摘要: 目的：基于家庭健康管理视角构建社区居民幽门螺杆菌(Hp)感染防控能力评价体系，评价社区居民Hp感染防控能力水平并分析其影响因素，为基层开展以家庭为单位的Hp综合防控提供评价工具和实践依据。方法：以知信行(KAP)理论和家庭聚集防控理念为基础，通过文献分析和两轮Delphi专家咨询筛选评价条目，采用层次分析法(AHP)确定指标权重，构建幽门螺杆菌感染防控能力评分(HPCS)体系。于2026年2~6月采用便利抽样方法选取上海市某社区223户常住家庭的310名成年居民进行横断面调查。采用Cronbach’s
α系数评价内部一致性，探索性因子分析(EFA)和验证性因子分析(CFA)评价结构效度；以家庭为聚类单位，采用广义估计方程(GEE)分析高防控能力的影响因素，并采用ROC曲线评价模型区分效能。结果：两轮Delphi专家咨询后形成包含Hp防控知识、家庭防控行为和家庭健康管理3个一级维度、29个二级条目的HPCS评价体系，3个维度权重分别为0.342、0.371和0.287，一致性检验结果显示判断矩阵具有较好一致性。HPCS总量表Cronbach’s
α系数为0.893，各维度
α系数均>0.800。EFA显示KMO = 0.900，Bartlett球形检验
χ2 = 3531.69 (df = 406, P < 0.001)，提取3个公因子，累计方差解释率为40.79%；CFA模型拟合良好，
χ2 = 186.700，df = 167，P = 0.141，CFI = 0.993，TLI = 0.992，RMSEA = 0.020，SRMR = 0.034。310名居民HPCS总分为(66.94 ± 9.84)分，其中69人(22.3%)达到高防控能力水平。GEE分析显示，大专学历(OR = 1.72, 95% CI: 1.13~2.62, P = 0.011)、本科及以上学历(OR = 1.76, 95% CI: 1.15~2.69, P = 0.009)、签约家庭医生(OR = 2.00, 95% CI: 1.05~3.78, P = 0.034)及经常接受Hp健康教育(OR = 1.71, 95% CI: 1.02~2.87, P = 0.040)是高防控能力的独立保护因素。模型ROC曲线下面积为0.728。结论：初步构建的HPCS评价体系具有较好的内部一致性，并获得了一定的初步结构效度证据，可用于社区居民家庭Hp感染防控能力的初步评价；但其知识维度收敛效度及量表结构的跨样本稳定性仍需进一步验证。社区居民Hp感染防控能力总体处于中等水平，家庭健康管理能力相对不足。高学历、签约家庭医生和持续接受Hp健康教育与较高的Hp感染防控能力相关。基层Hp防控应关注家庭聚集特征，依托家庭医生团队开展家庭风险识别、健康教育和连续健康管理，促进Hp防控由个体管理向家庭单元管理转变。
Abstract: Objective: To establish an evaluation system for community residents’ capacity to prevent and control Helicobacter pylori (Hp) infection from a family health management perspective; to assess the level of this capacity among community residents and analyze its influencing factors; and to provide an evaluation tool and practical basis for primary-level institutions to implement comprehensive, family-based Hp prevention and control. Methods: Based on the knowledge-attitude-practice (KAP) theory and the concept of family-based prevention and control, evaluation items were selected through literature review and two rounds of Delphi expert consultation. The Analytic Hierarchy Process (AHP) was used to determine indicator weights, and the Helicobacter pylori Prevention Capacity Score (HPCS) system was developed. From February to June 2026, a cross-sectional survey was conducted among 310 adult residents from 223 permanent households in the service area of a community health service center in Shanghai, selected using convenience sampling. Cronbach’s α was used to assess internal consistency, while exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) were employed to evaluate construct validity; chi-square tests and independent-samples t-tests were used for univariate analysis; with the household as the cluster unit, generalized estimating equations (GEE) with an exchangeable correlation structure were employed to analyze the determinants of high prevention and control capacity, and receiver operating characteristic (ROC) curves were used to evaluate the model’s discriminatory performance. Results: Following two rounds of Delphi expert consultation, the HPCS evaluation system was developed, comprising three first-order dimensions—HP prevention and control knowledge, family prevention and control behaviors, and family health management—and 29 second-order items. The weights of the three dimensions were 0.342, 0.371, and 0.287, respectively. Consistency test results indicated that the judgment matrix exhibited good consistency. The Cronbach’s α coefficient for the total HPCS scale was 0.893, and the α coefficients for each dimension were all >0.800. EFA results showed KMO = 0.900 and Bartlett’s sphericity test χ2 = 3531.69 (df = 406, P < 0.001); three common factors were extracted, explaining 40.79% of the cumulative variance; The CFA model fit was good, with χ2 = 186.700, df = 167, P = 0.141, CFI = 0.993, TLI = 0.992, RMSEA = 0.020, and SRMR = 0.034. The mean HPCS total score for the 310 residents was (66.94 ± 9.84) points, with 69 individuals (22.3%) reaching a high level of prevention and control capability. GEE analysis showed that having a college degree (OR = 1.72, 95% CI: 1.13~2.62, P = 0.011), a bachelor’s degree or higher (OR = 1.76, 95% CI: 1.15~2.69, P = 0.009), having a contracted family doctor (OR = 2.00, 95% CI: 1.05~3.78, P = 0.034), and frequent participation in Hp health education (OR = 1.71, 95% CI: 1.02~2.87, P = 0.040) were independent protective factors for high prevention and control capacity. The area under the ROC curve for the model was 0.728. Conclusion: The preliminarily constructed HPCS evaluation system exhibits favorable internal consistency and yields preliminary evidence of structural validity, rendering it applicable for the initial assessment of household Hp infection prevention and control capacity among community residents. Nevertheless, the convergent validity of the knowledge dimension and the cross-sample stability of the scale structure warrant further verification. Overall, the Hp infection prevention and control capacity of community residents are at a moderate level, with relative inadequacy in family health management capacity. Higher educational attainment, contracted family doctor services, and sustained receipt of Hp health education are associated with higher Hp infection prevention and control capacity. Primary-level Hp prevention and control should focus on the characteristics of family clustering, rely on family doctor teams to carry out household risk identification, health education, and continuous health management, and promote the transformation of Hp prevention and control from individual management to family unit management.