B\u1ea1n \u0111\u00e3 bao gi\u1edd t\u1ef1 h\u1ecfi t\u1ea1i sao d\u00f9 ch\u00fang ta bi\u1ebft r\u00f5 vi\u1ec7c t\u1eadp th\u1ec3 d\u1ee5c hay \u0103n u\u1ed1ng l\u00e0nh m\u1ea1nh l\u00e0 t\u1ed1t, nh\u01b0ng vi\u1ec7c duy tr\u00ec nh\u1eefng th\u00f3i quen \u0111\u00f3 l\u1ea1i kh\u00f3 kh\u0103n \u0111\u1ebfn v\u1eady? Ph\u1ea3i ch\u0103ng t\u1ea5t c\u1ea3 ch\u1ec9 n\u1eb1m \u1edf “\u00fd ch\u00ed”? V\u1edbi t\u01b0 c\u00e1ch l\u00e0 m\u1ed9t chuy\u00ean gia truy\u1ec1n th\u00f4ng y t\u1ebf, t\u00f4i mu\u1ed1n chia s\u1ebb v\u1edbi b\u1ea1n r\u1eb1ng: S\u1ee9c kh\u1ecfe kh\u00f4ng ph\u1ea3i l\u00e0 m\u1ed9t \u1ed1c \u0111\u1ea3o t\u00e1ch bi\u1ec7t. Nh\u1eefng l\u1ef1a ch\u1ecdn c\u1ee7a ch\u00fang ta th\u01b0\u1eddng b\u1ecb chi ph\u1ed1i b\u1edfi nh\u1eefng v\u00f2ng xo\u00e1y v\u00f4 h\u00ecnh t\u1eeb m\u00f4i tr\u01b0\u1eddng, c\u00e1c m\u1ed1i quan h\u1ec7 v\u00e0 c\u1ea3 ch\u00ednh s\u00e1ch x\u00e3 h\u1ed9i. \u0110\u1ec3 gi\u1ea3i m\u00e3 s\u1ef1 ph\u1ee9c t\u1ea1p n\u00e0y, ch\u00fang ta c\u1ea7n s\u1eed d\u1ee5ng m\u1ed9t l\u0103ng k\u00ednh chi\u1ebfn l\u01b0\u1ee3c: M\u00f4 h\u00ecnh Sinh th\u00e1i X\u00e3 h\u1ed9i (Social Ecological Model – SEM). \u0110\u00e2y l\u00e0 ch\u00eca kh\u00f3a gi\u00fap ch\u00fang ta hi\u1ec3u r\u1eb1ng \u0111\u1ec3 thay \u0111\u1ed5i h\u00e0nh vi c\u1ee7a m\u1ed9t con ng\u01b0\u1eddi, ch\u00fang ta ph\u1ea3i hi\u1ec3u v\u00e0 t\u00e1c \u0111\u1ed9ng v\u00e0o c\u1ea3 “h\u1ec7 sinh th\u00e1i” \u0111ang bao quanh h\u1ecd.<\/p>\n
\u0110i\u1ec3m \u0111\u1ed9t ph\u00e1 1: “Hi\u1ec7u \u1ee9ng g\u1ee3n s\u00f3ng” – B\u1ea1n kh\u00f4ng s\u1ed1ng trong m\u1ed9t \u1ed1c \u0111\u1ea3o<\/b><\/p>\n
M\u00f4 h\u00ecnh Sinh th\u00e1i X\u00e3 h\u1ed9i kh\u00f4ng ch\u1ec9 \u0111\u01a1n thu\u1ea7n nh\u00ecn v\u00e0o l\u1ed1i s\u1ed1ng c\u00e1 nh\u00e2n m\u00e0 coi s\u1ee9c kh\u1ecfe l\u00e0 k\u1ebft qu\u1ea3 c\u1ee7a s\u1ef1 t\u01b0\u01a1ng t\u00e1c ph\u1ee9c t\u1ea1p gi\u1eefa con ng\u01b0\u1eddi v\u00e0 m\u00f4i tr\u01b0\u1eddng. Theo Trung t\u00e2m Ki\u1ec3m so\u00e1t v\u00e0 Ph\u00f2ng ng\u1eeba D\u1ecbch b\u1ec7nh (CDC):<\/p>\n
