青少年社会生态学风险因素评定简短问卷信效度评价及应用

王娇娇; 张一; 谢阳; 张新宇; 张向林; 万宇辉; 陶芳标

doi:10.16835/j.cnki.1000-9817.2023.11.019

青少年社会生态学风险因素评定简短问卷信效度评价及应用

doi: 10.16835/j.cnki.1000-9817.2023.11.019

王娇娇¹,
张一¹,
谢阳¹,
张新宇¹,
张向林¹,
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

基金项目:

国家自然科学基金项目 82073578

详细信息

作者简介:
王娇娇(1997-)，女，安徽阜阳人，在读硕士，主要研究方向为儿童青少年卫生

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: C913.5 B844.2 R179
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出版历程
- 收稿日期: 2023-05-29
- 修回日期: 2023-08-02
- 网络出版日期: 2023-11-27
- 刊出日期: 2023-11-25

Evaluation of reliability and validity, and application on the Simplified Rating Questionnaire of Social Ecological Risks in Adolescents

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

摘要

摘要: 目的研制青少年社会生态学风险因素评定简短问卷，评价其信效度，为青少年累积生态风险因素暴露评定体系的构建提供资料和证据支持。方法采用多阶段整群随机抽样方法，于2021年10—12月抽取深圳市、郑州市、徐州市、南昌市、沈阳市、太原市、昆明市、重庆市等8个地市共22 868名青少年进行问卷调查。基于条目分析筛选、探索性因子分析、信效度评价等多种方法，利用沈阳、太原、昆明、重庆4个地区共10 838名青少年行为健康调查数据对原始问卷条目进行筛选；同时根据深圳市、郑州市、徐州市、南昌市4个地区共12 030名参与者相关监测资料评价其预测效度。结果通过对原始问卷条目分析及筛选，得出由25个条目构成的青少年社会生态学风险因素评定简短问卷，涵盖个人、家庭、学校、社区、政策、时间、文化7个维度，方差累积贡献率为54.95%，其Cronbach α系数为0.79，分半系数为0.70。相较于低累积生态风险暴露的儿童青少年，高风险组的儿童青少年发生吸烟(OR=4.05，95%CI=2.78~5.92)、饮酒(OR=3.47，95%CI=2.86~4.19)、自杀意念(OR=8.85，95%CI=7.68~10.21)、自杀计划(OR=8.85，95%CI=7.27~10.78)、自杀未遂行为(OR=8.86，95%CI=6.67~11.78)的可能性更高(P值均 < 0.05)；对性别分层后，累积生态风险暴露水平与上述行为间的正相关仍有统计学意义(P值均 < 0.05)。结论青少年社会生态学风险因素评定简短问卷信效度较好，且预测效度良好，未来可在研究社会生态风险因素领域推广使用。
- 累积生态风险 /
- 精神卫生 /
- 问卷调查 /
- 青少年
Abstract: Objective To develop a simplified Rating Questionnaire of Social Ecological Risks in Adolescents and to evaluate the reliability and predictive validity of the brief questionnaire, so as to provide data and evidence support for building the evaluation system of cumulative social-ecological risk exposure. Methods A large cross-sectional was conducted in eight areas, including Shenzhen, Zhengzhou, Xuzhou, Nanchang, Shenyang, Taiyuan, Kunming and Chongqing, from October to December 2021. A total of 22 868 adolescents were included in the analysis. Data on healthy behaviors from 10 838 adolescents from Shenyang, Taiyuan, Kunming, Chongqing were used for item selection, based on factor analysis, validity and reliability evaluation. The data from Shenzhen, Zhengzhou, Xuzhou, Nanchang, including 12 030 adolescents, were used to define the partition values of the brief questionnaire, and evaluate the predictive validity. Results The brief questionnaire containing 25-item were developed by analyzing and choosing all items of original questionnaire, and covered seven dimensions including individual, family, school, community, policy, time and culture. The cumulative contribution rate of variance was 54.95%, the Cronbach coefficient was 0.79, and the split-half coefficient was 0.70. Participants in the higher risk group had significantly higher risk of smoking (OR=4.05, 95%CI=2.78-5.92), drinking (OR=3.47, 95%CI=2.86-4.19), suicidal ideation (OR=8.85, 95%CI=7.68-10.21), suicidal plans (OR=8.85, 95%CI=7.27-10.78), suicidal attempt (OR=8.86, 95%CI=6.67-11.78) than individual in the lower risk group (P < 0.05). After stratified by gender, the above positive correlations still remained significant(P < 0.05). Conclusion The brief questionnaire, with good reliability and predictive validity, could be widely applicated in the further researches on social ecological risk factors.
- Cumulative ecological risk /
- Mental health /
- Questionnaires /
- Adolescent
注释:

1) 利益冲突声明 所有作者声明无利益冲突。

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表 1 青少年社会生态学风险因素评定简短问卷筛选后结果

Table 1. The selected results of the Simplified Rating Questionnaire of Social Ecological Risks in Adolescents

