Latent classes of health-risk behaviors and their association with school connectedness among adolescents in the Wuling Mountain Area
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摘要:
目的 了解武陵山区青少年危害健康行为潜在类别及其与学校联结的关联,为制定分类高效干预措施提供参考。 方法 于2023年3—6月,运用多阶段分层整群随机抽样法抽取武陵山区8所学校的3 386名初、高中学生为调查对象,采用基本信息问卷、危害健康行为问卷、学校联结量表进行调查。采用潜在类别分析探究武陵山区青少年危害健康行为的潜在类别,运用无序多分类Logistic回归模型分析潜在类别与学校联结的关联。 结果 武陵山区青少年危害健康行为可分为外显行为高风险组(5.64%)、内隐行为高风险组(26.90%)、低风险组(67.45%)3个潜在类别;不同性别、民族、家庭类型的青少年在外显行为高风险组、内隐行为高风险组和低风险组3个潜在类别组的分布差异均有统计学意义(χ2值分别为117.91,22.55,21.51,P值均 < 0.05);无序多分类Logistic回归模型分析结果显示,以低风险组为参照,学校联结得分高与外显行为高风险组(OR=0.89,95%CI=0.88~0.91)和内隐行为高风险组(OR=0.90,95%CI=0.89~0.91)均呈负相关(P值均 < 0.05)。 结论 武陵山区青少年危害健康行为类别特征明显,外显行为高风险组、内隐行为高风险组均与学校联结存在负向关联。应积极采取相应措施,提高青少年学校归属感,降低危害健康行为的聚集共存状况。 Abstract:Objective To understand the potential categories of health-risk behaviors among adolescents in the Wuling Mountain Area and their association with school connectedness, so as to provide reference for formulating classified and effective intervention measures. Methods From March to June 2023, 3 386 middle and high school students from eight schools in the Wuling Mountain Area were selected using the multistage stratified cluster random sampling method. A basic information questionnaire, health-risk behaviors questionnaire, and school connectedness scale were utilized for the survey. The latent classes of adolescent health-risk behaviors in the Wuling Mountain Area were investigated by using latent class analysis, while an multinomial Logistic regression model was employed to analyze the association between latent classes and school connectedness. Results Adolescent health-risk behaviors in the Wuling Mountains Area were classified into three latent classes: high-risk class of episodic behaviors (5.64%), high-risk class of implicit behaviors (26.90%), and low-risk class of implicit behaviors (67.45%). Gender, ethnicity, and family type revealed significant differences in the distribution of the three latent classes (χ2=117.91, 22.55, 21.51, P < 0.05). The results of the regression model analysis showed that, with the low-risk class as the reference category, high school connectedness scores were associated with the high-risk class of episodic behaviors (OR=0.89, 95%CI=0.88-0.91) and the high-risk class of implicit behaviors (OR=0.90, 95%CI=0.89-0.91)(P < 0.05). Conclusions The characteristics of adolescent health-risk behavior classes in the Wuling Mountain Area are obvious. The high-risk class of episodic behaviors and the high-risk class of implicit behaviors are negatively correlated with school connectedness. Corresponding measures should be taken to enhance adolescents' sense of belonging in school and reduce the aggregation and co-occurrence of health-risk behaviors. -
Key words:
- Dangerous behaivor /
- School connections /
- Regression analysis /
- Adolescent
1) 利益冲突声明 所有作者声明无利益冲突。 -
表 1 武陵山区青少年危害健康行为潜类别模型1~5类拟合指标(n=3 386)
Table 1. Fitting indicators of Category 1 to 5 of the latent category model of health-risk behaviors among adolescents in Wuling Mountain Area(n=3 386)
模型 参数条目 AIC值 BIC值 aBIC值 Entropy值 PLMR值 PBLRT值 类别概率 1 9 31 585.13 31 640.27 31 611.68 1.00 1.00 2 19 29 418.83 29 535.25 29 474.88 0.75 < 0.01 < 0.01 0.31/0.69 3 29 29 008.72 29 186.42 29 094.27 0.83 < 0.01 < 0.01 0.06/0.27/0.68 4 39 28 822.56 29 061.52 28 937.60 0.77 0.14 < 0.01 0.65/0.05/0.04/0.26 5 49 28 679.41 28 979.65 28 823.96 0.66 0.01 < 0.01 0.58/0.16/0.04/0.05/0.17 表 2 武陵山区不同人口学特征青少年危害健康行为潜在类别组分布比较
Table 2. Comparison of distribution of the potential categories of health-risk behaviors among adolescents with different characteristics in Wuling Mountain Area
人口学指标 选项 人数 外显行为高风险组 内隐行为高风险组 低风险组 χ2值 P值 性别 男 1 760 146(8.30) 354(20.11) 1 260(71.59) 117.91 < 0.01 女 1 626 45(2.77) 557(34.26) 1 024(62.98) 学段 初中 1 656 83(5.01) 448(27.05) 1 125(67.93) 2.41 0.30 高中 1 730 108(6.24) 463(26.76) 1 159(66.99) 民族 汉族 641 30(4.68) 183(28.55) 428(66.77) 22.55 0.01 土家族 2 293 137(5.97) 583(25.43) 1 573(68.60) 苗族 404 17(4.21) 131(32.43) 256(63.36) 侗族 14 2(14.29) 4(28.57) 8(57.14) 其他民族 34 5(14.71) 10(29.41) 19(55.88) 城乡 农村 719 42(5.84) 218(30.32) 459(63.84) 5.79 0.06 城市 2 667 149(5.59) 693(25.98) 1 825(68.43) 独生子女 是 565 35(6.19) 161(28.50) 369(65.31) 1.47 0.48 否 2 821 156(5.53) 750(26.59) 1 915(67.88) 住校 是 2 973 166(5.58) 793(26.67) 2 014(67.74) 0.93 0.63 否 413 25(6.05) 118(28.57) 270(65.38) 留守 是 746 50(6.70) 212(28.42) 484(64.88) 3.67 0.16 否 2 640 141(5.34) 699(26.48) 1 800(68.18) 父亲学历 小学及以下 676 34(5.03) 199(29.44) 443(65.53) 8.70 0.19 初中 1 636 95(5.81) 421(25.73) 1 120(68.46) 高中 728 37(5.08) 187(25.69) 504(69.23) 大学及以上 346 25(7.23) 104(30.06) 217(62.72) 母亲学历 小学及以下 1 114 61(5.48) 327(29.35) 726(65.17) 12.09 0.06 初中 1 421 82(5.77) 348(24.49) 991(69.74) 高中 589 28(4.75) 158(26.83) 403(68.42) 大学及以上 262 20(7.63) 78(29.77) 164(62.60) 家庭类型 核心家庭 1 944 112(5.76) 496(25.51) 1 336(68.72) 21.51 0.01 三代同堂 866 48(5.54) 217(25.06) 601(69.40) 单亲家庭 246 13(5.28) 90(36.59) 143(58.13) 重组家庭 215 13(6.05) 69(32.09) 133(61.86) 其他家庭 115 5(4.35) 39(33.91) 71(61.74) 注:()内数字为构成比/%;核心家庭指子女与父母一起生活的家庭,其他家庭主要包括隔代家庭、亲戚朋友为监护人的家庭。 -
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