上海市中学生健康危险行为聚集模式分析

朱艳; 史慧静; 罗春燕

doi:10.16835/j.cnki.1000-9817.2023.08.006

上海市中学生健康危险行为聚集模式分析

doi: 10.16835/j.cnki.1000-9817.2023.08.006

1.
复旦大学公共卫生学院，上海 200032
2.
上海市疾病预防控制中心儿童青少年健康所

基金项目:

上海市第五轮公共卫生三年行动计划重点学科项目 GWV-10.1-XK08

2022—2024年健康上海行动项目 JKSHZX-2022-10

详细信息

作者简介:
朱艳(1981-)，女，河南光山人，在读硕士，主要研究方向为疾病预防与控制

通讯作者:
罗春燕，E-mail：luochunyan@scdc.sh.cn

利益冲突声明 所有作者声明无利益冲突。
中图分类号: C913.5 R179 B844.2
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- 被引次数: 0
出版历程
- 收稿日期: 2022-12-23
- 修回日期: 2023-04-11
- 网络出版日期: 2023-08-26
- 刊出日期: 2023-08-25

Cluster analysis of health risk behaviors among secondary school students in Shanghai

1.
School of Public Health, Fudan University, Shanghai(200032), China

摘要

摘要: 目的探索上海市中学生健康危险行为聚集模式，为实施针对性的干预措施提供依据。方法于2021年5—6月采用分层随机整群抽样方法从上海市不同学段中抽取21所初中、普通高中及中职学校，采取学生自填问卷的形式调查6 092名学生健康危险行为的发生情况。样本聚类分析采用Ward离差和平方法。结果共发现3类聚集特征：受欺凌郁闷组(1 004名，16.5%)，以被欺凌、心情郁闷(64.9%)、孤独感(48.2%)、失眠(42.4%)等为主要特征；电子游戏超时及不健康饮食组(1 585名，26.0%)，以玩电子游戏超时(53.1%)及含糖饮料(89.3%)、油炸食物摄入(79.0%)为主要特征；低吸烟饮酒组(3 503名，57.5%)，以“0”饮酒率和极低吸烟率(0.4%)为主要特征。3组学生的含糖饮料摄入、油炸食物摄入、体力活动不足、被恶意取笑、被索取财物、被孤立/被有意排挤在集体活动之外、被威胁恐吓、被踢/打/推/挤或关屋里、吸烟、不健康减肥、玩电子游戏超时报告率差异均有统计学意义(χ²值分别为36.74，41.85，30.07，652.68，334.40，669.89，358.84，233.12，101.46，88.45，230.15，P值均 < 0.01)，3组学生的孤独感、心情郁闷、失眠和饮酒报告率差异均有统计学意义(Fisher精确概率，P值均 < 0.01)。受欺凌郁闷组初中生、普通高中学生、女生较多；电子游戏超时及不健康饮食组中男生、普通高中及初中生居多。结论上海市中学生健康危险行为存在聚集，集中表现在不良生活方式及心理健康两大方面。可根据健康相关危险行为聚集的特征实施针对性的干预措施，以提高干预效果。
- 危险行为 /
- 暴力 /
- 精神卫生 /
- 吸烟 /
- 饮酒 /
- 学生
Abstract: Objective To explore the patterns of health risk behaviors among secondary school students in Shanghai, so as to provide a basis for implementing targeted interventions. Methods From May to June 2021, 21 junior high schools, regular high schools and secondary vocational schools were selected from Shanghai, and the occurrence of dangerous health behaviors of 6 092 students were investigated in the form of self-filled questionnaires. The clustering analysis of the sample was performed by Ward's departure and peace method. Results Three types of clustering characteristics were found in this study: being bullied, depression (64.9%), loneliness (48.2%), and insomnia (42.4%) in the high-risk group (1 004, 16.5%); excessive video games (53.1%) and sugary drinks (89.3%) and fried food intake (79.0%) in the medium-risk group (1 585, 26.0%); the low-risk group (3 503, 57.5%) was characterized by extremely low alcohol consumption (0) and smoking (0.4%). The reporting rate on sugary beverage intake, fried food intake, physical activity, malicious teased, solicited, isolated/intentionally excluded, outside the group activities, threatened, kicked/hit/pushed/locked in house, smoking, unhealthy weight loss, playing video game overtime were statistically significant among the three groups (χ²=36.74, 41.85, 30.07, 652.68, 334.40, 669.89, 358.84, 233.12, 101.46, 88.45, 230.15, P < 0.01).The difference in reporting rates of loneliness, depression, insomnia and drinking were significant among the three groups (Fisher's test, P < 0.01). The majority of junior high school students, general high school students and girls in the high-risk group; boys, general high school students and junior high school students in the excessive video game and unhealthy diet group. Conclusion There are clusters of health-related risk behaviors among secondary school students in Shanghai, focusing on two major aspects: poor lifestyle and mental health. Targeted interventions should be implemented according to the characteristics of health-related risk behaviors clustering to enhance the intervention effect.
- Dangerous behavior /
- Violence /
- Mental health /
- Smoking /
- Alcohol drinking /
- Students
注释:

