中国学校卫生

Cultivating digital literacy to mitigate the harm of excessive smartphone use among adolescents

LI Xiuhong

2025, 46(5): 609-613. doi: 10.16835/j.cnki.1000-9817.2025152

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Smartphones are a double-edged sword, bringing convenience and access to new social resources for learning, social interaction, and entertainment, they also bring risks and problems such as smartphone addition, cybersecurity threats and cyberbullying. The study reviews the pros and cons of adolescent smartphone use and proposes the urgent need to enhance digital literacy. It suggests strengthening smartphone management across four levels—individual, family, school, and society, to provide comprehensive, multi-layered support and guidance for adolescents in developing healthy smartphone usage habits.

International experiences and implications of digital-empowered adolescent mental health services

YANG Juan, ZHU Feifei

2025, 46(5): 614-618. doi: 10.16835/j.cnki.1000-9817.2025157

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The accelerated development of digital technology has brought new opportunities for the innovation of adolescent mental health service models. Through international case analysis, the paper finds that developed countries have established adolescent mental health service systems with significant digital-empowerment characteristics. For example, the Crisis Text Line of US realizes risk-graded responses by relying on language processing technology, the Kooth platform of UK develops an Artificial Intelligence (AI) counseling system using cognitive-behavioral therapy, ReachOut of Australia has established a digital mental health resource library, SPARX of New Zealand reshapes the treatment experience with a gamified interface, and "Annie Advisor" of Finland pioneers the application of affective computing technology. The above innovative practices present six characteristics: precision service supply based on big data, intervention systems integrated with artificial intelligence, anonymous mechanisms to ensure privacy and security, highly accessible services that break through time and space limitations, human-machine collaborative dual track support models, and interdisciplinary service systems, providing many references and implications for China to continuously and deeply explore digital technology-empowered youth mental health services.

Association between negative life events and smartphone addiction among middle school students

SU Xintong, ZHAO Jingxian, FU Jiaxuan, YANG Kaize, GONG Ranran, LIN Xinyun, WANG Daosen, TANG Jie, CHEN Qifei, LIU Chuang, LI Xiuhong

2025, 46(5): 619-623. doi: 10.16835/j.cnki.1000-9817.2025153

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Objective To explore the association between negative life events and smartphone addiction among middle school students, so as to provide theoretical support and practical guidance for prevention and intervention of smartphone addiction among middle school students. Methods Using cluster sampling, 8 890 students were selected to survey from 27 junior high schools and 3 senior high schools in a district of Shenzhen in 2022 (baseline) and 2023 (follow-up). Data were collected through self-resigned questionnaires on basic information, the Smartphone Addiction Scale-Short Version, and the Adolescent Self-rating Life Events Checklist. Mixed-effects models were employed to analyze the association. Results Compared to 2022, the punishment scores of middle school students in 2023 [1.00(0.00, 6.00) and 1.00(0.00, 6.00)] decreased (Z=4.27), while the scores of interpersonal stress, learning stress and adaptation [4.00(0.00, 8.00), 4.00(0.00, 8.00); 4.00(1.00, 8.00), 5.00(2.00, 9.00); 2.00(0.00, 6.00), 3.00(0.00, 7.00)] increased (Z=-3.04, -8.36, -6.80) (P < 0.01). Mixed-effects models revealed a positive dose-response relationship between negative life events and smartphone addiction (OR=1.08-1.17, P < 0.01). Stepwise regression showed independent positive effects of interpersonal stress (OR=1.05), academic stress (OR=1.03), and adaptation stress (OR=1.11) on smartphone addiction (P < 0.01). Subgroup analysis of non-addicted students in 2022 confirmed persistent associations for academic stress (OR=1.03) and adaptation (OR=1.07) (P < 0.01). Conclusion Negative life events exhibit a positive dose-response relationship with smartphone addiction, particularly interpersonal stress, academic stress, and adaptation-related events.

Development trajectory of mobile phone dependence in middle school students and its association with loneliness and self-control

LUO Xiangyu, ZHANG Tiancheng, WANG Aolun, ZHANG Fulan, LIU Yang, YAN Chuqi, CHEN Ziyi

2025, 46(5): 624-629. doi: 10.16835/j.cnki.1000-9817.2025155

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Objective To analyze the heterogeneity of mobile phone dependence development trajectory in middle school students and its association with loneliness and self-control ability, so as to provide reference for the prevention of mobile phone dependence in middle school students. Methods A total of 941 grade 1 students from 4 public middle schools in Xiangxi Autonomous Prefecture, Hunan Province were selected for the follow-up survey by random cluster sampling from October 2023 to April 2024 and October 2024. Mobile Phone Addiction Index (MPAI), University of California, Los Angeles Loneliness Scale-20 (UCLA-20) and Self-control Scales (SCS) were used for questionnaire survey. The heterogeneity of the developmental trajectory of middle school students' mobile phone dependence was analyzed by the latent growth curve model (LGMM), and the influencing factors of the developmental trajectory of middle school students' mobile phone dependence were explored by multiple Logistic regression analysis. Results The development trajectory of middle school students mobile phone dependence could be divided into four categories: C1 "low risk slow decline group (n=438, 44.6%)", C2 "medium risk slow rise group (n=272, 29.7%)", C3 "high risk rapid decline group (n=73, 8.6%)" and C4 "high risk rapid rise group (n=158, 17.1%)". There were significant differences in the distribution of mobile phone dependence development track heterogeneity subgroups among sex, only child, lodging, and left-behind students (χ²=117.79, 44.88, 37.09, 130.50, P < 0.01). The results of the multinomial Logistic regression model analysis showed that, with C1 group as the reference, C2, C3, and C4 were positively correlated with students loneliness [OR (95%CI)=1.04 (1.02-1.06), 1.11 (1.08-1.14), 1.12 (1.09-1.14)]; C2 and C4 groups were negatively correlated with students self-control [OR(95%CI)=0.97(0.96-0.99), 0.95(0.93-0.97)] (P < 0.01). Conclusions The development trajectory of mobile phone dependence among middle school students is heterogeneous. Reducing the loneliness of individuals and cultivating good self-control ability are helpful to alleviate mobile phone dependence behavior among middle school students.

Longitudinal association between only-child status and smartphone addiction in middle school students

YANG Kaize, WANG Daosen, FU Jiaxuan, SU Xintong, ZHAO Jingxian, GONG Ranran, LIN Xinyun, LIU Chuang, LI Xiuhong

2025, 46(5): 630-633. doi: 10.16835/j.cnki.1000-9817.2025138

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Objective To explore the longitudinal association between only-child status and smartphone addiction among middle school students, so as to provide a basis for establishing family intervention measures for smartphone addiction in middle school students. Methods In October 2022 and October 2023, a preliminary survey and follow-up were conducted among 8 759 middle and high school students from 30 schools in a district of Shenzhen. A self-designed questionnaire was used to determine whether the students were the only-child, and the Chinese Version of the Smartphone Addiction Scale-Short Version (C-SAS-SV) was utilized to assess the students' smartphone addiction status. A multilevel mixed-effects model and subgroup analysis were applied to examine the association between only-child status and smartphone addiction among middle school students. Results During 2022 to 2023, the prevalence of smartphone addiction in the cohort of middle school students increased from 24.1% to 25.2%. Compared with only-child, non-only child were more likely to be addicted to smartphones (adjusted model: OR=1.2, 95%CI=1.1-1.4) and also scored higher on smartphone addiction (adjusted model: β=0.9, 95%CI=0.2-1.5)(P < 0.05). Subgroup analysis further revealed that compared to baseline, non-only child demonstrated an increased prevalence of smartphone addiction (adjusted model: OR=1.2, 95%CI=1.0-1.5) and higher addiction scores (adjusted model: β=0.8, 95%CI=0.2-1.5) after one year(P < 0.05). Conclusions Non-only child face higher risk of smartphone addiction. Under the current population policy, it is crucial to address smartphone addiction among middle school students who is not only child.

