Effects of parental involvement on children's eye-use behavior
-
摘要:
目的 分析家长参与和儿童良好用眼行为形成的相关性，为更精准的近视防控提供理论依据。 方法 通过整群抽样的方法，于2021年4—5月，选择温州市鹿城区3所学校2 726名小学生及其家长。通过眼部测量和问卷调查收集儿童眼部参数、儿童用眼行为、家长特征和家长参与情况。 结果 家庭经济水平、家长学历程度、家长是否近视与家长参与行为有关(P值均 < 0.05)。儿童近视风险较低与家长总是/经常参与睡眠和户外活动行为管理有关(P值均 < 0.01)。家长总是/经常参与儿童用眼行为管理对儿童平均每天视屏时间＜2 h(OR=1.95，95%CI=1.31~2.90)、每天户外活动时间＞2 h(OR=0.78，95%CI=0.65~0.93)、每天睡眠时间＞8 h(OR=0.52，95%CI=0.40~0.68)、每天持续读写时间＜1 h(OR=1.33，95%CI=1.30~1.56)、读写时距离桌面距离＞30 cm(OR=0.57，95%CI=0.34~0.95)影响均有统计学意义(P值均＜0.05)。 结论 家长参与性高可帮助儿童养成良好的用眼习惯并降低近视患病率。自身患有近视的家长参与度更高，且家长参与度与家庭总收入和家长文化程度呈正相关。 Abstract:Objective To analyze the correlation between parental involvement and the formation of good eye-use behavior in children, and to provide theoretical basis for more accurate prevention and control of myopia. Methods A total of 2 726 children and their parents from 3 primary schools were selected from April to May 2021 by clustering sampling method. Children's ocular parameters, eye-use behavior, general characteristics of parents, and parental involvement were collected through ocular measurements and questionnaires, respectively. Results Parental involvement was associated with family economic, parental education level, and parental myopic status(P < 0.05). Children's myopia risk was associated with parental involvement: lower myopia risk was associated with frequent parental involvement in behavioral management of child sleep and child outdoor activities(P < 0.01). Parents who always/frequently participate in the management of children's eye behavior have an average daily screen time of < 2 h (OR=1.95, 95%CI=1.31-2.90), and daily outdoor activity time>2 h (OR=0.78, 95%CI=0.65-0.93), daily sleep time >8 h (OR=0.52, 95%CI=0.40-0.68), daily continuous reading and writing time < 1 h (OR=1.33, 95%CI=1.30-1.56), reading and writing The distance from the desktop > 30 cm (OR=0.57, 95%CI=0.34-0.95) had a statistically significant effect (P < 0.05)。 Conclusion High parental involvement may help school-age children develop good eye habits and reduce the risk of childhood myopia. Parental involvement is higher among those who had myopia themselves, and parental involvement is positively associated with total household income and parental literacy. -
Key words:
- Legal guardians /
- Eye /
- Behavior /
- Health promotion /
- Regression analysis /
- Child
1) 利益冲突声明 所有作者声明无利益冲突。 -
表 1 不同性别与年级儿童主要用眼行为比较
Table 1. Comparison of primary eye-use behaviors of children by gender and grade level
