《学生常见病多病共防技术指南》专题解读

陶舒曼; 伍晓艳; 陶芳标

doi:10.16835/j.cnki.1000-9817.2024305

《学生常见病多病共防技术指南》专题解读

doi: 10.16835/j.cnki.1000-9817.2024305

陶舒曼^{1, 2},
伍晓艳^{1, 3},
陶芳标^{1, 3, ,}

1.
安徽医科大学出生人口健康教育部重点实验室/环境与人口健康安徽省重点实验室，合肥 230032
2.
安徽医科大学第二附属医院眼科
3.
安徽医科大学儿少卫生与妇幼保健学系

基金项目:

国家重点研发计划项目 2021YFC2702100

国家重点研发计划项目 2021YFC2702105

详细信息

作者简介:
陶舒曼(1991-)，女，安徽枞阳人，博士，副研究员，主要研究方向为儿童青少年眼健康

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: R179 R193 R174^+.6
计量
- 文章访问数: 375
- HTML全文浏览量: 145
- PDF下载量: 143
- 被引次数: 0
出版历程
- 收稿日期: 2024-10-04
- 网络出版日期: 2024-11-02
- 刊出日期: 2024-10-25

Expert interpretation on the Technical Guidelines for the Joint Prevention of Common Disease Multimorbidity among Students

TAO Shuman^{1, 2},
WU Xiaoyan^{1, 3},
TAO Fangbiao^{1, 3
, ,}

1.
MOE Key Laboratory of Population Health across Life Cycle/Anhui Provincial Key Laboratory of Environment and Population Health across the Life Course, Anhui Medical University, Hefei (230032), Anhui Province, China

摘要

摘要: 学生常见病如近视、超重肥胖、脊柱弯曲异常、心理健康问题等普遍流行，但往往不是单一存在，且通常具有相同或相似的公共卫生影响因素，因此需要开展多病共防。为此，国家疾病预防控制局组织制定《学生常见病多病共防技术指南》(以下称《指南》)。《指南》首次解释多病共防的概念，明确疾病预防控制部门应加强环境和行为监测，提出基于三级预防策略的多病共防公共卫生综合干预措施，推荐“6个1”适宜技术，倡导探索建立政府—专业机构—学校—社区—家庭—学生“六位一体”的多病共防协作模式，进而实现学生常见病防控理论和实践的飞跃。文章围绕《指南》的制定背景、理论依据、核心内容等方面进行解读，以提高公共卫生机构专业工作者和关注学生健康的相关人员对《指南》内容的理解，推进《指南》的应用。
- 共病现象 /
- 指南 /
- 公共卫生 /
- 干预 /
- 学生
Abstract: Common diseases among students such as myopia, overweight and obesity, scoliosis, and mental health problems are prevalent, which usually exist concurrently under similar public health influencing factors. Therefore, there is a need to carry out the joint prevention of multimorbidity. The National Disease Control and Prevention Administration of China have organize the development of the Technical Guidelines for the Joint Prevention of Common Disease Multimorbidity among Students (hereafter referred to as the Guidelines). For the first time, the Guidelines clarifies the concept of multimorbidity joint prevention, specifies that the departments of centers for disease control and prevention should strengthen environmental and behavioral surveillance, proposes integrated public health interventions for multimorbidity joint prevention based on a three tiered prevention strategy, and recommends the appropriate technology of a healthy lifestyle featuring six key principles. It also advocates exploring the establishment of a six-in-one model (government-professional institution-community-school-family-students collaboration) for multimorbidity joint prevention, which has achieved a leap in theory and practice in the prevention and control of common diseases among students. The article focuses on the background, theoretical basis and core content of the Guidelines, in order to improve the understanding of the Guidelines by professionals in public health institutions and people concerned about students' health, and to promote the application and dissemination of the Guidelines.
- Comorbidity /
- Guidebooks /
- Public health /
- Intervention /
- Students
注释:

1) 利益冲突声明 所有作者声明无利益冲突。

HTML全文

图 1 学生常见病多病共防三级预防策略和技术

Figure 1. Strategies and techniques of three-level prevention for the co-prevention of common diseases multimorbidity among students

下载: 全尺寸图片幻灯片

参考文献(41)