Association between physical exercise behavior with mobile phone addiction and mental health of college students

LIU Manluo, QI Xin, WU Min, SUN Qin, ZHAO Zhen

2025, 46(5): 634-637. doi: 10.16835/j.cnki.1000-9817.2025159

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Objective To explore the relationship of physical exercise behavior with mobile phone addiction and mental health of college students, so as to provide evidence for interventions to improve mobile phone addiction and mental health of college students. Methods From October 8 to December 20 in 2024, 896 college students from 4 colleges in Beijing were selected using a combination of convenience sampling and stratified random cluster sampling method. Physical Activity Rating Scale (PARS-3), Mobile Phone Addiction Tendency Scale (MPATS), Adolescence Mental Health Diathesis Questionnaire (AMHDQ) and Symptom Checklist 90 (SCL-90) were used. The correlation of mobile phone addiction and mental health on physical exercise behavior of college students were analyzed by multivariable Logistic regression and linear regression. Results Among the surveyed college students, 504 (56.25%) students had low exercise, 262 (29.24%) had moderate exercise, 130 (14.51%) had high exercise, and 392 (43.75%) had sufficient exercise. The total score of PARS-3 was 18.00 (15.00, 33.00) points. Logistic regression analysis showed that the total score of MPATS (OR=1.022, 95%CI=1.008-1.036), the total score of SCL-90 (OR=1.010, 95%CI=1.005-1.015), the total AMHDQ score (OR=0.995, 95%CI=0.992-0.998) were significantly associated with insufficient exercise among college students (P < 0.05). Linear regression analysis showed that the scores of MPATS, AMHDQS and SCL-90 were significantly correlated with physical exercise behavior (B=-0.20, 0.04, -0.07, P < 0.05). Conclusion The physical exercise behavior of college students is related to mobile phone addiction and mental health.

Longitudinal association between compulsive behaviour and smartphone addiction in middle school students

CHEN Qifei, WANG Daosen, GONG Ranran, LIN Xinyun, SU Xintong, ZHAO Jingxian, FU Jiaxuan, YANG Kaize, TANG Jie, CHEN Shihua, LI Xiuhong

2025, 46(5): 638-641. doi: 10.16835/j.cnki.1000-9817.2025150

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Objective To explore the potential causal association between adolescent compulsive behaviour and smartphone addiction based on longitudinal data, so as to provide reference for the establishment of adolescent smartphone addiction interventions. Methods A preliminary survey and follow-up were conducted on 8 907 middle and high school students in a district of Shenzhen in 2022 and 2023, respectively. Compulsive behaviours were measured by using the Mental Health Inventory for Middle School Students-60 Items (MMHI-60), smartphone addiction was assessed by using the Smartphone Addiction Scale-Short Version (SAS-SV), and the associations between compulsive behaviours and smartphone addiction were analysed by using multilevel mixed-effects models and subgroup analyses. Results Smartphone addiction detection rates among middle school students were significantly associated with genders, father's education level, mother's education level, study load subgroups, and whether or not they were single-parent families, and there were statistical differences (χ²=17.21-175.34, P < 0.05). Students with compulsive behaviours were 2.98 times more likely to develop smartphone addiction than those without compulsive behaviours (OR=2.98, 95%CI=2.77-3.22, P < 0.05). Subgroup analysis of middle school students without smartphone addiction in the first year found that compulsive behaviours significantly predicted smartphone addiction (OR=1.76, 95%CI=1.54-2.01, P < 0.05). Conclusion There is a potential causal association between obsessive-compulsive behaviours and smartphone addiction in middle school students, and obsessive-compulsive behaviours in middle school students could significantly predicted the occurrence of smartphone addiction.

Association of dining locations with nutritional status among Chinese children aged 6-17 years

FU Yimeng, GAN Qian, YANG Titi, XU Juan, XU Peipei, CAO Wei, WANG Hongliang, LUO Ruihe, PAN Hui, WANG Zhifang, SUN Wenxin, YANG Zhenyu, ZHAO Wenhua, ZHANG Qian

2025, 46(5): 642-646. doi: 10.16835/j.cnki.1000-9817.2025112

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Objective To analyze the association of eating dining locations and their association with nutritional status among Chinese children aged 6-17 years, so as to provide reference for guiding children's reasonable diet. Methods Stratified random cluster sampling was used to select children aged 6 to 17 years from 28 cities and rural areas of 14 provinces in East, North, Central, South, Southwest, Northwest, Northeast of China, and a total of 52 535 children were included in the study from 2019 to 2021. Information including dining locations, demographic characteristics, dietary intakes and physical activity were collected through a questionnaire survey. Fasting body height and weight were measured in the morning. Unordered multiclass Logistic regression analysis was conducted to assess the relationship between dining locations and nutritional status in children. Results Regarding children's dining locations, 66.3% ate breakfast at home, 25.8% ate breakfast at school, 7.9% ate breakfast outside (small dining tables, restaurants, stalls, etc.); 67.7% ate dinner at home, 29.0% ate dinner at school, 3.3% ate dinner outside; and 63.6% ate lunch at school, 30.8% ate lunch at home, 5.7% ate lunch outside. The prevalence rates of overweight/obesity and undernutrition were 28.6% and 9.3%, respectively. The adjusted multiclass Logistic regression analysis (controlling for age, region, parental education, household income, total energy intake, and moderate-to-vigorous physical activity) demonstrated that, compared to eating at home, school-based breakfast and dinner consumption was associated with significantly lower overweight/obesity risks for both genders (boys: breakfast OR=0.70, 95%CI=0.65-0.75; dinner OR=0.80, 95%CI=0.74-0.86; girls: breakfast OR=0.89, 95%CI=0.82-0.96; dinner OR=0.88, 95%CI=0.81-0.95), whereas eating lunch away from home significantly increased overweight/obesity risks (boys: OR=1.32, 95%CI=1.17-1.48; girls: OR=1.43, 95%CI=1.26-1.62), with all associations being statistically significant (P < 0.05). After adjusting for confounding factors, boys who ate breakfast away from home showed a significantly reduced risk of undernutrition (OR=0.80, 95%CI=0.66-0.97), while those consuming lunch away from home had an increased risk (OR=1.26, 95%CI=1.01-1.57) (P < 0.05). Conclusions The choice of dining locations for children is becoming more diverse, and a relatively high proportion of children eat meals outside the home and at school. Eating out have a higher risk of malnutrition for children. School feeding may be beneficial to children's physical health.

Vitamin D and ferritin nutritional status among primary and secondary school students in the key nutrition monitoring counties of Xinjiang

Najimai·Maimaitiaili, Daniel·Abuduwaili, DENG Xixi, Aiyireti·Maimaiti, LIN Qin, XIA Rongxiang, ZHE Wei

2025, 46(5): 647-650. doi: 10.16835/j.cnki.1000-9817.2025133

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Objective To analyze the relationship between vitamin D and ferritin nutritional status with physical indicators in primary and secondary school students in the key nutrition monitoring counties of Xinjiang, so as to provide reference for early prevention and intervention of students' nutrition issues. Methods From November to December 2023, 1 071 students aged 6-18 from key nutrition monitoring counties in the Xinjiang Nutrition Improvement Plan area were selected via stratified random sampling for physical and biochemical tests. The U test and Kruskal-Wallis H test were used to compare the differences in physical indicators and the distribution of vitamin D and ferritin levels. Chi-square test was used to compare the prevalence of vitamin D and ferritin deficiencies among different groups of primary and secondary school students. Pearson correlation was used to analyze the relationship between the nutritional levels of vitamin D and ferritin and physical indicators. Results The median vitamin D level was 14.7 (10.7, 19.0)ng/mL, with deficiency and insufficiency rates of 30.8% and 37.4% among primary and secondary school students in the key nutrition monitoring counties of Xinjiang Nutrition Improvement Plan area. Ferritin levels were 57.4 (37.7, 83.9)μg/L, with a deficiency rate of 5.7%. Males, primary school students, and rural residents had higher vitamin D and ferritin levels than females, secondary school students, and urban residents (U=-11.35, -6.88, -4.52; -3.94, -9.17, -5.23, P < 0.05). Vitamin D deficiency was more prevalent in females, secondary school students, and urban students (χ²=97.52, 49.01, 21.89, P < 0.05), while ferritin deficiency was higher in primary school students and urban areas (χ²=34.11, 5.63, P < 0.05). Significant differences in body mass index (BMI) and waist circumstance (WC) were observed across vitamin D/ferritin statuses (U/H=35.47, 22.82; -4.19, -5.36, P < 0.05). Vitamin D and ferritin levels negatively correlated with age, BMI, and WC but positively with waist-to-height ratio (WHtR) (r=-0.31, -0.19, -0.19, 0.20; -0.32, -0.13, -0.21, 0.08, P < 0.05). Conclusions Vitamin D and ferritin levels in primary and secondary school students in key nutritional monitoring counties in Xinjiang are correlated with age, BMI, WC and WHtR, and there are nutrient deficiencies. Targeted measures are recommended to improve nutritional status and physical health.

