Rudatsikira Emmanuel, Mataya Ronald H, Siziya Seter, Muula Adamson S
Department of Epidemiology and Biostatistics, Loma Linda University, School of Public Health, Loma, Linda, California, USA.
Indian J Pediatr. 2008 Dec;75(12):1243-7. doi: 10.1007/s12098-008-0244-x. Epub 2009 Feb 4.
Interpersonal violence is an important, but neglected public health issue in low and middle-income countries. Adolescent physical fighting not only results in injury, disability and death, but is also associated with other potentially harmful behaviors such substance use and premarital sex. The study aims at dose-response association to prevent adolescent problem behaviors.
We used data from the 2003-2004 Global School-Based Health Survey conducted among school adolescents in the Philippines. We estimated the prevalence of bullying victimization and physical fighting. We also conducted logistic regression analysis to assess the association between a selected list of explanatory variables and physical fighting. We hypothesized that there would be a dose-response relationship between physical fighting and number of times the adolescent reported being bullied in the past 30 days.
Of the 7,338 respondents, 35.5% (34.7% males and 36.1% females) were bullied and 50.0% (51.6% males and 48.8% females) reported having been in a physical fight in the past 12 months. There was a dose-response relationship between bullying victimization and physical fighting (p-trend <0.001). Compared to subjects who were not bullied, those who reported being bullied were more likely to engage in physical fighting after controlling for age, gender, substance use (smoking, alcohol drinking or drug use), and parental supervision (OR=2.38; 95% CI [1.99, 2.86] for 1-2 days of bullying victimization per month, OR=3.55; 95% CI [2.61, 4.83]) for 3-5 days/month per month, OR=4.45; 95% CI [2.61, 7.60]) for 6-9 days/ month, OR=1.91; 95% CI [1.17, 3.13]) for 10-30 days/month.)
The dose-response relationship between physical fighting and the number of times an adolescent had been a victim of bullying deserves further study. If causal relationship exists, preventing bullying, even if not totally eliminated, may have significant results in preventing physical fighting.
人际暴力是低收入和中等收入国家一个重要但被忽视的公共卫生问题。青少年肢体冲突不仅会导致受伤、残疾和死亡，还与其他潜在有害行为相关，如物质使用和婚前性行为。本研究旨在探讨剂量反应关系，以预防青少年的问题行为。
我们使用了2003 - 2004年在菲律宾学校青少年中进行的全球学校健康调查数据。我们估计了受欺凌和肢体冲突的发生率。我们还进行了逻辑回归分析，以评估一系列选定的解释变量与肢体冲突之间的关联。我们假设在过去30天里青少年报告的被欺凌次数与肢体冲突之间存在剂量反应关系。
在7338名受访者中，35.5%（男性为34.7%，女性为36.1%）曾遭受欺凌，50.0%（男性为51.6%，女性为48.8%）报告在过去12个月里曾发生过肢体冲突。受欺凌与肢体冲突之间存在剂量反应关系（p趋势<0.001）。在控制了年龄、性别、物质使用（吸烟、饮酒或吸毒）和父母监管因素后，与未遭受欺凌的受试者相比，报告遭受欺凌的受试者更有可能参与肢体冲突（每月遭受1 - 2天欺凌的受试者，OR = 2.38；95%置信区间[1.99, 2.86]；每月遭受3 - 5天欺凌的受试者，OR = 3.55；95%置信区间[2.61, 4.83]；每月遭受6 - 9天欺凌的受试者，OR = 4.45；95%置信区间[2.61, 7.60]；每月遭受10 - 30天欺凌的受试者，OR = 1.91；95%置信区间[1.17, 3.13]）。
肢体冲突与青少年遭受欺凌的次数之间的剂量反应关系值得进一步研究。如果存在因果关系，预防欺凌，即使不能完全消除，也可能在预防肢体冲突方面产生显著效果。