[1]	CHEN T J, DONG B, DONG Y, et al. Matching actions to needs: shifting policy responses to the changing health needs of Chinese children and adolescents[J]. Lancet, 2024, 403(10438): 1808-1820. doi: 10.1016/S0140-6736(23)02894-5
[2]	国家疾病预防控制局综合司关于印发学生常见病多病共防技术指南的通知[EB/OL]. (2024-05-31)[2024-09-01]. https://www.gov.cn/zhengce/zhengceku/202405/content_6949610.htm. Notice of the Department of General Affairs of the National Disease Control and Prevention Administration on the issuance of technical guidelines for the co-prevention of common diseases multimorbidity among students[EB/OL]. (2024-05-31)[2024-09-01]. https://www.gov.cn/zhengce/zhengceku/202405/content_6949610.htm. (in Chinese)
[3]	SATTAR N, NEELAND I J, MCGUIRE D K. Obesity and cardiovascular disease: a new dawn[J]. Circulation, 2024, 149(21): 1621-1623. doi: 10.1161/CIRCULATIONAHA.123.065485
[4]	FISHER H L. Editorial: the near ubiquity of comorbidity - what are the implications for children's mental health research and practice?[J]. J Child Psychol Psychiatry, 2022, 63(5): 505-506. doi: 10.1111/jcpp.13612
[5]	NICHOLSON K, LIU W, FITZPATRICK D, et al. Prevalence of multimorbidity and polypharmacy among adults and older adults: a systematic review[J]. Lancet Healthy Long, 2024, 5(4): e287-e296. doi: 10.1016/S2666-7568(24)00007-2
[6]	HU Y, WANG Z, HE H, et al. Prevalence and patterns of multimorbidity in China during 2002-2022: a systematic review and Meta-analysis[J]. Ageing Res Rev, 2024, 93: 102165. doi: 10.1016/j.arr.2023.102165
[7]	JOBE M, MACTAGGART I, BELL S, et al. Prevalence of hypertension, diabetes, obesity, multimorbidity, and related risk factors among adult Gambians: a cross-sectional nationwide study[J]. Lancet Glob Health, 2024, 12(1): e55-e65. doi: 10.1016/S2214-109X(23)00508-9
[8]	HEAD A, BIRKETT M, FLEMING K, et al. Socioeconomic inequalities in accumulation of multimorbidity in England from 2019 to 2049: a microsimulation projection study[J]. Lancet Public Health, 2024, 9(4): e231-e239. doi: 10.1016/S2468-2667(24)00028-8
[9]	宋逸, 张秀红, 马军. 儿童青少年主要健康问题"共病-共因-共防"机制建立与探索[J]. 中国学校卫生, 2023, 44(9): 1281-1285. doi: 10.16835/j.cnki.1000-9817.2023.09.001 SONG Y, ZHANG X H, MA J. Establishment and exploration of the mechanism of Co-morbidity, Shared Etiology, and Shared Prevention of major health problems of children and adolescents[J]. Chin J Sch Health, 2023, 44(9): 1281-1285. (in Chinese) doi: 10.16835/j.cnki.1000-9817.2023.09.001
[10]	李俊同, 刘辉, 叶盛, 等. 南京市中小学生生活方式与近视和抑郁症状共患的关系[J]. 中国学校卫生, 2024, 45(5): 630-634. doi: 10.16835/j.cnki.1000-9817.2024290 LI J T, LIU H, YE S, et al. Relationship between lifestyle and the comorbidity of myopia and depressive symptoms among primary and secondary school students in Nanjing[J]. Chin J Sch Health, 2024, 45(5): 630-634. (in Chinese) doi: 10.16835/j.cnki.1000-9817.2024290
[11]	黄生垒, 张凤云, 曲爽笑, 等. 上海市2021年中小学生常见病共患现状及相关因素[J]. 中国学校卫生, 2024, 45(5): 635-639. HUANG S L, ZHANG F Y, QU S X, et al. Comorbidity of common illnesses and associated factors among primary and middle school students in Shanghai in 2021[J]. Chin J Sch Health, 2024, 45(5): 635-639. (in Chinese)
[12]	张献伟, 陈璐, 刘忠慧, 等. 天津中小学生近视与脊柱侧弯共患现状及学校环境风险因素分析[J]. 中国学校卫生, 2024, 45(5): 626-629. ZHANG X W, CHEN L, LIU Z H, et al. Comorbidity of myopia and scoliosis in primary and secondary school students and analysis of risk factors in school environment in Tianjin[J]. Chin J Sch Health, 2024, 45(5): 626-629. (in Chinese)