Analysis of the nutritional status and influencing factors of Tibetan and Mongolian children and adolescents in Golmud City, Qinghai Province in 2022

GAZANG Zhuoma, ZHOU Keting, ZHAO Lei, ZHANG Bin, JIAN Wenxiu, NUO Gan, MENG Xiangyang, LI Tiemei, WANG Youfa, PENG Wen

2025, 46(5): 651-656. doi: 10.16835/j.cnki.1000-9817.2025136

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Objective To investigate the nutritional status and influencing factors among Tibetan and Mongolian children and adolescents aged 7-18 years in high-altitude regions, so as to provide evidence for early prevention and control of malnutrition in this population. Methods From May to June 2022, a cluster sampling method was employed to recruit 1 019 Tibetan and Mongolian children and adolescents aged 7-18 years from two primary and secondary schools in Golmud City. Physical examinations, dietary frequency questionnaires, and physical activity assessments were conducted. Nutritional status was classified as obesity, combined overweight/obesity, underweight, or central obesity according to national standards including Screening for Overweight and Obesity among School-age Children and Adolescents, Screening Standard for Malnutrition of School-age Children and Adolescents, Blue Book on Obesity Prevention and Control in China. Chi-square tests, t test and Logistic regression analyses were performed to identify factors associated with different nutritional statuses. Results The detection rates of obesity, combined overweight/obesity, underweight, and central obesity were 8.0%, 18.1%, 5.2%, and 19.7%, respectively. The height of children and adolescents across all age groups was generally lower than the national standard values. Tibetan participants exhibited significantly lower height-for-age Z-scores (HAZ)(9-10, 13-17 years, Z=2.01, 2.78, 4.16, 3.38, 4.12, 3.63, 3.00) and BMI-for-age Z-scores (BAZ) compared to Mongolian participants (Z=-2.95, -2.47, -2.31, -2.89, -2.14, -2.17)(P < 0.05). Multivariate Logistic regression revealed that Mongolian children and adolescents had higher risks of obesity (OR=2.20) and combined overweight/obesity (OR=2.18) (P < 0.05). Additionally, insufficient moderate-to-vigorous physical activity (MVPA) was associated with an increased risk of central obesity (OR=1.48, P < 0.05), compared with children and adolescents who meet the standard of MVPA. Conclusions The rates of overweight and obesity among Tibetan and Mongolian children and adolescents in Golmud City are higher, influenced by multiple factors. Nutrition interventions and physical activity strategies tailored to ethnic characteristics should be implemented, with emphasis on promoting MVPA to improve nutritional outcomes in this population.

Impact of peer dating behavior and cohabitation with parents on sexual behaviors among secondary vocational school students

JIA Xin, FANG Yuhang, JIN Yan, ZUO Xiayun, YU Chunyan, LIAN Qiguo, LI Lihe, HONG Ping, TU Xiaowen

2025, 46(5): 657-661. doi: 10.16835/j.cnki.1000-9817.2025143

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Objective To understand the moderating effect of cohabitation with parents on the association between peer dating behavior and sexual behaviors among secondary vocational school students, so as to provide a scientific basis for preventing sexual behaviors among secondary vocational school students. Methods From March to April 2021, an electronic questionnaire survey was conducted among 3 180 students from 6 vocational schools in Shanghai (urban, suburban, exurban) and Shaanxi (Shangluo, Ankang, Baoji) using cluster sampling. Spearman correlation analysis was used to investigate the relationship of cohabitation with parents, peer dating behavior and sexual behaviors among secondary vocational school students. Binary Logistic regression analysis was performed to investigate the role of cohabitation with parents on peer dating behavior and sexual behaviors among secondary vocational students. Results There was a significant negative between cohabitation with parents and sexual (r=-0.04); and there was a positive correlation between peer dating behavior and sexual behaviors (r=0.24), as well as cohabitation with parents and peer dating behavior (r=0.04)(P < 0.05). Multivariable Logistic regression analysis showed an association between peer dating behavior and the occurrence of sexual behaviors (OR=2.79-12.95, P < 0.05). Cohabitation with parents played a moderating role in the association between peer dating behavior and sexual behaviors, and a signification interaction was found between cohabitation with parents and reporting that a small part or about half of their peers had dating behavior (OR=0.48, P < 0.05). Conclusions The more peers' dating behavior are associated with a higher risk of sexual behaviors among secondary vocational school students, and cohabitation with parents can partly reduce this risk. School and family sexuality education for secondary vocational students should be strengthened to improve their interpersonal skills and decision-making, and ability to resist peer pressure, so as to reduce their risk of sexual behaviors.

Alternative benefits of 24-hour activity behavior on the physical shape and cardiorespiratory endurance of middle school students with central obesity

LI Hui, WANG Le

2025, 46(5): 662-666. doi: 10.16835/j.cnki.1000-9817.2024329

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Objective To investigate the health benefits of 24-hour activity behavioral changes on the physical shape and cardiorespiratory endurance of middle school students with central obesity, so as to provide a basis for improving the health status of middle school students with central obesity. Methods From October to December 2022, a total of 362 middle school students with central obesity were recruited from 4 middle schools (2 senior high schools and 2 junior high schools) in Dalian by using the random number table method. The 24-hour activity behavior was understood using the International Physical Activity Questionnaire short form and Pittsburgh Sleep Quality Index. The height, weight, waist circumference, body fat percentage, lung capacity, heart function index, maximum oxygen uptake (VO_2max) of the subjects were measured, and body mass index (BMI) and waist-to-height ratio (WHtR) were calculated. Physical shape and cardiorespiratory endurance indicators were normalized, and the component regression was used to explore the correlation between 24-hour activity behavior and physical shape, as well as cardiorespiratory endurance; finally, an isochronous replacement model was established. Results The results of the component regression showed that sleep of the participants was positively correlated with BMI, waist circumference, and WHtR (β=2.35, 5.21, 0.01); and sedentary behavior (SB) was negatively correlated with lung capacity and VO_2max (β=-392.45, -1.01), and positively correlated with BMI, waist circumference, WHtR, body fat percentage and cardiac function index (β=4.67, 5.10, 0.14, 3.53, 0.29) (P < 0.05). Low physical activity (LPA) was negatively correlated with BMI, WHtR, body fat percentage and cardiac function index (β=-2.03, -3.70, -0.82), and positively correlated with lung capacity and VO_2max (β=322.23, 0.50) (P < 0.05). Moderate-to-vigorous physical activity (MVPA) had a negative correlation with BMI, waist circumference, WHtR, body fat percentage and heart function index (β=-0.48, -1.20, -0.20, -4.53, -1.12), and a positive correlation with lung capacity and VO_2max (β=393.13, 1.51) (P < 0.05). Increasing MVPA for 30 minutes while reducing SB resulted in a decrease of 0.17-2.05 units in BMI, waist circumference, WHtR, body fat percentage and heart function index, and an increase of 0.38-0.43 units in lung capacity and VO_2max (P < 0.05). When MVPA was replaced by SB, the negative benefits were the greatest, with BMI, waist circumference, WHtR, body fat percentage and heart function index increasing by 0.23-3.06 units (P < 0.05). Conclusions Shifts in the 24-hour behavior pattern among obese middle school students may result in significant health benefits. Increasing MVPA by 30 minutes per day while reducing SB can reduce waist circumference, WHtR and body fat percentage, while also improve cardiorespiratory endurance.