“M\u00f4 h\u00ecnh Sinh th\u00e1i X\u00e3 h\u1ed9i hay SEM l\u00e0 m\u1ed9t khung l\u00fd thuy\u1ebft nh\u1eb1m th\u1ea5u hi\u1ec3u c\u00e1c t\u00e1c \u0111\u1ed9ng ph\u1ee9c t\u1ea1p v\u00e0 t\u01b0\u01a1ng t\u00e1c c\u1ee7a c\u00e1c y\u1ebfu t\u1ed1 c\u00e1 nh\u00e2n v\u00e0 m\u00f4i tr\u01b0\u1eddng \u2013 nh\u1eefng y\u1ebfu t\u1ed1 quy\u1ebft \u0111\u1ecbnh c\u00e1c h\u00e0nh vi kh\u00e1c nhau.”<\/p>\n
\u0110i\u1ec3m \u0111\u1ed9t ph\u00e1 c\u1ee7a m\u00f4 h\u00ecnh n\u00e0y n\u1eb1m \u1edf vi\u1ec7c th\u1eeba nh\u1eadn r\u1eb1ng c\u00e1c y\u1ebfu t\u1ed1 x\u00e3 h\u1ed9i v\u00e0 m\u00f4i tr\u01b0\u1eddng ch\u00ednh l\u00e0 “\u0111i\u1ec1u ki\u1ec7n ti\u00ean quy\u1ebft” (prerequisites) \u0111\u1ec3 \u0111\u1ea1t \u0111\u01b0\u1ee3c k\u1ebft qu\u1ea3 s\u1ee9c kh\u1ecfe t\u1ed1t h\u01a1n. Thay v\u00ec ch\u1ec9 \u0111\u01b0a ra nh\u1eefng l\u1eddi khuy\u00ean su\u00f4ng, SEM t\u1eadp trung v\u00e0o vi\u1ec7c t\u1ea1o ra m\u1ed9t h\u1ec7 th\u1ed1ng h\u1ed7 tr\u1ee3 \u0111a t\u1ea7ng, gi\u00fap vi\u1ec7c ph\u00f2ng ng\u1eeba b\u1ec7nh t\u1eadt tr\u1edf n\u00ean kh\u1ea3 thi v\u00e0 b\u1ec1n v\u1eefng h\u01a1n trong th\u1ef1c t\u1ebf \u0111\u1eddi s\u1ed1ng.<\/p>\n
\u0110i\u1ec3m \u0111\u1ed9t ph\u00e1 2: “N\u00fat th\u1eaft” mang t\u00ean C\u00e1 nh\u00e2n – Khi m\u1ecdi th\u1ee9 b\u1eaft \u0111\u1ea7u t\u1eeb t\u00e2m tr\u00ed<\/b><\/p>\n
Trong t\u01b0 duy chi\u1ebfn l\u01b0\u1ee3c y t\u1ebf, c\u1ea5p \u0111\u1ed9 c\u00e1 nh\u00e2n ch\u00ednh l\u00e0 “\u0111i\u1ec3m nh\u1eadp” (entry point) quan tr\u1ecdng nh\u1ea5t. \u0110\u00e2y l\u00e0 n\u01a1i h\u1ed9i t\u1ee5 c\u1ee7a th\u00e1i \u0111\u1ed9, ki\u1ebfn th\u1ee9c v\u00e0 ni\u1ec1m tin. Tuy nhi\u00ean, ch\u00fang ta c\u1ea7n hi\u1ec3u r\u1eb1ng SEM l\u00e0 m\u1ed9t “khung l\u00fd thuy\u1ebft”. Theo \u0111\u1ecbnh ngh\u0129a t\u1eeb t\u1eeb \u0111i\u1ec3n Merriam-Webster, l\u00fd thuy\u1ebft l\u00e0 “m\u1ed9t nguy\u00ean t\u1eafc chung c\u00f3 th\u1ec3 ch\u1ea5p nh\u1eadn \u0111\u01b0\u1ee3c v\u1ec1 m\u1eb7t khoa h\u1ecdc nh\u1eb1m gi\u1ea3i th\u00edch c\u00e1c hi\u1ec7n t\u01b0\u1ee3ng”. N\u00f3 kh\u00f4ng d\u1ef1a tr\u00ean nh\u1eefng s\u1ef1 th\u1eadt b\u1ea5t bi\u1ebfn hay \u00fd ki\u1ebfn c\u00e1 nh\u00e2n, m\u00e0 l\u00e0 m\u1ed9t s\u1ef1 ch\u1ea5p nh\u1eadn chung r\u1eb1ng n\u00f3 c\u00f3 hi\u1ec7u qu\u1ea3. \u0110i\u1ec1u n\u00e0y \u0111\u1ed3ng ngh\u0129a