小学生体力活动视屏时间和情绪行为问题的关系

桂曌环; 汪慧; 张婧姝; 陈亚军

doi:10.16835/j.cnki.1000-9817.2021.08.004

小学生体力活动视屏时间和情绪行为问题的关系

doi: 10.16835/j.cnki.1000-9817.2021.08.004

中山大学公共卫生学院妇幼卫生学系，广东广州 510080

基金项目:

国家自然科学基金项目 81673193

详细信息

作者简介:
桂曌环(1991-)，女，安徽芜湖人，在读博士，主要研究方向为视屏时间和儿童心理行为

通讯作者:
陈亚军，E-mail：chenyj68@mail.sysu.edu.cn

中图分类号: R179 G478 G444
计量
- 文章访问数: 1360
- HTML全文浏览量: 556
- PDF下载量: 129
- 被引次数: 0
出版历程
- 收稿日期: 2020-11-19
- 修回日期: 2020-12-26
- 网络出版日期: 2021-08-20
- 刊出日期: 2021-08-25

Associations of physical activity and screen time with emotional and behavioral problems in children

Department of Maternal and Child Health, School of Public Health, Sun Yat-sen University, Guangzhou(510080), China

摘要

摘要: 目的探讨中高等强度体力活动(moderate-to-vigorous intensity physical activity, MVPA)、视屏时间(screen time, ST)和儿童情绪与行为问题的关联，为筛查学龄儿童心理问题和制定相关干预措施提供参考。方法采用分层整群随机抽样，于2017年3月在广州市5个区各抽取1所小学，纳入4 922名6~12岁小学生。问卷收集学生的社会人口学信息、MVPA、ST和情绪行为问题。采用广义线性混合回归模型分析MVPA、ST和情绪行为问题的关系。结果平均每天MVPA≥60 min的学生占37.5%，平均每天ST≤2 h的学生占87.7%。与低水平MVPA组(< 60 min/d)相比，高水平MVPA组(≥60 min/d)学生在多动行为、同伴交往和困难总分较低，亲社会行为得分较高(t值分别为2.80，2.47，2.56，-1.97，P值均 < 0.05)。与高水平ST组(>2 h/d)相比，低水平ST组(≤2 h/d)儿童在情绪症状、品行问题、多动行为、同伴交往和困难总分各维度得分较低，亲社会行为得分较高(t值分别为3.18，3.35，3.70，3.80，-3.21，4.97，P值均 < 0.05)。低水平MVPA和高水平ST的联合暴露会增加儿童品行问题(OR=1.45，95%CI=1.02~2.05)、同伴交往(OR=1.93，95%CI=1.11~3.36)、亲社会行为(OR=1.55，95%CI=1.08~2.23)和困难总分(OR=1.73，95%CI=1.12~2.68)发生风险。结论 MVPA和ST独立与儿童情绪和行为问题有关，且MVPA不足和ST较长的联合暴露可以增加儿童情绪与行为问题的发生风险。
- 运动活动 /
- 注视，眼 /
- 时间 /
- 情绪 /
- 回归分析 /
- 儿童
Abstract: Objective To investigate the associations of moderate-to-vigorous intensity physical activity (MVPA) and screen time (ST) with emotional and behavioral problems in children and to provide evidence for related intervention measures. Methods In March 2017, a total of 4 922 children aged 6-12 years from 5 primary schools in Guangzhou were enrolled using stratified random cluster sampling method. Questionnaires were used to assess children's socio-demographic information, MVPA, ST and emotional and behavioral problems. The associations of MVPA and ST with behavioral problems were explored by using generalized linear mixed models. Results Students with MVPA≥60 min per day accounted for 37.5%, and with ST≤2 h per day accounted for 87.7%. Children who were physically active showed lower scores for total difficulties, hyperactivity, and peer problems and higher score for prosocial than inactive peers(t=2.80, 2.47, 2.56, -1.97, all P < 0.05). Also, children who spent less than 2 h ST per day reported lower scores for total difficulties, emotional symptoms, conduct problems, hyperactivity, and peer problems and higher score for prosocial compared to those with high ST(t=3.18, 3.35, 3.70, 3.80, -3.21, 4.97, all P < 0.05). Children who met neither MVPA nor ST recommendations had significantly increased risks of total difficulties(OR=1.73, 95%CI=1.12-2.68), conduct problems(OR=1.45, 95%CI=1.02-2.05), peer problems(OR=1.93, 95%CI=1.11-3.36), and prosocial (OR=1.55, 95%CI=1.08-2.23) than those who met both. Conclusion MVPA and ST are independently related to children's emotional and behavioral problems, and the risks of emotional and behavioral problems increased in children with insufficient MVPA and longer ST.
- Motor activity /
- Fixation, ocular /
- Time /
- Emotions /
- Regresson analysis /
- Child