Drinking water knowledge, attitudes and practices among primary school students in rural areas of China

ZHANG Yaning, CHENG Shuai, XIA Yunting, YU Jian, LI Hongxing

2025, 46(5): 667-671. doi: 10.16835/j.cnki.1000-9817.2025149

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Objective To investigate the current status of knowledge, attitudes and practices regarding drinking water among primary school students in rural areas of China, so as to provide scientific basis for implementing health interventions related to drinking water. Methods From November to December 2023, a stratified cluster random sampling method was employed to select 6 354 fourth to sixth grade primary school students in Shanxi, Zhejiang, Jiangxi, Guangxi and Gansu for a questionnaire survey. A uniformly designed questionnaire (including basic information, drinking water-related knowledge, attitudes and practices indicators) was distributed and completed by the students themselves. The χ² test was used to analyze the differences in drinking water-related indicators among students of different gender and boarder, and Logistic regression was used to analyze the influencing factors of drinking water practices among students. Results Among the indicators of drinking water knowledge, the awareness rate of appropriate daily water intake for respective student age groups was the lowest (27.90%). The awareness rate among nonresident students was significantly higher than that among boarding students (31.29%, 15.49%, χ²=132.75, P < 0.01). Regarding attitudes toward drinking water, 13.33% of the students believed that well water or tap water could be drunk directly, and 9.58% believed that going to the toilet at school was troublesome. Regarding practices, the self-reported water intake among students was 1 000 (600, 1 200) mL. The results of multifactorial Logistic regression showed that higher grades (OR=1.60, 95%CI=1.34-1.92), nonresident students (OR=1.32, 95%CI=1.15-1.52), northern region (OR=1.43, 95%CI=1.27-1.61), knowledge of appropriate daily water intake (OR=1.41, 95%CI=1.24-1.60), drinking temperature (OR=1.43, 95%CI=1.28-1.60), scientific hydration methods (OR=1.25, 95%CI=1.08-1.44), and adopting scientific hydration methods regularly (OR=1.75, 95%CI=1.50-2.04) were the independent influences on daily water intake attainment (P < 0.05). Conclusions Rural primary school students lack knowledge about healthy drinking water, have cognitive biases about safe drinking water and exhibit unhealthy drinking behavior. It is suggested that health education be carried out in combination with the characteristics of students to enhance their drinking water literacy.

Health literacy of infectious disease and its influencing factors for school doctors and health teachers in Beijing primary and secondary schools, 2023

XU Wenjie, BAI Chengxu, CHEN Dongni, WU Shuangsheng, SUN Bingjie, YANG Peng

2025, 46(5): 672-675. doi: 10.16835/j.cnki.1000-9817.2025140

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Objective To investigate the levels of knowledge and skills in infectious diseases among school doctors and health teachers in Beijing's primary and secondary schools in 2023, and analyze the influencing factors, so as to provide a reference basis for enhancing the professional competencies of school doctors and health teachers. Methods From October to November 2023, a census method was used to conduct a questionnaire survey among all school doctors and health teachers in 16 districts of Beijing. Chi-square tests and multivariate Logistic regression analysis was used perform statistical analysis. Results The awareness rate of infectious disease-related knowledge among school doctors and health teachers in primary and secondary schools in Beijing in 2023 ranged from 34.44% to 98.57%, while the behavior formation rate ranged from 65.90% to 98.64%. The proportions of those with literacy in infectious disease knowledge and behavior among school doctors and health teachers were 82.76% and 85.70%, respectively. Multivariate Logistics regression analysis showed that being a full-time employee, having a bachelor's degree or above, and holding a senior professional title were positively correlated with having literacy in infectious disease knowledge (OR=1.76, 2.57, 1.42, P < 0.01). Compared to medical professionals, those in education and other professions were negatively correlated with having literacy in infectious disease knowledge (OR=0.37, 0.55, P < 0.01). Being a full-time employee, being female, and age were positively correlated with having literacy in infectious disease behavior (OR=1.66, 2.18, 1.02, P < 0.01). Conclusions The level of health literacy for infectious diseases among school doctors in Beijing primary and secondary schools is relatively high. Targeted training on key professional knowledge and skills should be prioritized for individuals with deficiencies in infectious disease prevention and control.

Preliminary development of Health Literacy Evaluation Scale for Chinese High School Students

GUO Shihao, ZHU Fan, ZHU Guiyin, QI Tiantian, YANG Shuang, HU Bin, WU Huiyun, JIANG He, MA Yinghua

2025, 46(5): 676-680. doi: 10.16835/j.cnki.1000-9817.2025145

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Objective To develop a health literacy evaluation scale for Chinese high school students, providing a tool for dynamic monitoring of health literacy among high school students and evaluating the effectiveness of health school construction. Methods Through theoretical research, an evaluation index system for health literacy of Chinese high school students was constructed. Two rounds of Delphi expert consultations were conducted to quantitatively screen the items, and the item pool was revised based on expert opinions to compile the health literacy evaluation scale for Chinese students. Two focus group interviews were held to collect suggestions from health educators, high school teachers, and high school students regarding optimized scale length, question types, difficulty and wording of the scale. The scale was revised accordingly. A pilot survey was conducted in Beijing and Tianjin in November 2024, and the reliability and validity of the scale were evaluated based on the pilot survey data. Results The response rate in both rounds of Delphi expert consultations was over 80%, and the expert authority coefficient was over 0.70. The expert opinions were highly concentrated, and the dispersion was small. The revised item pool based on expert opinions contained 39 items. The revised scale based on the suggestions and opinions collected from the focus group interviews had a moderate number of questions and difficulty level. The pilot survey obtained 800 valid responses, with the response rate of 89.39%. The Cronbach α coefficient of the scale was 0.911, χ²/df=3.321, the root mean square error of approximation was 0.054, the adjusted goodness-of-fit index was 0.991, and the factor loadings of some items were less than 0.40. Conclusion The health literacy evaluation scale for Chinese high school students demonstrates scientific rigor and practical applicability, with good internal consistency and structural validity.

Influencing factors of school sports environment on physical activity levels among middle school students

XIE Dan, HOU Xiao, WANG Yunliang, CHEN Weijie, WANG Ying, JI Zhe, LI Hongjuan

2025, 46(5): 685-689. doi: 10.16835/j.cnki.1000-9817.2025139

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Objective To explore the relationship between school sports environment and physical activity levels of middle school students, so as to provide theoretical and empirical support for optimizing school sports environment and enhance adolescent physical activity. Methods Using multi-stage random cluster sampling, from September to December 2023, 1 329 junior and senior high school students from Xuancheng City of Anhui Province, Lianyungang City of Jiangsu Province, Wuhan City of Hubei Province, Qiqihar City and Suihua City of Heilongjiang Province, and Shenzhen City of Guangdong Province were selected. The International Physical Activity Questionnaire-Short Form (IPAQ-SF) assessed students' physical activity levels, and the questionnaire on the characteristics of school sports environment was developed to evaluate the factors of school sports environment. Multivariate ordered Logistic regression was performed to analyze the correlation between school sports environment factors and physical activity levels, and the analytic hierarchy process determined the weight of key influencing factors. Results The results showed that weekly vigorous physical activity time was [60 (25, 90)] minutes, moderate physical activity time was [60 (30, 90)] minutes, light physical activity time was [105 (40, 200)] minutes, and sedentary behavior time was [3 300 (2 100, 4 500)] minutes, only 10.53% of the students met World Health Organization physical activity recommendations, and 89.69% of the students averaged >8 h daily sedentary time. Multivariate ordered Logistic regression showed that adequate sports equipment significantly promoted physical activity across all intensities and reduced sedentary time (OR=4.97, 11.54, 4.03, 0.11); diverse sports activities improved vigorous and moderate physical activity while reducing sedentary time (OR=4.20, 14.06, 0.17); and peer encouragement was associated with increased low-intensity physical activities and decreased sedentary time (OR=10.40, 0.15)(P < 0.05). The analytic hierarchy process weighting analysis identified the top three influential factors related to physical activity among middle school students: sufficient sports equipment, varied physical education activities, frequent peer encouragement, the influence weight accounts for 23.55%, 14.18% and 11.77% of the total, respectively. Conclusion Key school sports environmental factors for adolescent physical activity level include ensuring adequate sports equipment and class availability, diversifying activity content, fostering peer support, and cultivating an active sports culture and a comprehensive approach encourage students' participation in extracurricular physical activities.