v\u1edbi vi\u1ec7c: m\u1ed9t chi\u1ebfn l\u01b0\u1ee3c t\u1eebng th\u00e0nh c\u00f4ng trong qu\u00e1 kh\u1ee9 kh\u00f4ng \u0111\u1ea3m b\u1ea3o s\u1ebd lu\u00f4n th\u00e0nh c\u00f4ng trong t\u01b0\u01a1ng lai n\u1ebfu ch\u00fang ta kh\u00f4ng th\u1ea5u hi\u1ec3u s\u1ef1 thay \u0111\u1ed5i trong t\u00e2m tr\u00ed con ng\u01b0\u1eddi.<\/p>\n
Nghi\u00ean c\u1ee9u v\u1ec1 vi\u1ec7c ti\u00eam vaccine c\u00fam H1N1 n\u0103m 2009 l\u00e0 m\u1ed9t minh ch\u1ee9ng \u0111\u1eaft gi\u00e1. C\u00e1c nh\u00e0 nghi\u00ean c\u1ee9u k\u1ebft lu\u1eadn r\u1eb1ng d\u00f9 m\u1ecdi c\u1ea5p \u0111\u1ed9 c\u1ee7a SEM \u0111\u1ec1u quan tr\u1ecdng, nh\u01b0ng “b\u1ed9 ba” g\u1ed3m: c\u00e1 nh\u00e2n, li\u00ean c\u00e1 nh\u00e2n v\u00e0 c\u1ed9ng \u0111\u1ed3ng<\/b> m\u1edbi l\u00e0 nh\u1eefng y\u1ebfu t\u1ed1 c\u00f3 t\u00e1c \u0111\u1ed9ng l\u1edbn nh\u1ea5t. C\u00e1 nh\u00e2n kh\u00f4ng t\u1ed3n t\u1ea1i bi\u1ec7t l\u1eadp m\u00e0 “\u0111an xen ch\u1eb7t ch\u1ebd” v\u1edbi t\u1ea5t c\u1ea3 c\u00e1c c\u1ea5p \u0111\u1ed9 kh\u00e1c. N\u1ebfu nh\u1eadn th\u1ee9c c\u1ee7a m\u1ed9t ng\u01b0\u1eddi v\u1ec1 t\u00ednh an to\u00e0n c\u1ee7a vaccine kh\u00f4ng \u0111\u01b0\u1ee3c “\u0111i\u1ec1u ch\u1ec9nh” \u0111\u00fang \u0111\u1eafn ngay t\u1eeb \u0111\u1ea7u, th\u00ec m\u1ecdi n\u1ed7 l\u1ef1c \u1edf c\u1ea5p \u0111\u1ed9 ch\u00ednh s\u00e1ch hay c\u00e1c \u0111i\u1ec1u lu\u1eadt \u0111\u1ec1u tr\u1edf n\u00ean v\u00f4 ngh\u0129a. Thay \u0111\u1ed5i t\u01b0 duy ch\u00ednh l\u00e0 th\u00e1ch th\u1ee9c l\u1edbn nh\u1ea5t v\u00ec n\u00f3 l\u00e0 n\u1ec1n m\u00f3ng \u0111\u1ec3 to\u00e0n b\u1ed9 h\u1ec7 sinh th\u00e1i s\u1ee9c kh\u1ecfe v\u1eadn h\u00e0nh.<\/p>\n
\u0110i\u1ec3m \u0111\u1ed9t ph\u00e1 3: 5 L\u1edbp c\u1ee7a “Chi\u1ebfc b\u00e1nh” s\u1ee9c kh\u1ecfe (B\u00e0i h\u1ecdc t\u1eeb ch\u01b0\u01a1ng tr\u00ecnh t\u1ea7m so\u00e1t ung th\u01b0)<\/b><\/p>\n
\u0110\u1ec3 \u1ee9ng d\u1ee5ng SEM m\u1ed9t c\u00e1ch chi\u1ebfn l\u01b0\u1ee3c, ch\u00fang ta c\u1ea7n can thi\u1ec7p \u0111\u1ed3ng b\u1ed9 v\u00e0o 5 c\u1ea5p \u0111\u1ed9 t\u01b0\u01a1ng t\u00e1c. H\u00e3y nh\u00ecn v\u00e0o c\u00e1ch CDC \u00e1p d\u1ee5ng m\u00f4 h\u00ecnh n\u00e0y trong Ch\u01b0\u01a1ng tr\u00ecnh Ki\u1ec3m so\u00e1t Ung th\u01b0 \u0110\u1ea1i tr\u1ef1c tr\u00e0ng (2013):<\/p>\n
