青少年简明健康指数综合评价方法的构建

徐慧琼; 张新宇; 李晓恒; 谌丁艳; 张新东; 王熙; 万宇辉; 陶芳标

doi:10.16835/j.cnki.1000-9817.2023.05.015

青少年简明健康指数综合评价方法的构建

doi: 10.16835/j.cnki.1000-9817.2023.05.015

徐慧琼^{1, 2},
张新宇^{1, 2},
李晓恒³,
谌丁艳³,
张新东⁴,
王熙⁴,
万宇辉^{1, 2},
陶芳标^{1, 2, ,}

1.
安徽医科大学公共卫生学院儿少卫生与妇幼保健学系，合肥 230032
2.
出生人口健康教育部重点实验室/人口健康与优生安徽省重点实验室/国家卫生健康委配子及生殖道异常研究重点实验室
3.
深圳市疾病预防控制中心学校卫生所
4.
深圳市宝安区疾病预防控制中心

基金项目:

安徽省高校协同创新项目 GXXT-2021-072

2021年度安徽高校研究生科学研究项目 YJS20210261

详细信息

作者简介:
徐慧琼(1993- )，女，安徽合肥人，在读博士，主要研究方向为青少年心理与行为健康

通讯作者:
陶芳标，E-mail：fbtao@ahmu.edu.cn

利益冲突声明 所有作者声明无利益冲突。
中图分类号: B844.2 G804.49 R194.3
计量
- 文章访问数: 428
- HTML全文浏览量: 165
- PDF下载量: 52
- 被引次数: 0
出版历程
- 收稿日期: 2022-12-20
- 修回日期: 2023-02-26
- 网络出版日期: 2023-05-25
- 刊出日期: 2023-05-25

Establishment of a concise health index synthetic evaluation method for adolescents

XU Huiqiong^{1, 2},
ZHANG Xinyu^{1, 2},
LI Xiaoheng³,
CHEN Dingyan³,
ZHANG Xindong⁴,
WANG Xi⁴,
WAN Yuhui^{1, 2},
TAO Fangbiao^{1, 2
, ,}

1.
Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, Hefei(230032), China

摘要

摘要: 目的构建青少年简明健康指数(concise health index, CHI)综合评价方法，为中国青少年整体健康状况的研判提供依据。方法基于文献复习和核心研究组共识制定了由体格、体能、常见病、心理健康和行为健康5个维度构成的青少年CHI指标体系，共24位专家咨询，利用层次分析法(AHP)计算主观权重。于2021年10—12月，选取A和B两个地区开展实证性研究，利用CRITIC法计算客观权重。最终，采用AHP-CRITIC组合赋权法确定各指标权重系数，结合TOPSIS法进行综合评价。结果在不同学段和性别中，各健康指标的组合权重系数范围依次为体质量指数(0.081~0.095)，腰围(0.070~0.081)，相对握力(0.101~0.108)，近视(0.110~0.128)，龋齿(0.055~0.070)，心理症状(0.240~0.262)，体育锻炼(0.085~0.115)，视屏时间(0.097~0.111)，睡眠时长(0.086~0.103)。城市A中学生的健康指数(0.626±0.065)高于城市B(0.613±0.066)，差异有统计学意义(t=6.34，P<0.01)。结论青少年CHI综合评价方法具有较好的一致性和应用价值，可为青少年健康监测工作提供参考。
- 体格检查 /
- 精神卫生 /
- 行为 /
- 健康指数 /
- 青少年
Abstract: Objective The aim of this study was to establish a comprehensive concise health index (CHI) for evaluating adolescents, so as to provide a basis for determining the overall health status of adolescents in China. Methods On the basis of a literature review and consensus among core researchers, adolescent CHI indicators in the following five dimensions were assessed: physical growth, physical fitness, common diseases, mental health and behavioral health. A total of 24 experts used an analysis hierarcgy process (AHP) to calculate the indicators' subjective weights. In addition, from October to December of 2021, two regions, A and B were selected to conduct empirical research, and the CRITIC method was used to calculate the objective weights of the indicators. Finally, the weight coefficients were determined through the AHP-CRITIC combination weight method, and comprehensive evaluation was performed with the TOPSIS method. Results Across academic period and genders, the combined weighted coefficients of the health indicators were as follows: BMI, 0.081-0.095; waist circumference, 0.070-0.081; relative grip strength, 0.101-0.108; myopia, 0.110-0.128; dental caries, 0.055-0.070; psychological symptoms, 0.240-0.262; physical exercise, 0.085-0.115; screen time, 0.097-0.111; and sleep duration, 0.086-0.103. The health index of middle school students in city A (0.626±0.065) was significantly higher than that in city B(0.613±0.066)(t=6.34, P<0.01). Conclusion The comprehensive adolescent CHI evaluation method has good consistency and application value, and may serve as a reference for adolescent health monitoring.
- Physical examination /
- Mental health /
- Behavior /
- Health index /
- Adolescent
注释:

1) 利益冲突声明 所有作者声明无利益冲突。

HTML全文

表 1 不同学段男女生基于CRITIC法的各健康指标客观权重系数

Table 1. The objective weight coefficient of each health index for boys and girls of different academic period based on CRITIC method

学段	性别	人数	BMI	腰围	相对握力	近视	龋齿	心理症状	体育锻炼	视屏时间	睡眠时长
初中	男	1 210	0.082	0.077	0.080	0.149	0.085	0.147	0.146	0.157	0.077
	女	1 109	0.075	0.077	0.083	0.153	0.094	0.158	0.118	0.151	0.093
普高	男	720	0.078	0.086	0.081	0.140	0.080	0.149	0.149	0.152	0.086
	女	446	0.085	0.065	0.084	0.170	0.085	0.167	0.091	0.145	0.110
职高	男	542	0.080	0.064	0.075	0.154	0.109	0.122	0.140	0.163	0.093
	女	337	0.057	0.070	0.089	0.177	0.111	0.138	0.090	0.172	0.096

下载: 导出CSV

表 2 不同学段男女生基于组合赋权法的各健康指标权重系数

Table 2. The weight coefficient of each health index for boys and girls of different academic period based on the combined empowerment method

学段	性别	人数	BMI	腰围	相对握力	近视	龋齿	心理症状	体育锻炼	视屏时间	睡眠时长
初中	男	1 210	0.094	0.077	0.104	0.114	0.057	0.253	0.113	0.103	0.086
	女	1 109	0.090	0.076	0.105	0.116	0.061	0.258	0.099	0.100	0.094
普高	男	720	0.091	0.081	0.104	0.110	0.055	0.254	0.115	0.101	0.091
	女	446	0.095	0.071	0.106	0.125	0.057	0.262	0.086	0.097	0.103
职高	男	542	0.093	0.070	0.101	0.117	0.069	0.240	0.110	0.106	0.094
	女	337	0.081	0.073	0.108	0.128	0.070	0.248	0.085	0.111	0.096

下载: 导出CSV

表 3 两座城市各学段男女生综合健康指数水平比较(x ±s)

Table 3. Comparison of the comprehensive health index level among middle school students in two regions of different academic period(x ±s)

城市	初中		普高		职高
城市	男	女	男	女	男	女
A	0.638±0.066	0.621±0.062	0.635±0.067	0.613±0.057	0.617±0.063	0.583±0.067
B	0.624±0.069	0.617±0.062	0.616±0.071	0.617±0.052	0.613±0.068	0.587±0.060
t值	3.30	0.95	3.57	-0.74	0.67	-0.51
P值	<0.01	0.34	<0.01	0.46	0.51	0.61

下载: 导出CSV

参考文献(37)

