Current Articles

2025, Volume 46,  Issue 9

Exploring pathways for promoting mental health among children and adolescents in the context of Chinese practice
LI Jing, SONG Yi
2025, 46(9): 1217-1221. doi: 10.16835/j.cnki.1000-9817.2025283
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Abstract:
Mental health issues among children and adolescents have become an important public health problem. To address the growing complexity of mental health issues among children and adolescents as well as the emerging challenges posed by novel influencing factors the study develops a framework for promoting mental health among children and adolescents including dimensional elevation reduction and breakthrough approaches. It also proposes a paradigm innovation of "awareness-analysis-action-assessment-advance". The study comprehensively considers the traditional and new influencing factors and introduces new technologies such as digital technology so as to achieve dynamic adaptation and system optimization of theory and practice thereby advancing the high-quality development of the mental health service system with Chinese characteristics for children and adolescents.
Expert Viewpoint
Exploration and reference of Finnish school meal services
WANG Shiying, HAO Wen
2025, 46(9): 1222-1225. doi: 10.16835/j.cnki.1000-9817.2025260
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To promote the high-quality development of school meal services, and to shape civilized and healthy eating habits for children and adolescents, the study analyzes Finnish school meal services. Finnish school meal services are not only free of charge, nutritionally balanced, safe and hygienic, but also carry the educational function of edutainment in meals. In order to ensure the high-quality and efficient operation of the school meal service system, Finland has built a horizontal collaborative governance model, that is, the departments of education, finance, health and quality inspection have a clear division of labor and respective responsibilities. China can learn from the experience of Finnish schools in meal services, strengthen financial and legal guarantees, develop the educational functions of school meal services, and make full use of information technology such as the Internet, the Internet of things, and big data to promote the high-quality development of school meal services.
Column on Child and Adolescent Mental Health Promotion
Correlation between depressive symptom and traditional Chinese medicine constitution among school-aged children and adolescents
WEN Nannan, ZHONG Xia, LI Jing, SONG Yi, LI Ning, BAI Minghua, GUO Jiayi, ZHANG Dachao, MA Long, LIU Yudong, JIANG Juran
2025, 46(9): 1226-1231. doi: 10.16835/j.cnki.1000-9817.2025284
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  Objective  To explore the correlation between traditional Chinese medicine (TCM) constitution and depressive symptom among school-aged children and adolescents, so as to provide evidences for informing constitution-based regulation and prevention of depressive symptom.  Methods  From June to December 2024, a total of 4 729 students aged 6-14 were recruited by cluster random sampling from 10 primary schools in Baoding (Hebei Province), Heze and Liaocheng (Shandong Province). General information, TCM constitution and depressive symptom were collected. Restricted cubic spline (RCS) models were used to analyze related factors and threshold effects of depressive symptom. Binary Logistic regression was applied to examine the association between depressive symptom and TCM constitution, with subgroup analyses conducted.  Results  The detection rate of depressive symptom among the included children and adolescents was 25.82%. RCS analyses indicated non-linear associations between depressive symptom and age (inflection point at 10 years old), bedtime (inflection point at 22:00), and wake-up time (inflection point at 6:30) (all Pnon-linearity < 0.01). Linear associations were observed with body mass index (BMI) and sleep duration (all Pnon-linearity>0.05). After adjusting for covariates such as age, BMI and sleep status, binary Logistic regression analyses showed that Yin-deficient constitution (OR=1.26, 95%CI=1.09-1.45) and Phlegm-dampness constitution (OR=1.42, 95%CI=1.11-1.82) were significantly associated with depressive symptom among children and adolescents (all P < 0.05).  Conclusions  Depressive symptom among school-aged children and adolescents is primarily associated with Yin-deficiency and Phlegm-dampness constitutions in TCM constitution. Active attention should be paid to susceptible TCM constitution among children and adolescents. Targeted health guidance and interventions should be implemented to improve TCM constitution health status for preventing the occurrence of depressive symptom.
Association between mental health and muscle strength among Chinese adolescents aged 13-18
YANG Ruolan, CAI Shan, MA Ning, DANG Jiajia, LIU Yunfei, ZHANG Yihang, CHEN Ziyue, LI Jiaxin, HUANG Tianyu, LU Lili, SUN Ziyue, YANG Yang, HU Peijin, MA Jun, SONG Yi
2025, 46(9): 1232-1236. doi: 10.16835/j.cnki.1000-9817.2025285
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  Objective  To explore the association between mental health and muscle strength among Chinese adolescents aged 13-18, providing a theoretical foundation and intervention strategies for mental health promotion.  Methods  Data were obtained from the 2019 Chinese National Survey on Students' Constitution and Health, including 98 631 Chinese adolescents aged 13-18. Psychological distress was assessed by using the Kessler Psychological Distress Scale (K10), and mental well-being was measured with the Warwick-Edinburgh Mental Well-being Scale (WEMWBS). Based on the gender- and age-specific Z-scores of various test items [grip strength, standing long jump, pull-ups (for males), and sit-ups (for females)], muscle strength index (MSI) was constructed to evaluate the comprehensive level of muscle strength in adolescents. According to the Dual-factor Model (DFM) of mental health, participants were categorized into four groups: troubled, symptomatic but content, vulnerable, and complete mental health. Gender differences were analyzed by using Chi-square tests, trends were tested with Cochran-Armitage tests, and multinomial Logistic regression models were applied to assess associations between muscle strength and mental health among adolescents.  Results  In 2019, 37.4% of Chinese adolescents aged 13-18 were reported of high mental distress, and 59.9% were reported of low mental well-being. Boys had significantly lower rates of high mental distress (35.3%) and low mental well-being (55.6%) compared to girls (39.4%, 64.3%), and the differences were of statistical significance (χ2=176.13, 780.42, both P < 0.05). In 2019, the rate of complete mental health among adolescents showed a downward trend with increasing age (χtrend2=258.47) and a gradual upward trend with increasing muscle strength levels (χtrend2=123.14), and both boys and girls exhibited similar trends (χtrend2=103.83, 168.46; 57.00, 67.34) (all P < 0.05). The results of the unordered multiclass Logistic regression model showed that after controlling for confounding factors such as age and gender, when the completely pathological group as a reference, for every 1 unit increase in MSI in adolescents, the likelihood of being in a completely mental health state increased by 29% (OR=1.29); for every unit increase in the Z-score for pull-ups, the likelihood of being in a completely mental health state increased by 6% (OR=1.06) among boys; for every 1 unit increase in sit-up Z-score, the likelihood of being in a completely mental health state increased by 19% (OR=1.19) among girls (all P < 0.05).  Conclusions  The mental health status of Chinese adolescents is not good enough. Muscle strength is positively associated with mental health.
Relationship of college students' satisfaction with psychological health work in colleges and psychological capital with psychological health status
WANG Aohang, CHEN Peiru, ZHANG Qiang
2025, 46(9): 1237-1241. doi: 10.16835/j.cnki.1000-9817.2025278
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  Objective  To explore the impact mechanism of psychological health work in colleges on the psychological health status of college students, in order to provide a basis and practical guidance for optimizing the psychological health service system in colleges and formulating scientific and effective psychological capital intervention strategies.  Methods  Through stratified cluster random sampling, 1 148 colleges students were selected from 7 colleges in Shanghai from October to November 2024. A survey was conducted using the Satisfaction Questionnaire for Psychological Health Work in colleges, Psychological Capital Questionnaire (PCQ) and Symptom Checklist-90 (SCL-90). Spearman correlation analysis, multiple Logistic regression analysis and structural equation model pathway analysis were conducted to analyze the relationship of psychological health work in colleges and psychological capital with psychological health status of college students.  Results  The scores of satisfaction with college psychological health work, PCQ, and SCL-90 were [2.78(2.55, 3.02), 3.08(2.85, 3.32), 1.56(1.42, 1.78)]. Spearman correlation analysis results showed that the four dimensions scores of satisfaction with psychological health work in colleges (satisfaction with psychological health course teaching, satisfaction with practical activities, satisfaction with psychological counseling services and satisfaction with crisis intervention and management) were negatively correlated with SCL-90 score of college students (r=-0.26, -0.31, -0.24, -0.21); the four dimensions scores of psychological capital (self-confidence, optimism, resilience, and hope) of college students were negatively correlated with SCL-90 score (r=-0.29, -0.34, -0.28, -0.29) (all P < 0.05). The results of multiple Logistic regression analysis showed that after adjusting for confounding factors such as gender, grade level, parents' highest education level, major type, and physical health status, compared with college students who were "very satisfied" with their psychological health work, those who were "very dissatisfied" and "dissatisfied" with their psychological health work had a higher proportion of poor psychological health status (OR=2.15, 1.68); compared to college students with higher level of psychological capital, those with lower level of psychological capital had a higher proportion of poor psychological health status (OR=2.73, 2.05) (all P < 0.05). The results of structural equation modeling path analysis showed that the satisfaction of psychological health work in colleges indirectly reduced psychological health risks by increasing psychological capital among colleges (β=0.12, P < 0.05), with mediation effect accounting for 60% of the total effect.  Conclusion  The satisfaction with psychological health work in colleges is positively correlated with both psychological health status and psychological capital among college students; and psychological capital, as an intermediary bridge, further amplifies and transmits the positive impact of satisfaction with psychological health work in colleges on psychological health among college students.
