four provinces (Jiangsu, Anhui, Shandong, and Henan) as the study areas. All rural residents underwent H. pylori infection testing via the 13C-urea breath test, and a questionnaire survey was conducted among 16 144 individuals who were identified as H. pylori-positive. Cluster analysis and Logistic regression were utilized to assess the current status of knowledge, attitudes, and practices (KAP) and to identify behavioral influencing factors among the H. pylori-positive population.

Results

The standardized scores for the knowledge, attitude, and practice dimensions among the H. pylori-positive population were (0.69±0.29), (0.91±0.15), and (0.73±0.15) points, respectively. K-means cluster analysis revealed that 27.99%, 5.49%, and 15.59% of the surveyed participants exhibited low levels in the knowledge, attitude, and practice dimensions, respectively. Based on knowledge and attitude levels, the population was categorized into four distinct characteristic groups: high knowledge-high attitude, low knowledge-high attitude, high knowledge-low attitude, and low knowledge-low attitude. The multivariate analysis results indicated that compared to the low knowledge-low attitude level group, the high knowledge-high attitude level group had a higher behavioral dimension level (OR=6.45, 95% CI: 5.45-6.83), followed by the low knowledge-high attitude level group (OR=2.48, 95% CI: 2.09-2.95). Compared to males, females had a higher behavioral dimension level (OR=1.46, 95% CI: 1.33-1.60). Compared to farmers, non-farmer occupational groups had a higher behavioral dimension level (OR=1.30, 95% CI: 1.18-1.44).

Conclusion

The H. pylori-positive population in rural areas demonstrates relatively positive attitudes but suboptimal knowledge and health practices. It is recommended to implement precise stratified intervention strategies tailored to different population characteristics. Emphasis should be placed on groups with low knowledge-low attitude and high knowledge-low attitude to enhance their cognitive levels and risk awareness. This approach provides evidence-based strategic support for the comprehensive prevention and control of H. pylori infection and gastric cancer in rural areas.

