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Abstract：
Knowledge, Attitude, and Practice (KAP) survey, as an effective measure tool, is of practical significance for identifying the susceptible population in high-incidence regions of tuberculosis (TB). We aim to identify the health education targeted susceptible population of TB and discuss the acting pathway of KAP in Ningxia. A multistage random sampling method was used to conduct a face-to-face questionnaire survey for residents. The latent class analysis (LCA) model was used to classify susceptible populations of TB, and the structural equation modeling (SEM) model was also employed to investigate the interaction mechanisms of KAP (mediation analysis). We further applied the ordered logistic regression model to explore the associated factors. A total of 973 residents were enrolled, 70.6% were male, aged from 16 to 89. The LCA analysis demonstrated that 3 categories of susceptible populations of TB (\"overall good\", \"positive attitude\" and \"overall poor\") have optimal goodness of fit (BIC = 7889.5, Entropy = 0.923). SEM model indicated that the attitude plays a significant mediation effect from knowledge to practice toward TB (an indirect effect of 0.038, and a direct effect of 0.138). The ordered logistic regression results found that age, sex, marital status, education level, occupation, family income, self-perceived health status, having a family member or friend with TB, and knowing the DOTS strategy were significantly associated with classifications of KAP level towards TB. Based on the LCA model, we accurately classified the susceptible population of TB into 3 groups with different degrees of KAP. We found that TB attitude plays a mediating role between knowledge and practice. Therefore, we should pay more attention and carry out targeted health education in the community to these populations with overall poor KAP towards TB, and develop effective strategies and measures to realize the End TB Plan.
摘要：
知识,态度,和实践（KAP）调查，作为一种有效的测量工具，对于确定结核病高发地区的易感人群具有现实意义。目的明确宁夏结核病易感人群的健康教育目标,探讨KAP的作用途径。采用多阶段随机抽样方法对居民进行面对面问卷调查。利用潜在类别分析(LCA)模型对结核病易感人群进行分类,并采用结构方程模型（SEM）模型研究了KAP（中介分析）的相互作用机制。我们进一步应用有序逻辑回归模型来探索相关因素。共有973名居民入组,70.6%为男性，年龄从16岁到89岁。LCA分析表明，结核病的3类易感人群(“总体良好”，“积极的态度”和“整体差”）具有最佳的拟合优度（BIC=7889.5，熵=0.923）。SEM模型表明，态度对结核病具有从知识到实践的显着中介作用（间接作用为0.038，直接作用为0.138）。有序逻辑回归结果发现，年龄，性别,婚姻状况,教育水平,职业,家庭收入,自我感知的健康状况，有一个家庭成员或朋友患有结核病，并且知道DOTS策略与结核病的KAP水平分类显着相关。基于LCA模型，我们准确地将结核病易感人群分为3组不同程度的KAP。我们发现结核病态度在知识和实践之间起着中介作用。因此,我们应该更加关注并在社区开展有针对性的健康教育，并制定有效的战略和措施来实现《终结结核病计划》。