Longitudinal cross-lagged analysis of body mass index and weight stigma with depressive symptom in adolescents
DONG Ziqi, SONG Xinli, YUAN Wen, LI Jing, YANG Tian, ZHANG Xiuhong, SONG Yi, DONG Yanhui
2025, 46(9): 1242-1245. doi: 10.16835/j.cnki.1000-9817.2025286
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  Objective  To explore the bidirectional associations among body mass index Z-scores (BMI Z-scores) and weight stigma with depressive symptoms in adolescents, thereby providing evidence for targeted intervention strategies.  Methods  A stratified cluster random sampling method was employed to select 18 301 adolescents aged 12-18 years from all 12 prefectures (103 counties) in the Inner Mongolia Autonomous Region, and two waves of longitudinal surveys were conducted in September 2023 (T1) and September 2024 (T2) among the adolescents. Weight stigma was assessed by using a self-developed questionnaire, depressive symptom was measured with the Center for Epidemiologic Studies Depression Scale (CES-D), and BMI Z-scores were calculated according to the World Health Organization standards. Pearson correlation analysis was used to examine associations among variables, and cross-lagged panel models were constructed to investigate the dynamic bidirectional relationships among the three variables.  Results  Adolescents' BMI Z-scores and weight stigma with depressive symptoms all exhibited autoregressive stability across the two time points (autoregressive paths, all P < 0.01). Cross-lagged model comparisons indicated that the bidirectional path model achieved the best fit (χ2=12.65, RMSEA=0.017, CFI=1.000; △χ2=193.39, P < 0.01), supporting dynamic bidirectional associations among the three variables. After adjusting for gender, age, subjective social status and only-child status, T1 BMI Z-scores among adolescents positively predicted T2 weight stigma (β=0.061), and T1 weight stigma positively predicted T2 depressive symptoms (β=0.608); in the reverse direction, T1 depressive symptoms predicted T2 weight stigma (β=0.003), and T1 weight stigma predicted T2 BMI Z-scores (β=0.081) (all P < 0.01).  Conclusions  There is a bidirectional cross-lagged relationship among adolescents' BMI Z-scores and weight stigma with depressive symptoms, suggesting that weight stigma may serve as a key psychological variable linking obesity and depressive symptoms. Greater attention should be paid to the potential threat of weight stigma to adolescents' mental health, with intervention strategies expanded from a solely physiological focus to encompass psychosocial dimensions.
Evolution and development of mental health policies for children and adolescents in China
GUO Xiaoting, YANG Juan, DANG Jiajia, LI Jiaxin, CAI Shan, HUANG Tianyu, SUN Ziyue, ZHANG Yihang, YANG Ruolan, SONG Yi
2025, 46(9): 1246-1251. doi: 10.16835/j.cnki.1000-9817.2025227
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  Objective  To systematically review the development and changes in mental health policies within the National Outline for Children's Development in China from 1992 to 2030, providing a reference basis for future formulation of mental health policies among children and adolescent in China.  Methods  Based on the four editions of the National Outline for Children's Development in China across different periods from 1992 to 2030, word frequency analysis was used to reveal shifts in policy priorities, and an internationally recognized framework for adolescent health policy analysis was applied to conduct a textual review.  Results  Word frequency analysis revealed that the term "psychological" appeared 6 times in the National Outline for Children's Development in China (2001-2010) but increased to 20 times in the National Outline for Children's Development in China (2021-2030) (abbreviated as the National Outline of 2021), while the term "health" rose from 4 times in the National Outline for Children's Development Plan in China in the 1990s to 68 times in the National Outline of 2021. The scope of mental health policy interventions expanded to encompass five key areas: health, safety, education, welfare and legal protection. Textual analysis highlighted that the policies of the National Outline for Children's Development in China were demand-driven, prioritized vulnerable groups and continuously broadened their coverage, emphasizing sustainability and appropriateness, and monitoring/evaluation mechanisms. By 2023, 42.3% of primary schools and 64.8% of secondary schools employed full-time mental health education teachers. However, the National Outline for Children's Development in China lacked direct evidence of children and adolescents participation in policy formulation, and publicly available mental health data disaggregated by age and gender remained limited.  Conclusion  Mental health policies of children and adolescents in China have evolved from nonexistence to gradual refinement, yet institutionalized channels for youth involvement in policy development and evaluation remain insufficient, and transparency in age- and gender-specific mental health data needs improvement.
Student Nutrition
Monitoring results on iodine nutrition status of children in water-borne iodine-excess areas of Hebei Province from 2018 to 2023
YIN Zhijuan, JIA Lihui, TIAN Shenqian, GAO Xuejie, XU Ning, XU Dong, MA Jing
2025, 46(9): 1252-1256. doi: 10.16835/j.cnki.1000-9817.2025269
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  Objective  To investigate the iodine nutrition status of children in water-borne iodine-excess areas in Hebei Province, so as to provide references for scientific prevention and control of water-borne iodine-excess hazards.  Methods  From March to September each year during 2018 to 2023, a cross-sectional survey was conducted in 39 water-borne iodine-excess counties (measured in 2017) from 5 cities (Cangzhou, Hengshui, Xingtai, Handan and Langfang) in Hebei Province. The survey included the detection of iodine content in residents' drinking water, the measurement of thyroid volume in children aged 6-12, the detection of salt iodine and urinary iodine. The iodine nutrition status and water iodine distribution of 6-12 year-old children were evaluated from different perspectives such as years, gender, and age. Kruskal-Wallis H test, Mann-Whitney U test and Chi-square test were used for group comparison.  Results  A total of 38 755 children were surveyed from 2018 to 2023, and 1 270 drinking water samples were tested across the province. The mass volume concentration of iodine in water showed a decreasing trend over the years (Z=-30.87, P < 0.01). Among 38 470 salt samples monitored from children 's home, 24 790 were not non-iodized salt, with a non-iodized salt rate of 64.44%. A total of 31 989 urine samples were collected from children aged 8-10 years, with the median urine iodine was 245.94 μg/L. Comparing the results of urinary iodine in children from different years, the median urinary iodine from 2018 to 2023 were 328.0, 339.3, 267.8, 279.1, 291.3, 186.5 μg/L, respectively, with statistically significant differences (H=4 138.40, P < 0.01). Further pairwise comparisons showed that the median urinary iodine of children in 2023 was lower than in all other years (Z=-51.59 to -11.41, all P < 0.01). Among children aged 6-12 years, 1 150 cases of goiter were detected and the rate of goiter was 3.0%; and the goiter rates in boys and girls were 2.8% and 3.1%, with no significant difference between the sexes (χ2=2.76, P>0.05). There were significant differences in the rate of goiter among different years and ages (χ2=324.02, 191.61, both P < 0.05).  Conclusions  With the progress of water reform in water-borne iodine-excess areas of Hebei Province, children's iodine nutrition has reduced from excessive state to suitable state. It is necessary to continue to expand the coverage of water-based iodine reduction projects, and strengthen the monitoring of iodine nutrition status of key populations in water-borne iodine-excess areas.