[1]	PATTON G C, SAWYER S M, SANTELLI J S, et al. Our future: a Lancet commission on adolescent health and wellbeing[J]. Lancet, 2016, 387(10036): 2423-2478. doi: 10.1016/S0140-6736(16)00579-1
[2]	马冠生, 米杰, 马军, 等. 中国儿童肥胖报告(2017)[R]. 北京: 人民卫生出版社, 2017: 1. MA G S, MI J, MA J, et al. Report on childhood obesity in China(2017)[R]. Beijing: People's Medical Publishing House, 2017: 1. (in Chinese)
[3]	陈长洲, 王红英, 项贤林, 等. 改革开放40年我国青少年体质健康政策的回顾、反思与展望[J]. 体育科学, 2019, 39(3): 38-47. doi: 10.16469/j.css.201903005 CHEN C Z, WANG H Y, XIANG X L, et al. Retrospection, reflection and prospect of China's youth physical health policy on the 40th anniversary of reform and opening-up[J]. Chin Sport Sci, 2019, 39(3): 38-47. (in Chinese) doi: 10.16469/j.css.201903005
[4]	温勃, 徐荣彬, 杨忠平, 等. 2014年中国13~18岁学生体质健康现状及地区分布[J]. 中华流行病学杂志, 2019, 40(6): 616-620. doi: 10.3760/cma.j.issn.0254-6450.2019.06.003 WEN B, XU R B, YANG Z P, et al. Physical fitness and its regional distribution of Chinese students aged 13 to 18 in 2014[J]. Chin J Epidemiol, 2019, 40(6): 616-620. (in Chinese) doi: 10.3760/cma.j.issn.0254-6450.2019.06.003
[5]	傅小兰, 张侃, 陈雪峰. 中国国民心理健康发展报告(2019—2020)[M]. 北京: 社会科学文献出版社, 2021. FU X L, ZHANG K, CHEN X F. Report on national mental health development in China(2019-2020)[M]. Beijing: Social Sciences Academic Press, 2021. (in Chinese)
[6]	WAN Y H, CHEN R L, MA S S, et al. Associations of adverse childhood experiences and social support with self-injurious behaviour and suicidality in adolescents[J]. Br J Psychiatry, 2019, 214(3): 146-152. doi: 10.1192/bjp.2018.263
[7]	中共中央国务院印发《"健康中国2030"规划纲要》[EB/OL]. (2016-10-25)[2022-11-12]. http://www.gov.cn/zhengce/2016-10/25/content_5124174.htm. The Central Committee of the Communist Party of China and State Council of China issued the outline of the "Healthy China 2030" plan[EB/OL]. (2016-10-25)[2022-11-12]. http://www.gov.cn/zhengce/2016-10/25/content_5124174.htm.
[8]	中国青少年儿童睡眠健康白皮书2019年[C]//艾瑞咨询系列研究报告. 上海: 上海艾瑞市场咨询有限公司, 2019: 185-235. White paper on sleep health of Chinese adolescents 2019[C]//Iresearch Series Report. Shanghai: Shanghai IResearch Market Consulting Co., LTD, 2019: 185-235. (in Chinese)
[9]	SHIVAPPA N, STECK S E, HURLEY T G, et al. Designing and developing a literature-derived, population-based dietary inflammatory index[J]. Public Health Nutr, 2014, 17(8): 168921696.
[10]	乔田, 段若男, 成果. 修订中国儿童膳食指数[J]. 营养学报, 2019, 41(2): 105-109. doi: 10.3969/j.issn.0512-7955.2019.02.002 QIAO T, DUAN R N, CHENG G. Revision of the Chinese children dietary index[J]. Acta Nutr Sinica, 2019, 41(2): 105-109. (in Chinese) doi: 10.3969/j.issn.0512-7955.2019.02.002
[11]	赵玉秋. 儿童青少年健康相关体能综合评价方法的建立及其应用研究[D]. 合肥: 安徽医科大学, 2013. ZHAO Y Q. Development and application of comprehensive evaluation method for health-related physical fitness in children and adolescents[D]. Hefei: Anhui Medical University, 2013. (in Chinese)
[12]	KÅKS P, MÅLQVIST M. Using an urban child health index to detect intra-urban disparities in Sweden[J]. Scand J Public Health, 2021, 49(5): 563-570. doi: 10.1177/1403494820980261
[13]	Centers for Disease Control and Prevention. School health index: a self-assessment and planning guide[EB/OL]. (2019-03-27) [2022-11-16]. https://www.cdc.gov/healthyschools/shi/index.htm.
