2016年武陵山区侗族与白族农村青少年健康危险行为及影响因素

Analysis on prevalence and influencing factors of health risk behaviors of Dong and Bai Nationality adolescents in rural of Wuling mountainous area in 2016

目的了解武陵山区侗族与白族农村青少年健康危险行为现状及影响因素。方法按照分层整群随机抽样原则,于2016年9—10月从武陵山区抽取2176名侗族与白族农村青少年,采用"中国青少年健康相关/危险行为调查问卷"对其偏食、缺乏锻炼、自杀意念、吸烟、饮酒、网络成瘾等健康危险行为进行问卷调查,并对可能的影响因素进行非条件Logistic回归分析。结果侗族与白族青少年健康危险行为报告率分别为:偏食36.95%(804人),缺乏锻炼55.15%(1200人),自杀意念19.03%(414人),吸烟13.60%(296人),饮酒30.88%(672人),网络成瘾7.12%(155人)。Logistic回归显示,偏食的危险因素有女生(OR=1.275,P=0.012)、缺乏锻炼(OR=1.751,P<0.001)、抑郁(OR=1.297,P=0.046)、自杀意念(OR=1.280,P=0.036)、网络成瘾(OR=1.753,P=0.001);缺乏锻炼的危险因素有高中(OR=1.839,P<0.001)、女生(OR=1.478,P<0.001)、核心家庭(OR=1.240,P=0.034)、偏食(中等OR=1.717,P<0.001);自杀意念的危险因素有女生(OR=1.789,P<0.001)、独生子女(OR=1.452,P=0.030)、打架(OR=1.894,P<0.001)、孤独(经常或总是OR=4.484,P<0.001)、失眠(经常或总是OR=2.392,P<0.001)、抑郁(OR=2.555,P<0.001)、网络成瘾(OR=1.766,P=0.004),保护因素有住校(OR=0.755,P=0.029);吸烟的危险因素有住校(OR=1.638,P=0.004)、打架(OR=2.315,P<0.001)、失眠(经常或总是OR=2.116,P=0.004)、饮酒(OR=5.456,P<0.001),保护因素有女生(OR=0.132,P<0.001)、学习成绩(中等偏上或好OR=0.571,P=0.004);饮酒的危险因素有家庭月总收入3000元以上(OR=1.648,P=0.015)、打架(OR=1.990,P<0.001)、自杀意念(OR=1.363,P=0.019)、吸烟(OR=5.351,P<0.001)、网络成瘾(OR=1.797,P=0.002),保护因素有女生(OR=0.459,P<0.001);网络成瘾的危险因素有偏食(OR=1.812,P=0.001)、自杀意念(OR=1.843,P=0.002)、孤独(经常或总是OR=3.029,P=0.003)、饮酒(OR=2.028,P<0.001)、上网以玩游戏为主(OR=3.650,P<0.001)。结论武陵山区侗族与白族农村男生易发生吸烟、饮酒、网络成瘾行为,女生易发生偏食、自杀意念、缺乏锻炼行为;失眠以及孤独、抑郁等不良心理为多种健康危险行为的危险因素;应加强联合行动,预防和干预侗族与白族农村青少年健康危险行为。

Objective To understand the health risk behaviors prevalence and influencing factors of Dong and Bai Nationality adolescents in rural of Wuling mountainous area. Methods By the method of layered, random and total sampling, 2176 Dong and Bai Nationality adolescents were recruited from September to Octomber 2016 in rural of Wuling mountainous area. The investigation was conducted based on ＂ The scale and evaluation method of health related/risk behaviors for adolescents in China＂. To analyze the behaviors on dietary bias, lack of physical exercise, suicidal ideation, smoking, drinking and internet addiction. Non conditional Logistic regression analysis was used to analyze the possible influencing factors of health risk behaviors. Results The report rates of dietary bias, lack of physical exercise, suicidal ideation,smoking,drinking and internet addiction were 36.95% （804） ,55.15% （1200） ,19.03% （414） ,13.60% （296） ,30.88% （672） and 7.12% （155） , respectively. Logistic regression analysis result showed that the risk factors of dietary bias were schoolgirl （ OR = 1. 275, P = 0. 012 ） , lack of physical exercise （ OR = 1. 751, P 〈 O. 001 ） , depression （ OR = 1. 297, P = 0. 046 ） , suicidal ideation （ OR = 1. 280,P =0. 036） and internet addiction（ OR = 1. 753 ,P =0. 001 ）. The risk factors of lack of physical exercise were high school （ OR = 1. 839, P 〈 0. 001 ） , schoolgirl （ OR --- 1. 478, P 〈 0. 001 ）, nuclear family （ OR = 1. 240, P = 0. 034） and dietary bias （ OR = 1. 717, P 〈0. 001 ）. The risk factors of suicidal ideation were schoolgirl（ OR = 1. 789, P 〈0. 001） ,only child（OR = 1. 452,P = 0. 030） ,fight（OR = 1. 894, P 〈 0. 001 ） ,lonely （often or always OR =4. 484, P 〈 0. 001 ） , insomnia（ often or always OR = 2. 392, P 〈 0. 001 ） ,depression（ OR = 2. 555, P 〈 0. 001 ） and internet addiction （ OR = 1. 766, P = 0. 004）, the protective factor was in residence （ OR = 0. 755,P = 0. 029）. The risk factors of smoking were in residence （ OR = 1. 638, P = O. 004）, fight （ OR = 2. 315, P 〈 O. 001 ） , insomnia（ often or always OR = 2. 116,P = 0. 004 ） and drinking （ OR -- 5. 456, P 〈 O. 001 ）, the protective factor were schoolgirl （ OR = O. 132, P 〈 0. 001 ） and school record （ above average or good OR = 0. 571,P = O. 004）. The risk factors of drinking were total monthly income of family （ above 3000 yuan OR = 1. 648, P = 0. 015 ）, fight （ OR = 1. 990, P 〈 0. 001 ）, suicidal ideation（ OR = 1. 363, P = 0. 019 ） , smoking （ OR = 5. 351, P 〈 0. 001 ） and internet addiction（ OR = 1. 797, P = 0. 002） , the protective factor was schoolgirl （ OR = 0. 459, P 〈 0. 001）. The risk factors of internet addiction were dietary bias（ OR = 1. 812,P = 0. 001 ） , suicidal ideation （ OR = 1. 843, P = O. 002）, lonely （ often or always OR = 3. 029, P = 0. 003 ） drinking（OR = 2. 028, P 〈 0. 001 ） and mainly to play games （ OR = 3. 650, P 〈 0. 001 ）. Conclusion The Dong and Bai Nationality boys are more prone to smoking,drinking and internet addiction behaviors, while girls were likely to happen dietary bias, lack of physical exercise and suicidal ideation. Insomnia and unhealthy psychology such as lonely and depression become risk factors of multiple health risk behaviors. The combined action should be carried out in order to prevent and intervene the health risk behaviors of Dong and Bai Nationality rural adolescents.