Helicobacter pylori  /  Knowledge-attitude-practice  /  Health education  /  Cluster analysis
芮向依, 韩亚蓉, 杨心仪, 冯雪菲, 王宇琦, 王宁, 王宝华. 农村幽门螺杆菌阳性人群对H.pylori感染防治知信行现状及行为影响因素分析. 现代预防医学, 2026 , 53 (2) : 200 -204 . DOI: 10.20043/j.cnki.MPM.202510029
Xiang-yi RUI, Ya-rong HAN, Xin-yi YANG, Xue-fei FENG, yu-qi WANG, Ning WANG, Bao-hua WANG. Analysis of the current status of knowledge,attitude,and practice regarding H.pylori infection prevention and control, and the influencing factors of practices among H.pylori-positive individuals in rural China[J]. Modern Preventive Medicine, 2026 , 53 (2) : 200 -204 . DOI: 10.20043/j.cnki.MPM.202510029
幽门螺杆菌(Helicobacter pylori, H.pylori)已被WHO列为Ⅰ类致癌物,是胃癌可干预的主要危险因素之一[1]。《中国幽门螺杆菌感染防控》白皮书指出[2],根除 H.pylori 可显著降低胃癌的发病率与死亡率。2022年全球成人H. pylori的感染率为43.10%[3],而2023年我国成人感染率也处于较高的水平,为42.89%[4]。现有研究多聚焦于一般人群对胃癌及 H.pylori 的知晓情况及其影响因素分析[5-6],针对感染阳性人群的相关研究较少。因此,本研究基于知信行(Knowledge,Attitude,Practice,KAP)理论,深入分析感染人群对H.pylori感染的知信行现状及行为影响因素,制定具有针对性的干预策略,为胃癌的一级预防提供依据。
本研究于2024年10—12月开展,采用多阶段分层整群随机抽样的方法,在江苏、安徽、山东和河南省共抽取27个农村县区,每个县(区)抽取4个乡镇(街道),每个乡镇/街道抽取1~2个行政村(居委会),对所抽取行政村(居委会)的全部成年常住居民进行13C尿素呼气试验检测。根据横断面调查样本量计算公式[7]:N=deff[μ2P(1-P)/d2],设定置信水平取95%(双侧),μ=1.96;P值参考2023年我国成人H. pylori感染率42.89%;设计效应deff值取3;d为容许误差,d=0.1×P。假设应答率为80%,共计样本量为51 786人。其中,对13C尿素呼气试验为阳性的调查对象开展H. pylori知信行问卷调查。最终在16 741名H. pylori感染者中回收有效问卷16 144份,有效回收率为 96.43%。
纳入标准:①年龄在18~70岁(含18岁);②13C尿素呼气试验为阳性;③签署知情同意书,自愿参加者。排除标准:①调查时行为认知能力受损而无法配合调查者;②因外出务工或其他原因导致无法参与本次调查的人员。本研究已获得中国疾病预防控制中心慢病中心伦理委员会批准(审批号202025-1)。
查阅国内外相关文献[6,8],并经课题组和专家讨论后设计调查问卷。问卷内容包括4部分:①一般人口学特征:包括年龄、性别、文化程度、职业、婚姻状况。②知识维度:共27个条目,包括H.pylori的危害性、传播途径、诊断与治疗方法、预防措施4个方面,答案设置为“是”“否”“不知道”,回答“是”得1分,回答“否”或“不知道”则不得分,总分为0~27分。③态度维度:共5个条目,主要内容为H.pylori筛查与治疗的态度,采用Likert 10级评分法,从“非常不愿意”到“非常愿意”分别计1~10分,总分为5~50分。④行为维度:共16个条目,主要内容为服药行为、就餐行为、日常行为。其中,服药行为得分范围为0~6分,就餐行为、日常行为采用Likert3级评分法,即“很少或从不”“有时候”“经常”分别赋值0、1、2分,行为维度总分为0~32分。该问卷克隆巴赫α系数为0.879,KMO(Kaiser-Meyer-Olkin)值为0.951,说明问卷信效度较好。
采用SAS 9.4软件进行统计学分析。连续性变量采用均数±标准差()描述,分类变量采用构成比或率(%)描述。由于各个维度的条目数量不同,采用Min-Max 归一化法对数据进行预处理[9],将各维度得分映射到区间[0,1]范围内。其公式为:xnorm=(x-xmin)/(xmax-xmin)。其中x是原始数据点,xmin是数据集中的最小值,xmax是数据集中的最大值,xnorm是归化后的数据。采用K-means聚类方法[10]对H. pylori阳性人群的知识、态度及行为维度得分进行聚类分析划分。根据肘部法则确定最佳聚类数[11]:计算不同K值对应的簇内平方和(Within-Cluster Sum of Squares, WCSS),结果显示在K=2时出现明显拐点,因此将各维度均划分为低水平与高水平两类。基于聚类分析结果,将知识得分≤0.75分界定为低知识水平,态度得分≤0.71分界定为低态度水平,行为得分≤0.64界定为低行为水平。通过卡方检验验证知识与态度维度间的关联性,并将知识维度与态度维度进行二元交叉组合,划分为四组:高知识—高态度、高知识—低态度、低知识—高态度、低知识—低态度。运用logistic回归分析行为维度水平的影响因素。所有统计分析均采用双侧检验,检验水准α=0.05。
研究对象平均年龄为(51.31±13.45)岁,年龄在41~60岁占比较高(7 502人,46.47%)。文化程度以初中及以下者占大多数(11 630 人,72.04%);职业以农民为主(7 947人,49.23%);婚姻状况以已婚者为主(14 709 人,91.11%),见表1。
调查对象对H.pylori治疗与筛查知识、态度与健康行为标准分得分分别为(0.91±0.15)、(0.69±0.29)、(0.73±0.15)分。根据聚类分析结果显示,知识维度中,27.99%的调查对象知识维度水平较低,其中对H.pylori传染性知识的掌握最差(得分:0.55±0.45分),H.pylori一般知识得分也相对较低(得分:0.67±0.33分)。态度维度中,5.49%处于低态度水平,其中当胃部出现不适症状,其中愿意去医院检测H. pylori的意愿相对较低(得分:0.89±0.23分)。行为维度中,15.59%处于低水平状态,其中就餐行为(得分:0.72±0.16分)和用药行为(得分:0.73±0.26分)相对较差,见表2。