[14]	The United Nations Development Programme. Human Development Index(HDI)[EB/OL]. (2021-04-06)[2022-11-16]. https://hdr.undp.org/data-center/human-development-index#/indicies/HDI.
[15]	徐荣彬, 杨招庚, 王西婕, 等. 青少年健康指标体系研究进展[J]. 中国儿童保健杂志, 2017, 25(12): 1225-1228. doi: 10.11852/zgetbjzz2017-25-12-11 XU R B, YANG Z G, WANG X J, et al. Research progress on adolescent health indicator system[J]. Chin J Child Health Care, 2017, 25(12): 1225-1228. (in Chinese) doi: 10.11852/zgetbjzz2017-25-12-11
[16]	中华人民共和国国家卫生健康委员会办公厅关于印发2019年全国学生常见病和健康影响因素监测与干预工作方案的通知[EB/OL]. (2019-03-22)[2022-11-02]. http://www.nhc.gov.cn/jkj/s5898bm/201903/1bcbac21e1864377ad24984fac014c7d.shtml. National Health Commission of the PRC on printing and distributing the national student common diseases and health influencing factors monitoring and intervention work plan in 2019[EB/OL]. (2019-03-22)[2022-11-02]. http://www.nhc.gov.cn/jkj/s5898bm/201903/1bcbac21e1864377ad24984fac014c7d.shtml.(in Chinese)
[17]	陶芳标. 儿童少年卫生学[M]. 北京: 人民卫生出版社, 2017. TAO F B. Child and adolescent health[M]. Beijing: People's Medical Publishing House, 2017. (in Chinese)
[18]	刘励. 儿童青少年体质健康的综合评价及影响因素研究[D]. 武汉: 华中科技大学, 2009. LIU L. A study on synthetical evaluation of children and adolescents health and its influencing factors[D]. Wuhan: Huazhong University of Science and Technology, 2009. (in Chinese)
[19]	陶芳标. 构建面向健康中国2030青少年健康促进体系[J]. 中国学校卫生, 2023, 44(1): 1-5. doi: 10.16835/j.cnki.1000-9817.2023.01.001 TAO F B. Construction systems of adolescent health promotion towards Healthy China 2030[J]. Chin J Sch Health, 2023, 44(1): 1-5. (in Chinese) doi: 10.16835/j.cnki.1000-9817.2023.01.001
[20]	陶舒曼, 万宇辉, 伍晓艳, 等. 《青少年心理健康评定简明问卷》的心理学评价及应用[J]. 中国学校卫生, 2020, 41(9): 1331-1334, 1338. doi: 10.16835/j.cnki.1000-9817.2020.09.014 TAO S M, WAN Y H, WU X Y, et al. Evaluation and application of Brief Instrument on Psychological Health of Youths[J]. Chin J Sch Health, 2020, 41(9): 1331-1334, 1338. (in Chinese) doi: 10.16835/j.cnki.1000-9817.2020.09.014
[21]	梁德清. 高校学生应激水平及其与体育锻炼的关系[J]. 中国心理卫生杂志, 1994, 9(1): 5-6. doi: 10.3321/j.issn:1000-6729.1994.01.020 LIANG D Q. The stress level of college students and its relationship with physical exercise[J]. Chin Ment Health J, 1994, 9(1): 5-6. (in Chinese) doi: 10.3321/j.issn:1000-6729.1994.01.020
[22]	潘婉, 江流, 耿梦龙, 等. 学龄前儿童视屏时间及户外活动对情绪的影响[J]. 中华流行病学杂志, 2019, 40(12): 1569-1572. doi: 10.3760/cma.j.issn.0254-6450.2019.12.012 PAN W, JIANG L, GENG M L, et al. Correlation between screen-watching time and emotional problems as well as combination effect of outdoor time among preschool children[J]. Chin J Epidemiol, 2019, 40(12): 1569-1572. (in Chinese) doi: 10.3760/cma.j.issn.0254-6450.2019.12.012
[23]	刘贤臣, 唐茂芹, 胡蕾, 等. 匹兹堡睡眠质量指数的信度和效度研究[J]. 中华精神科杂志, 1996, 26(2): 103-107. https://www.cnki.com.cn/Article/CJFDTOTAL-ZHMA199602018.htm LIU X C, TANG M Q, HU L, et al. Reliability and validity of Pittsburgh Sleep Quality Index[J]. Chin J Psychiatry, 1996, 26(2): 103-107. (in Chinese) https://www.cnki.com.cn/Article/CJFDTOTAL-ZHMA199602018.htm
[24]	Notice of the Ministry of Education of the PRC on printing and distributing the National Physical Health Standards for Students(revised in 2014)[J]. Teach Phys Educ, 2014, 34(9): 10-11. (in Chinese) https://www.cnki.com.cn/Article/CJFDTOTAL-KJJF202210008.htm
