Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, Guangdong, 510080, China.
Department of Public Health, Guangzhou Huangpu District Center for Disease Control and Prevention, Guangzhou, Guangdong, 510530, China.
Health Qual Life Outcomes. 2023 Oct 31;21(1):119. doi: 10.1186/s12955-023-02201-2.
To examine the associations of the independent and combined healthy lifestyle factors with health-related quality of life (HRQOL) in adolescents, and to test the moderating role of gender.
This cross-sectional study included 5125 adolescents aged between 11 and 20 years. They provided self-reported data on six healthy lifestyle factors, including never smoking, never drinking, good sleep quality, sufficient sleep duration, appropriate Internet use, and adequate physical activity. Adolescents' HRQOL was evaluated using the Pediatric Quality of Life Inventory version 4.0. Linear regression models were conducted to explore the association of individual and combined healthy lifestyle factors with adolescents' HRQOL. We further performed stratified analyses and likelihood ratio test to explore the moderating role of gender in these associations.
Of the included adolescents, the proportions with 0-2, 3, 4, and 5-6 healthy lifestyle factors were 13.6%, 26.4%, 44.3%, and 15.7%, respectively. Compared to adolescents with composite healthy lifestyle scores of 0-2, those with scores of 3, 4, or 5-6 had significantly higher HRQOL scores across all dimensions, summary scales, and total scale in both unadjusted and adjusted models. Specifically, adolescents with 5-6 healthy lifestyle factors had a total scale score that was 19.03 (95%CI: 17.76 to 20.30) points higher than their counterparts who only had 0-2 healthy lifestyle factors. Significant dose-response patterns were also observed in aforementioned associations. Gender was a significant moderator in the associations between composite healthy lifestyle groups and HRQOL scores, except for the social functioning dimension.
Our results confirmed that combined healthy lifestyle factors were associated with improved HRQOL among adolescents, with a stronger association observed in girls. These findings underscore the necessity for education and healthcare authorities to design health-promoting strategies that encourage multiple healthy lifestyle factors in adolescents, with the objective of enhancing their overall health outcomes.
本研究旨在探讨独立和综合健康生活方式因素与青少年健康相关生活质量（HRQOL）之间的关联，并检验性别在其中的调节作用。
本横断面研究纳入了 5125 名 11 至 20 岁的青少年。他们提供了关于六个健康生活方式因素的自我报告数据，包括从不吸烟、不饮酒、良好的睡眠质量、充足的睡眠时间、适当的互联网使用和足够的体育锻炼。青少年的 HRQOL 采用儿童生活质量量表第 4.0 版进行评估。采用线性回归模型探讨个体和综合健康生活方式因素与青少年 HRQOL 的关联。我们进一步进行了分层分析和似然比检验，以探讨性别在这些关联中的调节作用。
在所纳入的青少年中，具有 0-2、3、4 和 5-6 个健康生活方式因素的比例分别为 13.6%、26.4%、44.3%和 15.7%。与综合健康生活方式评分在 0-2 分的青少年相比，评分在 3、4 或 5-6 分的青少年在未经调整和调整后的模型中，所有维度、综合量表和总分的 HRQOL 评分均显著更高。具体而言，具有 5-6 个健康生活方式因素的青少年总分比仅具有 0-2 个健康生活方式因素的同龄人高 19.03（95%CI：17.76 至 20.30）分。在上述关联中还观察到了显著的剂量反应模式。性别是综合健康生活方式组与 HRQOL 评分之间关联的一个显著调节因素，但社会功能维度除外。
我们的研究结果证实，综合健康生活方式因素与青少年 HRQOL 的提高有关，在女孩中关联更强。这些发现强调了教育和医疗保健部门有必要制定促进健康的策略，鼓励青少年采取多种健康生活方式因素，以提高他们的整体健康结果。
