目的 研究在贫困地区有效推广科学喂养婴幼儿的理念和方法的路径效果, 改善喂养人的喂养技能, 达到提高婴幼儿健康水平的目的。方法 为完成国家“消除婴幼儿贫血行动”健康教育任务, 依托国家项目的政策、管理、技术平台, 采用临床路径及成人培训方法, 对基层业务人员及婴幼儿家长进行多轮培训;用婴幼儿喂养指数及喂养困难两个指标评价培训效果。结果 1)培训前后婴幼儿喂养指数各年龄组改善显著。培训前, 各年龄组均低于城市样本, 6~8个月龄低于农村样本, 9~11月龄与农村样本相似, 12~24月龄高于农村样本;培训后, 各年龄组均高于培训前的水平。2)培训前后喂养困难9~11月龄组改善不显著, 其余各年龄组改善显著。9~11月龄组喂养困难显示出涉及面宽、警示度低的特点, 依据是:问卷共14个项目, 该组有8个项目差异不显著;问卷每项最高分为7分, 该组干预前后分值分别为2.61±1.154、2.51±1.115。结论 临床路径的健康教育方法, 可全面、有效改善家长的婴幼儿喂养水平;但对于喂养困难, 需要更加系统和有针对性的措施。

Objective To effectively promote the concept and method of feeding infants scientifically in poor areas, improving the feeding skills and raise the health level of infants. Methods Based on completing the national health education task themed as "the activity of eliminating the infant anemia", the clinical pathway and adult training Methods were used to conduct the multiple trainings on the grass-roots service personnel and the infants' parents;the two indexes, including the feeding index and feeding difficulty of the infants, were used to evaluate the training effect. Results 1) Before and after the training, the feeding indexes of the infants in all age groups were significantly improved.Before training, the feeding indexes of all age groups were lower than those of the urban sample;the indexes of aged 6 to 8 months were lower than those of the rural sample;the indexes of aged 9 to 11 months were similar to those of the rural sample;and the indexes of aged 12 to 24 months were higher than those of the rural sample.After training, the indexes of each age group were higher than those before training.2) Before and after the training, the feeding difficulty in the group aged 9 to 11 months was not significantly improved;and the feeding difficulties of other groups in different ages were improved significantly.The feeding difficulty of aged 9 to 11 months was characterized by the broad coverage and low warning degree;which is based on:there were 14 projects in the questionnaire;and 8 projects in this group had no significant difference; the top score of each item was 7, the scores of this group before and after intervention were 2.61±1.154 and 2.51±1.115 respectively. Conclusions Based on the health education method of the clinical pathway, the feeding situation of the infants can be improved effectively and comprehensively.For the feeing difficulty, it is needed to be more systematic and targeted measures.