1) 利益冲突声明 所有作者声明无利益冲突。

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图 1 上海市中学生健康危险行为聚集模式特征

Figure 1. Characteristics of health risk behavior aggregation patterns of secondary school students in Shanghai City

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表 1 上海市不同人口统计学特征青少年健康危险行为报告率比较

Table 1. Comparison of reported health risk behaviors among adolescents in different demographic characteristics in Shanghai City

人口统计学指标		人数	统计值	摄入含糖饮料	摄入油炸食物	体力活动不足	孤独感	心情郁闷	失眠	被恶意取笑	被索取财物
性别	男	3 234		2 736(84.6)	2 368(73.2)	899(27.8)	353(10.9)	561(17.4)	285(8.8)	851(26.3)	144(4.5)
	女	2 858		2 435(85.2)	2 093(73.2)	1 242(43.5)	412(14.4)	778(27.2)	313(11.0)	525(18.4)	65(2.3)
			χ²值	0.42	0.00	163.21	16.93	86.27	7.84	54.77	21.73
			P值	0.52	0.99	< 0.01	< 0.01	< 0.01	< 0.01	< 0.01	< 0.01
学段	初中	3 084		2 537(82.3)	2 045(66.3)	825(26.8)	380(12.3)	707(22.9)	330(10.7)	805(26.1)	103(3.3)
	普通高中	1 994		1 716(86.1)	1 610(80.7)	867(43.5)	286(14.3)	561(28.1)	188(9.4)	374(18.8)	74(3.7)
	中职校	1 014		918(90.5)	806(79.5)	449(44.3)	99(9.8)	71(7.0)	80(7.9)	197(19.4)	32(3.2)
			χ²值	43.86	152.98	193.24	13.16	178.30	7.31	44.32	0.78
			P值	< 0.01	< 0.01	< 0.01	< 0.01	< 0.01	0.03	< 0.01	0.68

人口统计学指标		人数	统计值	被孤立/被有意排挤在集体活动之外		被恐吓威胁	被踢/打/推/挤或关屋里	吸烟	饮酒	不健康减肥	玩电子游戏超时
性别	男	3 234		329(10.2)		203(6.3)	189(5.8)	79(2.4)	563(17.4)	1 152(35.6)	1 402(43.4)
	女	2 858		304(10.6)		91(3.2)	80(2.8)	30(1.1)	392(13.7)	1 471(51.5)	892(31.2)
			χ²值	0.35		31.60	33.33	16.76	15.65	155.42	95.27
			P值	0.55		< 0.01	< 0.01	< 0.01	< 0.01	< 0.01	< 0.01
学段	初中	3 084		382(12.4)		179(5.8)	171(5.5)	33(1.1)	327(10.6)	1 246(40.4)	802(26.0)
	普通高中	1 994		168(8.4)		85(4.3)	68(3.4)	27(1.4)	422(21.2)	940(47.1)	727(36.5)
	中职校	1 014		83(8.2)		30(3.0)	30(3.0)	49(4.8)	206(20.3)	437(43.1)	765(75.4)
			χ²值	26.76		15.50	19.19	64.67	121.97	22.44	796.29
			P值	< 0.01		< 0.01	< 0.01	< 0.01	< 0.01	< 0.01	< 0.01
注：()内数字为报告率/%。

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表 2 上海市不同聚集模式行为组青少年健康危险行为报告率比较

Table 2. Comparison of reported health risk behaviors among adolescents in different behavior clusters in Shanghai City

