Department of Health Behavior and Social Medicine, West China School of Public Health and West China Fourth Hospital, Research Center for Palliative Care, West China-PUMC C.C. Chen Institute of Health, Sichuan University West China School of Public Health, Chengdu, Sichuan, China.
Department of Palliative Care, West China School of Public Health and West China Fourth Hospital, Research Center for Palliative Care, West China-PUMC C.C. Chen Institute of Health, Sichuan University West China School of Public Health, Chengdu, Sichuan, China.
BMJ Open. 2024 Sep 10;14(9):e079531. doi: 10.1136/bmjopen-2023-079531.
This study explored the mechanisms by which physical activity was associated with depressive symptoms in multi-ethnic (Han, Yi and Tibetan) adolescents in southwest China. The mediating role of insomnia in the association of physical activity with depressive symptoms, the moderating role of resilience in this mediation model and the moderating role of parental absence in the moderated mediation model were also examined.
A cross-sectional survey.
In southwest China (Sichuan Province and Tibet Autonomous Region).
3195 adolescents from a school-based survey conducted between April and October 2020.
There were 3143 valid samples in this study (47.2% males with mean age=12.88±1.68 years). Structural equation models were developed to estimate the direct and mediating effect, and the moderating effect. Multigroup comparison was performed to examine the differences and similarities of the moderated mediation model across three parental absence subgroups: (1) both parents present, (2) one parent absent and (3) both parents absent.
As hypothesised, physical activity was significantly and positively associated with the reduction of depressive symptoms in adolescents. Insomnia partially mediated the effect of physical activity on depressive symptoms. In addition, resilience moderated the direct and indirect effects of physical activity (through insomnia) on depressive symptoms. Finally, the multigroup comparison indicated the moderating effect of parental absence on the moderated mediation model.
Physical activity was associated with alleviating insomnia symptoms among adolescents, thus correlating with the improvement of their depressive symptoms. Resilience was associated with enhancing the beneficial effects of physical activity, further improving depressive symptoms among adolescents, especially those with both absent parents. It is evident that physical activity interventions should be further incorporated into public health programmes to foster the physical and mental health of left-behind adolescents in southwest China.
本研究旨在探讨身体活动与中国西南地区多民族（汉族、彝族和藏族）青少年抑郁症状之间的关联机制。研究还考察了失眠在身体活动与抑郁症状之间的关联中的中介作用、韧性在该中介模型中的调节作用以及父母缺失在调节中介模型中的调节作用。
横断面调查。
中国西南地区（四川省和西藏自治区）。
2020 年 4 月至 10 月期间进行的一项基于学校的调查中，共有 3195 名青少年参与。
本研究共纳入 3143 名有效样本（男生占 47.2%，平均年龄=12.88±1.68 岁）。采用结构方程模型来估计直接和中介效应，以及调节效应。进行多组比较，以检验调节中介模型在三个父母缺失亚组（1）父母均在、（2）单亲缺失和（3）双亲均缺失之间的差异和相似性。
正如假设的那样，身体活动与青少年抑郁症状的减轻显著正相关。失眠部分中介了身体活动对抑郁症状的影响。此外，韧性调节了身体活动（通过失眠）对抑郁症状的直接和间接效应。最后，多组比较表明父母缺失对调节中介模型具有调节作用。
身体活动与缓解青少年的失眠症状相关，从而与改善抑郁症状相关。韧性与增强身体活动的有益效果相关，进一步改善了青少年，特别是那些双亲均缺失的青少年的抑郁症状。显然，应进一步将身体活动干预纳入公共卫生计划，以促进中国西南地区留守青少年的身心健康。