Health Education and Promotion
Follow-up analysis on the relationship between 24-hour movement behaviors and physical fitness in preschool children
CHEN Lanzhi, WANG Junyu, LIANG Yixin, WANG Tian, HUANG Haiquan, ZHUANG Jie
2025, 46(9): 1257-1261. doi: 10.16835/j.cnki.1000-9817.2025279
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  Objective  To explore the cross-sectional and longitudinal associations between 24-hour movement behaviors and physical fitness in preschool children, and to adopt the method of equal time substitution analysis to evaluate the impact of time redistribution of different activity behaviors on physical fitness scores, so as to provide a scientific basis for promoting the health of preschool children.  Methods  A total of 193 preschool children aged 3-6 years were selected from three Shanghai districts (Jing'an, Baoshan, Jiading) from October to December 2023 by the stratified cluster random sampling method. The 24-hour movement behaviors were monitored via 7-day accelerometry, and physical fitness was measured according to the National Physical Fitness Measurement Standards (Revised 2023, preschool section). From October to December 2024, the follow-up of physical fitness among preschool children used the same testing method. The comparison between groups was conducted by t-test. Compositional regression analyses evaluated the relationship of 24-hour movement behaviors and physical fitness among preschool children.  Results  At baseline, moderate-to-vigorous physical activity (MVPA) time was significantly higher in boys [(84.10±25.78)min/d] than in girls [(70.44±25.98)min/d]; the composite physical fitness score was significantly higher in boys (71.65±8.69) than in girls (68.84±9.89), and the differences were statistically significant (t=3.65, 2.10, both P < 0.01). After adjusting for gender, age and body mass index, the results of component multiple linear regression analysis showed that MVPA time proportion was positively correlated with the composite physical fitness score at baseline among preschool children (β=6.61), but was negatively correlated with two-legged continuous hopping time at 1 year (β=-1.12) (both P < 0.05). Light physical activity (LPA) time proportion was negatively correlated with walking on the balance beam time at 1 year (β=-4.44), and sedentary behavior (SB) time proportion was negatively correlated with the composite score of physical fitness at baseline (β=-6.55) (both P < 0.05). Isotemporal substitution analysis revealed that replacing 10 minutes of sleep (SP), SB, and LPA with MVPA increased the baseline physical fitness composite score by 0.750, 0.689 and 0.575 units, respectively; at 1-year follow-up, the composite score increased by 1.440, 1.419 and 1.430 units, respectively (all P < 0.05). Conversely, replacing MVPA with 10 minutes of SP, SB, and LPA, resulted in decreases in baseline physical fitness composite scores of 0.836, 0.777 and 0.669 units, and reductions of 1.613, 1.592 and 1.598 units at 1-year follow-up (all P < 0.05).  Conclusions  Preschool children's 24-hour movement behaviors, especially MVPA, are closely related to physical health. Implementing appropriate strategies to increase physical activity and reduce sedentary time may improve the physical fitness of preschoolers.
Current status of indoor light-at-night exposure during sleep among children and adolescents in Shanghai
QU Shuangxiao, YAO Chunxia, GAO Guiling, YANG Dongling, ZHENG Keyang, HUANG Shenglei, ZHANG Fengyun, LUO Chunyan
2025, 46(9): 1262-1265. doi: 10.16835/j.cnki.1000-9817.2025264
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  Objective  To understand the indoor light-at-night (LAN) exposure intensity during sleep among children and adolescents in Shanghai, so as to provide a basis for exploring potential health risks and formulating effective interventions.  Methods  From April to December in 2024, a total of 628 students in grades 4-7 were recruited from three schools in Shanghai. A portable illuminance meter was used to measure LAN for one week, and participants recorded their sleep time. The Kruskal-Wallis H test was used for comparison between groups, and the error bar chart was used to show the trend and variation range of average LAN exposure intensity in different sleep periods.  Results  The indoor LAN exposure intensity of children and adolescents in Shanghai was [2.4(0.8, 5.9)lx] during sleep, and 28.8% of children and adolescents were exposed to indoor LAN≥5 lx. There was no significant differences in indoor LAN exposure intensity between boys [2.4(1.0, 5.9)lx] and girls [2.3(0.7, 5.9)lx] (Z=-0.86, P>0.05). The indoor LAN exposure intensity of primary school students [2.9(1.1, 6.6)lx] was higher than that of junior high school students [1.0(0.3, 3.1)lx] (Z=-5.87), and indoor LAN exposure intensity of students in the main urban area [3.2(1.1, 7.8)lx] was higher than that of rural students [1.6(0.5, 4.3)lx] (Z=-5.23)(both P < 0.05). The indoor LAN exposure intensity showed an overall decreasing trend during sleep of children and adolescents (tau=-0.81, P=0.02), with a slight increase before waking up.  Conclusions  Indoor LAN exposure intensity among children and adolescents in Shanghai is generally high, especially among primary school students and students living in the main urban area. Health policy and education should be strengthened to reduce the impact of LAN on children and adolescent health.
Mental Health
Association of parenting style with emotional and behavioral problems in preschool children
LIANG Xi, LI Ruoyu, FANG Jiao, WANG Xiaoyan, WANG Yuhui
2025, 46(9): 1266-1271. doi: 10.16835/j.cnki.1000-9817.2025273
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  Objective  To explore the effects of parenting style on emotional and behavioral problems (EBPs) of preschool children and to provide theoretical reference for promoting children's physical and mental health.  Methods  In October-November 2021, a stratified cluster random sampling method was adopted to select 3 575 preschool children aged 3-6 years from 12 kindergartens in Hefei. Data on parenting styles and children's EBPs were collected through electronic questionnaires. Binary Logistic regression model was used to explore the effects of parenting styles on children's EBPs.  Results  The detection rates of emotional symptoms, conduct problems, hyperactivity, peer interaction problems, and prosocial behavior problems were 15.5% (n=554), 23.2% (n=830), 22.4% (n=802), 38.2% (n=1 367), and 29.5% (n=1 055) in preschool children, respectively. Binary Logistic regression analysis showed that after adjusting for covariates such as child's age, sex, and preterm birth, a high authoritative parenting style reduced the risk of EBPs in children (OR=0.29-0.78), while a high authoritarian (OR=1.36-2.15) and high permissive (OR=1.36-1.68) parenting style in mothers increased the risk of EBPs in children (all P < 0.05). Further stratified analysis indicated that among children with fathers exhibiting high authoritative, high authoritarian, or high permissive parenting styles, a high authoritative parenting style in mothers reduced the risk of peer interaction problems and prosocial behavior problems (OR=0.51, 0.30; 0.44, 0.23; 0.51, 0.29, all P < 0.05). Among children with fathers exhibiting a high authoritative parenting style, a high authoritarian parenting style in mothers increased the risk of emotional problems (OR=2.59), and both high authoritarian and high permissive parenting styles in mothers increased the risk of conduct problems (OR=3.25, 2.09) and hyperactivity problems (OR=2.35, 2.87) (all P < 0.05). Among children with fathers exhibiting high authoritarian or high permissive parenting styles, a high authoritarian parenting style in mothers increased the risk of EBPs (OR=1.65-2.71, 1.62-2.52, all P < 0.05).  Conclusion  Parenting style is an important factor affecting EBPs of preschool children, and appropriate parenting style is beneficial for children's psychological development.
Characteristics of unintentional injury among college students and its association with sexual orientation and gender identity
LI Ruyu, ZHOU Xiaoding, GAO Qi, CHENG Peixia, ZHU Huiping
2025, 46(9): 1272-1276. doi: 10.16835/j.cnki.1000-9817.2025251
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  Objective  To analyze the occurrence of unintentional injuries among college students and their association with sexual orientation and gender identity, so as to provide a targeted scientific basis for injury prevention measures and intervention strategies.  Methods  From October 24 to November 18, 2023, a sample of 1 629 college students from two general universities in Beijing was selected using convenience sampling method. A questionnaire survey was conducted to collect information on the gender identity, sexual orientation and occurrence of unintentional injuries among college students in the past year. The Symptom Checklist-90 (SCL-90), Pittsburgh Sleep Quality Index (PSQI), Childhood Trauma Questionnaire (CTQ), and Delaware Bullying Victimization Scale-Student (DBVS-S) were used to assess mental health, sleep quality, childhood trauma, and dysfunctional impulsivity status. Analyses of sexual orientation and gender identity were conducted. The t-test and Chi-square test were used for intergroup comparison, and multivariate Logistic regression analysis was used to examine risk factors for unintentional injuries among college students of different gender identities.  Results  The incidence rate of unintentional injuries among college students was 16.94%, with boys (17.08%) being higher than girls (16.90%). Compared with those who did not experience unintentional injuries (5.28±3.60, 118.68±41.38), college students who experienced unintentional injuries had poorer sleep quality and mental health status (6.38±3.93, 135.59±50.96)(t=-3.92, -4.26); the differences in the incidence of unintentional injury among college students with non-suicidal self-injury, interpersonal violence, childhood trauma, and different sexual orientations and gender identities were all statistically significant (χ2=28.75, 75.18, 9.83, 16.20, 4.13) (all P < 0.05). Multivariate Logistic regression analysis showed that after adjusting for age, gender and body mass index, non-heterosexual orientation increased the risk of unintentional injuries (OR=1.61, 95%CI=1.09-2.38), whereas existing non-suicidal self-injury behaviors (OR=2.10, 95%CI=1.02-4.37) and poorer mental health status (OR=1.54, 95%CI=1.05-2.27) increased the risk of unintentional injuries among non-heterosexual college students (all P < 0.05).  Conclusions  The incidence rate of unintentional injuries among college students is relatively high, with non-heterosexual groups having increased risk of unintentional injuries. Mental health status and non-suicidal self-injury behaviors are important factors related to unintentional injuries among non-heterosexual college students.
