同伴影响、风险决策与青少年健康危害行为的相关性

Correlation of resistance to peer pressure and risky decision-making with adolescent health risk behaviors

目的探讨同伴影响抵抗和风险决策与青少年健康危害行为的相关性。方法于2010年10月在广州和沈阳两市分别整群选取5所和3所初中，每所初中选取初中一年级全体学生进行调查，采用自填式问卷的方式调查健康危害行为的发生情况，同时分别采用《同伴影响抵抗问卷》（Resistancetopeerinfluencescale，RPIS）和《青少年决策问卷》（Youthdecision—makingquestionnaire，YDMQ）评价同伴影响抵抗和风险决策水平。采用logistic回归分析探讨同伴影响抵抗和风险决策与青少年健康危害行为的相关性。结果共获得有效问卷1985份，其中男生1001名（占50．4％）、女生984名（占49．6％）。调查对象健康危害行为报告率为27．1％（537／1985），男生（30．7％，307／1001）高于女生（23．4％，230／984）（P〈0．05）。调查前30d内吸烟、饮酒、上学日网络使用超过3h／d和周末网络使用超过3h／d的报告率分别为5．1％（102名）、14．3％（284名）、3．5％（70名）、13．7％（272名）。男生饮酒、上学日或周末网络使用超过3h／d的比例[分别为16．4％（164名）、4．5％（45名）、16．2％（162名）]高于女生[分别为12．2％（120名）、2．5％（25名）、11．2％（110名）]（P值均〈0．05）。两市初一学生RPIS和YDMQ的平均得分分别为（2．82±0．39）、（1．68±0．62）分。调查前30d，有吸烟、饮酒、周末网络使用超过3h／d的初一学生RPIS得分[分别为（2．43±0．40）、（2．61±0．41）、（2．77±0．40）分]均低于无这些健康危害行为的学生[分别为（2．84±0．38）、（2．85±0．38）、（2．82±0．39）分]（P〈0．05）。有吸烟、饮酒、上学日网络使用超过3he＇d和周末网络使用超过3h／d的初一学生YDMQ得分[分别为（2．384-0．66）、（2．06±0．66）、（1．97±0．72）、（1．84±0．64）分]均高于无这些健康危害行为的学生[分别为（1．644-0．38）、（1．61±0．58）、（I．67±0．61）、（1．65±0．61分）]（P值均〈0．05）。多因素logistic回归分析结果显示，低、中等同伴影响抵抗[低、中等对高等，OR（95％C／）值分别2．97（1．96—4．50）、1．51（1．05—2．16）]和中、高等风险决策[中、高等对低等，OR（95％C／）值分别1．62（1．19～2．22）、3．43（2．39～4．90）]都是青少年健康危害行为的危险因素。结论同伴影响抵抗能力较差和风险决策较高均为青少年健康危害行为的危险因素。

Objective To explore possible interrelationships among resistance to peer pressure, risky decision-making and health risk behaviors among young adolescents. Methods Based on the cluster sampling method, the participants who were recruited from 5 junior middle schools in Guangzhou and 3 junior middle schools in Shenyang city on October,2010, were administered to complete the questionnaire concerned with their experiences with drinking and smoking during the past 30 days preceding the survey, and the hoursusing computer daily both in weekdays and in weekend. The level of resistance to peer influence and risky decision-making were assessed by Resistance to peer influence scale （RPIS） and Youth decision-making questionnaire （YDMQ）. Logistic regression was used to explore possible interrelationships among resistance to peer influence,risky decision-making and health risk behaviors among young adolescents. Results A total of 1985 questionnaires were valid, including 1001 （ 50. 4% ） boys and 984 （49.6%） girls. About 27. 1% （537/1985） junior middle school students reported having health risk behaviors, boys＇ （30. 7% , 307/1001 ） was higher than girls＇ （23.4% ,230/984） with significant gender difference （P 〈 0. 05 ）. The prevalence of smoking,drinking during the past 30 days before the survey and using computer over 3 hours daily in weekdays and in weekend were 5.1% （ 102/1985 ）, 14. 3% （284/1985）, 3.5% （70/1985） and 13.7% （272/1985）, respectively. The rate of drinking, using computer over 3 hours daily in weekdays and in weekend were higher in males （ 16.4% （ 164/1001 ） ,4.5% （45/1001）, 16. 2% （ 162/1001 ） ） than those in females（ 12. 2% （ 120/984）, 2. 5% （25/984）, 11.2% （110/984） ） （ P 〈 0. 05 ）. The scores of RPIS and YDMQ of the two cities adolescents were 2. 82 ± 0. 39 and 1.68 ± 0. 62. The students reported smoking, drinking during the past 30 days before the survey and using computer over 3 hours daily in weekend gained lower RPIS scores（2.43 ±0. 40,2. 61 ±0. 41,2. 77 ±0. 40） than their counterparts who didn＇t report these kind of health risk behaviors （ 2. 84 ± 0. 38,2. 85 ± 0. 38,2. 82 ± 0. 39 ） （ P 〈 0. 05 ）. And those reported smoking,drinking during the past 30 days before the survey and using computer over 3 hours daily in weekdays and in weekend gained higher YDMQ scores （ 2. 38 ±0. 66,2. 06 ± 0. 66,1.97 ± 0. 72,1.84 ± 0. 64, respectively ） than their counterparts who didn＇t report these kind of health risk behaviors （ 1.64 ± 0. 38,1.61 ± 0. 58,1.67 ± 0. 61,1.65 ± 0. 61, respectively ） （ P 〈 0. 05 ）. After adjusting gender, area, parental education degree, self-reported family economic condition, multi-variant logistic regression analysis indicated that the low and middle level of resistance to peer influence （ low and middle level vs high level,had odds ratios of 2. 97（ 1.96-4. 50） and 1.51 （1.05 -2. 16）） ,and also the middle and high level of risky decision-making （ middle and high level vs low level, had odds ratios of 1.62 （ 1.19 - 2. 22 ） and 3.43 （2. 39 -4. 90 ）） were all the risk factors of adolescent health risk behaviors. Conclusion Adolescents with poor ability of resistance to peer pressure and high risky decision-making were both the risk factors of adolescent health risk behaviors.