[25]	中华人民共和国国家卫生健康委员会. 关于印发中小学生健康体检管理办法(2021年版)的通知[EB/OL]. (2021-10-19)[2022-11-02]. http://www.nhc.gov.cn/yzygj/s7659/202110/331a6dbacf 244f7eac9da bcf758f387a.shtml. National Health Commission of the PRC. Notice on issuance of the administrative measures of health examinations for primary and secondary school students (2021 Edition)[EB/OL]. (2021-10-19)[2022-11-02]. http://www.nhc.gov.cn/yzygj/s7659/202110/331a6dbacf 244f7eac9dabcf758f387a.shtml.(in Chinese)
[26]	American Academy of Pediatrics. 2022 recommendations for preventive pediatric health care[J]. Pediatrics, 2022, 150(1): e2022058044.
[27]	李倢. 日本青少年发展指标体系的研究与启示[J]. 青少年学刊, 2022(5): 56-64. https://www.cnki.com.cn/Article/CJFDTOTAL-QSNY202205009.htm LI J. The research and enlightenment of Japanese adolescent development indicator system[J]. Youth Adolesc Stud, 2022(5): 56-64. (in Chinese) https://www.cnki.com.cn/Article/CJFDTOTAL-QSNY202205009.htm
[28]	王文, 杨土保, 张吉吉, 等. 学生体质综合评价研究综述[J]. 实用预防医学, 2010, 17(1): 189-192. https://www.cnki.com.cn/Article/CJFDTOTAL-SYYY201001079.htm WANG W, YANG S B, ZHANG J J, et al. Research summarization of comprehensive evaluation on student's physical fitness[J]. Practic Prev Med, 2010, 17(1): 189-192. (in Chinese) https://www.cnki.com.cn/Article/CJFDTOTAL-SYYY201001079.htm
[29]	徐浙宁. 中国与欧美儿童健康指标体系比较[J]. 中国青年研究, 2008(9): 52-57. https://www.cnki.com.cn/Article/CJFDTOTAL-ZGQL200809013.htm XU Z N. Comparison of health index system between Chinese children and Euro-American children[J]. Chin Youth Study, 2008(9): 52-57. (in Chinese) https://www.cnki.com.cn/Article/CJFDTOTAL-ZGQL200809013.htm
[30]	余文昱. 基于熵值法的湖北省《国家学生体质健康标准》测试数据综合评价研究[D]. 武汉: 华中科技大学, 2016. YU W Y. Research on comprehensive evaluation of the test data of National Student Physical Health Standard in Hubei Province based on entropy method[D]. Wuhan: Huazhong University of Science and Technology, 2016. (in Chinese)
[31]	WHO. Adolescent mental health[EB/OL]. (2021-11-17)[2022-12-16]. https://www.who.int/news-room/fact-sheets/detail/adolescent-mental-health.
[32]	WHEELER L A, ZEIDERS K H, UPDEGRAFF K A, et al. Mexican-origin youth's risk behavior from adolescence to young adulthood: the role of familism values[J]. Dev Psychol, 2017, 53(1): 126-137.
[33]	NOBLE N, PAUL C, TURON H, et al. Which modifiable health risk behaviours are related?A systematic review of the clustering of Smoking, Nutrition, Alcohol and Physical activity (SNAP) health risk factors[J]. Prev Med, 2015, 81: 16-41.
[34]	陈孝萍. 赣州市13~18岁中学生体质健康状况及影响因素研究[D]. 南昌: 江西师范大学, 2020. CHEN X P. Study on physical health status and influencing factors of middle school students aged 13-18 in Ganzhou City[D]. Nanchang: Jiangxi Normal Univerity, 2020. (in Chinese)
[35]	GARCÍA-HERMOSO A, RAMÍREZ-CAMPILLO R, IZQUIERDO M. Is muscular fitness associated with future health benefits in children and adolescents? A systematic review and Meta-analysis of longitudinal studies[J]. Sports Med, 2019, 49(7): 1079-1094.
[36]	ORTEGA F B, SILVENTOINEN K, TYNELIUS P, et al. Muscular strength in male adolescents and premature death: cohort study of one million participants[J]. BMJ, 2012, 345: e7279.
[37]	COHEN D D, GÓMEZ-ARBELÁEZ D, CAMACHO P A, et al. Low muscle strength is associated with metabolic risk factors in Colombian children: the ACFIES study[J]. PLoS One, 2014, 9(4): e93150.