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

ZHU Yan; SHI Huijing; LUO Chunyan

doi:10.16835/j.cnki.1000-9817.2023.08.006

Volume 44 Issue 8

Aug. 2023

Turn off MathJax

Article Contents

Article Navigation > CHINESE JOURNAL OF SCHOOL HEALTH > 2023 > 44(8): 1145-1150

ZHU Yan, SHI Huijing, LUO Chunyan. Cluster analysis of health risk behaviors among secondary school students in Shanghai[J]. CHINESE JOURNAL OF SCHOOL HEALTH, 2023, 44(8): 1145-1150. doi: 10.16835/j.cnki.1000-9817.2023.08.006

Citation:

ZHU Yan, SHI Huijing, LUO Chunyan. Cluster analysis of health risk behaviors among secondary school students in Shanghai[J]. CHINESE JOURNAL OF SCHOOL HEALTH, 2023, 44(8): 1145-1150. doi: 10.16835/j.cnki.1000-9817.2023.08.006

Citation:

PDF( 530 KB)

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

doi: 10.16835/j.cnki.1000-9817.2023.08.006

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

Received Date: 2022-12-23
Rev Recd Date: 2023-04-11

Available Online: 2023-08-26

Publish Date: 2023-08-25

Abstract

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

FullText(HTML)

References(40)

