Study on the effectiveness of vision prevention and control measures for preschool children through "Family-school-hospital" Collaboration
“家－校－医”模式下在学龄前儿童中科学使用电子屏幕视力防控效果研究

摘要

目的 探索在“家庭－学校－医院（社区卫生）”模式下，在学龄前儿童中科学使用电子屏幕防控的效果，为学龄前儿童眼保健工作提供参考和依据。方法 采用现场试验研究方法，在上海市远郊某幼儿园内采取“家－校－医”模式下合理采取电子屏幕的宣教及干预措施，干预前后在家长群体中开展眼保健知识问卷调查，在儿童群体中开展视力检查和屈光检查。评估家长眼健康知识知晓情况、电子屏幕使用情况，视力不良及复诊情况。结果 使用家长眼保健知识问卷进行调查，基线调查时312位学生家长平均得分4.28±3.55分，终末调查时291位学生家长平均得分8.26±2.47分，差异有统计学意义（P＜0.001）。干预前后工作日和节假日儿童电子屏幕使用时长情况经Mann-Whitney U 检验，差异均有统计学意义（P＜0.001）。干预前后有效视力检查人数309人和286人，裸眼视力不良人数占比12.00%和17.10%，差异无统计学意义（P＞0.05）。屈光异常人数占比10.70%和14.00%，差异无统计学意义（P＞0.05）。复查率57.14%和85.71%，差异有统计学意义（P＜0.05）。结论 学龄前儿童“家庭－学校－医院（社区卫生）”视力防控一体的干预能提升家长眼保健知识水平，降低儿童电子屏幕使用时间，提高眼睛异常儿童复诊率。在控制视力不良和屈光异常率方面，有待进一步观察。

Abstract

Objective To explore the effectiveness of scientifically using electronic screens in preschool children under the "family-school-hospital (community health)" model, providing reference and basis for eye health care in preschool children.
Methods Using a field trial sampling method, educational and intervention measures for the reasonable use of electronic screens under the "family-school-hospital" model were implemented in a kindergarten in the outskirts of Shanghai. Before and after the intervention, a questionnaire survey on eye health knowledge was conducted among parents, and vision and refractive error tests were conducted among children. The study assessed parents' awareness of eye health knowledge, the usage of electronic screens, and the prevalence and follow-up of poor vision.
Results The parent eye health knowledge questionnaire survey showed that the average score of 312 parents during the baseline survey was 4.28±3.55 points, while the average score of 291 parents during the final survey was 8.26±2.47 points, with a statistically significant difference (P<0.001). The Mann-Whitney U test showed a statistically significant difference in children's electronic device usage time on weekdays and holidays before and after the intervention (P<0.001). The number of valid vision test participants before and after the intervention was 309 and 286, respectively, with the proportion of children with poor uncorrected visual acuity being 12.00% and 17.10%, respectively, showing no statistically significant difference (P>0.05). The proportion of children with refractive errors was 10.70% and 14.00%, respectively, also showing no statistically significant difference (P>0.05). The re-examination rate was 57.14% and 85.71%, respectively, with a statistically significant difference (P<0.05).
Conclusion   The integrated vision prevention and control measures of the "Family-School-Hospital (Community Health)" model can enhance parents' eye health knowledge, reduce children's electronic device usage time, and increase the re-examination rate of children with eye abnormalities. However, further observation is needed to evaluate the effectiveness of these measures in controlling poor vision and refractive error rates.