四川省农村留守儿童健康危险行为潜类别分析

Health risk behaviors among rural left-behind children in Sichuan province:a latent class analysis

目的探讨四川省农村留守儿童健康危险行为模式的潜类别,为制定有针对性的干预计划提供科学依据。方法采用《青少年健康相关行为调查问卷》对四川省资中县2所乡镇中学2805名学生进行自填式问卷调查,以其中1596名留守儿童为研究对象,采用MPLUS7.4软件运行潜在类别分析。结果根据潜在类别模型将八类留守儿童健康危险行为分4个潜类:高危险行为组,即所有的健康危险行为条件概率相对均高,有69人,占总体4%;高自我伤害和自杀行为组有321人,占总体20%;中等危险行为组有479人,占总体30%;低危险行为组,即所有的健康危险行为条件概率均低,有727人,占总体46%。多类别logistic回归结果显示,相对于低危险行为组,父母关系越不好(OR=4.491,95%CI=2.480~9.727)的留守男生(OR=2.221,95%CI=1.319~3.740)更易进入高危险行为组;月生活费高(≥700元)(OR=2.032,95%CI=1.175~3.514)、父母关系不好(OR=2.983,95%CI=1.927~4.616)的留守儿童更易进入高自我伤害和自杀行为组;月生活费高(OR=2.448,95%CI=1.497~4.004)、父母关系一般(OR=1.774,95%CI=1.305~2.411)的高一(OR=2.016,95%CI=1.409~2.883)留守男生(OR=2.109,95%CI=1.654~2.689)更易进入中等危险行为组。结论留守儿童的健康危险行为存在明显潜类别,行为成簇出现且比例不同,生活费越高且父母关系越差的男性留守儿童健康危险行为比例高。提示这类留守儿童是健康危险行为干预重点,并且应该制定成组干预方案。

Objective To investigate the latent classes of health risk behaviors among rural left-behind children in Sichuan province and to provide evidences for making targeted intervention plans. Methods Totally 1 596 rural left-behind children from two township high schools in Zizhong county, Sichuan province were surveyed with the Health Related Behavior Questionnaire for Adolescents. We carried out latent class analysis using MPLUS 7.4 software. Results Among the left-behind students, the identified four latent classes for eight types of health risk behaviors were high-risk behavior group （ involving 4% ~ 69 ~ of the students with relatively higher conditional probabilities for all the health risk behaviors） ,high self-injury and suicide behavior group （involving 20% [321 J of the students）, moderate-risk behavior group （30% E 479 ] ）, and low-risk behavior group （46% E 7271 ）. Multinominal logistic regression analysis revealed that boy students （ odds ratio E OR ] = 2. 221,95 % confidence interval [ 95 % CI ] ： 1.319 - 3. 740 ） and the students with the parents having poor conjugal relationship （ OR = 4. 491,95% CI：2. 480 - 9. 727 ） were more likely to be classified into the high-risk behavior group; the students with higher living expenses （ ≥700 yuan RMB per month） （ OR = 2. 032, 95% CI： 1. 175 -9. 727 ） and with the parents having poor conjugal relationship （OR = 2. 983,95% CI： 1. 927 -4. 616 ） were more likely to be classified into the self-injury and suicide behavior group;and boy students （ OR = 2. 109,95 % CI： 1. 654 - 2. 689） and the students with higher monthly living expenses （ OR = 2. 448,95 % CI： 1. 497 - 4. 004 ）, with the parents having general conjugal relationship （ OR = 1. 774,95 % CI： 1. 305 - 2.411 ）, and during the first year of senior high school （ OR =2. 016,95% C1 = 1. 409 - 2. 883 ） were more likely to be classified into the moderate-risk behavior group. Conclusion There are obvious latent classes in health risk behaviors and the proportion of clustered health risk behaviors are different among left-behind children. More attention should be paid to the left-behind boys with high living expenses and with the parents having poor conjugal relationship.