组别	人数	含糖饮料摄入	油炸食物摄入	体力活动不足	孤独感	心情郁闷	失眠	被恶意取笑	被索取财物
受欺凌郁闷组	1 004	858(85.5)	744(74.1)	428(42.6)	484(48.2)	652(64.9)	426(42.4)	535(53.3)	130(13.0)
电子游戏超时及不健康饮食组	1 585	1 415(89.3)	1 252(79.0)	545(34.4)	78(4.9)	188(11.9)	57(3.6)	292(18.4)	39(2.5)
低吸烟饮酒组	3 503	2 898(82.7)	2 465(70.4)	1 168(33.3)	203(5.8)	499(14.2)	115(3.3)	115(15.7)	40(1.1)
χ²值		36.74	41.85	30.07				652.68	334.40
P值		< 0.01	< 0.01	< 0.01	< 0.01^*	< 0.01^*	< 0.01^*	< 0.01	< 0.01

组别	人数	被孤立/被有意排挤在集体活动之外		被威胁恐吓	被踢/打/推/挤或关屋里	吸烟	饮酒	不健康减肥	玩电子游戏超时
受欺凌郁闷组	1 004	333(33.2)		166(16.5)	135(13.5)	46(4.6)	380(37.9)	555(55.3)	370(36.9)
电子游戏超时及不健康饮食组	1 585	90(5.7)		42(2.7)	48(3.0)	50(3.2)	575(36.3)	708(44.7)	842(53.1)
低吸烟饮酒组	3 503	210(6.0)		86(2.5)	86(2.5)	13(0.4)	0	1 360(38.8)	1 082(30.9)
χ²值		669.89		358.84	233.12	101.46		88.45	230.15
P值		< 0.01		< 0.01	< 0.01	< 0.01	< 0.01^*	< 0.01	< 0.01
注：*为Fisher精确概率法；()内数字为报告率/%。

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表 3 上海市中学生不同特征构成在各健康危险行为组间比较

Table 3. Comparison of different types of homeowners among different health risk behavior group among middle school students in Shanghai City

特征	选项	受欺凌郁闷组(n=1 004)	电子游戏超时及不健康饮食组(n=1 585)	低吸烟饮酒组(n=3 503)	χ²值	P值
性别	男	463(46.1)	984(62.1)	1 787(51.0)	77.13	< 0.01
	女	541(53.9)	601(37.9)	1 716(49.0)
学段	初中	478(47.6)	528(33.3)	2 078(59.3)	348.22	< 0.01
	普高	415(41.3)	669(42.2)	910(26.0)
	中职	111(11.1)	388(24.5)	515(14.7)
兄弟姐妹个数	0	723(72.0)	1 201(75.8)	2 591(74.0)	5.10	0.28
	1~2	268(26.7)	370(23.3)	872(24.9)
	≥3	13(1.3)	14(0.9)	40(1.1)
母亲文化程度	初中及以下	197(19.6)	316(19.9)	638(18.2)	26.95	< 0.01
	高中/中专	215(21.4)	431(27.2)	781(22.3)
	大专	229(22.8)	344(21.7)	794(22.7)
	本科	311(31.0)	426(26.9)	1 090(31.1)
	研究生及以上	52(5.2)	68(4.3)	200(5.7)
父亲文化程度	初中及以下	180(17.9)	290(18.3)	520(14.8)	27.81	< 0.01
	高中/中专	218(21.7)	424(26.8)	837(23.9)
	大专	208(20.7)	325(20.5)	803(22.9)
	本科	325(32.4)	445(28.1)	1 070(30.6)
	研究生及以上	73(7.3)	101(6.4)	273(7.8)
是否住校	是	156(15.5)	290(18.3)	389(11.1)	51.13	< 0.01
	否	848(84.5)	1 295(81.7)	3 114(88.9)
家庭类型	非重组	936(93.2)	1 493(94.2)	3 352(95.7)	11.93	< 0.01
	重组	68(6.8)	92(5.8)	151(4.3)
家庭社会经济地位满意度	不满意	293(29.2)	316(19.9)	520(14.8)	169.92	< 0.01
	一般	363(36.2)	633(39.9)	1 163(33.2)
	满意	348(34.7)	636(40.1)	1 820(52.0)
注：()内数字为构成比/%。

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