Shen Guanghui, Huang Jiahui, Fang Juan, Zhen Yawen, Tang Jiayi, Wu Liujun, Yang Xudong, Wu Shaochang, Chen Li
Wenzhou Seventh People's Hospital, Wenzhou, Zhejiang, China.
School of Mental Health, Wenzhou Medical University, Wenzhou, Zhejiang, China.
Popul Health Metr. 2025 May 1;23(1):17. doi: 10.1186/s12963-025-00379-9.
Adverse Childhood Experiences have been implicated in a range of health-related risk behaviors in adulthood, but there is limited research on how these patterns manifest among internal migrant workers in China. This study aims to elucidate the mediating role of family functioning and explore generational differences in this relationship.
A cross-sectional study was conducted among two groups of migrant workers in China: first-generation migrant workers (FGWs) and new-generation migrant workers (NGMWs). A total of 2,187 participants completed surveys that assessed adverse childhood experiences, family functioning, and health-related risk behaviors. Mediation analysis was performed to examine the indirect effects of adverse childhood experiences on health risks through family functioning. Additionally, moderated mediation analysis was conducted to explore potential differences between FGWs and NGMWs.
Adverse childhood experiences significantly predicted higher health-related risk behaviors and lower family functioning (p < 0.001). Family Functioning mediated the relationship between adverse childhood experiences and health-related risks behaviors, which accounted for approximately 16.67% of the total effect (95% CI 0.03 to 0.07, p < 0.001). There was a significant difference in the indirect effects between NGMWs and FGWs (95% CI 0.01 to 0.06, p < 0.05). The indirect effect of adverse childhood experiences through family functioning was significant for NGMWs (p < 0.001), but non-significant for FGWs.
Our study fills a critical gap in understanding the intricate links between adverse childhood experiences, family functioning, and health-related risk behaviors among China migrant workers in China. It highlights the role of family functioning as a significant mediator of the impact of early adverse childhood experiences on adult health-related risks behaviors, particularly in a vulnerable population like migrant workers. More importantly, our findings indicate that this mediation varies significantly between FGWs and NGMWs. Family functioning exhibited a stronger mediating effect between early adverse childhood experience and adult health-related risks behaviors for NGMWs compared to FGWs.
童年不良经历与成年后的一系列健康相关风险行为有关，但在中国农民工群体中，关于这些模式如何表现的研究有限。本研究旨在阐明家庭功能的中介作用，并探讨这种关系中的代际差异。
在中国两组农民工中进行了一项横断面研究：第一代农民工（FGWs）和新生代农民工（NGMWs）。共有2187名参与者完成了评估童年不良经历、家庭功能和健康相关风险行为的调查。进行中介分析以检验童年不良经历通过家庭功能对健康风险的间接影响。此外，进行了调节中介分析以探讨FGWs和NGMWs之间的潜在差异。
童年不良经历显著预测了更高的健康相关风险行为和更低的家庭功能（p < 0.001）。家庭功能介导了童年不良经历与健康相关风险行为之间的关系，约占总效应的16.67%（95% CI 0.03至0.07，p < 0.001）。NGMWs和FGWs之间的间接效应存在显著差异（95% CI 0.01至0.06，p < 0.05）。童年不良经历通过家庭功能的间接效应在NGMWs中显著（p < 0.001），但在FGWs中不显著。
我们的研究填补了理解中国农民工童年不良经历、家庭功能和健康相关风险行为之间复杂联系的关键空白。它强调了家庭功能作为早期童年不良经历对成人健康相关风险行为影响的重要中介作用，特别是在农民工这样的弱势群体中。更重要的是，我们的研究结果表明，这种中介作用在FGWs和NGMWs之间存在显著差异。与FGWs相比，家庭功能在NGMWs的早期童年不良经历和成人健康相关风险行为之间表现出更强的中介作用。