性别与年级 人数 统计值 看电视时间/(h·d-1) 看手机时间/(h·d-1) 户外活动时间/(h·d-1) 睡眠时间/(h·d-1) >2 ≤2 >2 ≤2 >2 ≤2 >8 ≤8 性别 男 1 448 148(10.4) 1 269(89.6) 178(12.5) 1 229(87.5) 532(38.1) 866(61.9) 905(64.0) 507(36.0) 女 1 278 78(6.2) 1 178(93.8) 116(9.2) 1 143(90.8) 383(30.6) 868(69.4) 839(67.2) 410(32.8) χ2值 15.88 7.42 15.75 3.27 P值 <0.01 <0.01 <0.01 0.14 年级 低 1 385 138(10.2) 1 209(89.8) 126(9.4) 1 215(90.6) 464(34.9) 865(65.1) 899(67.5) 433(32.5) 高 1 341 88(6.6) 1 238(93.4) 167(12.6) 1 157(87.4) 451(34.1) 871(65.9) 845(63.6) 484(36.4) χ2值 11.24 7.05 0.19 4.50 P值 <0.01 <0.01 0.67 0.03 性别与年级 人数 统计值 持续读写时间/h 读写时距离桌面距离/cm 躺着看书的习惯 >1 ≤1 >30 ≤30 偶尔或从不 总是或经常 性别 男 1 448 585(41.2) 835(58.8) 328(22.7) 1 122(77.3) 1 262(90.2) 138(9.8) 女 1 278 497(39.5) 760(60.5) 230(18.0) 1 046(82.0) 1 138(91.0) 112(9.0) χ2值 0.71 10.10 0.62 P值 0.66 <0.01 0.11 年级 低 1 385 497(36.9) 851(63.1) 326(23.5) 1 059(76.5) 1 254(94.1) 78(5.9) 高 1 341 585(44.0) 744(56.0) 232(17.3) 1 109(82.7) 1 146(86.9) 250(13.1) χ2值 14.20 16.28 40.13 P值 <0.01 <0.01 <0.01 注：用眼行为有数据缺失；()内数字为构成比/%。 
下载: 导出CSV
表 2 不同家长特征对儿童用眼行为的管理情况
Table 2. Management of children's eye-using behavior with different parental characteristics
家长特征 人数 统计值 会限制孩子每天屏幕时间 会利用周末或休假带孩子参加户外活动 会规定孩子每天晚上按时睡觉，保证8 h充足睡眠 总是/经常 偶尔/从不 总是/经常 偶尔/从不 总是/经常 偶尔/从不 家长近视情况 都没有 607 527(86.8) 80(13.2) 325(53.5) 282(46.5) 541(89.1) 66(10.9) 一方 974 877(90.0) 97(10.0) 610(62.6) 364(37.4) 889(91.3) 85(8.7) 双方 993 914(92.0) 79(8.0) 625(62.9) 368(37.1) 892(89.8) 101(10.2) 不清楚 152 136(89.7) 16(10.3) 89(58.7) 63(41.3) 138(90.8) 14(9.2) χ2值 11.48 16.62 2.22 P值 < 0.01 < 0.01 0.33 家长文化程度 高中及以下 734 615(25.2) 119(41.5) 325(20) 409(37.1) 646(26.4) 88(31.8) 大学及以上 1 992 1 824(74.8) 168(58.5) 1 299(80) 693(62.9) 1 803(73.6) 189(68.2) χ2值 34.45 97.59 3.68 P值 < 0.01 < 0.01 0.06 家庭年总收入/万元 ≤15 957 818(33.5) 139(48.4) 453(27.9) 504(45.7) 817(33.4) 140(50.5) >15 1 769 1 621(66.5) 148(51.6) 1 171(72.1) 598(54.3) 1 632(66.6) 137(49.5) χ2值 25.00 91.73 32.24 P值 < 0.01 < 0.01 < 0.01 家长特征 人数 统计值 会规定孩子读写40 min后要休息或远眺 会提醒孩子学习不要太靠近书本 会告诉孩子不要躺着看书 总是/经常 偶尔/从不 总是/经常 偶尔/从不 总是/经常 偶尔/从不 家长近视情况 都没有 607 313(51.6) 294(48.4) 556(91.6) 51(8.4) 551(90.8) 56(9.2) 一方 974 472(48.5) 502(51.5) 927(95.2) 47(4.8) 920(94.5) 54(5.5) 双方 993 453(45.6) 540(54.4) 949(95.6) 44(4.4) 946(95.3) 47(4.7) 不清楚 152 73(47.9) 79(52.1) 142(93.8) 10(6.2) 141(92.8) 11(7.2) χ2值 5.42 12.83 14.12 P值 0.07 < 0.01 < 0.01 家长文化程度 高中及以下 734 351(27.0) 383(26.9) 673(26.2) 61(38.1) 664(26.1) 70(38.5) 大学及以上 1 992 951(73.0) 1 041(73.1) 1 893(73.8) 99(61.9) 1 880(73.9) 112(61.5) χ2值 < 0.01 10.84 13.19 P值 0.97 < 0.01 < 0.01 家庭年总收入/万元 ≤15 957 434(33.3) 523(36.7) 878(34.2) 79(49.4) 864(34) 93(51.1) >15 1 769 868(66.7) 901(63.3) 1 688(65.8) 81(50.6) 1 680(66) 89(48.9) χ2值 3.44 15.19 21.89 P值 0.06 < 0.01 < 0.01 注： ()内数字为构成比/%。
下载: 导出CSV
表 3 家长参与对儿童用眼行为的影响(n=2 726)