HTML全文

表 1 不同性别学生MVPA与ST分布比较

Table 1. The distribution of MVPA and ST across sex of primary school students

性别	人数	MVPA/(min·d^-1)			ST/(h·d^-1)			MVPA和ST
性别	人数	60	≥60	χ²值	≤2	>2	χ²值	低水平MVPA 高水平ST	低水平MVPA 低水平ST	高水平MVPA 高水平ST	高水平MVPA 低水平ST	χ²值
男	2 663	1 574(59.1)	1 089(40.9)	34.0	2 311(86.8)	352(13.2)	8.8	192(7.2)	1 377(51.7)	152(5.7)	943(35.4)	45.3
女	2 259	1 500(66.4)	759(33.6)		2 006(88.8)	253(11.2)		142(6.3)	1 365(60.4)	109(4.8)	642(28.4)
合计	4 922	3 076(62.5)	1 846(37.5)		4 317(87.7)	605(12.3)		335(6.8)	2 742(55.7)	261(5.3)	1 585(32.2)
注：( )内数字为构成比/%。P值均 < 0.01。

下载: 导出CSV

表 2 不同水平MVPA和ST小学生SDQ各维度得分比较(x±s)

Table 2. Scores of SDQ of primary school students by MVPA and ST categories(x±s)

变量	组别	人数	统计值	困难总分	情绪症状	品行问题	多动行为	同伴交往	亲社会行为
MVPA	< 60	3 076		9.87±0.24	1.82±0.08	1.76±0.07	4.06±0.09	2.24±0.05	7.08±0.11
/(min·d^-1)	≥60	1 846		9.45±0.25	1.71±0.08	1.80±0.08	3.85±0.09	2.12±0.06	7.21±0.11
			t值	2.56	1.91	-0.78	2.80	2.47	-1.97
			P值	0.01	0.06	0.44	0.01	0.01	0.05
ST	>2	605		10.28±0.30	1.90±0.10	1.90±0.09	4.16±0.12	2.33±0.08	6.98±0.13
/(h·d^-1)	≤2	4 317		9.04±0.22	1.62±0.07	1.66±0.07	3.75±0.08	2.03±0.04	7.31±0.10
			t值	4.97	3.18	3.35	3.70	3.80	-3.21
			P值	< 0.01	< 0.01	< 0.01	< 0.01	< 0.01	< 0.01

下载: 导出CSV

表 3 MVPA和ST联合暴露与小学生SDQ得分的关系[B值(B值95%CI)，n=4 922]

Table 3. Joint associations of MVPA and ST with scores of SDQ of primary school students[B(B 95%CI), n=4 922]

SDQ	高MVPA高ST	低MVPA低ST	低MVPA高ST
困难总分	1.46(0.71~2.21)^*	0.47(0.12~0.82)^*	1.56(0.90~2.22)^*
情绪症状	0.20(-0.06~0.47)	0.09(-0.03~0.22)	0.43(0.20~0.67)^*
品行问题	0.30(0.08~0.52)^*	-0.03(-0.13~0.08)	0.18(-0.02~0.37)
多动行为	0.57(0.24~0.89)^*	0.24(0.08~0.39)^*	0.53(0.24~0.81)^*
同伴交往	0.31(0.08~0.54)^*	0.13(0.02~0.24)^*	0.41(0.21~0.62)^*
亲社会行为	-0.30(-0.61~0.01)	-0.13(-0.27~0.02)	-0.49(-0.76~-0.21)^*
注：*P < 0.05。

下载: 导出CSV

表 4 MVPA和ST联合暴露与小学生情绪与行为问题的关系[OR值(OR值95%CI)，n=4 922]