Correlation among picky eating levels in preschool children, parenting self-efficacy and parenting stress

YANG Jing, LIU Qian, YIN Xia, GU Ling, ZHU Jie

2025, 46(5): 681-684. doi: 10.16835/j.cnki.1000-9817.2025146

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Objective To explore the correlation among picky eating levels in preschool children, parental self-efficacy and parenting stress. Methods A convenience sampling method was employed to conduct an electronic questionnaire survey among 459 children aged 3-6 years and their parents from five kindergartens in Urumqi in November 2023. The survey included a general information questionnaire, the Children's Eating Behavior Questionnaire (CEBQ), the Parenting Sense of Competence Scale (PSOC), and the Parenting Stress Index-Short Form (PSI-SF). The Mann-Whitney U test was used for two-group comparisons, and the Kruskal-Wallis H test was applied for multi-group comparisons. Spearman correlation analysis was conducted to examine the relationships between children's picky eating levels and parenting self-efficacy as well as parenting stress. Results The picky eating score of preschool children was 10.00 (4.00), and the parenting self-efficacy score was 58.00 (12.00), both indicating a moderate level. The parenting stress score was 75.00 (16.00), reflecting a moderately low level. Spearman correlation analysis showed that children's picky eating levels were negatively correlated with the total score of parenting self-efficacy (r=-0.28) and positively correlated with the total score of parenting stress(r=0.25)(P < 0.01). Conclusions Picky eating levels of preschool children are closely associated with parenting self-efficacy and parenting stress. Picky eating behaviors in children can be reduced by implementing various effective measures to enhance parenting self-efficacy and alleviate parenting stress.

Analysis of depressive symptoms and influencing factors among university students in Shandong Province

GAO Chang, YAN Yehao, ZHANG Cuicui

2025, 46(5): 690-693. doi: 10.16835/j.cnki.1000-9817.2025151

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Objective To explore the prevalence and influencing factors of depressive symptoms among university students in some universities in Shandong Province, so as to provide a theoretical reference for implementing corresponding intervention measures. Methods A cluster-sampling method was used to select 8 079 university students studying in universities in Shandong Province from March 2023 to May 2024 as the research subjects. They were randomly divided into a training set (6 463) and a validation set (1 616) according to the 8/2 ratio. The influencing factors of depression among university students were analyzed, and a risk prediction model for depression among university students was constructed and validated. Results In the training set of university students, the detection rate of depression was 35.09%(2 268/6 463), with 1 632 cases (71.96%) of mild depression, 545 cases (24.03%) of moderate depression, and 91 cases (4.01%) of severe depression. In the validation set of university students, the detection rate of depression was 33.97% (549/1 616), with 384 cases (69.95%) of mild depression, 127 cases (23.13%) of moderate depression, and 38 cases (6.92%) of severe depression. In the training set, the proportions of those who surfed the Internet for more than 3 h/d, occasionally or did not participate in physical exercise, had average or poor relationships with classmates, often drank sugary drinks, occasionally or did not have breakfast, had unsatisfactory academic performance, had an average monthly living expense of less than 1 500 yuan on campus, and had divorced or widowed parents in the depression-detected group were all higher than those in the undetected group(χ²=1 193.85, 1 584.41, 1 115.10, 826.00, 1 424.05, 924.58, 803.68, 797.65, P < 0.05). The scores of the Chinese version of the Childhood Trauma Questionnaire (CTQ-SF) in the depression-detected group were also higher than those in the undetected group(t=98.48, P < 0.05). The results of Logistic regression analysis showed that physical exercise, classmate relationships, academic performance, average monthly living expenses on campus, and CTQ-SF scores were influencing factors for depression among university students(OR=3.87, 4.82, 3.63, 3.75, 4.39, P < 0.05). The sensitivity of the model in the training set for predicting depression among university students was 89.0%(95%CI=87.6%-90.2%), the specificity was 93.0% (95%CI=92.2%-93.7%), and the area under the curve was 0.9(95%CI=0.8-1.0); the sensitivity of the model in the validation set for predicting depression among university students was 87.6%(95%CI=84.5%-90.1%), the specificity was 91.3%(95%CI=89.4%-92.9%), and the area under the curve was 0.9(95%CI=0.8-1.0). Conclusions The high detection rate of depressive symptoms among university students in some universities in Shandong Province warrants attention. Constructing a risk prediction model is helpful for early identifying the risk of depression among university students.

Longitudinal association of dietary behavior scores trajectories with anxiety and depression symptoms among middle school students in Jiading District, Shanghai

TONG Min, LIU Xinxin, ZHANG qin, JING Guangzhuang, ZHU Yanhong, SHI Huijing

2025, 46(5): 694-698. doi: 10.16835/j.cnki.1000-9817.2024331

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Objective To analyze the trajectory of dietary behaviors among middle school students in Jiading District, Shanghai, from 2021 to 2023, and longitudinally verify their association with anxiety and depression symptoms, aiming to provide scientific evidence for promoting the mental health of adolescents. Methods The data were sourced from the National Monitoring and Intervention Project on Common Diseases and Health Impact Factors of students in Jiading District, Shanghai. A total of 1 217 middle school students who participated in at least two surveys from 2021 to 2023 were selected as the research objects, and group-based trajectory model was constructed to identify their dietary behavior scores trajectories. Modified Poisson regression was used to investigate the impact of dietary behavior scores trajectories on anxiety and depression, while Logistic regression was employed to explore the association between trajectories and changes in depression score levels. Results The dietary behavior scores trajectories of middle school students were divided into three groups: Persistent Healthy Dietary Behavior (9.5%), Persistent Relatively Unhealthy Dietary Behavior (85.0%), and Persistent Very Unhealthy Dietary Behavior (5.5%). Students who perceived their academic performance as poor and whose parents had a cultural level of high school or below had a significantly lower proportion in the Persistent Healthy Dietary Behavior group compared to students with other characteristics (χ²=12.87, 8.69, 6.50, P < 0.05). Compared with the Persistent Healthy Dietary Behavior group, the risk of anxiety symptoms in middle school students in the Persistent Very Unhealthy Dietary Behavior group was significantly increased (aRR=3.04, 95%CI=1.15-8.02); Persistent Relatively Unhealthy Dietary Behavior and Persistent Very Unhealthy Dietary Behavior increased the risk of depressive symptoms (aRR=1.80, 2.45, respectively), and were positively correlated with the increase in depression scores (aOR=1.70, 2.24) (P < 0.05). Conclusions The dietary behavior of middle school students have not changed significantly in the past three years, with persistent unhealthy dietary behavior being the most common. Unhealthy dietary behaviors are positively correlated with the risk of anxiety and depressive symptoms and an increase in depression scores.

Promoting effect of exercise-integrated cognitive intervention on the inhibition control function of college students

GAO Shuqing, YANG Yi, ZHANG Liancheng, YAN Chenli

2025, 46(5): 703-707. doi: 10.16835/j.cnki.1000-9817.2025116

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Objective To explore the short-term improvement effect of physical exercise and cognitive training on inhibitory control function of college students, and to clarify the temporal quantitative-effectiveness relationships between long-term exercise-integrated cognitive interventions and inhibitory control function of college students, in order to provide a reference for promoting inhibitory control function in this population. Methods College students from Tianjin University of Sport were recruited in May 2022 to participate in the intervention study, which included both short-term and long-term interventions. The short-term intervention used a 2 (physical exercise: yes, no) × 2 (cognitive training: yes, no) between-groups design, with 69 participants randomized into a movement integration cognitive group (n=18), a physical exercise group (n=16), a cognitive training group (n=17), and a control group (sedentary viewing of a health information video, n=18), for a 30-min intervention.The long-term intervention used a mixed experimental design with a 2 (intervention groups; intervention group, control group, between-group variable) ×5 (intervention time: pre-test, 1 week, 4 weeks, 6 weeks, and 8 weeks, within-group variable) mixed experimental design with 24 participants, including 13 in the intervention group, who underwent the exercise-integrated cognitive intervention for 30 min, 3 times per week, and 11 in the control group, who maintained their daily activities without the intervention. The main effects of the independent variables and their interactions were analyzed using covariance and repeated measures ANOVA. Results There was a statistically significant interaction between physical exercise and cognitive training on accuracy of the Flanker task for the short intervention[F_{(1, 64)}=7.05, P=0.01, η_P²=0.10], and the simple effect test showed that cognitive training reduced accuracy of responses in the presence of physical exercise condition(P=0.02), and the main effect of physical exercise among college students was significant for the reaction time [F_{(1, 65)}=14.12, P < 0.01, η²_p=0.18]; for Flanker task reaction time in the long-term intervention, the main effect of intervention time was significant[F_{(4, 19)}=3.03, P=0.04, η_P²=0.39].However, the intervention results of 1, 4, 6 and 8 weeks in the intervention group [(28.13±10.32)(14.14±26.98)(13.54±25.61)(15.14±21.34)ms] were all better than the pre-test [(77.54±39.34)ms], the main effect of intervention group was significant [F_{(1, 22)}=6.96, P=0.02, η=0.24]. Conclusion In a short-term intervention for inhibitory control function in college students, physical exercise is more effective than cognitive training; long-term exercise and cognitive training can improve the inhibitory control function of college students.