Follow-up study on the association of anxiety and depressive symptoms with smartphone addiction among middle school students
JI Mingxia, YANG Jie, JIA Qu, DONG Ying, WANG Daosen, LI Zhumin, WEN Xiang, CHEN Qifei, LI Xiuhong
2025, 46(9): 1277-1281. doi: 10.16835/j.cnki.1000-9817.2025223
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  Objective  To investigate the changing trends for associations of anxiety and depressive symptoms with smartphone addiction among middle school students, so as to provide a scientific basis for preventing smartphone addiction in middle school students.  Methods  From 2022 to 2023, a method of combining convenient sampling with cluster sampling was used to select 8 923 middle school students from 27 junior high schools and 3 senior high schools in a district of Shenzhen City between September 2022 (baseline, T1) and September 2023 (follow-up, T2). The Smartphone Addiction Scale-Short Version (SAS-SV), Patients Health Questionnaire-9 Item (PHQ-9), and Generalized Anxiety Disorder 7-item Scale (GAD-7) were administered to assess smartphone addiction, anxiety and depressive symptoms. Mixed-effects models were used to analyze the association of anxiety and depressive symptoms with smartphone addiction among middle school students.  Results  From September 2022 to September 2023, the reported prevalence of smartphone addiction increased from 24.22% to 25.25% (χ2=45.71); and smartphone addiction scores [24.00(16.00, 32.00), 25.00(16.00, 33.00)], anxiety symptom scores [2.00(0.00, 7.00), 3.00(0.00, 7.00)] and depressive symptom scores[3.00(0.00, 8.00), 5.00(0.00, 9.00)] all significantly increased (Z=-17.43, -42.38, -41.57) (all P < 0.05). There were statistically significant difference in the distribution of anxiety and depression symptom levels among middle school students in 2022 and 2023 (χ2=85.15, 106.85, both P < 0.05). After adjusting for covariates such as age, gender and family background, mixed-effects models revealed dose-response associations of anxiety and depressive symptoms with smartphone addiction among middle school students: mild anxiety symptom(OR=3.22), moderate-to-severe anxiety symptom (OR=5.36), mild depressive symptom (OR=3.32) and moderate-to-severe depressive symptom (OR=6.13) were significantly associated with higher risks of smartphone addiction (all P < 0.05). Interaction effect analysis found that co-existing anxiety and depressive symptoms synergistically increased addiction risk by 5.60 times (OR=5.60) compared to the asymptomatic group, with 32% of the combined risk attributable to their interaction (S=1.64, AP=0.32)(both P < 0.05).  Conclusions  Anxiety and depressive symptoms are significantly associated with smartphone addiction, exhibiting a synergistic effect. Attention should be paid to emotional issues and smartphone addiction among middle school students.
Epidemiological characteristics and trends of non-suicidal self-injury among middle school students in Jiading District of Shanghai from 2015 to 2023
ZHU Yanhong, ZHANG Qin, LIU Xinxin, ZHANG Yanfei, JING Guangzhuang, GUO Manyu, XUE Junlei, PENG Qian, MA Feifei, YU Hongjie, SHI Huijing, PENG Hui
2025, 46(9): 1282-1286. doi: 10.16835/j.cnki.1000-9817.2025263
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  Objective  To analyze the epidemiological characteristics and changing trends of non-suicidal self-injury (NSSI) behaviors among middle school students in Jiading District of Shanghai, from 2015 to 2023, so as to provide a basis for the development of NSSI prevention and control measures among students.  Methods  Using a stratified cluster random sampling method, a total of five times for Shanghai Adolescent Health Risk Behavior Surveys were conducted for every two years in Jiading District of Shanghai from 2015 to 2023. A total of 5 231 middle school students from junior high schools and senior high schools were selected for questionnaire surveys. Intergroup comparisons were performed using the χ2 test or the χ2 trend test, and the JointPoint 5.0 software was used to analyze the changing trends, with the annual percent change (APC) used for evaluation. A binary Logistic regression model was employed to analyze the related factors of NSSI behavior among middle school students.  Results  In 2023, the reported NSSI rate among middle school students in Jiading District was 14.2%. The rate was significantly higher among junior high school students (17.1%) than that among senior high school students (11.1%), and higher among females (19.2%) than that among males (10.0%) (χ2=10.04, 23.21, both P < 0.01). From 2015 to 2023, the overall reported NSSI rate showed an increasing trend, rising from 8.6% in 2015 to 14.2% in 2023 (χtrend2=22.25), with an APC of 6.64% (t=3.49), and the APC for girls was 9.79% (t=3.20) (all P < 0.05). Among students reporting NSSI, the proportion experiencing ≥6 episodes increased from 10.8% in 2015 to 19.2% in 2023 (χtrend2=6.57, P < 0.05). Multivariate Logistic regression analysis indicated that girls, junior high school students, those with insomnia, depressive emotion and drinkers had higher risks of NSSI, compared to boys, senior high school students, those without insomnia, non-depressive emotion students and non-drinkers (OR=1.71, 1.96, 3.44, 4.76, 1.77, all P < 0.05).  Conclusions  The reported rate of NSSI among middle school students in Jiading District of Shanghai, increased annually from 2015 to 2023, and the proportion of repeated NSSI also showed an upward trend. Early intervention measures targeting middle school students, especially junior high school students and females, should be implemented to prevent and control its occurrence and development.
Cross-sectional and cross-lagged network analyses of Internet addiction among university students
GOU Hao, HUANG Wenying, SUN Qunqun, HU Chang, ZHANG Wen, XIANG Luyao, SONG Chao
2025, 46(9): 1287-1291. doi: 10.16835/j.cnki.1000-9817.2025277
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  Objective  To understand the dynamic temporal evolution pathways of Internet addiction among university students and to identify the core driving nodes, so as to provide theoretical evidences for the precise implementation of targeted interventions.  Methods  Using a convenient cluster sampling method, a total of 1 066 full-time freshmen and sophomores were recruited from three universities in Guizhou, Jiangxi, and Guangdong Provinces for a follow-up survey (T1:January-March 2024; T2:January-March 2025). The Revised Chen Internet Addiction Scale (CIAS-R) was employed to assess the status of Internet addiction among university students, and cross-sectional as well as cross-lagged panel network models were constructed to analyze Internet addiction and its multidimensional influencing factors.  Results  The T1 network comprised 19 nodes and 114 non-zero edges, while the T2 network comprised 19 nodes and 126 non-zero edges. Cross-sectional network analysis revealed the strongest association between "insufficient sleep" and "daytime fatigue"; the core nodes were "first thought upon waking for going online" and "feeling low after disconnection" (characteristics of psychological dependence) at T1, while the core nodes shifted to "impaired health" and "excitement when online" (characteristics of functional impairment and addictive psychodynamic features) at T2. Cross-lagged network analysis further indicated that "reduced leisure" directly predicted "sleep compression", and a bidirectional relationship was observed between "needing more time to achieve satisfaction" and "academic decline".  Conclusions  Internet addiction among university students exhibits dynamic evolutionary characteristics. Stage-specific targeted interventions focusing on core driving nodes are needed, integrating behavioral regulation and academic support to break the vicious cycle and enhancing the ability to cope with real-life demands.