\u0110i\u1ec3m \u0111\u1ed9t ph\u00e1 4: Ngh\u1ecbch l\u00fd c\u1ee7a s\u1ef1 thay \u0111\u1ed5i – T\u1ea1i sao ki\u1ebfn th\u1ee9c l\u00e0 ch\u01b0a \u0111\u1ee7?<\/b><\/p>\n
D\u00f9 l\u00e0 m\u1ed9t m\u00f4 h\u00ecnh \u01b0u vi\u1ec7t, SEM v\u1eabn t\u1ed3n t\u1ea1i nh\u1eefng h\u1ea1n ch\u1ebf m\u00e0 m\u1ed9t nh\u00e0 t\u01b0 v\u1ea5n chi\u1ebfn l\u01b0\u1ee3c ph\u1ea3i \u0111\u1ed1i m\u1eb7t:<\/p>\n
“M\u1ed9t th\u00e1i \u0111\u1ed9 l\u00e0nh m\u1ea1nh c\u00f3 th\u1ec3 l\u00e2y lan, nh\u01b0ng \u0111\u1eebng ch\u1edd \u0111\u1ee3i \u0111\u1ec3 l\u00e2y t\u1eeb ng\u01b0\u1eddi kh\u00e1c. H\u00e3y l\u00e0 ng\u01b0\u1eddi mang m\u1ea7m b\u1ec7nh \u0111\u00f3.” \u2013 Tom Stoppard.<\/p>\n
\u0110i\u1ec3m \u0111\u1ed9t ph\u00e1 5: Ph\u00f2ng b\u1ec7nh “R\u1ebb” h\u01a1n ch\u1eefa b\u1ec7nh – M\u1ed9t g\u00f3c nh\u00ecn kinh t\u1ebf<\/b><\/p>\n
S\u1eed d\u1ee5ng SEM kh\u00f4ng ch\u1ec9 l\u00e0 c\u00e2u chuy\u1ec7n y t\u1ebf m\u00e0 c\u00f2n l\u00e0 m\u1ed9t b\u00e0i to\u00e1n kinh t\u1ebf h\u1ecdc x\u00e3 h\u1ed9i. Vi\u1ec7c \u0111\u1ea7u t\u01b0 v\u00e0o ph\u00f2ng ng\u1eeba v\u00e0 thay \u0111\u1ed5i h\u00e0nh vi \u1edf nhi\u1ec1u c\u1ea5p \u0111\u1ed9 kh\u00e1c nhau gi\u00fap ch\u00fang ta ph\u00e1t hi\u1ec7n b\u1ec7nh s\u1edbm v\u00e0 \u0111i\u1ec1u tr\u1ecb \u0111\u00fang c\u00e1ch. Theo c\u00e1c ph\u00e2n t\u00edch chi\u1ebfn l\u01b0\u1ee3c, chi ph\u00ed \u0111\u1ec3 ng\u0103n ng\u1eeba m\u1ed9t c\u0103n b\u1ec7nh lu\u00f4n th\u1ea5p h\u01a1n nhi\u1ec1u so v\u1edbi chi ph\u00ed c\u1ee9u ch\u1eefa \u1edf giai \u0111o\u1ea1n mu\u1ed9n. Quan tr\u1ecdng h\u01a1n, b\u1eb1ng c\u00e1ch hi\u1ec3u r\u00f5 c\u00e1c y\u1ebfu t\u1ed1 quy\u1ebft \u0111\u1ecbnh s\u1ee9c kh\u1ecfe, ch\u00fang ta kh\u00f4ng ch\u1ec9 ng\u0103n ch\u1eb7n b\u1ec7nh t\u1eadt m\u00e0 c\u00f2n k\u00e9o d\u00e0i nh\u1eefng n\u0103m s\u1ed1ng ch\u1ea5t l\u01b0\u1ee3ng (quality life years)<\/b> cho c\u1ea3 c\u00e1 nh\u00e2n v\u00e0 c\u1ed9ng \u0111\u1ed3ng. \u0110\u00e2y ch\u00ednh l\u00e0 l\u1ee3i nhu\u1eadn b\u1ec1n v\u1eefng nh\u1ea5t c\u1ee7a m\u1ecdi kho\u1ea3n \u0111\u1ea7u t\u01b0 cho s\u1ee9c kh\u1ecfe.<\/p>\n