Relationship between weight-adjusted-waist index and cardiopulmonary endurance in Chinese middle school students

MENG Jiasen, YIN Xiaojian, BI Cunjian, GUO Yaru, HU Yanyan

2025, 46(5): 699-702. doi: 10.16835/j.cnki.1000-9817.2025156

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Objective To understand the association between weight-adjusted-waist index (WWI) and cardiopulmonary endurance among middle school students, so as to provide references for the improvement of cardiopulmonary endurance levels in adolescents. Methods From June 2015 to December 2018 by using the method of purposive sampling, height, weight, waist circumference, and 20 m shuttle-run tests were measured among 44 870 adolescents aged 13-18 from Northeast, North, East, South, Southwest and Northwest of China. The WWI of the adolescents and the maximum oxygen uptake (VO_2max) were calculated indirectly. The t-test and one-way analysis of variance were used for comparison, and the curve regression analysis method was adopted to analyze the relationship between WWI and VO_2max. Results For Chinese middle school students aged 13-18, the WWI was (9.35±1.02), the number of 20 m shuttle-run was (38.89±18.14) times, and VO_2max was (39.96±5.88) mL/(kg ·min^-1). The differences of VO_2max between WWI quartile arrays of boys aged 13-18 were statistically significant (F=15.19, 9.00, 14.97, 20.48, 28.13, 10.13, P < 0.01), girls had the same trend (F=23.36, 16.61, 33.45, 32.96, 18.23, 19.36, P < 0.01). There was an inverted U-shaped curve relationship between WWI and cardiopulmonary endurance. When WWI was 8.5, the VO_2max level reached the highest, which was 40.07 mL/(kg ·min^-1). Compared with girls, WWI in boys had a more significant impact on cardiopulmonary endurance. Conclusion Maintaining optimal WWI levels may enhance adolescents' cardiopulmonary endurance.

Spinal curvature abnormalities and related factors among primary and secondary school students in Guangxi in 2023

LUO Yuemei, LI Yan, REN Yiwen, DONG Yonghui, CHEN Li, ZHANG Dengcheng, ZHANG Yi, MA Jun, DONG Yanhui

2025, 46(5): 712-716. doi: 10.16835/j.cnki.1000-9817.2025147

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Objective To investigate the prevalence and associated factors of spinal curvature abnormalities among primary and secondary school students in the Guangxi Zhuang Autonomous Region, so as to provide a scientific basis for the prevention and control of such abnormalities. Methods From September to November 2023, adopting a stratified cluster random sampling method, spinal curvature screenings and questionnaire surveys were conducted among 168 931 students from grade 4 of primary school to grade 12 of high school in 111 districts and counties across 14 cities in Guangxi. Chi-square tests and binary Logistic regression analysis were used to analyze influencing factors of spinal curvature abnormalities. Results In 2023, the detection rate of poor posture among students above grade 4 in Guangxi was 4.24%, and the detection rate of spinal curvature abnormalities was 2.13%. The detection rate was higher among urban students (2.84%) than rural students (1.66%), boarding students (2.61%) than non-boarding students (1.60%), and high school students (3.16%) than junior high (2.45%) and primary school students (1.15%), and the differences were statistically significant (χ²=269.85, 221.44, 565.10, P < 0.01). A trend of increasing detection rates with higher grade levels was observed (χ_trend²=617.63, P < 0.01). Binary Logistic regression analysis indicated that students without boarding at school (OR=0.82, 95%CI=0.75-0.90), engaging in high-intensity physical activity for over 60 min per day ≥5 days per week (OR=0.90, 95%CI=0.82-0.98), and adequate sleep (OR=0.87, 95%CI=0.81-0.94) had lower risks of detecting spinal curvature abnormalities (P < 0.05). Conclusions The prevalence of spinal curvature abnormalities increases with grade level among primary and secondary school students in Guangxi. Regular moderate-to-vigorous physical activity demonstrates protective effects against spinal abnormalities.

Correlation between environmental factors and pediatric respiratory disease visits in a central hospital of Shanghai

ZHOU Shuangshuang, CAI Yizhou, MIAO Xueqin, ZHANG Lili, ZHOU Yibin, HE Dandan, LIU Jie, HU Yanqi

2025, 46(5): 708-711. doi: 10.16835/j.cnki.1000-9817.2025135

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Objective To explore the correlation and lag effects of environmental factors on pediatric respiratory disease visits at hospital, so as to provide scientific basis for disease prediction and optimizing clinical diagnosis and treatment. Methods Data from 503 889 pediatric respiratory disease outpatient and emergency visits a central hospital in Minhang District of Shanghai between 2017 and 2019, along with concurrent meteorological data were collected. A distributed lag non-linear models (DLNM) was constructed to explore the specific relationship between pediatric respiratory disease consultations and various environmental factors and to quantify the cumulative lag effects of environmental factors on respiratory disease consultations. Results Among the environmental factors, temperature, fine particulate matter (PM_2.5), inhalable particulate matter (PM₁₀), nitrogen dioxide (NO₂), and sulfur dioxide (SO₂) were associated with pediatric respiratory disease visits. After adjusting for temperature, PM_2.5 and PM₁₀ concentrations did not show significant immediate or lag effects. The relative risk (RR) of pediatric respiratory disease visits increased with rising NO₂ concentrations. When NO₂ concentration ≥55 μg/m³, significant immediate and lagged effects (lag 3, 5, and 7 days) were observed. The RR values were 1.05, 1.13, 1.17, and 1.21(P < 0.05). The RR values showed an inverted "U"-shaped relationship with SO₂ concentrations. When SO₂ concentration ≥5 μg/m³, significant lagged effects (lag 3, 5, and 7 days) were observed. The RR values were 1.03, 1.03, and 1.04 (P < 0.05). Conclusion High concentrations of NO₂ and SO₂ increase the risk of pediatric respiratory disease visits, with observable lag effects.

Epidemiological characteristics of mumps in Shanxi Province from 2014 to 2023

YANG Bei, HUO Junfeng, YANG Qian, WANG Xiaofang, CHEN Xiao

2025, 46(5): 717-722. doi: 10.16835/j.cnki.1000-9817.2025160

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Objective To analyze the epidemiological characteristics of mumps in Shanxi Province from 2014 to 2023, so as to provide scientific evidence for targeted prevention strategies. Methods Mumps case data in Shanxi Province were obtained from the China Information System for Disease Prevention and Control. Descriptive epidemiological analysis and age-period-cohort (APC) analysis were carried out on the reported incidence of mumps from 2014 to 2023. Results A total of 44 360 mumps cases were reported in Shanxi Province from 2014 to 2023, with an average annual incidence rate of 11.78/100 000. The incidence rates were high during 2017-2019, which were 21.00/100 000, 16.76/100 000, and 19.51/100 000, respectively. Males had a higher incidence rate (13.50/100 000) than females (9.98/100 000). Children aged 5-9 years were the most affected group, accounting for 47.29% of total cases. In 2017 and 2019, incidence rates among the 5-15-year-old group were particularly high, reaching 155.08/100 000 and 131.78/100 000, respectively. The APC model age effect, period effect and cohort effect of the reported incidence rate in the high-incidence population aged 0-20 years all had statistical significance (P < 0.05). The age-relative risk (RR) decreased from 1.75 in the 0-year-old group to 0.33 in the 20-year-old group, and the birth cohort-RR decreased from 2.58 in 1994 to 0.26 in 2023. The morbidity risk of the population aged 0-20 years showed a trend of first increasing and then decreasing over time, among which it was the highest in 2017 (RR=1.23) and the lowest in 2023 (RR=0.29). Conclusions Shanxi exhibits cyclical mumps epidemics, with school-aged children as the high-risk population. School health management work should be carried out, and the surveillance of mumps in high-risk areas and the routine vaccination of two doses of mumps-containing vaccines for eligible children should be strengthened.

