中国青少年累积生态风险与健康危害行为的关系

The relationship between cumulative ecological risk and health risk behaviors among Chinese adolescents

中国青少年累积生态风险与健康危害行为的关系

Authors: Jiaojiao Wang, Yang Xie, Yi Zhang, Huiqiong Xu, Xianglin Zhang , Yuhui Wan, Fangbiao Tao

Source: Wang J, Xie Y, Zhang Y, et al. The relationship between cumulative ecological risk and health risk behaviors among Chinese adolescents. BMC Public Health. 2024; 24(1): 603. doi:10.1186/s12889-024-17934-y.

Abstract

Objectives  To explore the relationship between cumulative ecological risk and individual risky behavior and multiple forms of aggregated behaviors among adolescents, and examine the gender diferences.

Methods  A large-scale, nationally representative, and students-based investigation was conducted in rural and urban areas of eight provinces in China from October to December 2021. A total of 22 868 adolescents with an average age of 14.64 years completely standardized questionnaire in which the sociodemographic characteristics, socio-ecological risk factors and risky behaviors were used to analyze.

Results  Of included students, 48.4% encountered the high level of social-ecological risk. The prevalence of breakfast intake not daily, alcohol use (AU), smoking, physical inactivity, prolonged screen time (ST) on weekdays and weekends, suicidal ideation, suicidal plan, suicidal attempt, and non-suicidal self-injury (NSSI) was 41.0%, 11.9%, 3.4%, 61.9%, 15.1%, 51.1%, 27.7%, 13.9%, 6.5% and 27.0% respectively. 22.2% of participants engaged in high-risk behaviors. All were signifcantly infuences of increased cumulative ecological risk on individual behavior and low-risk clustering behaviors separately. The odds ratio of breakfast intake not daily, AU, smoking, physical inactivity, prolonged ST in weekday and weekend, suicidal ideation, suicidal plan, suicidal attempt, and NSSI for the adjusted model in low versus high level of cumulative ecological risk was respectively signifcant in both boy and girls, and the ratio of odds ratios (ROR) was separately 0.95 (p=0.228), 0.67 (p<0.001), 0.44 (p<0.001), 0.60 (p<0.001), 0.78 (p=0.001), 0.83 (p=0.001), 0.80 (p=0.001), 0.83 (p=0.022), 0.71 (p=0.005), 0.75 (p=0.001). Girls encountering a high level of cumulative ecological risk were more likely to engage in multiple forms of clustering risky behaviors than boys (RORs: 0.77, p=0.001).

Conclusions  Research and efective inventions at the social-ecological environment, based on the view of cumulative risk, are needed to promote the healthy development of behaviors in adolescence, and pay more attention to decreasing the occurrence of risky behaviours in girls than boys.

目的  探讨青少年累积生态风险与个体危害行为及聚集之间的关系，并探讨性别差异。

方法  2021年10月至12月，在中国8个省份的城乡地区开展了大规模、具有全国代表性和学生性的调查。共对22 868名平均年龄为14.64岁的青少年进行完全标准化的问卷调查，其中采用社会人口学特征、社会生态危险因素和危害行为进行分析。

结果  48.4%的学生面临较高的社会生态风险。非每日早餐摄入、饮酒（AU）、吸烟、缺乏体力活动、工作日和周末屏幕时间延长（ST）、自杀意念、自杀计划、自杀未遂和非自杀性自伤（NSSI）的患病率分别为41.0%、11.9%、3.4%、61.9%、15.1%、51.1%、27.7%、13.9%、6.5%和27.0%。22.2%的参与者从事高危害行为。累积生态风险增加分别对个体行为和低风险聚类行为有显著影响。非每日早餐摄入量、AU、吸烟、缺乏身体活动、工作日和周末ST延长、自杀意念、自杀计划、自杀未遂和NSSI的低与高累积生态风险水平的比值比在男孩和女孩中均显著，比值比（ROR）分别为0.95（p = 0.228）， 0.67 （p < 0.001）、0.44 （p < 0.001）、0.60 （p < 0.001）、0.78 （p = 0.001）、0.83 （p = 0.001）、0.80 （p = 0.001）、0.83 （p = 0.022）、0.71 （p = 0.005）、0.75 （p = 0.001）。与男孩相比，遇到高水平累积生态风险的女孩更有可能从事多种形式的聚类危害行为（RAR：0.77，p = 0.001）。

结论  基于累积风险的观点，需要在社会生态环境中进行研究和有效发明，以促进青春期行为的健康发展，并更加重视减少女孩比男孩的危害行为的发生。