References

[1]	AHMADI-MONTECALVO H, LILLY C L, ZULLIG K J, et al. A latent class analysis of the co-occurrence of risk behaviors among adolescents[J]. Am J Health Behav, 2019, 43(3): 449-463. doi: 10.5993/AJHB.43.3.1
[2]	AKASAKI M, PLOUBIDIS G B, DODGEON B, et al. The clustering of risk behaviours in adolescence and health consequences in middle age[J]. J Adolesc, 2019, 77: 188-197. doi: 10.1016/j.adolescence.2019.11.003
[3]	MEADER N, KING K, MOE-BYRNE T, et al. A systematic review on the clustering and co-occurrence of multiple risk behaviours[J]. BMC Public Health, 2016, 16: 657. doi: 10.1186/s12889-016-3373-6
[4]	马军. 儿童青少年主要健康问题和研究热点[J]. 中国学校卫生, 2020, 41(9): 1281-1284. doi: 10.16835/j.cnki.1000-9817.2020.09.001 MA J. Major health issues and research hotspots in child and adolescent health[J]. Chin J Sch Health, 2020, 41(9): 1281-1284. (in Chinese) doi: 10.16835/j.cnki.1000-9817.2020.09.001
[5]	Centers for Disease Control and Prevention. Youth risk behavior survey data summary & trends report: 2011-2021[EB/OL]. (2023-02-13)[2023-03-15]. https://www.cdc.gov/healthyyouth/data/yrbs/pdf/YRBS_Data-Summary-Trends_Report2022_508.pdf.
[6]	马军, 董彦会, 王鑫鑫, 等. 中国儿童青少年健康危险行为状况分析报告[J]. 中国校外教育, 2022(6): 61-78. https://www.cnki.com.cn/Article/CJFDTOTAL-XWLL202206007.htm MA J, DONG Y H, WANG X X, et al. Analysis of health risk behaviors of Chinese children and adolescents[J]. Aftersch Educ Chin, 2022(6): 61-78. (in Chinese) https://www.cnki.com.cn/Article/CJFDTOTAL-XWLL202206007.htm
[7]	UDDIN R, LEE E Y, KHAN S R, et al. Clustering of lifestyle risk factors for non-communicable diseases in 304 779 adolescents from 89 countries: a global perspective[J]. Prev Med, 2020, 131: 105955. doi: 10.1016/j.ypmed.2019.105955
[8]	CHAMPION K E, MATHER M, SPRING B, et al. Clustering of multiple risk behaviors among a sample of 18-year-old Australians and associations with mental health outcomes: a latent class analysis[J]. Front Public Health, 2018, 6: 135. doi: 10.3389/fpubh.2018.00135
[9]	WIJBENGA L, DE WINTER A F, ALMANSA J, et al. Multiple health risk behaviors and mental health from a life course perspective: the Dutch TRAILS study[J]. Prev Med, 2022, 154: 106870. doi: 10.1016/j.ypmed.2021.106870
[10]	罗春燕, 彭宁宁, 周月芳, 等. 上海市青少年危险行为聚集现象分析[J]. 中国校医, 2004(3): 193-195. https://www.cnki.com.cn/Article/CJFDTOTAL-XIYI200403000.htm LUO C Y, PENG N N, ZHOU Y F, et al. Analysis of collective risk behaviors among youth in Shanghai[J]. Chin J School Doctor, 2004(3): 193-195. (in Chinese) https://www.cnki.com.cn/Article/CJFDTOTAL-XIYI200403000.htm
[11]	季成叶. 中国青少年健康相关/危险行为调查综合报告2005[M]. 北京: 北京大学医学出版社, 2005. JI C Y. A comprehensive report on the survey of health-related/risky behaviors among Chinese adolescents 2005[M]. Beijing: Peking University Medical Press, 2005. (in Chinese)
[12]	ZWEIG J M, LINDBERG L D, MCGINLEY K A. Adolescent health risk profiles: the co-occurrence of health risks among females and males[J]. J Youth Adolesc, 2001, 30(6): 707-728. doi: 10.1023/A:1012281628792
[13]	ROSINGER A, HERRICK K, GAHCHE J, et al. Sugar-sweetened beverage consumption among U.S. Youth, 2011-2014[J]. NCHS Data Brief, 2017(271): 1-8.
[14]	马志敏, 郝晓燕, 王东阳, 等. 中国膳食模式的特征、分布及其与健康相关性研究进展[J]. 食品工业科技, 2023, 44(10): 396-405. https://www.cnki.com.cn/Article/CJFDTOTAL-SPKJ202310050.htm MA Z M, HAO X Y, WANG D Y, et al. The evolution and distribution of dietary patterns in China and the research progress of its correlation with health[J]. Sci Technol Food Ind, 2023, 44(10): 396-405. (in Chinese) https://www.cnki.com.cn/Article/CJFDTOTAL-SPKJ202310050.htm
[15]	MADIGAN S, EIRICH R, PADOR P, et al. Assessment of changes in child and adolescent screen time during the COVID-19 pandemic: a systematic review and Meta-analysis[J]. JAMA Pediatr, 2022, 176(12): 1188-1198. doi: 10.1001/jamapediatrics.2022.4116
[16]	XIANG M, ZHANG Z, KUWAHARA K. Impact of COVID-19 pandemic on children and adolescents' lifestyle behavior larger than expected[J]. Prog Cardiovasc Dis, 2020, 63(4): 531-532. doi: 10.1016/j.pcad.2020.04.013
[17]	ZHU Z, TANG Y, ZHUANG J, et al. Physical activity, screen viewing time, and overweight/obesity among Chinese children and adolescents: an update from the 2017 physical activity and fitness in China-the youth study[J]. BMC Public Health, 2019, 19(1): 197. doi: 10.1186/s12889-019-6515-9
[18]	ZHAO W, SU D, MO L, et al. Lifestyle clusters and cardiometabolic risks in adolescents: a Chinese school-based study using a latent class analysis approach[J]. Front Pediatr, 2021, 9: 728841. doi: 10.3389/fped.2021.728841
[19]	ZHOU J, LI X, ZOU Y, et al. Longitudinal relations among family dysfunction, depressive symptoms, and cyberbullying involvement in Chinese early adolescents: disentangling between and within-person associations[J]. Dev Psychopathol, 2022: 1-9. DOI:10.1017/s095457942 2001274.