Table 4. Joint associations between MVPA and ST with emotion and behavioral problems of primary school students [OR(OR 95%CI), n=4 922]

SDQ	高MVPA高ST	低MVPA低ST	低MVPA高ST
困难总分	1.67(1.01~2.75)^*	1.20(0.92~1.56)	1.73(1.12~2.68)^*
情绪症状	1.14(0.69~1.89)	0.98(0.77~1.25)	1.48(0.98~2.24)
品行问题	1.44(0.97~2.14)	0.98(0.81~1.20)	1.45(1.02~2.05)^*
多动行为	1.27(0.74~2.20)	1.19(0.91~1.55)	1.15(0.70~1.87)
同伴交往	1.73(0.90~3.32)	1.19(0.83~1.71)	1.93(1.11~3.36)^*
亲社会行为	1.07(0.68~1.67)	1.15(0.93~1.41)	1.55(1.08~2.23)^*
注：*P < 0.05。

下载: 导出CSV

参考文献(40)

[1]	Committee PAGA. Physical activity and guidelines advisory committee scientific report[R]. Washington, DC: US Department of Health and Human Services, 2018.
[2]	SALLIS J F, BULL F, GUTHOLD R, et al. Progress in physical activity over the olympic quadrennium[J]. Lancet, 2016, 388(10051): 1325-1336. doi: 10.1016/S0140-6736(16)30581-5
[3]	ROMAN-VINAS B, CHAPUT J P, KATZMARZYK P T, et al. Proportion of children meeting recommendations for 24-hour movement guidelines and associations with adiposity in a 12-country study[J]. Int J Behav Nutr Phys Act, 2016, 13(1): 123. doi: 10.1186/s12966-016-0449-8
[4]	Sedentary Behaviour Research Network. Letter to the editor: standardized use of the terms "sedentary" and "sedentary behaviours"[J]. Appl Physiol Nutr Metab, 2012, 37(3): 540-542. doi: 10.1139/h2012-024
[5]	WIJNDAELE K, WHITE T, ANDERSEN LB, et al. Substituting prolonged sedentary time and cardiovascular risk in children and youth: a meta-analysis within the International Children's Accelerometry database(ICAD)[J]. Int J Behav Nutr Phys Act, 2019, 16(1): 96. doi: 10.1186/s12966-019-0858-6
[6]	COSTIGAN S A, BARNETT L, PLOTNIKOFF R C, et al. The health indicators associated with screen-based sedentary behavior among adolescent girls: a systematic review[J]. J Adolesc Health, 2013, 52(4): 382-392. doi: 10.1016/j.jadohealth.2012.07.018
[7]	HANCOX R J, MILNE B J, POULTON R. Association between child and adolescent television viewing and adult health: a longitudinal birth cohort study[J]. Lancet, 2004, 364(9430): 257-262. doi: 10.1016/S0140-6736(04)16675-0
[8]	American Academy of Pediatrics. Committee on public education. American Academy of Pediatrics: Children, adolescents, and television[J]. Pediatrics, 2001, 107(2): 423-426. doi: 10.1542/peds.107.2.423
[9]	ZHU Z, TANG Y, ZHUANG J, et al. Physical activity, screen viewing time, and overweight/obesity among Chinese children and adolescents: an update from the 2017 physical activity and fitness in China-the youth study[J]. BMC Public Health, 2019, 19(1): 197. doi: 10.1186/s12889-019-6515-9
[10]	POLANCZYK G V, SALUM G A, SUGAYA L S, et al. Annual research review: a meta-analysis of the worldwide prevalence of mental disorders in children and adolescents[J]. J Child Psychol Psychiatry, 2015, 56(3): 345-365. doi: 10.1111/jcpp.12381
[11]	CASPI A, MOFFITT T E, NEWMAN D L, et al. Behavioral observations at age 3 years predict adult psychiatric disorders. Longitudinal evidence from a birth cohort[J]. Arch Gen Psychiatry, 1996, 53(11): 1033-1039. doi: 10.1001/archpsyc.1996.01830110071009
[12]	MARMOT M, AI E. The marmot review: fair society, healthy lives. strategic review of health inequalities in England post 2010[R]. London: Institute of Health Equity, 2010.