Association of habitual reading and writing postures with common diseases and comorbidities among children and adolescents in Ningxia

WEI Rong, LUO Haiyan, MA Ning, ZHAO Yu, YANG Yi, CHEN Yaogeng

2025, 46(5): 723-727. doi: 10.16835/j.cnki.1000-9817.2025117

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Objective To investigate the association between habitual reading/writing postures and the co-occurrence of common health conditions (overweight/obesity, visual impairment, hypertension, and scoliosis) and comorbidities among children and adolescents, in order to provide data support for the joint prevention of common diseases and comorbidities among children and adolescents. Methods From September 2021 to June 2022, a multi-stage cluster random sampling method was used to select a total of 4 577 children and adolescents from 16 primary and secondary schools in Ningxia: Jinfeng District of Yinchuan City, Shapotou District of Zhongwei City, Yanchi County of Wuzhong City, and Pingluo County of Shizuishan City. A weighted complex sampling design was used to investigate the association of habitual reading and writing postures with common comorbidities in children and adolescents. Results The prevalence rates of common diseases among children and adolescents in Ningxia were as follows: overweight/obesity was 22.87%, visual impairment was 62.52%, scoliosis was 2.30%, and hypertension was 1.30%. The prevalence of multimorbidity (co-occurrence of ≥2 conditions) among Ningxia children and adolescents was 15.95%. Multivariate unconditional Logistic regression analysis showed that frequent/always collapsing waist and sitting forward with head lowered increased the risk of common comorbidities in children and adolescents (OR=1.90, P < 0.05). Compared with the corresponding reference group, male children and adolescents aged 9 to 12 years and boys had relatively lower risks of overweight/obesity (OR=0.71, 0.70); the risk of poor vision among children and adolescents aged 9 to 12 years, male, and urban was relatively low (OR=0.59, 0.60, 0.73)(P < 0.05). Children and adolescents who often/always sat leaning to the left or right were at higher risk of poor vision (OR=1.78); urban children and adolescents had a higher risk of developing scoliosis (OR=3.71); children and adolescents aged 9 to 12 had a relatively low risk of developing hypertension (OR=0.09), and children and adolescents who often/always bent their backs and sat forward on their knees had a higher risk of hypertension (OR=5.03)(P < 0.05). Conclusions Ningxia has a high incidence of common diseases and multiple diseases among children and adolescents, frequent or always collapsing waist and sitting forward with head lowered is associated with common comorbidities in children and adolescents in Ningxia. Proper postural measures for reading and writing should be carried out as soon as possible to encourage children and adolescents to develop good reading and writing habits for effectively preventing and controlling the occurrence of common diseases.

Longitudinal trajectory analysis of orthokeratology lens wearing adherence in myopic children and adolescents

BAI Guoxin, CAO Mingcong, LI Haiyue, WANG Jian, WANG Yuhe, XU Xiaoteng, CHEN Zhongfei

2025, 46(5): 728-731. doi: 10.16835/j.cnki.1000-9817.2025148

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Objective To analyze the potential categories and influencing factors of the compliance trajectory of orthokeratology lenses (OK lens) in myopic children and adolescents, so as to provide a basis for dynamic and accurate intervention of OK lens compliance in myopic children and adolescents. Methods From January to June 2024, 310 myopic children and adolescents wearing OK lens were selected as research subjects from the Ophthalmology Medical Center of Cangzhou Central Hospital using a convenient sampling method. Data were collected at four time points: when the glasses were first fitted (T0), 2 weeks after fitting (T1), 1 month later (T2), 3 months later (T3), and 6 months later (T4). The data collection methods included general information questionnaires, compliance surveys for OK lens wearers, the Behavior Rating Inventory of Executive Function-Self-report Version (BRIEF-SR), family support scales, and a self-made questionnaire on myopia control attitudes. A growth mixed model was used to identify the trajectory categories of compliance with OK lens wearing among myopic children and adolescents, and multiple Logistic regression analysis was employed to examine the influencing factors. Results The compliance with OK lens among myopic children and adolescents were roughly divided into four developmental trajectories: C1 exemplary adherent (58 cases, 18.71%), C2 gradual progressor (130 cases, 41.94%), C3 fluctuating (85 cases, 27.42%), and C4 stubborn low follower (37 cases, 11.94%). Multivariate Logistic regression analysis showed that, with C1 group as the reference, age (C3, OR=0.74), parental education level (C4, OR=0.67), executive function (C2, OR=0.69; C4, OR=0.44), family support (C3, OR=0.75) and myopia control attitude (C2, OR=0.39) were all influencing factors for the compliance trajectory of OK lens; with C2 group as the reference, age (C3, OR=0.55), parental education level (C3, OR=0.34; C4, OR=0.64), executive function (C3, OR=0.77), and family support (C4, OR=0.58) were all influencing factors for the compliance trajectory of OK lens; with C3 group as the reference, age (C4, OR=0.68), and myopia control attitude (C4, OR=0.44) were both influencing factors for the compliance trajectory of OK lens (P < 0.05). Conclusions The compliance of wearing OK lens in children and adolescents with myopia can be roughly divided into four trajectories, and there is group heterogeneity. Dynamic and precise compliance intervention strategies should be given based on different trajectories and influencing factors.

Diarrhea caused by foodborne Salmonella infection in children aged 0-6 years in Guizhou Province from 2016 to 2023

LIAO Hongxia, WANG Yafang, LIU Lin, ZHANG Lili, YANG Qi, LI Lei

2025, 46(5): 732-736. doi: 10.16835/j.cnki.1000-9817.2025144

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Objective To analyze the epidemilogical and seasonal characteristics of foodborne Salmonella-associated diarrhea among children aged 0-6 years in Guizhou Province from 2016 to 2023, so as to provide a basis for the prevention and control of foodborne diseases. Methods Data were extracted from the Foodborne Disease Survellance System for cases reported between January 1, 2016, and December 31, 2023. The incidence, seasonal characteristics, and peak periods were analyzed by the method of concentration and circular distribution. Results A total of 6 434 cases of diarrhea in children aged 0-6 years were collected, and 455 cases of Salmonella were detected, with a positive detection rate of 7.07%. Salmonella typhimurium was the main serotype causing diarrhea (59.34%). The peak of the disease was from May 3 to September 30, with certain seasonal characteristics. The highest detection rate was found in children aged 1-3 years (8.66%). Among food types, the positive detection rates of Salmonella were relatively high in other foods (17.39%), fruits and their products (10.22%), infant and toddler foods (10.09%), and aquatic animals and their products (9.80%). The processing and packaging methods of food were mainly home-made (9.38%) and bulk food (7.54%). Conclusions The detection rate of Salmonella in children aged 0-6 years is high in Guizhou Province, with strong seasonal characteristics. The detection rates of other foods, fruits and their products, infant and toddler foods, and aquatic animals and their products are high. Enhanced pathogen surveillance for susceptible populations and high-risk foods, coupled with public health education during summer/autumn, is recommended.