[20]	D'SOUZA N J, KUSWARA K, ZHENG M, et al. A systematic review of lifestyle patterns and their association with adiposity in children aged 5-12 years[J]. Obes Rev, 2020, 21(8): e13029.
[21]	HANSON S K, MUNTHALI R J, MICKLESFIELD L K, et al. Longitudinal patterns of physical activity, sedentary behavior and sleep in urban South African adolescents, birth-to-twenty plus cohort[J]. BMC Pediatr, 2019, 19(1): 241. doi: 10.1186/s12887-019-1619-z
[22]	PARKER K, TIMPERIO A, SALMON J, et al. Activity-related typologies and longitudinal change in physical activity and sedentary time in children and adolescents: the UP&DOWN study[J]. J Sport Health Sci, 2021, 10(4): 447-453. doi: 10.1016/j.jshs.2020.02.004
[23]	GARDNER L A, CHAMPION K E, PARMENTER B, et al. Clustering of six key risk behaviors for chronic disease among adolescent females[J]. Int J Environ Res Public Health, 2020, 17(19): 7211. doi: 10.3390/ijerph17197211
[24]	NOLEN-HOEKSEMA S. Emotion regulation and psychopathology: the role of gender[J]. Ann Rev Clin Psychol, 2012, 8: 161-187.
[25]	史慧静, 谭晖. 儿童青少年卫生学[M]. 上海: 复旦大学出版社, 2014. SHI H J, TAN H. Child and adolescent health[M]. Shanghai: Fudan University Press, 2014. (in Chinese)
[26]	SYLVETSKY A C, VISEK A J, HALBERG S, et al. Beyond taste and easy access: physical, cognitive, interpersonal, and emotional reasons for sugary drink consumption among children and adolescents[J]. Appetite, 2020, 155: 104826.
[27]	王誉铮. 青少年体像烦恼的影响因素及其注意偏向的实证研究[D]. 海口: 海南师范大学, 2020. WANG Y Z. An empirical study on the influencing factors and attentional bias of teenagers' body image anxiety[D]. Haikou: Hainan Normal University, 2020. (in Chinese)
[28]	文小桐, 陈飞宇, 李旭阳, 等. 农村地区高中生体重自我评价与饮食行为习惯分析[J]. 中国公共卫生, 2020, 36(2): 174-177. https://www.cnki.com.cn/Article/CJFDTOTAL-ZGGW202002011.htm WEN X T, CHEN F Y, LI X Y, et al. Self-evaluation of weight and eating habits among rural high school students[J]. Chin J Public Health, 2020, 36(2): 174-177. (in Chinese) https://www.cnki.com.cn/Article/CJFDTOTAL-ZGGW202002011.htm
[29]	STEVENS M W, DORSTYN D, DELFABBRO P H, et al. Global prevalence of gaming disorder: a systematic review and Meta-analysis[J]. Aust N Z J Psychiatry, 2021, 55(6): 553-568.
[30]	徐涛, 张天成, 张福兰. 湘西州农村初中生健康危险行为聚集特征及多发特点分析[J]. 中国慢性病预防与控制, 2021, 29(12): 892-897. https://www.cnki.com.cn/Article/CJFDTOTAL-ZMXB202112003.htm XU T, ZHANG T C, ZHANG F L. Cluster and multiple characteristics of health risk behaviors of rural junior high school students in Xiangxi Autonomous Prefecture[J]. Chin J Prev Control Chron Dis, 2021, 29(12): 892-897. (in Chinese) https://www.cnki.com.cn/Article/CJFDTOTAL-ZMXB202112003.htm
[31]	张桂蓉, 顾妮. 中国中小学生校园欺凌相关因素的Meta分析[J]. 中国心理卫生杂志, 2022, 36(1): 37-43. https://www.cnki.com.cn/Article/CJFDTOTAL-ZXWS202201006.htm ZHANG G R, GU N. A Meta-analysis of related factors of school bullying among primary and middle school students in China[J]. Chin Ment Health J, 2022, 36(1): 37-43. (in Chinese) https://www.cnki.com.cn/Article/CJFDTOTAL-ZXWS202201006.htm
[32]	王雅娟. 青少年对食物线索与负性情绪的内隐联结: 情绪性进食的调节作用[D]. 重庆: 西南大学, 2020. WANG Y J. Implicit asscociation between food cues and negative emotions in adolescents: the regulatory role of emotional eating[D]. Chongqing: Southwest University, 2020. (in Chinese)
[33]	ATORKEY P, OWIREDUA C. Clustering of multiple health risk behaviours and association with socio-demographic characteristics and psychological distress among adolescents in Ghana: a latent class analysis[J]. SSM Popul Health, 2021, 13: 100707.
[34]	YANG Y, LIU X, LIU Z Z, et al. Life stress, insomnia, and anxiety/depressive symptoms in adolescents: a three-wave longitudinal study[J]. J Affect Disord, 2023, 322: 91-98.
[35]	WIJNANT K, KLOSOWSKA J, BRAET C, et al. Stress responsiveness and emotional eating depend on youngsters' chronic stress level and overweight[J]. Nutrients, 2021, 13(10): 3654.
[36]	贾继超. 压力性生活事件与青少年网络成瘾[D]. 武汉: 华中师范大学, 2019. JIA J C. Stressful life events and adolescent internet addiction: a 3-year prospective study[D]. Wuhan: Central China Normal University, 2019. (in Chinese)
[37]	DE COCK N, VAN LIPPEVELDE W, GOOSSENS L, et al. Sensitivity to reward and adolescents' unhealthy snacking and drinking behavior: the role of hedonic eating styles and availability[J]. Int J Behav Nutr Phys Act, 2016, 13: 17.
[38]	NELSON E E, LEIBENLUFT E, MCCLURE E B, et al. The social re-orientation of adolescence: a neuroscience perspective on the process and its relation to psychopathology[J]. Psychol Med, 2005, 35(2): 163-174.
[39]	MATHUR M R, SINGH A, MISHRA V K, et al. Socioeconomic inequalities in clustering of health-compromising behaviours among Indian adolescents[J]. Ind J Commun Med, 2020, 45(2): 139-144.
[40]	KINO S, BERNABÉ E, SABBAH W. Socioeconomic inequality in clusters of health-related behaviours in Europe: latent class analysis of a cross-sectional European survey[J]. BMC Public Health, 2017, 17(1): 497.