Study On The Current Situation Of Osteoporosis Health Management And The Effect Of Intervention By Community Health Care Workers In Shanghai

Objective:To evaluate the implementation status of health management of osteoporosis among community health care workers in Shanghai,and to explore the related influencing factors by using society ecosystems theory.And to evaluate the effects of standard community manage intervention on the knowledge,attitude and practice(KAP)of osteoporosis prevention among community health care workers.Methods:A convenient sample survey was conducted among community health care workers in the 20 pilot communities.Evaluate the reliability and validity of the Health management Behavior Scale for Osteoporosis.And evaluate the status of implementation of osteoporosis health management.Logistic regression and path analysis were used to analyze the relevant influencing factors.A randomized controlled study based on propensity score matching was conducted.The intervention group conducted standardized osteoporosis health management intervention.While the control group only under the guidance of the Shanghai Municipal Health Planning Commission document.Then through comparison between the two group as well as between before and after the intervention in the group,to assess the effects of interventions on health management for osteoporosis among health care workers.Res_ults:(1)S-CV1/UA and S-CVI/Ave of the 18-item scale the were 0.85 and 0.96respectively.The confirmatory factor analysis showed good model fit:yl/df~=3.323?CFI=0.971,GFI=0.941,RMSEA=0.076.The overall Cronbach’a coefficient of this scale was 0.978.the ICC was 0.654,and the split-half reliability coefficient was 0.932.(2)The implementation rate of health management for osteoporosis among community health care workers was 45.5%.logistic regression results showed:osteoporosis risk factor identification skills(ORm=l.66,95%CI=1.14-2.42),self-efficacy(ORm=8.39,95%CI=5.90-11.92)and Community hospitals environmental support(ORm~=1.65,95%CI=1.19-2.29)are all associated with health management behaviour Path analysis results showed that self-efficacy can directly promote implementation of osteoporosis health management(factor loading:0.60,p<0.001),while community hospitals environmental support(factor loading~=0.11,p<0.001)and risk factor identification skills(factor loading~=0.08,p<0.001)can be directly and indirectly promote the implementation of health management of osteoporosis.(3)After intervention,the knowledge level of osteoporosis in the intervention group was significantly higher than that of the control group,87.27士8.48 points and 72.38士12.06points(p<0.01),respectively.The rate of positive attitude toward health management was higher than that in control group(intervention group:78.7%,control group:43.3%,p<0.01).Health management implementation rate was 63%in the intervention group and 59%in the control group,the difference was not statistically significant(p>0.05).Conclusion:The health management of osteoporosis among community health care workers needs to be strengthened.Targeted intervention should be carried out in combination with the individual and the surrounding environment.The intervention of standardized osteoporosis health management shows good effect,but the effect of improving health management implementation is still unclear Further strengthen relevant policies and community resource support that to promote the health management implementation are really necessary.