[13]	VASILEVA M, GRAF R K, REINELT T, et al. Research review: a Meta-analysis of the international prevalence and comorbidity of mental disorders in children between 1 and 7 years[J]. J Child Psychol Psychiatry, 2021, 62(4): 372-381. doi: 10.1111/jcpp.13261
[14]	DANG J, CAI S, ZHONG P, et al. Associations of school physical activity environment with comorbid obesity and myopia in children and adolescents: findings from a Chinese national follow-up study[J]. Scand J Med Sci Sports, 2024, 34(1): e14562. doi: 10.1111/sms.14562
[15]	MORALES-MUÑOZ I, MALLIKARJUN P K, CHANDAN J S, et al. Impact of anxiety and depression across childhood and adolescence on adverse outcomes in young adulthood: a UK birth cohort study[J]. Br J Psychiatry, 2023, 222(5): 212-220. doi: 10.1192/bjp.2023.23
[16]	KIDO A, MIYAKE M, WATANABE N. Interventions to increase time spent outdoors for preventing incidence and progression of myopia in children[J]. Cochrane Database Syst Rev, 2024, 6(6): CD013549.
[17]	FOREMAN J, SALIM A T, PRAVEEN A, et al. Association between digital smart device use and myopia: a systematic review and Meta-analysis[J]. Lancet Digit Health, 2021, 3(12): e806-e818. doi: 10.1016/S2589-7500(21)00135-7
[18]	JANG H, CHO Y, OH H. Recreational screen time and obesity risk in Korean children: a 3-year prospective cohort study[J]. Int J Behav Nutr Phys Act, 2024, 21(1): 112. doi: 10.1186/s12966-024-01660-0
[19]	ZHU L, RU S, WANG W, et al. Associations of physical activity and screen time with adolescent idiopathic scoliosis[J]. Environ Health Prev Med, 2023, 28: 55. doi: 10.1265/ehpm.23-00004
[20]	ECHEVERRIA M S, SCHUCH H S, CENCI M S, et al. Trajectories of sugar consumption and dental caries in early childhood[J]. J Dent Res, 2022, 101(6): 724-730. doi: 10.1177/00220345211068743
[21]	CALCATERRA V, CENA H, MAGENES V C, et al. Sugar-sweetened beverages and metabolic risk in children and adolescents with obesity: a narrative review[J]. Nutrients, 2023, 15(3): 702. doi: 10.3390/nu15030702
[22]	WANG H, ZHAO J, YU Z, et al. Types of on-screen content and mental health in kindergarten children[J]. JAMA Pediatr, 2024, 178(2): 125-132. doi: 10.1001/jamapediatrics.2023.5220
[23]	NELSON C A, SCOTT R D, BHUTTA Z A, et al. Adversity in childhood is linked to mental and physical health throughout life[J]. BMJ, 2020, 371: m3048.
[24]	马鑫悦, 张秀红, 宋逸, 等. 内蒙古地区2019—2022年中小学生脊柱侧弯与近视共患流行趋势及相关因素分析[J]. 中国学校卫生, 2023, 44(9): 1289-1293. MA X Y, ZHANG X H, SONG Y, et al. Prevalence trend and related factors of scoliosis and myopia co-morbidities among primary and middle school students in Inner Mongolia Autonomous Region from 2019 to 2022[J]. Chin J Sch Health, 2023, 44(9): 1289-1293. (in Chinese)
[25]	蒋家诺, 杨田, 袁雯, 等. 内蒙古地区学生超重肥胖与血压偏高及其共病状况的生活方式影响因素分析[J]. 中国学校卫生, 2023, 44(9): 1313-1318. JIANG J N, YANG T, YUAN W, et al. Co-occurrence trend of overweight, obesity and elevated blood pressure and its association with lifestyle factors among students in Inner Mongolia Autonomous Region[J]. Chin J Sch Health, 2023, 44(9): 1313-1318. (in Chinese)
[26]	PREISS K, BRENNAN L, CLARKE D. A systematic review of variables associated with the relationship between obesity and depression[J]. Obes Rev, 2013, 14(11): 906-918. doi: 10.1111/obr.12052
[27]	DIFRANCESCO S, LAMERS F, RIESE H, et al. Sleep, circadian rhythm, and physical activity patterns in depressive and anxiety disorders: a 2-week ambulatory assessment study[J]. Depress Anx, 2019, 36(10): 975-986. doi: 10.1002/da.22949