[13]	KANTOMAA M T, TAMMELIN T H, EBELING H E, et al. Emotional and behavioral problems in relation to physical activity in youth[J]. Med Sci Sports Exerc, 2008, 40(10): 1749-1756. doi: 10.1249/MSS.0b013e31817b8e82
[14]	AHN J V, SERA F, CUMMINS S, et al. Associations between objectively measured physical activity and later mental health outcomes in children: findings from the UK Millennium Cohort Study[J]. J Epidemiol Commun Health, 2018, 72(2): 94-100. doi: 10.1136/jech-2017-209455
[15]	SLYKERMAN R F, BUDD C, THOMPSON J M D, et al. Physical activity, sleep, body mass index, and associated risk of behavioral and emotional problems in childhood[J]. J Dev Behav Pediatr, 2020, 41(3): 187-194. doi: 10.1097/DBP.0000000000000754
[16]	WU X, TAO S, RUTAYISIRE E, et al. The relationship between screen time, nighttime sleep duration, and behavioural problems in preschool children in China[J]. Eur Child Adolesc Psychiatry, 2017, 26(5): 541-548. doi: 10.1007/s00787-016-0912-8
[17]	GUERRERO M D, BARNES J D, CHAPUT J P, et al. Screen time and problem behaviors in children: exploring the mediating role of sleep duration[J]. Int J Behav Nutr Phys Act, 2019, 16(1): 105. doi: 10.1186/s12966-019-0862-x
[18]	CARLSON S A, FULTON J E, LEE S M, et al. Influence of limit-setting and participation in physical activity on youth screen time[J]. Pediatrics, 2010, 126(1): e89-e96. doi: 10.1542/peds.2009-3374
[19]	GARCÍA-HERMOSO A, SAAVEDRA J M, RAMÍREZ-VÉLEZ R, et al. Reallocating sedentary time to moderate-to-vigorous physical activity but not to light-intensity physical activity is effective to reduce adiposity among youths: a systematic review and meta-analysis[J]. Obes Rev, 2017, 189(9): 1088-1095.
[20]	ROSENBERGER M E, FULTON J E, BUMAN M P, et al. The 24-hour activity cycle: a new paradigm for physical activity[J]. Med Sci Sports Exerc, 2019, 51(3): 454-464. doi: 10.1249/MSS.0000000000001811
[21]	GARCIA-HERMOSO A, HORMAZABAL-AGUAYO I, FERNANDEZ-VERGARA O, et al. Physical activity, screen time and subjective well-being among children[J]. Int J Clin Health Psychol, 2020, 20(2): 126-134. doi: 10.1016/j.ijchp.2020.03.001
[22]	曹慧. 体力活动、视屏时间与青少年心理健康关系研究[D]. 合肥: 安徽医科大学, 2012. CAO H. Physical activity, screen time and mental health among adolescents in China[D]. Hefei: Anhui Medical University, 2012.
[23]	屈宁宁, 李可基. 国际体力活动问卷中文版的信度和效度研究[J]. 中华流行病学杂志, 2004, 25(3): 87-90. https://www.cnki.com.cn/Article/CJFDTOTAL-ZHLX200403030.htm QU N N, LI K J. Study on the relibility and validity of international physical activity questionnaire(Chinese version, IPAQ)[J]. Chin J Epidemiol, 2004, 25(3): 87-90. https://www.cnki.com.cn/Article/CJFDTOTAL-ZHLX200403030.htm
[24]	WHO. Global recommendations on physical activity for health: WHO guidelines approved by the guidelines review committee[Z]. Geneva: WHO, 2010.
[25]	DU Y, KOU J, COGHILL D. The validity, reliability and normative scores of the parent, teacher and self report versions of the strengths and difficulties questionnaire in China[J]. Child Adolesc Psychiatry Ment Health, 2008, 2(1): 8. doi: 10.1186/1753-2000-2-8
[26]	SILVA D, CHAPUT J P, KATZMARZYK P T, et al. Physical education classes, physical activity, and sedentary behavior in children[J]. Med Sci Sports Exerc, 2018, 50(5): 995-1004. doi: 10.1249/MSS.0000000000001524
[27]	DAY K. Physical environment correlates of physical activity in developing countries: a review[J]. J Phys Act Health, 2018, 15(4): 303-314. doi: 10.1123/jpah.2017-0184