Table 3. The influence of parental involvement on children's eye-use behavior(n=2 726)
因变量 自变量 模型1 模型2 OR值(OR值95%CI) P值 OR值(OR值95%CI) P值 看电视时间 会限制孩子每天屏幕时间 偶尔/从不 2.09(1.46~3.00) < 0.01 1.95(1.31~2.90) < 0.01 总是/经常 1.00 1.00 看手机时间 会限制孩子每天屏幕时间 偶尔/从不 2.34(1.71~3.22) < 0.01 2.11(1.49~2.98) < 0.01 总是/经常 1.00 1.00 户外活动时间 会利用周末或休假带孩子参加户外活动 偶尔/从不 0.80(0.68~0.94) 0.01 0.78(0.65~0.93) 0.01 总是/经常 1.00 1.00 睡眠时间 会规定孩子每天晚上按时上床睡觉，保证8 h睡眠 偶尔/从不 0.47(0.37~0.60) < 0.01 0.52(0.36~0.68) < 0.01 总是/经常 1.00 1.00 持续读写时间 会规定孩子读书写字40 min后要休息或远眺 偶尔/从不 1.34(1.15~1.56) < 0.01 1.33(1.13~1.56) < 0.01 总是/经常 1.00 1.00 读写时距离桌面距离 会提醒孩子学习不要太靠近书本 偶尔/从不 0.60(0.38~0.96) 0.03 0.57(0.34~0.95) 0.03 总是/经常 1.00 1.00 躺着看书 会告诉孩子不要躺着看书 偶尔/从不 0.47(0.31~0.72) < 0.01 0.66(0.41~1.06) 0.08 总是/经常 1.00 1.00
下载: 导出CSV
表 4 不同家长参与行为组儿童近视报告率比较
Table 4. Comparison of myopia reporting rates among children in different parental involvement behavior groups
家长参与行为 人数 儿童近视 χ2值 P值 会限制孩子每天屏幕时间 总是/经常 2 438 1 129(46.3) 0.47 0.49 偶尔/从不 288 139(48.4) 会利用周末或休假带孩子参加户外活动或体育锻炼 总是/经常 1 627 710(43.7) 12.62 < 0.01 偶尔/从不 1 099 558(50.8) 会规定孩子每天晚上按时上床睡觉，保证8 h充足睡眠 总是/经常 2 449 1 114(45.5) 10.22 < 0.01 偶尔/从不 277 154(55.6) 会规定孩子读书写字40 min后要休息或远眺 总是/经常 1 303 598(45.9) 0.34 0.56 偶尔/从不 1 423 670(47.1) 会提醒孩子学习不要太靠近书本 总是/经常 2 567 1 191(46.4) 0.18 0.67 偶尔/从不 159 77(48.1) 会告诉孩子不要躺着看书 总是/经常 2 545 1 191(46.8) 1.39 0.24 偶尔/从不 181 77(42.3) 注： ()内数字为报告率/%。
下载: 导出CSV
-
[1] CAI X B, SHEN S R, CHEN D F, et al. An overview of myopia genetics[J]. Exp Eye Res, 2019, 188: 107778. doi: 10.1016/j.exer.2019.107778 [2] GRZYBOWSKI A, KANCLERZ P, TSUBOTA K, et al. A review on the epidemiology of myopia in school children worldwide[J]. BMC Ophthalmol, 2020, 20(1): 27. doi: 10.1186/s12886-019-1220-0 [3] HANSEN M H, LAIGAARD P P, OLSEN E M, et al. Low physical activity and higher use of screen devices are associated with myopia at the age of 16-17 years in the CCC2000 Eye Study[J]. Acta Ophthalmol, 2020, 98(3): 315-321. doi: 10.1111/aos.14242 [4] SANDERS L M, SHAW J S, GUEZ G, et al. Health literacy and child health promotion: implications for research, clinical care, and public policy[J]. Pediatrics, 2009, 124(Suppl 3): S306-S314. [5] DAVISON K K, JURKOWSKI J M, LAWSON H A. Reframing family-centred obesity prevention using the family ecological model[J]. Public Health Nutr, 2013, 16(10): 1861-1869. doi: 10.1017/S1368980012004533 [6] LIU S M, CHANG F C, CHEN C Y, et al. Effects of parental involvement in a preschool-based eye health intervention regarding children's screen use in China[J]. Int J Environ Res Public Health, 2021, 18(21): 11330. doi: 10.3390/ijerph182111330 [7] KIM H S, PARK