维度	项目	与总量表相关系数	与所属维度相关系数	与其他维度相关系数	最大负荷	Cronbach α系数变化	反应度分析	筛选结果
个人	我自信能有效地应对任何突如其来的事情	0.38^**	0.64^**	a	0.78	↓	b	√
	在遇到痛苦的事情时，能用积极的行为去减缓痛苦	0.44^**	0.66^**	a	0.69	↓	b	√
	喜欢将不开心的事情憋在心里不表现出来，但又忘不了	0.31^**	0.47^**	a	0.70	—	b	√
家庭	我与父母能够很好地谈心	0.48^**	0.73^**	a	0.74	↓	b	√
	当我为一些事情不安的时候，父母能觉察到	0.49^**	0.68^**	a	0.78	↓	b	√
	我的父母经常因为一点小事就责骂我	0.44^**	0.66^**	a	0.75	↓	b	√
学校	我的老师很喜欢我	0.47^**	0.62^**	a	0.64	↓	b	√
	我觉得我能很好地融入学校的生活	0.60^**	0.73^**	a	0.82	↓	b	√
	我和同学相处融洽	0.52^**	0.63^**	a	0.75	↓	b	√
	我感觉在学校很不舒服	0.60^**	0.66^**	a	0.66	↓	b	√
社区	住的地方(包括宿舍)空气中常有异味	0.48^**	0.72^**	a	0.74	↓	b	√
	住的地方(包括宿舍)离马路比较近，噪声影响我休息	0.46^**	0.68^**	a	0.69	↓	b	√
	住的地方(包括宿舍)周围没有专门供人锻炼的场所	0.37^**	0.72^**	a	0.67	—	b	√
	住的地方(包括宿舍)周围有陌生人对我作出危险的举动	0.42^**	0.63^**	a	0.67	↓	b	√
政策	学校对参加运动会同学有奖励政策	0.31^**	0.54^**	a	0.78	-	b	√
	学校对故意损害公共财产有惩罚措施	0.39^**	0.47^**	a	0.83	—	b	√
	社区鼓励大家参加社区活动	0.48^**	0.70^**	a	0.75	↓	b	√
	学校对周边网吧和娱乐场所的监管很严格	0.46^**	0.78^**	a	0.87	↓	b	√
	社区对周边网吧和娱乐场所的监管很严格	0.44^**	0.77^**	a	0.87	↓	b	√
文化	我觉得出去玩不如在家玩直播或抖音	0.44^**	0.62^**	a	0.82	↓	b	√
	只要我喜欢，再贵的东西我都会买下来	0.35^**	0.63^**	a	0.49	↓	b	√
	我觉得手机聊天比当面聊天更好玩，比如说能发表情包	0.37^**	0.62^**	a	0.80	↓	b	√
时间	父母近3年离异	0.25^**	0.59^**	a	0.62	↓	b	√
	近3年父母又养了弟弟或妹妹	0.16^**	0.50^**	a	0.62	↓	b	√
	近3年我搬过家或转过学	0.20^**	0.67^**	a	0.52	↓	b	√
注：↓表示删除该条目后Cronbach系数减小；√表示保留该条目；a与其他维度相关系数均小于该条目与其所属维度相关系数；b该条目5个选项中有<3个选项的应答率<10%；**P<0.01。

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表 2 不同性别青少年累积生态风险暴露分布及物质使用自杀相关行为检出率比较

Table 2. Comparison of the detection rates of cumulative ecological risk exposure, substance use and suicide-related behaviors between different genders

性别	人数	累积生态风险			吸烟	饮酒	自杀意念	自杀计划	自杀未遂
性别	人数	低风险组	中风险组	高风险组	吸烟	饮酒	自杀意念	自杀计划	自杀未遂
男	6 311	1 714(27.2)	3 080(48.8)	1 517(24.0)	271(4.3)	925(14.7)	1 335(21.2)	635(10.1)	233(3.7)
女	5 719	1 427(25.0)	2 881(50.4)	1 411(24.7)	68(1.2)	394(6.9)	1 875(32.8)	938(16.4)	483(8.4)
合计	12 030	3 141(26.1)	5 961(49.6)	2 228(24.3)	339(2.8)	1 319(11.0)	3 210(26.7)	1 573(13.1)	716(6.0)
χ²值			7.59		105.63	185.43	207.50	106.09	121.11
P值			<0.05		<0.01	<0.01	<0.01	<0.01	<0.01
注：( )内数字为构成比或检出率/%。

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表 3 青少年累积生态风险暴露与物质使用自杀相关行为Logistic回归分析[OR值(95%CI)]

Table 3. Logistic analysis of cumulative ecological risk exposure to adolescents and substance use, and suicide-related behaviors [OR(95%CI)]

性别	累积生态风险	吸烟	饮酒	自杀意念	自杀计划	自杀未遂
男生	低风险组	1.00	1.00	1.00	1.00	1.00
(n=6 311)	中风险组	1.63(1.09~2.44)^*	1.76(1.43~2.16)^**	3.21(2.63~3.93)^**	3.38(2.50~4.57)^**	2.35(1.44~3.81)^**
	高风险组	3.26(2.17~4.92)^**	2.66(2.13~3.32)^**	8.04(6.50~9.95)^**	8.54(6.27~11.63)^**	7.54(4.66~12.19)^**
女生	低风险组	1.00	1.00	1.00	1.00	1.00
(n=5 719)	中风险组	3.68(1.28~10.58)^*	3.45(2.35~5.06)^**	3.13(2.63~3.73)^**	3.23(2.52~4.13)^**	3.09(2.18~4.38)^**
	高风险组	10.37(3.62~29.69)^**	6.64(4.48~9.85)^**	9.72(8.01~11.78)^**	9.13(7.06~11.81)^**	9.63(6.76~13.72)^**
总人群	低风险组	1.00	1.00	1.00	1.00	1.00
(n=12 030)	中风险组	1.88(1.29~2.73)^**	2.11(1.77~2.53)^**	3.17(2.78~3.61)^**	3.29(2.72~3.98)^**	2.83(2.13~3.75)^**
	高风险组	4.05(2.78~5.92)^**	3.47(2.86~4.19)^**	8.85(7.68~10.21)^**	8.85(7.27~10.78)^**	8.86(6.67~11.78)^**
注：P<0.05，*P<0.01；模型调整了年龄、性别、年级、家庭居住地、是否独生子女、父母文化程度、家庭经济水平协变量。

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