K\u1ebft lu\u1eadn: Tr\u1edf th\u00e0nh “ng\u01b0\u1eddi v\u1eadn chuy\u1ec3n” cho s\u1ee9c kh\u1ecfe c\u1ee7a ch\u00ednh m\u00ecnh<\/b><\/p>\n
S\u1ee9c kh\u1ecfe c\u1ee7a b\u1ea1n \u0111\u01b0\u1ee3c \u0111\u1ecbnh h\u00ecnh b\u1edfi m\u1ecdi th\u1ee9: t\u1eeb th\u1ef1c ph\u1ea9m b\u1ea1n \u0103n, kh\u00f4ng kh\u00ed b\u1ea1n th\u1edf, \u0111\u1ebfn c\u00e1ch b\u1ea1n th\u1ea5u hi\u1ec3u v\u00e0 v\u1eadn d\u1ee5ng c\u00e1c ch\u00ednh s\u00e1ch y t\u1ebf t\u1ea1i \u0111\u1ecba ph\u01b0\u01a1ng. Hi\u1ec3u v\u1ec1 M\u00f4 h\u00ecnh Sinh th\u00e1i X\u00e3 h\u1ed9i gi\u00fap ch\u00fang ta tho\u00e1t kh\u1ecfi c\u00e1i nh\u00ecn h\u1ea1n h\u1eb9p v\u1ec1 “\u00fd ch\u00ed c\u00e1 nh\u00e2n” \u0111\u1ec3 th\u1ea5y \u0111\u01b0\u1ee3c b\u1ee9c tranh l\u1edbn h\u01a1n c\u1ee7a h\u1ec7 sinh th\u00e1i s\u1ee9c kh\u1ecfe.<\/p>\n
Khi b\u1ea1n n\u1eafm b\u1eaft \u0111\u01b0\u1ee3c c\u00e1c y\u1ebfu t\u1ed1 quy\u1ebft \u0111\u1ecbnh h\u00e0nh vi, b\u1ea1n c\u00f3 kh\u1ea3 n\u0103ng t\u1ef1 ph\u1ea3n chi\u1ebfu v\u00e0 t\u01b0 duy ph\u1ea3n bi\u1ec7n \u0111\u1ec3 b\u1ea3o v\u1ec7 ch\u00ednh m\u00ecnh. V\u1eady, b\u1ea1n \u0111\u00e3 s\u1eb5n s\u00e0ng \u0111\u1ec3 tr\u1edf th\u00e0nh “ng\u01b0\u1eddi v\u1eadn chuy\u1ec3n” nh\u1eefng th\u00e1i \u0111\u1ed9 t\u00edch c\u1ef1c v\u00e0 ch\u1ee7 \u0111\u1ed9ng thay \u0111\u1ed5i v\u00f2ng xo\u00e1y s\u1ee9c kh\u1ecfe c\u1ee7a ch\u00ednh m\u00ecnh hay ch\u01b0a?<\/p>\n","protected":false},"excerpt":{"rendered":"
B\u1ea1n \u0111\u00e3 bao gi\u1edd t\u1ef1 h\u1ecfi t\u1ea1i sao d\u00f9 ch\u00fang ta bi\u1ebft r\u00f5 vi\u1ec7c t\u1eadp th\u1ec3 d\u1ee5c hay \u0103n u\u1ed1ng l\u00e0nh m\u1ea1nh l\u00e0 t\u1ed1t, nh\u01b0ng vi\u1ec7c duy tr\u00ec nh\u1eefng th\u00f3i quen \u0111\u00f3 l\u1ea1i kh\u00f3 kh\u0103n \u0111\u1ebfn v\u1eady? Ph\u1ea3i ch\u0103ng t\u1ea5t c\u1ea3 ch\u1ec9 n\u1eb1m \u1edf “\u00fd ch\u00ed”? V\u1edbi t\u01b0 c\u00e1ch l\u00e0 m\u1ed9t chuy\u00ean gia truy\u1ec1n th\u00f4ng […]\n","protected":false},"author":1,"featured_media":145,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[30,21],"tags":[33],"class_list":["post-144","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-c4-ung-dung-mo-hinh-sinh-thai-xa-hoi","category-hoc-ve-y-te-cong-cong","tag-mo-hinh-sinh-thai-xa-hoi"],"yoast_head":"\n