Impact of childhood adversity and recent stressful events on procrastination of middle school students
HE Yitong, JIANG Weiqing, PENG Shuyi, LIU Qianyu, GUO Lan
2025, 46(9): 1292-1296. doi: 10.16835/j.cnki.1000-9817.2025271
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  Objective  To investigate the influence of childhood adversity on procrastination of middle school students, and to analyze the mediating effect and interaction of recent stressful events, providing a scientific basis for developing prevention and intervention strategies for procrastination behavior in adolescents.  Methods  In March 2023, a multi-stage cluster random sampling method was used to select 3 167 students from 9 junior and senior high schools in Guangzhou for investigation. Self-administered questionnaires were used to gather information on demographic characteristics, childhood adversity, procrastination and recent stressful life events. Generalized linear mixed models were employed to analyze the association between childhood adversity and procrastination among middle school students. Mediation analysis with multiplicative and additive interaction models were constructed to examine the mediating and interactive effects of recent stressful events.  Results  Among the middle school students, 28.8% reported experiencing at least one type of childhood adversity. The mean scores for recent stressful events and procrastination were (18.85±16.69) and (23.13±9.25), respectively. After adjusting for age, sex, school, household living conditions and economic status, parental education level, and depressive symptom, generalized linear mixed model analysis revealed that childhood adversity and its subdimensions were positively associated with procrastination among middle school students(β=0.83-3.27, all P < 0.05). Mediation analysis indicated that recent stressful events partially mediated the relationship between childhood adversity and procrastination among middle school students, accounting for 26.7% of the total effect. Interaction analysis showed no statistically significant interaction between childhood adversity and recent stressful events among middle school students[OR(95%CI)=0.98(0.60-1.36), RERI(95%CI)=0.87(-0.22-1.96), both P>0.05].  Conclusion  Childhood adversity is a potential risk factor for procrastination among middle school students, and recent negative life events partially mediate this association.
Association of adverse childhood experiences with the co-occurrence of non-suicidal self-injury and suicide attempts in junior high school students
WANG Zhouyan, YANG Siwei, WAN Xiaoke, CHEN Gen, LI Xia, PENG Chang, WANG Hong
2025, 46(9): 1297-1302. doi: 10.16835/j.cnki.1000-9817.2025247
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  Objective  To explore the independent effects and gender differences of different types of adverse childhood experiences (ACEs) on the co-occurrence of non-suicidal self-injury (NSSI) and suicide attempts (SA), so as to provide a reference for the precise prevention and control of self-harm in junior high school students.  Methods  From May to June 2023, a total of 7 360 junior high school students were selected from 12 schools in three districts/counties of Chongqing using a combination of stratified cluster sampling and convenience sampling methods. Information on NSSI, SA, ACEs, and depressive symptom, as well as other related data were collected through the Adolescent Non-suicidal Self-injury Assessment Questionnaire (ANSAQ), suicide-related section of the Chinese Adolescent Health-related Behavior Questionnaire (Junior High School Version), Childhood Trauma Questionnaire-Short Form (CTQ-SF), and Center for Epidemiologic Studies-Depression Scale (CES-D). Statistical analyses of the data were performed using the Chi-square test and multiple Logistic regression.  Results  The detection rates of NSSI, SA, NSSI+SA and ACEs in junior high school students were 19.2%, 4.6%, 3.5% and 57.9% respectively. After controlling for factors such as gender, grade, family type, self-rated family economic status, self-rated academic performance, self-rated academic pressure, number of close friends, and depressive symptom scores, results from the multiple Logistic regression analysis showed that junior high school students with physical abuse (OR=1.98, 95%CI=1.23-3.18), emotional abuse (OR=2.83, 95%CI=1.92-4.19), sexual abuse (OR=1.70, 95%CI=1.07-2.69), physical neglect (OR=1.67, 95%CI=1.20-2.33) and witnessing domestic violence (OR=2.10, 95%CI=1.41-2.87) in childhood had higher risks for the occurrence of NSSI+SA (all P < 0.05). After stratification by gender, boys with sexual abuse in childhood had a high risk for the occurrence of NSSI+SA (OR=2.17, 95%CI=1.06-4.43), whereas girls with emotional abuse (OR=3.69, 95%CI=2.29-5.94), physical neglect (OR=1.62, 95%CI=1.07-2.45) and witnessing domestic violence (OR=2.17, 95%CI=1.41-3.34) in childhood had hgih risks for the occurrence of NSSI+SA (all P < 0.05).  Conclusions  Different types of ACEs have different effects on the co-occurrence of self-harm in junior high school students and there are gender differences. When family interventions are conducted for the combined model, emphasis should be placed on aspects of emotional abuse and domestic violence while optimizing the interventions based on gender differences.
Correlation of physical activity and screen time with anxiety and depressive symptoms among college students
WANG Ziyu, ZHOU Long
2025, 46(9): 1303-1306. doi: 10.16835/j.cnki.1000-9817.2025241
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  Objective  To analyze the correlation of physical activity and screen time with anxiety and depressive symptoms among college students, so as to provide a reference for formulating intervention measures for anxiety and depressive symptoms among college students.  Methods  In May 2024, the method of combining convenient sampling with stratified sampling was adopted to select 3 076 college students from 5 colleges in Shaoxing of Zhejiang Province. Self-compiled general situation questionnaires, Screen Time Questionnaire, Self-rating Anxiety Scale and Self-rating Depression Scale were used to investigate the current status of college students' physical activities, screen time, anxiety and depressive symptoms, etc. Inter-group comparisons were conducted by using the χ2 test, Fisher's exact probability test, t-test or analysis of variance. A multivariate Logistic regression model was established to explore the correlations between physical activity, screen time with anxiety and depressive symptoms among college students.  Results  The constituent ratios of mild, moderate and severe anxiety symptoms were 59.97%, 28.99% and 11.04%, respectively. The constituent ratios of mild, moderate and severe depressive symptoms were 64.96%, 29.92% and 5.12%, respectively. There were statistically significant differences in the detection rates of anxiety symptom (χ2=15.99) and depressive symptom (χ2=16.54) among college students of different grades and screen time daily (both P < 0.05). There were statistically significant differences in physical activity among college students of different genders and subject types (t/F=11.67, 11.90, both P < 0.01). Multivariate Logistic regression analysis showed that when physical activity was at least 1 hour per week < 3 d, a screen time < 2 h/d could reduce the risk of anxiety symptoms among college students (OR=0.57), and screen time < 2, 2- < 3, 3- < 4 h/d could reduce the risk of depressive symptoms among college students (OR=0.65, 0.56, 0.64); when the number of days of physical activity exercise was at least 1 h per week ≥3 d, the occurrence risks of anxiety symptom(OR=0.49, 0.58) and depressive symptom (OR=0.36, 0.43) were reduced for students with screen time < 2 and 2- < 3 h/d (all P < 0.05).  Conclusions  There are correlations of physical activity and screen time with anxiety and depressive symptoms among college students. Low physical activity and longer screen time are more likely to increase the risk of anxiety and depressive symptom among college students.
Growth, Development and Surveillance
Impact of high-intensity interval training exercise prescription on the physical and mental health of female college students with obesity
CHEN Yang, LUO Yong, WANG Xiaoli, SUN Peng
2025, 46(9): 1307-1311. doi: 10.16835/j.cnki.1000-9817.2025262
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  Objective  To compare the effects of high-intensity interval training (HIIT) exercise prescription based on machine vision and routine on HIIT the physical and mental health of female college students with simple obesity, so as to provide a basis for the development of weight loss intervention plans for this population.  Methods  From August 2023 to February 2024, 115 female college students with simple obesity, selected from Lianyungang Vocational and Technical College and East China Normal University, were randomly divided into a control group (n=57) and an observation group (n=58) according to a random number table. The control group received routine HIIT, while the observation group received machine vision based on HIIT exercise prescription (including image acquisition module, image processing module, database management module, backend computer processing and feedback, intelligent evaluation module, which could be customized according to the subjects' preferences, providing exercise prescription based on the selected training program and supervised its standardized completion of the training plan). Both were intervened for 12 weeks, 30 minutes each time, once every 2 days, and rest every Sunday. The t-test was used to compare body shape, glucose and lipid metabolism, cardiopulmonary function indicators, anxiety and depression states between two groups before and after intervention.  Results  Before intervention, there were no statistically significant differences in physical and mental health status indicators between two groups of female college students (t=0.13-0.86, all P>0.05). After intervention, body mass indexes, waist hip ratios, body fat percentage, fasting plasma glucose, 2-hour postprandial plasma glucose, hemoglobin A1c, triglycerides, total cholesterol, lowdensity lipoprotein cholesterol (LDL-C), anxiety and depression scores were all reduced in both groups (tobservation=-6.94 to -12.92, tcontrol=-2.71 to -10.95), of which the observation group [(23.46±2.18)kg/m2, 0.70±0.06, (28.03±3.16)%, (4.55±0.67)mmol/L, (6.03±0.74)mmol/L, (5.10±0.70)%, (1.63±0.31)mmol/L, (4.24±0.58)mmol/L, (2.45±0.43)mmol/L, 35.28±4.76, and 33.03±4.03] were lower compared with the control group [(26.54±2.32)kg/m2, 0.77±0.06, (30.74±4.38)%, (5.03±0.76)mmol/L, (6.62±0.82)mmol/L, (5.82±0.73)%, (1.98±0.35)mmol/L, (4.95±0.61)mmol/L, (2.88±0.47)mmol/L, 39.18±5.04, and 37.25±4.16] (t=-7.34, -6.26, -3.81, -3.59, -4.05, -5.40, -5.68, -6.40, -5.12, -4.27, -5.53)(all P < 0.05). After intervention, high density lipoprotein cholesterol, stroke volume, left ventricular ejection fraction, maximum oxygen consumption, volume of tidal, and vital capacity increased in both groups (tobservation=7.43-18.23, tcontrol=3.89-10.13), of which the observation group [(1.49±0.22)mmol/L, (72.35±4.69)mL, (68.95±5.10)%, (36.97±3.22)mL/(kg · min), (25.29±4.11)mL/(kg · min), and (3 374.26±169.54)mL] were higher compared with the control group [(1.23±0.20)mmol/L, (67.32±4.06)mL, (64.83±5.05)%, (33.24±3.14)mL/(kg · min), (23.01±3.58)mL/(kg · min), and (3 197.50±125.81)mL] (t=6.63, 6.15, 4.35, 6.29, 3.17, 6.34)(all P < 0.05).  Conclusion  HIIT exercise prescription based on machine vision has better effects than routine HIIT on impoving the body shape, glucose and lipid metabolism, cardiopulmonary function of female college students with simple obesity, and also their mental health.