知识-态度维度的交叉分析显示,高知识-高态度人群占比最高(70.60%,11 398人),而高知识-低态度人群占比最低(1.41%,228人)。不同知识维度与态度维度组合之间差异有统计学意义(χ2=996.31,P<0.001),见表3。
以H.pylori阳性人群的行为维度水平(取得分0.64为分界,赋值1=低,2=高)为因变量进行单因素分析,结果显示,不同年龄、性别、文化程度、职业、知识-态度维度水平的差异均具有统计学意义(P<0.05)。
将单因素分析中具有统计学意义的变量作为自变量,进行多因素分析。结果显示,与低知识、态度水平的人群相比,高知识-高态度水平(OR=6.45,95% CI:5.45~6.83)、低知识-高态度水平(OR=2.48,95% CI:2.09~2.95)是行为维度水平的保护因素,而女性(OR=1.46,95% CI:1.33~1.60)、非农民职业(OR=1.30,95% CI:1.18~1.44)也与行为维度水平高相关,见表4。
《健康中国行动—癌症防治行动实施方案(2023—2030年)》[12]提出,要促进癌症防治关口前移,倡导健康生活方式,普及健康科普知识,积极推进全民健康生活方式行动。在此背景下,剖析农村地区H.pylori阳性人群的知识、态度与行为(KAP)现状及内在关联,为制定差异化干预措施提供了实证依据。
本研究揭示了农村地区幽门螺杆菌(H. pylori)阳性人群在知识、态度与行为水平上存在不均衡现象:态度水平较高(标准分为0.91±0.15),但知识水平(0.69±0.29)与健康行为水平(0.73±0.15)相对偏低。27.99%的个体知识水平较低,传染性知识尤为薄弱;5.49%表现为低态度水平,而15.59%存在行为水平不足,说明居民对H. pylori普遍持有积极关注态度,但认知深度与行为转化仍显不足。究其原因,调查对象主要以初中及以下文化程度为主,其知识掌握能力本身有限,加之基层健康教育资源相对不足[13]、基层医疗能力薄弱[6]及乡村医生认知参差[8],导致知识得分偏低;而态度层面表现积极,一方面得益于国家早诊早治项目的宣传引导[14]以及对家庭内感染风险重视程度高[15],另一方面也源于对基层医生的信赖,但问卷测量中可能会出现社会期望偏差与选项集中倾向[16],也会导致态度得分偏高;尽管居民态度较为积极,因自身认知不足及外部条件限制(如难以改变长期共餐习惯),在规范服药与饮食分餐等方面依从性较差,反映出“知-信-行”链条在现实转化中存在明显断裂。研究还发现,知识与态度维度间显著相关,且知识-态度维度水平与行为维度显著相关,这一结果与Qin D[13]和Liu M[17]等分析结果基本一致。基于K-means聚类结果,目标人群可依据知识和态度水平划分为四类特征群体:高知识-高态度、低知识-高态度、高知识-低态度及低知识-低态度。单一宣传教育虽可提升认知与态度,却不足以促成持久行为改变[17],建议可基于信息—动机—行为技巧模型(Information-Motivation-Behavioral Skills Model,IMB),从知识传递、动机激励与技能培养多维度设计干预策略,从而以提高行为依从性[6,18-21],切实降低感染风险。
H.pylori感染行为影响因素分析结果显示,与低知识—低态度人群相比,高知识—高态度人群(OR=6.45,95% CI:5.45~1.83)不仅具备较高的知识掌握程度,且表现出积极的筛查与治疗态度,能够主动采取健康行为,应着重强化其示范引领作用;低知识—高态度人群(OR=2.48,95% CI:2.09~2.95)虽缺乏H.pylori相关知识但态度积极,仍具备一定的健康行为,后续需通过针对性健康教育(如社区讲座、宣传海报等)提升其知识水平以行为转化;而高知识—低态度人群和低知识—低态度认识是重点干预对象,前者因态度消极阻碍行为转化,需借助案例讲解、现场主题活动等方式增强其风险感知和行为动机;后者知识储备薄弱且态度消极,需采取高强度、个性化的综合干预措施,如签约家庭医生定期跟踪随访、建立激励机制、结合其生活场景进行面对面指导等,强化其认知水平及风险意识。女性(OR=1.46,95% CI:1.33~1.60)及非农业职业群体(OR=1.30,95% CI:1.18~1.44)的健康行为水平显著较高,可能与女性在家庭健康管理中会担任主要职责,以及非农民职业者更易接触多元化健康教育资源和医疗服务可及性有关[6]。因此,为强化宣传教育,提高农村居民行为水平,需整合新媒体与传统渠道科普H. pylori致病机制与早诊早治重要性,加强基层医疗服务能力建设,保障四联疗法药物储备,并推行社区—家庭联动干预激发行为积极性。
此外,本研究存在一定的局限性。首先,问卷调查属于自我报告,可能存在信息偏倚。其次,调查样本主要集中在中部地区,样本的代表性存在不足,可能会影响结果的外推性。未来的研究可采用更客观的测量工具,结合全国代表性的抽样设计加以验证。
综上,农村地区H. pylori阳性人群接受筛查与治疗态度水平较高,但知识和健康行为水平偏低。应重点针对低知识—低态度和高知识—低态度人群,聚焦“高态度”优势,着力破解“低知识”瓶颈,促进“中行为”向“优行为”转化,为农村地区H.pylori感染及胃癌的综合防控提供循证策略支持。
  • 国家重点研发计划(2024YFC3607800)
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2026年第53卷第2期
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doi: 10.20043/j.cnki.MPM.202510029
  • 接收时间:2025-10-09
  • 首发时间:2026-11-02
  • 出版时间:2026-01-25
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  • 收稿日期:2025-10-09
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    1.中国疾病预防控制中心慢性非传染性疾病预防控制中心,北京 100050
    2.南通市疾病预防控制中心健康教育与慢性病防治科

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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
种数
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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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