肖敏 冯宗丽 彭文湃

[摘要]目的 探討口服避孕药社区推广的新模式，提高育龄群众口服避孕药使用率，降低人工流产率，促进生殖健康。方法 2013年10月根据年龄的差异进行分层随机抽取深圳市福田区2个定点街道（沙头街道和梅林街道）的1000例人工流产术后育龄妇女作为研究对象，按照随机数字表法，将研究对象分为观察组和对照组，每组500例。对照组采取常规的社区推广模式。观察组在对照组的基础上采用规范化的社区干预模式：培训督导、宣传教育和随访防治等方式全面开展口服避孕药的推广使用。为期2年。评价两组对口服避孕药的认知水平、总使用率。结果 干预前，两组患者的口服避孕药种类、作用机制、不良反应认知情况评分比较，差异均无统计学意义（P>0.05）。干预后，两组患者的口服避孕药种类、作用机制、不良反应认知情况评分均高于干预前，且观察组患者的口服避孕药种类、作用机制、不良反应认知情况得分均高于对照组，差异有统计学意义（P<0.05）。观察组口服避孕药的总使用率高于对照组，差异有统计学意义（P<0.05）。结论 采用新型的社区干预推广模式能够提升育龄妇女对口服避孕药的认识、接受程度以及总使用率。

[关键词]口服避孕药；社区推广；流产率；认知；效果

[中图分类号] R169.49 [文献标识码] A [文章编号] 1674-4721（2018）7（c）-0152-03

[Abstract] Objective To explore the new mode of promoting oral contraceptives in community to increase the use rate of oral contraceptives among people of child-bearing age， reduce artificial abortion rate， and promote reproductive health. Methods According to the age difference in October 2013， stratified random sampling of 1000 women at reproductive age after artificial abortion at two selected streets including Shatou Street and Meilin Street in Futian District of Shenzhen City was selected as study objects. According to the random number table Method， participants were divided into the observation group and control group， and there were 500 cases in each group. In the control group， a regular community promotion mode was used， while in the observation group， on the basis of the control group， a standardized community intervention mode including training and supervision， publicity and education， and follow-up prevention and treatment as an intervention was adopted to comprehensively promote the use of oral contraceptives. The observation lasted two years. The cognitive level and total use rate of oral contraceptives in the two groups were evaluated. Results Before intervention， the score of varieties of oral contraceptives， mechanism of action， and awareness of adverse reactions between the two groups were not statistically different （P>0.05）. After intervention， the score of the three indexes were all higher than those before intervention. What′s more， the score of these three indexes in the observation group after intervention were higher compared with those in the control group with statistical significance （P<0.05）. The total use rate of oral contraceptives in the observation group was higher than that in the control group with a significant difference （P<0.05）. Conclusion Application of a new promotion mode as an intervention in community can raise the awareness， acceptance and the total use rate of oral contraceptives among women of child-bearing age.

[Key words] Oral contraceptives； Community promotion； Abortion rate； Awareness； Effect

据统计，在世界范围约有10亿妇女服用口服避孕药（oral contraceptives，OC）[1]。不同国家和地区的使用情况有较大差别。国外OC的比率较高，据联合国最新统计，荷兰和英国分别有41%和29%的育龄妇女使用OC。但是在国内OC的使用率较低，主要是由于人们对OC存在一定的误解，认为OC监测防治体系不健全，大多数妇女选择侥幸避孕也不选择使用避孕药，失去了女性自主选择避孕方法的机会，导致了人工流产率逐年上升[2-3]。再……