Change of forced vital capacity-to-weight index and future trend forecasting among Chinese Han students aged 7-18 during 2000-2019
ZHOU Yun, ZHANG Siying, ZHONG Yumei, TANG Lijun, LI Wenge, WU Xiulong
2025, 46(9): 1312-1317. doi: 10.16835/j.cnki.1000-9817.2025267
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  Objective  To explore the long-term trend of forced vital capacity-to-weight index (FWI) among Chinese Han students aged 7-18 from 2000 to 2019, and to predict its changes over the next decade, so as to provide scientific evidences for targeted health interventions and school health policies.  Methods  Based on the data of the five Chinese National Surveys on Students' Constitution and Health conducted from 2000 to 2019, a total of 216 500, 233 565, 215 267, 214 256 and 212 632 Han students aged 7-18 were included, respectively. The long-term trend of FWI among students was analyzed, and the GM (1, 1) grey model was used to predict FWI changes over the next decade. Subgroup analyses were conducted by sex, age, and urban-rural residence.  Results  The FWI levels of Chinese Han students aged 7-18 were (55.30±11.47)(47.43±11.92)(48.11±12.46)(48.75±12.81)(50.93±13.11)mL/kg in 2000, 2005, 2010, 2014, and 2019, respectively. The FWI of Chinese Han students showed a decreasing-then-increasing trend from 2000 to 2019, reaching the lowest point of approximately 47.03 mL/kg around 2006, and was projected to recover to 52.88 mL/kg by 2029. Boys had higher FWI for each year and the total level than girls from 2000 to 2019(t=72.58-304.66), and the decline between 2000 and 2005 was smaller in boys (13.1%) than in girls (15.4%). However, the gender gap gradually narrowed and was projected to reduce to 5.36 mL/kg by 2029. FWI increased with age, with the largest difference observed in 2014 between the 7-9 and 16-18 age groups (8.62 mL/kg). Before 2014, urban boys had slightly lower FWI than rural boys; the gap narrowed thereafter, and their FWI levels were expected to become similar by 2029. Urban girls generally had higher FWI than rural girls, and the urban-rural gap showed an increasing trend. By 2029, the largest difference was projected to occur in the 13-15 age group, reaching 7.74 mL/kg.  Conclusions  The FWI of Chinese Han students showed a trend of initial decline followed by a gradual increase from 2000 to 2019, with notable differences across sex, age, and urban-rural residence. Greater attention should be paid to the respiratory health of rural girls, and effective measures should be taken to reduce urban-rural disparities.
Association of physical activity and sedentary behavior with cardiorespiratory fitness among middle school students in Lhasa
LIU Chenyu, YUAN Meng, PENG Feng, SONG Bowen, ZHANG Xiaotong, LI Ming, LI Desheng, SUN Yi, YIN Xiaojian
2025, 46(9): 1318-1322. doi: 10.16835/j.cnki.1000-9817.2025270
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  Objective  To explore the relationship of physical activity (PA) and sedentary behavior (SB) with cardiorespiratory fitness (CRF) among middle schoold students in Tibet, so as to provide empirical references for improving the cardiorespiratory fitness and health levels of adolescents in Tibet.  Methods  From August to December 2020, 1 225 junior and senior high school students were selected from 2 middle schools in Lhasa, Tibet Autonomous Region, using the stratified cluster random sampling method. Triaxial accelerometers were used to evaluate PA and SB behaviors, and the 20-meter shuttle run was employed to assess CRF among the middle school students. Isochronous substitution modeling was used to analyze the associations of SB, low-intensity physical activity (LPA), and moderate-vigorous physical activity (MVPA) with CRF, and the saturation threshold effect in the dose-response relationship between MVPA and CRF was analyzed through restricted cubic spline and two-stage linear regression.  Results  After adjusting for covariates such as gender, body mass index and sleep quality score, isotemporal substitution analysis showed that among junior high school students aged 13-15, replacing 30 minutes of SB (B=1.73) or LPA (B=2.38) with MVPA were positively associated with CRF (both P < 0.05). Among senior high school students aged 16-18, replacing SB (B=0.99) or LPA (B=1.38) with MVPA were also positively associated with CRF (both P < 0.05). Restricted cubic spline and two-piecewise linear regression analyses indicated that only middle school girls aged 13-18 exhibited a saturation threshold effect between MVPA and CRF (logarithmic likelihood ratio test=0.03), with the optimal CRF improvement observed at 60 minutes of MVPA per day (B=0.13, P < 0.01).  Conclusions  Reducing SB and LPA while increasing MVPA can improve CRF in Tibetan middle school students. To maximize CRF improvement, middle school girls should engage in at least 60 minutes of MVPA daily.
Disease Control
Analysis of risk prevention behaviors and influencing factors of HIV infection among young students with MSM
ZHANG Xiaoyan, LIU Yuanyuan, DONG Jingran, LIN Zhan, ZHANG Junfeng, YANG Jie, YU Maohe, LI Changping, CUI Zhuang
2025, 46(9): 1323-1327. doi: 10.16835/j.cnki.1000-9817.2025268
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  Objective  To explore the potential category patterns of risk prevention and control behaviors of HIV infection among young students who have sex with men (MSM) and their impact on HIV infection and late detection, aiming to optimize intervention strategies.  Methods  From September 2017 to December 2024, a total of 1 637 MSM young students in Tianjin were recruited through both online and offline channels. Latent class analysis was applied to classify 11 HIV risk prevention and control behaviors. Multivariate Logistic regression analyzed associations between demographic characteristics/intervention services factors and latent classes. Differences in HIV infection and late detection across behavior patterns were compared.  Results  HIV risk prevention and control behaviors among MSM students were classified into three latent classes: condom-dependent group (38.42%), low prevention group (27.73%), and comprehensive prevention group (33.85%). Students who received condom promotion/testing services were more likely to belong to the comprehensive prevention group (OR=5.58), while those who received peer education were less likely to the comprehensive prevention group (OR=0.43) (both P < 0.01). Among the MSM student population, the HIV infection rate was 4.83%, with 2.26% of cases detected late. The HIV infection rate (1.45%) and late detection proportion (0.82%) in the comprehensive prevention group were lower than those in the low prevention group (7.89% and 3.83%, respectively) (χ2=16.20, 7.31, both P < 0.01).  Conclusions  HIV risk prevention and control behaviors among MSM young students exhibit significant heterogeneity. Comprehensive prevention strategies can effectively reduce HIV infection and late detection risks. It is necessary to optimize peer education content and improve the accessibility of diversified prevention measures such as PrEP/PEP to enhance HIV prevention and control.