[28]	RAJI O E, KYEREMAH E B, SEARS D D, et al. Chrononutrition and cardiometabolic health: an overview of epidemiological evidence and key future research directions[J]. Nutrients, 2024, 16(14): 2332. doi: 10.3390/nu16142332
[29]	QU G, MA S, LIU H, et al. Positive childhood experiences can moderate the impact of adverse childhood experiences on adolescent depression and anxiety: results from a cross-sectional survey[J]. Child Abuse Negl, 2022, 125: 105511. doi: 10.1016/j.chiabu.2022.105511
[30]	DOLGIN E. A myopia epidemic is sweeping the globe. Here's how to stop it[J]. Nature, 2024, 629(8014): 989-991. doi: 10.1038/d41586-024-01518-2
[31]	NOETEL M, SANDERS T, GALLARDO-GÓMEZ D, et al. Effect of exercise for depression: systematic review and network Meta-analysis of randomised controlled trials[J]. BMJ, 2024, 384: e075847.
[32]	CHANG Q, ZHU Y, LIU Z, et al. Replacement of sedentary behavior with various physical activities and the risk of all-cause and cause-specific mortality[J]. BMC Med, 2024, 22(1): 385. doi: 10.1186/s12916-024-03599-2
[33]	SCHMIDT-PERSSON J, RASMUSSEN M G B, SØRENSEN S O, et al. Screen media use and mental health of children and adolescents: a secondary analysis of a randomized clinical trial[J]. JAMA Netw Open, 2024, 7(7): e2419881. doi: 10.1001/jamanetworkopen.2024.19881
[34]	GUINDON G E, MURPHY C A, MILANO M E, et al. Turn off that night light! Light-at-night as a stressor for adolescents[J]. Front Neurosci, 2024, 18: 1451219. doi: 10.3389/fnins.2024.1451219
[35]	SKOWRON E A, NEKKANTI A K, SKORANSKI A M, et al. Randomized trial of parent-child interaction therapy improves child-welfare parents' behavior, self-regulation, and self-perceptions[J]. J Consult Clin Psychol, 2024, 92(2): 75-92. doi: 10.1037/ccp0000859
[36]	HOYNIAK C P, WHALEN DJ, BARCH D, et al. Sleep problems in preschool-onset major depressive disorder: the effect of treatment with parent-child interaction therapy-emotion development[J]. Eur Child Adolesc Psychiatry, 2021, 30(9): 1463-1474. doi: 10.1007/s00787-020-01641-1
[37]	HARGREAVES D, MATES E, MENON P, et al. Strategies and interventions for healthy adolescent growth, nutrition, and development[J]. Lancet, 2022, 399(10320): 198-210. doi: 10.1016/S0140-6736(21)01593-2
[38]	ADAB P, BARRETT T, BHOPAL R, et al. The west midlands active lifestyle and healthy eating in school children (WAVES) study: a cluster randomised controlled trial testing the clinical effectiveness and cost-effectiveness of a multifaceted obesity prevention intervention programme targeted at children aged 6-7 years[J]. Health Technol Assess, 2018, 22(8): 1-608. doi: 10.3310/hta22080
[39]	FISHER M. Multi-sectoral action to promote psychological wellbeing: theorising the role of place-based policy[J]. Health Promot J Austr, 2023, 34(3): 644-650. doi: 10.1002/hpja.754
[40]	LI B, PALLAN M, LIU W J, et al. The CHIRPY DRAGON intervention in preventing obesity in Chinese primary-school-aged children: a cluster-randomised controlled trial[J]. PLoS Med, 2019, 16(11): e1002971. doi: 10.1371/journal.pmed.1002971
[41]	FLATTUM C, DRAXTEN M, HORNING M, et al. Home plus: program design and implementation of a family-focused, community-based intervention to promote the frequency and healthfulness of family meals, reduce children's sedentary behavior, and prevent obesity[J]. Int J Behav Nutr Phys Act, 2015, 12: 53. doi: 10.1186/s12966-015-0211-7