[28]	ZHANG T. Modeling the effect of physical activity on obesity in China: evidence from the longitudinal China health and nutrition study 1989-2011[J]. Int J Environ Res Public Health, 2017, 14(8): 844. doi: 10.3390/ijerph14080844
[29]	BELL S L, AUDREY S, GUNNELL D, et al. The relationship between physical activity, mental wellbeing and symptoms of mental health disorder in adolescents: a cohort study[J]. Int J Behav Nutr Phys Act, 2019, 16(1): 138. doi: 10.1186/s12966-019-0901-7
[30]	BORNHORST C, WIJNHOVEN T M, KUNESOVA M, et al. WHO european childhood obesity surveillance initiative: associations between sleep duration, screen time and food consumption frequencies[J]. BMC Public Health, 2015, 15(3): 442. http://smartsearch.nstl.gov.cn/paper_detail.html?id=bdb242e8af0261b6fdab998e1d8ab9a0
[31]	HALE L, GUAN S. Screen time and sleep among school-aged children and adolescents: a systematic literature review[J]. Sleep Med Rev, 2015, 21: 50-58. doi: 10.1016/j.smrv.2014.07.007
[32]	WILSON P B, HAEGELE J A, ZHU X. Mobility status as a predictor of obesity, physical activity, and screen time use among children aged 5-11 years in the united states[J]. J Pediatr, 2016, 176: 23-29. doi: 10.1016/j.jpeds.2016.06.016
[33]	NIGHTINGALE C M, RUDNICKA A R, DONIN A S, et al. Screen time is associated with adiposity and insulin resistance in children[J]. Arch Dis Child, 2017, 102(7): 612-616. doi: 10.1136/archdischild-2016-312016
[34]	MARAS D, FLAMENT M F, MURRAY M, et al. Screen time is associated with depression and anxiety in Canadian youth[J]. Prev Med, 2015, 73: 133-138. doi: 10.1016/j.ypmed.2015.01.029
[35]	盛玉璐, 何晓燕, 孙蕾, 等. 学龄前儿童视屏时间对情绪和行为问题的影响[J]. 中国妇幼卫生杂志, 2018, 9(5): 1-5. https://www.cnki.com.cn/Article/CJFDTOTAL-YZWS201805001.htm SHENG Y L, HE X Y, SUN L, et al. Effects of the screen time on emotional and behavioral problems among preschool children[J]. Chin J Women Child Health, 2018, 9(5): 1-5. https://www.cnki.com.cn/Article/CJFDTOTAL-YZWS201805001.htm
[36]	GUERRERO M D, BARNES J D, CHAPUT J P, et al. Screen time and problem behaviors in children: exploring the mediating role of sleep duration[J]. Int J Behav Nutr Phys Act, 2019, 16(1): 105. doi: 10.1186/s12966-019-0862-x
[37]	VILLANI S. Impact of media on children and adolescents: a 10-year review of the research[J]. J Am Acad Child Adolesc Psychiatry, 2001, 40(4): 392-401. doi: 10.1097/00004583-200104000-00007
[38]	SEGEV A, MIMOUNI-BLOCH A, ROSS S, et al. Evaluating computer screen time and its possible link to psychopathology in the context of age: a cross-sectional study of parents and children[J]. PLoS One, 2015, 10(11): e140542. http://www.ncbi.nlm.nih.gov/pubmed/26536037
[39]	TRINH L, WONG B, FAULKNER G E. The independent and interactive associations of screen time and physical activity on mental health, school connectedness and academic achievement among a population-based sample of youth[J]. J Can Acad Child Adolesc Psychiatry, 2015, 24(1): 17-24. http://europepmc.org/articles/PMC4357330
[40]	MATIN N, KELISHADI R, HESHMAT R, et al. Joint association of screen time and physical activity on self-rated health and life satisfaction in children and adolescents: the CASPIAN-Ⅳ study[J]. Int Health, 2017, 9(1): 58-68. doi: 10.1093/inthealth/ihw044