中国北京小学生风险行为及其社会决定因素的聚类分析：一项横断面研究

Clustering of Risk Behaviors and their Social Determinants among Primary School Learners in Beijing, China: A Cross-sectional Study.

作者信息

Zhang Yan, Ji Ying

机构信息

Department of Social Medicine and Health Education, School of Public Health, Peking University Health Science Center, Beijing 100191, China.

出版信息

Chin Med J (Engl). 2015 Jun 20;128(12):1567-73. doi: 10.4103/0366-6999.158289.

DOI:10.4103/0366-6999.158289

PMID:26063355

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC4733749/

Abstract

BACKGROUND

Studies in developed countries reveal that poor lifestyle choices triggering diseases typically cluster among children. However, there is insufficient evidence on the clustering of risk behaviors among children in developing countries. This study aimed to determine the clustering of risk behaviors and their social determinants among 4 th -and 5 th -grade learners in Beijing, China.

METHODS

The sample comprised of 967 learners from six primary schools enrolled migrant and resident learners by two-stage stratified cluster sampling. Prevalence denoted the risk behaviors and their clustering. A log-linear model was used to explore the clustering patterns. Ordinal logistic regression determined the influence of demographic characteristics, school environment, and family context on behavioral clustering.

RESULTS

The prevalence of none, one, two, and three or more risk factors was 61.2%, 20.0%, 10.8%, and 8.1% for infectious diseases and 46.0%, 30.6%, 15.4%, and 8.0% for chronic diseases, respectively. Some behaviors appeared dependent and were more likely to be observed together. The three most influential factors for infectious diseases were school type (odds ratio [OR] =4.47, 95% confidence interval [CI] 3.00-6.66), school located in an inner suburb (OR = 0.27, 95% CI 0.18-0.38), and gender (OR = 0.56, 95% CI 0.42-0.74). Regarding risk behaviors for chronic diseases, clustering was not associated with household registration status and number of appliances, but was significantly associated with school type (OR = 5.36, 95% CI 3.72-7.73), school located in an inner suburb (OR = 0.59, 95% CI 0.43-0.81), and gender (OR = 0.61, 95% CI 0.47-0.78). School environment variables were the most significant contributor to the number of risk behaviors.

CONCLUSIONS

The characteristics of schools enrolling migrants and residents influenced the number of risk behaviors. Therefore, improved school conditions and integrated behavioral interventions are particularly recommended for health promotion.

摘要

背景

发达国家的研究表明，引发疾病的不良生活方式选择通常在儿童中聚集。然而，关于发展中国家儿童风险行为聚集情况的证据不足。本研究旨在确定中国北京四、五年级学生中风险行为的聚集情况及其社会决定因素。

方法

样本包括来自六所小学的967名学生，通过两阶段分层整群抽样纳入了流动儿童和本地儿童。患病率表示风险行为及其聚集情况。使用对数线性模型探索聚集模式。有序逻辑回归确定人口统计学特征、学校环境和家庭背景对行为聚集的影响。

结果

传染病方面，无风险因素、有一个风险因素、有两个风险因素以及有三个或更多风险因素的患病率分别为61.2%、20.0%、10.8%和8.1%；慢性病方面，相应患病率分别为46.0%、30.6%、15.4%和8.0%。一些行为似乎相互关联，更有可能同时出现。传染病的三个最具影响力的因素是学校类型（比值比[OR]=4.47，95%置信区间[CI]3.00 - 6.66）、位于近郊区的学校（OR = 0.27，95%CI 0.18 - 0.38）以及性别（OR = 0.56，95%CI 0.42 - 0.74）。关于慢性病的风险行为，聚集情况与户籍状况和家电数量无关，但与学校类型（OR = 5.36，95%CI 3.72 - 7.73）、位于近郊区的学校（OR = 0.59，95%CI 0.43 - 0.81）以及性别（OR = 0.61，95%CI 0.47 - 0.78）显著相关。学校环境变量是风险行为数量的最重要影响因素。