Adverse treatment outcome and spatio-temporal characteristics of pulmonary tuberculosis cases among students in Qinghai Province, 2013-2023
MA Binzhong, LI Yongsheng, LIANG Da, SI Yajing
2025, 46(9): 1328-1332. doi: 10.16835/j.cnki.1000-9817.2025261
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  Objective  To analyze the adverse treatment outcome status and spatio-temporal characteristics of pulmonary tuberculosis cases among students in Qinghai Province, providing a reference basis for pulmonary tuberculosis prevention and control in schools.  Methods  The data of student pulmonary tuberculosis cases during 2013-2023 in Qinghai Province were obtained through the "National Tuberculosis Management Information System", and the treatment outcome was retrospectively analyzed. The Joinpoint model was applied to analyze the adverse outcome rate trend. Global and local spatial autocorrelation analysis, and spatiotemporal scan cluster analysis were conducted on the adverse outcome rate of pulmonary tuberculosis among students in Qinghai Province.  Results  During 2013-2023, 488 cases of adverse outcomes were reported among 6 155 students with pulmonary tuberculosis in Qinghai Province, with an adverse outcome rate of 7.93%. The reporting adverse outcome rate of pulmonary tuberculosis among students showed a downward trend from 2013 to 2023 (APC=-16.20, t=-3.89, P < 0.05). The results of spatial autocorrelation showed that the adverse outcome rate of pulmonary tuberculosis was Moran's I >0 among students in Qinghai Province. Among them, there was a spatially positive correlation in the adverse outcome rate of pulmonary tuberculosis among students in 2020, 2021 and 2022(all Z>1.96, all P < 0.05). The results of clustering and outlier analysis in local spatial autocorrelation showed that the areas with high-high aggregation were mainly concentrated in Yushu Prefecture(Zhiduo County, Zaduo County, Nangqian County, Yushu City), Huangnan Prefecture (Zeku County, Henan County) and Hainan Prefecture (Tongde County). The low-low concentration areas were distributed in Haidong City, Xining City, Haibei Prefecture (Gangcha County, Qilian County), Haixi Prefecture (Tianjun County, Ulan County), Hainan Prefecture (Gonghe County, Guide County) and Huangnan Prefecture (Tongren City, Jianzha County). The spatio-temporal scanning showed that a total of two possible aggregation areas had been detected. Among them, the first-level aggregation area composed of 10 counties and districts in Yushu Prefecture and Guoluo Prefecture of Qinghai Province, and the cluster radius was 658.09 km, the RR was 10.58, and the LLR was 305.91; the second-level aggregation area was composed of 16 counties and districts in Hainan Prefecture, Haixi Prefecture, Huangnan Prefecture and Guoluo Prefecture, and the cluster radius was 407.02 km, the RR was 9.83, and the LLR was 152.48 (both P < 0.05).  Conclusions  The reporting rates of adverse treatment outcome of pulmonary tuberculosis cases among students in Qinghai Province remain relatively high and unevenly distribute throughout the province. Supervision should be strengthened to improve cases compliance, and to reduce student pulmonary tuberculosis adverse treatment outcomes incidence.
Association between intergenerational parent-child separation and allergic diseases among rural preschool children
ZHU Min, MA Kai, ZHANG Anhui, YU Min, WANG Yufen, SUN Ying
2025, 46(9): 1333-1336. doi: 10.16835/j.cnki.1000-9817.2025274
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  Objective  To investigate the impact of intergenerational parent-child separation (PCS) on allergic diseases among rural preschool children, providing theoretical guidance for developing targeted public health interventions.  Methods  From March to June 2024, 10 kindergartens were selected from Nanling, Wuhu City, Anhui Province. A total of 2 279 children aged 3-6 years and their parents/primary caregivers participated in the survey by a combination of convenience sampling and cluster sampling method. Children's fathers and mothers reported the experiences of PCS during their childhood. The children's PCS experiences and allergies were reported by their primary caregivers. The International Study of Asthma and Allergies in Childhood (ISAAC) questionnaire was used to supplement the allergies (allergic asthma, allergic rhinitis and atopic dermatitis). Analysis of variance (ANOVA) and Chi-square tests were used to compare differences between children in different PCS groups. Logistic regression models assessed the association between PCS and the risk of allergic diseases in preschool children.  Results  Among the preschoolers enrolled, the prevalence of allergic diseases in only parent-child separation group in childhood, only child separation group, and the intergenerational continuity of PCS groups were significantly higher than those of the none separation group (38.0%, 41.8%, 48.1%, 30.4%; χ2=40.45, P < 0.01). After adjusting for covariates including child age, sex and body mass index, Logistic regression model revealed that compared to children in the group without PCS, those in the only parent-child separation in childhood(OR=1.43, 95%CI=1.06-1.94), only child separation (OR=1.82, 95%CI=1.22-2.71), and intergenerational continuity of PCS (OR=2.33, 95%CI=1.68-3.24) exhibited higher allergic disease risk (all P < 0.05).  Conclusions  Intergenerational continuity of PCS is related to the increased risk of allergies in preschool children. The multigenerational accumulation of adverse effects from PCS underscores the importance of breaking the cycle of disadvantage across generations.
Visualization analysis of research hotspots and trends in weight management for obese children from 2014 to 2024
ZHANG Ziqi, DONG Dengbo, ZOU Shengqiang
2025, 46(9): 1337-1341. doi: 10.16835/j.cnki.1000-9817.2025275
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  Objective  To analyze the research hotspots and advancements in weight management for obese children both domestically and internationally, providing a theoretical foundation for future studies of related fields.  Methods  Relevant literature for weight management of obese children were retrieved from CNKI, Wanfang, Weipu, Web of Science (WOS) databases for the period from January 1, 2014, to December 31, 2024. Excel, CiteSpace, and VOSviewer were used to analyze annual publication volume, authors, institutions, keywords, and other bibliometric characteristics.  Results  A total of 158 Chinese literature and 484 English literature were included. Domestic publications remained stable, while international publications fluctuated but stabilized during 2018-2022. The publication volume and institutional collaboration map indicated that foreign scholars' collaborations were concentrated, whereas domestic collaborations were scattered. The foreign scholar with the highest number of publications was Ball (29 articles). And the country with the most publications was the United States (256 articles). Journal dual-map overlay indicated future would focus on medicine, internal medicine and clinical medicine. Both domestic and foreign studies focused on participants, weight management methods and monitoring indicators, with foreign studies further exploring research methods.  Conclusions  In the past decades, weight management methods and specific measures have been a primary focus in this field, with distinct priorities observed between domestic and international scholars. In the future, international exchanges and cooperation should be strengthened, and weight management plans for obese children with Chinese characteristics should be developed according to actual conditions.
Prevalence trends of elevated blood pressure and its association with nutritional status among primary and secondary school students in Inner Mongolia
LI Guofeng, ZHANG Xiuhong, YANG Tian, ZHAO Jing, ZHAO Jufang, TIAN Shujuan, GAO Jianqiong, PEI Haotian, YU Dong, ZHANG Rong, MA Caixia
2025, 46(9): 1342-1345. doi: 10.16835/j.cnki.1000-9817.2025265
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Abstract:
  Objective  To analyze the prevalence trends of different types of elevated blood pressure and their association with nutritional status among primary and secondary school students in Inner Mongolia from 2019 to 2024, providing references for targeted prevention strategies.  Methods  From September 2019 to 2024, a stratified random cluster sampling method was used to select 12 primary and secondary schools from each league city in Inner Mongolia Autonomous Region. A total of 177 108, 137 758, 190 182, 180 084, 188 056, 180 351 primary and secondary school students (excluding grades one to three of primary school) were included for physical examination. The correlation between their nutritional status and high blood pressure was analyzed based on the basic situation of 129 821 primary and secondary school students who completed a questionnaire survey at the same time in 2024. Statistical analysis was conducted using a Chi-square test and multiple Logistic regression model.  Results  From 2019 to 2024, the detection rates of elevated blood pressure were 13.60%, 13.68%, 17.60%, 17.24%, 14.77% and 15.96%, respectively. The rates for isolated systolic hypertension were 4.24%, 5.83%, 7.26%, 7.19%, 6.24% and 6.93%; isolated diastolic hypertension rates were 6.38%, 4.99%, 6.23%, 6.41%, 5.39% and 5.66%; and combined systolic and diastolic hypertension rates were 2.97%, 2.86%, 4.11%, 3.65%, 3.14% and 3.36%. Multivariate Logistic regression analysis showed that girls, junior high school, senior high school, overweight, and obesity were positively associated with elevated blood pressure risk (OR=1.27, 1.25, 1.32, 1.66, 3.07, all P < 0.05); conversely, county residence, Mongolian ethnicity, and other ethnicities showed negative associations (OR=0.90, 0.93, 0.90, all P < 0.05).  Conclusions  Overweight and obesity among children and adolescents are closely related to various types of elevated blood pressure. Prevention strategies should prioritize effectively controlling weight issues among children and adolescents, thereby effectively reducing the incidence of elevated blood pressure.