J, PARK K Y, et al. Parent involvement intervention in developing weight management skills for both parents and overweight/obese children[J]. Asian Nurs Res, 2016, 10(1): 11-17. doi: 10.1016/j.anr.2015.07.006 [8] BAKER C E, BROOKS-GUNN J. Early parenting and the intergenerational transmission of self-regulation and behavior problems in african American head start families[J]. Child Psychiatry Hum Dev, 2020, 51(2): 220-230. doi: 10.1007/s10578-019-00921-5 [9] VELARDO S, DRUMMOND M. Emphasizing the child in child health literacy research[J]. J Child Health Care, 2017, 21(1): 5-13. doi: 10.1177/1367493516643423 [10] PERKINS R B, CLARK J A. Providers' perceptions of parental concerns about HPV vaccination[J]. J Health Care Poor Underserved, 2013, 24(2): 828-839. doi: 10.1353/hpu.2013.0080 [11] 温州医学院. 标准对数视力表[Z]. 北京: 国家质量监督检验检疫总局, 2011: 13.Wenzhou Medical University. Standard logarithmic visual acuity chart[Z]. Beijing: General Administration of Quality Supervision, Inspection and Quarantine, 2011: 13. [12] FLITCROFT D I, HE M G, JONAS J B, et al. IMI-defining and classifying myopia: a proposed set of standards for clinical and epidemiologic studies[J]. Invest Ophthalmol Vis Sci, 2019, 60(3): M20-M30. doi: 10.1167/iovs.18-25957 [13] LIN Y Y, JIANG D D, LI C C, et al. Simultaneous changes in astigmatism with noncycloplegia refraction and ocular biometry in Chinese primary schoolchildren[J]. J Ophthalmol, 2019, 2019: 5613986. [14] 蒋丹丹, 周文哲, 郑森国, 等. 学龄期儿童用眼行为调查问卷的信度和效度检验[J]. 预防医学, 2017, 29(3): 255-259. doi: 10.3969/j.issn.1673-758X.2017.03.025JIANG D D, ZHOU W Z, ZHENG S G, et al. Development, reliability and validity evaluation of eye health related behaviors questionnaire for school age children[J]. Prev Med, 2017, 29(3): 255-259. doi: 10.3969/j.issn.1673-758X.2017.03.025 [15] ZHOU S, YANG L H, LU B L, et al. Association between parents' attitudes and behaviors toward children's visual care and myopia risk in school-aged children[J]. Medicine, 2017, 96(52): e9270. doi: 10.1097/MD.0000000000009270 [16] PARSSINEN O, KAUPPINEN M. Associations of near work time, watching TV, outdoors time, and parents' myopia with myopia among school children based on 38-year-old historical data[J]. Acta Ophthalmol, 2022, 100(2): E430-E438. [17] SUN J T, AN M, YAN X B, et al. Prevalence and related factors for myopia in school-aged children in Qingdao[J]. J Ophthalmol, 2018, 2018: 9781987. [18] TANDON P S, ZHOU C, SALLIS J F, et al. Home environment relationships with children's physical activity, sedentary time, and screen time by socioeconomic status[J]. Int J Behav Nutr Phys Act, 2012, 9: 88. doi: 10.1186/1479-5868-9-88 [19] DLUGONSKI D, DUBOSE K D, HABEEB C M, et al. Physical activity coparticipation among parent-young-child dyads[J]. Pediatr Exerc Sci, 2020, 32(3): 132-139. doi: 10.1123/pes.2019-0213 [20] QIU M, WANG S Y, SINGH K, et al. Racial disparities in uncorrected and undercorrected refractive error in the united states[J]. Invest Ophthalmol Vis Sci, 2014, 55(10): 6996-7005. doi: 10.1167/iovs.13-12662 [21] NGO C S, PAN C W, FINKELSTEIN E A, et al. A cluster randomised controlled trial evaluating an incentive-based outdoor physical activity programme to increase outdoor time and prevent myopia in children[J]. Ophthalmic Physiol Opt, 2014, 34(3): 362-368. doi: 10.1111/opo.12112 [22] ASSARI S. Parental education and children's sleep disturbance: minorities' diminished returns[J]. Int J Epidemiol Res, 2021, 8(1): 31-39. doi: 10.34172/ijer.2021.06 [23] BALL K, CRAWFORD D, MISHRA G. Socio-economic inequalities in women's fruit and vegetable intakes: a multilevel study of individual, social and environmental mediators[J]. Public Health Nutr, 2006, 9(5): 623-630. doi: 10.1079/PHN2005897 [24] 张晓凤, 徐泽华, 张红杰, 等. 家长对小学生近视的知信行分析[J]. 医学研究与教育, 2020, 37(6): 54-60. doi: 10.3969/j.issn.1674-490X.2020.06.009ZHANG X F, XU Z H, ZHANG H J, et al. Analysis on knowledge, attitude and practice of myopia in parents of primary school students[J]. Med Res Educ, 2020, 37(6): 54-60. doi: 10.3969/j.issn.1674-490X.2020.06.009 [25] PEARSON N, BIDDLE S J H, GRIFFITHS P, et al. Reducing screen-time and unhealthy snacking in 9-11 year old children: the Kids FIRST pilot randomised controlled trial[J]. BMC Public Health, 2020, 20(1): 122. doi: 10.1186/s12889-020-8232-9 [26] VERLOIGNE M, VAN LIPPEVELDE W, MAES L, et al. Family-and school-based correlates of energy balance-related behaviours in 10-12-year-old children: a systematic review within the ENERGY (EuropeaN Energy balance Research to prevent excessive weight Gain among Youth) project[J]. Public Health Nutr, 2012, 15(8): 1380-1395. doi: 10.1017/S1368980011003168 [27] LANCA C, SAW S M. The association between digital screen time and myopia: a systematic review[J]. Ophthalmic Physiol Opt, 2020, 40(2): 216-229. doi: 10.1111/opo.12657 [28] 程广印, 张岚, 安毅, 等. 北京西城区低年级小学生增加户外活动时间干预效果分析[J]. 中国学校卫生, 2020, 41(12): 1886-1889. doi: 10.16835/j.cnki.1000-9817.2020.12.030CHENG G Y, ZHANG L, AN Y, et al. Analysis of the effect of an intervention to increase outdoor activity time for lower grade elementary school students in Xicheng District, Beijing[J]. Chin J Sch Health, 2020, 41(12): 1886-1889. doi: 10.16835/j.cnki.1000-9817.2020.12.030 -
点击查看大图
表(4)
计量
- 文章访问数: 471
- HTML全文浏览量: 179
- PDF下载量: 59
- 被引次数: 0