Epidemiological trends analysis of syphilis among students in Yunnan Province from 2005 to 2023

TAN Min, CHANG Litao, ZHANG Wanyue, HUANG Dafeng, LIU Chunyan, ZHANG Lifang, YANG Yanling

2025, 46(5): 737-740. doi: 10.16835/j.cnki.1000-9817.2025134

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Objective To analyze epidemiological trends and changing characteristics of syphilis among students in Yunnan Province from 2005 to 2023, so as to provide evidence for the comprehensive prevention and control of syphilis in schools. Methods The case data of syphilis among students in Yunnan Province from 2005 to 2023 were obtained from the China Information System for Disease Control and Prevention. The Joinpoint regression model was used to conduct a time trend analysis of the reported incidence rate of syphilis. Results From 2005 to 2023, a cumulative total of 3 191 cases of syphilis were reported in schools in Yunnan Province(1 248 male cases and 1 943 female cases). The reported incidence rate rose continuously from 0.17/100 000 in 2005 to 8.26/100 000 in 2023, with an average annual percent change (AAPC) of 24.89%(Z=13.18, P < 0.01). The reported incidence rate was higher in female students than in male students (χ²=229.48, P < 0.05). The incidence rates in the primary school, junior high school, senior high school and higher education were 0.21/100 000, 2.42/100 000, 4.45/100 000 and 6.29/100 000 respectively, and the difference was statistically significant(χ²=3 432.84, P < 0.05). The average annual growth rate was the highest in the junior high school stage(AAPC=30.68%, Z=7.57, P < 0.05), followed by the senior high school stage (AAPC=24.28%, Z=5.70, P < 0.05).The reported incidence rate of primary and secondary syphilis increased from 0.12/100 000 in 2005 to 2.06/100 000 in 2023, with an AAPC of 16.86% (Z=4.57, P < 0.05). Conclusions The overall reported incidence rate of syphilis among students in schools in Yunnan Province shows a sustained upward trend, with the most rapid annual increase observed in junior high schools. Schools should prioritize syphilis education and expand awareness campaigns to curb transmission.

Trends analysis of first-dose influenza vaccination coverages among teachers and students in Shandong Province, 2015-2024

LUAN Guijie, LIU Yao, LIU Shaonan, SUN Huifeng, ZHANG Weiyan, SUN Liang

2025, 46(5): 741-745. doi: 10.16835/j.cnki.1000-9817.2025154

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Objective To analyze the institutional and regional differences in influenza vaccination for teachers and students, so as to provide a basis for influenza prevention and control in campus. Methods Influenza vaccination data for teachers and students in Shandong Province from 2015 to 2024 were collected from Immunization Information Systems. Joinpoint regression models were used to calculate the annual percent change (APC) and average annual percent change (AAPC) in first-dose vaccination rates. Results The vaccination coverages for the first dose of influenza vaccine among teachers in Shandong Province from 2015 to 2024 were 0.01%, 0.02%, 0.15%, 0.29%, 0.60%, 2.06%, 1.64%, 2.27%, 3.00%, and 2.43%, with a turning point in 2020. For preschools, primary/secondary schools, and higher education institutions, APCs during 2015-2020 were 163.36%, 162.09%, and 174.94%, respectively(P < 0.01), declining to 9.53%, 9.92%, and 8.14% during 2020-2024(P>0.05). Corresponding AAPCs were 78.32%, 78.13%, and 81.61%(P < 0.01). High, middle, and low GDP regions exhibited APCs of 173.84%, 162.75%, and 136.67% during 2015-2020(P < 0.01) and 5.77%, 13.92%, and 11.86% during 2020-2024(P>0.05), with AAPCs of 79.42%, 81.23%, and 69.63%(P < 0.01), respectively. Among students, vaccination coverage ranged from 1.59% to 7.20%. Preschool students showed no turning points, with an AAPC of 18.73%(P < 0.01). Primary/secondary students had turning points in 2018 and 2022, APCs were -32.59% during 2015-2018(P < 0.01), 48.45% during 2018-2022(P < 0.01), and -26.25% during 2022-2024(P=0.04), yielding an AAPC of -2.32%(P=0.45). Higher education students had a turning point in 2020, with APCs of 63.27% during 2015-2020(P < 0.01) and 4.31% during 2020-2024 (P=0.77), and the AAPC was 33.79% during 2015-2024 (P < 0.01). High, middle, and low GDP regions for students showed no turning points, with AAPCs of 10.46%(P=0.18), 13.67%(P=0.01), and 10.42%(P=0.05), respectively. Conclusions The influenza vaccination rate among teachers and students in Shandong Province has shown an upward trend from 2015 to 2024, but the overall level is still relatively low. However, continued efforts are needed to enhance health education on influenza and vaccination, to further improve the vaccination rate of teachers and students.

Trends and associated factors of overweight and obesity among children and adolescents in Macao from 2005 to 2020

CHEN Jiaxin, ZHAO Deqiang, WANG Yibei, WANG Chunmiao, ZHANG Yanfeng

2025, 46(5): 751-755. doi: 10.16835/j.cnki.1000-9817.2025132

Abstract(10) HTML (3) PDF(3)

Abstract:
Objective To analyze the prevalence trends and associated factors of overweight and obesity among children and adolescents in Macao from 2005 to 2020, so as to provide evidence for developing health promotion strategies. Methods Data were obtained from the Macao Citizen Physical Fitness Monitoring Database for the years 2005, 2010, 2015, and 2020 for participants aged 6-22 years. The χ² test was employed to analyze trends in detection rates, while univariate and multivariate Logistic regression analyses were conducted to identify influencing factors. Results The overweight rate among Macao's children and adolescents increased from 10.4% in 2005 to 14.8% in 2020. The obesity rate rose from 6.8% to 12.1%, with the total detection rate increasing from 17.2% to 26.9%, and the differences were statistically significant (χ_trend²=46.7, 87.5, 145.9, P < 0.01). Notably, the overweight/obesity rate among boys showed rapid growth (χ_trend²=118.6, P < 0.01), while girls exhibited a declining inflection point in 2020. Multivariate Logistic regression analysis revealed that children and adolescents with the following characteristics faced higher risks of overweight/obesity: a physical education performance score of 3 points (overweight: OR=2.34, 95%CI=1.10-4.96; obesity: OR=2.39, 95%CI=1.19-4.81), paternal obesity (overweight: OR=2.07, 95%CI=1.38-3.11; obesity: OR=1.51, 95%CI=1.01-2.27), and maternal obesity (overweight: OR=1.69, 95%CI=1.08-2.63; obesity: OR=1.77, 95%CI=1.16-2.71) (P < 0.05). Conversely, lower risks were observed in those who performed appropriate warm-up activities before exercise (obesity: OR=0.37, 95%CI=0.15-0.95), participated in two academic/non-sports extracurricular classes (obesity: OR=0.46, 95%CI=0.24-0.88), and reported moderate physical exertion during extracurricular exercise (obesity: OR=0.60, 95%CI=0.36-0.98) (P < 0.05). Conclusions Overweight and obesity among Macao's children and adolescents remain severe, particularly among boys, while girls show early signs of improvement. It is recommended to establish a multi-sectoral collaborative prevention and control system to reduce childhood and adolescent obesity.

Research progress on the effectiveness of bibliotherapy interventions for adolescent mental health

SU Fan, LU Jinkui, SONG Yongjing, LIU Cong

2025, 46(5): 746-750. doi: 10.16835/j.cnki.1000-9817.2025130

Abstract(10) HTML (1) PDF(1)

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As a systematic psychological intervention method, bibliotherapy possesses advantages such as low cost, high accessibility, and significant efficacy. The paper systematically reviews the recent research progress of bibliotherapy in the field of adolescent mental health intervention including covering preventive, therapeutic, developmental, personalized, and comprehensive approaches. It discusses the effectiveness and key influencing factors of these interventions. Findings indicate that bibliotherapy can effectively reduce the risk of depressive and anxiety symptoms in adolescents, and improve their emotional regulation skills and social adaptability. Different types of interventions demonstrate varied effects across different populations. Personalized and comprehensive intervention models can further enhance the outcomes, to provide theoretical basis and practical guidance for the development of localized bibliotherapy intervention programs.

Health benefits and application strategies of small-sided games intervention for children and adolescents

LIU Wenshuo, JIN Zongqiang, WANG Xuan

2025, 46(5): 756-760. doi: 10.16835/j.cnki.1000-9817.2025141

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To explore the mechanism of the impact of small games (SSG) on the physical health of children and adolescents and the reasonable application strategies, the study reviewes the multi-dimensional effects of SSG on the body composition, motor ability, cardiovascular health, musculoskeletal health and metabolic health of children and adolescents, and proposes the strategies for the reasonable application of SSG, which include scientifically designing training programs, emphasizing individualized differences, and strengthening monitoring and feedback. It can provide theoretical support and practical suggestions for the application of SSG in promoting the physical health of children and adolescents.

Current Articles 2025, Volume 46, Issue 5

Current Articles
2025, Volume 46, Issue 5