Epidemiological characteristics analysis of pulmonary tuberculosis among children aged 0-14 in Shaanxi Province from 2010 to 2024
HE Zhiqiang, ZHAO Yan, LI Kaikai, ZHANG Hongwei
2025, 46(9): 1346-1350. doi: 10.16835/j.cnki.1000-9817.2025276
Abstract(37) HTML (14) PDF(2)
Abstract:
  Objective   To analyze the epidemiological characteristics and incidence trends of pulmonary tuberculosis (TB) in children aged 0-14 years in Shaanxi Province from 2010 to 2024, so as to provide a reference for optimizing child TB prevention and control strategies.   Methods   Data on pulmonary TB cases in children aged 0-14 years and demographic information in Shaanxi Province from 2010 to 2024 were collected from Surveillance and Reporting Management System with Disease Prevention and Control Information Management System under the National Health Security Informatization Project Disease Prevention and Control Information System. A Joinpoint regression model was established to analyze the temporal, spatial, and population distribution trends of child pulmonary TB incidence.   Results   A total of 2 954 cases of pulmonary TB in children aged 0-14 years were reported in Shaanxi Province from 2010 to 2024, accounting for 0.97% of all TB cases in the general population. The average annual reported incidence rate in children was 3.32 per 100 000. Among these cases, 804 were pathogenetically positive, showing a increasing trend (χtrend2=420.94, P < 0.01). The overall reported incidence rate of pulmonary TB in children aged 0-14 years in Shaanxi Province showed a decreasing trend, dropping from 5.35 per 100 000 in 2010 to 2.41 per 100 000 in 2024. Joinpoint regression analysis identified three distinct phases for the reported incidence rate of TB: a rapid decline from 2010 to 2013 (APC=-20.02%, 95%CI=-33.64% to -10.42%), a slight increase from 2013 to 2017 (APC=11.18%, 95%CI=3.07%-24.17%) and a slight decline again from 2017 to 2024 (APC=-7.27%, 95%CI=-12.73% to -4.30%) (all P < 0.01). Among children aged 0-14 years, the age group with the highest average annual reported incidence rate was 10-14 years (8.02 per 100 000), followed by 5-9 years (1.44 per 100 000), and 0-4 years had the lowest rate (0.95 per 100 000). The difference in reported incidence rates among the three age groups was statistically significant (χ2=51.91, P < 0.01). The average annual reported incidence rate of TB was 3.25 per 100 000 in boys and 3.39 per 100 000 in girls, with no statistically significant difference (χ2=2.01, P>0.05). There was no obvious periodic variation in the annual case reporting. Among all cities in Shaanxi Province, Ankang City had the highest average annual reported incidence rate (5.16 per 100 000).   Conclusions   From 2010 to 2024, the reported incidence rate of pulmonary TB in children aged 0-14 years in Shaanxi Province showed an overall decreasing trend. However, it is still necessary to strengthen active surveillance, implement targeted measures in high-incidence areas such as Ankang City, and maintain continuous attention to child TB prevention and control.
Follow-up analysis of tuberculosis incidence risk and risk factors among middle school students in Chongqing
ZHANG Wen, SU Qian, LIAO Wenping, ZHANG Liyi, XIN Yu, LÜ Juan, LUO Jie, SHI Lin, FAN Jun, SHI Yaling
2025, 46(9): 1351-1354. doi: 10.16835/j.cnki.1000-9817.2025280
Abstract(32) HTML (13) PDF(3)
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  Objective   To understand the incidence risk and risk factors of tuberculosis (TB) among middle school students in Chongqing, so as to provide a basis for formulating TB prevention and control strategies.   Methods   From September to December 2022, 32 181 middle school students were selected as the study cohort from 15 administrative districts in Chongqing by using the stratified cluster random sampling method. All cohort members were screened with the tuberculin skin test (TST), and relevant information was collected from January 1, 2023 to December 31, 2024. On the basis of active screening, the follow-up data of the participants were compared with the National Tuberculosis Management Information System to obtain the incidence status of the study subjects. The Log-rank test was used to compare the TB incidence rates among students with different characteristics, and a Cox proportional hazards model was established to analyze the incidence risk and risk factors of TB.   Results   The TST screening rate of the cohort members was 93.0%. During the 2-year follow-up period, a total of 36 TB cases occurred, with a cumulative incidence rate of 111.87/100 000 and an incidence density of 55.95/100 000. Among them, the cumulative incidence rate of students from public schools (170.44/100 000) was higher than that of students from private schools (41.16/100 000), the cumulative incidence rate of students in schools located in high-epidemic areas (153.95/100 000) was higher than that in medium-epidemic areas (69.00/100 000), and the difference was statistically significant (χ2=11.49, 4.73, both P < 0.05). The Log-rank test for different TST results showed that the difference in TB comulative incidence rate between students with strongly positive TST results (216.55/100 000) and those with negative TST results (81.40/100 000) was statistically significant (χ2=5.85, P < 0.05). Univariate analysis using the Cox proportional hazards model revealed that the risk of TB was lower in students from private schools (HR=0.25, 95%CI=0.10-0.59) and students in medium-epidemic areas (HR=0.46, 95%CI=0.23-0.94); whereas the risk of TB was increased in students with strongly positive TST results (HR=1.39, 95%CI=1.05-1.84) (all P < 0.05). Multivariate Cox regression analysis showed that the risk of TB in students from private schools was lower than that of students from public schools (HR=0.23, 95%CI=0.08-0.62, P < 0.05).   Conclusions   The annual average incidence rate of TB among middle school students in Chongqing is at a relatively high level. It is necessary to strengthen the management and intervention for student groups, including those in public schools, those in schools located in high-epidemic areas, and those with strongly positive TST results, so as to reduce the incidence rate of TB.
Review
Research progress on adolescent health literacy assessment tools
ZHOU Qingyuan, YIN Zhihua, JIANG Jiajun
2025, 46(9): 1355-1360. doi: 10.16835/j.cnki.1000-9817.2025282
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Adolescent health literacy constitutes a fundamental, economical and effective strategy for addressing their health issues and fostering healthy behaviors, while assessing health literacy plays a pivotal role in evaluating adolescents' health literacy. The study systematically reviews existing adolescent health literacy assessment tools at both domestically and internationally, and analyzes them through three dimensions: structural components, applicability and scientific validity. It further examines emerging trends in the development of such tools, aiming to offer theoretical underpinnings and practical recommendations for their refinement, thereby more effectively addressing the evolving health needs of adolescents.
Research progress and implications of pediatric inactivity triad
LIU Haochong, YANG Wenpu, BAO Dapeng, LIU Haoyang
2025, 46(9): 1361-1364. doi: 10.16835/j.cnki.1000-9817.2025272
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The framework of pediatric inactivity triad (PIT) consists of three core factors: exercise deficit disorder, pediatric dynapenia, and physical illiteracy. It emphasizes that physical activity (PA) insufficiency is not a singular phenomenon but rather a vicious cycle resulting from the interaction of multiple factors. Based on the PIT framework, the paper explores its core components and their interrelationships, as well as analyzes the framework's application value and practical implications for improving PA levels among Chinese children and adolescents, to provide a systematic theoretical perspective for analyzing the complex causes of PA insufficiency in children and adolescents, and to offer a scientific basis for developing intervention strategies.
Research progress on influencing factors and behavioral interventions for bedtime procrastination in adolescents
LI Nan, HU Yue
2025, 46(9): 1365-1368. doi: 10.16835/j.cnki.1000-9817.2025281
Abstract(52) HTML (22) PDF(8)
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Sleep serves as a fundamental pillar for healthy development of adolescents. However, insufficient sleep has become a common challenge among adolescents worldwide. Among the various factors disrupting sleep, bedtime procrastination is increasingly recognized as a key disruptor of adolescents' sleep rhythms. The internal influencing factors of bedtime procrastination in individuals mainly include cognitive bias, emotional needs, delayed circadian rhythms, and imbalanced development of brain regions; and the external environmental factors mainly include family, school and digital media environment. The intervention methods for sleep include cognitive-behavioral therapy, motivational interviews, family support, regular physical exercise, so as to promote sleep health in adolescents.