以社会生态学理论为基础的青少年伤害因素及效应

A social ecological approach to understanding of youth injury associated factors and health implications

目的探讨青少年伤害发生的相关因素及作用路径,为青少年伤害的有效预防和干预提供基础。方法基于社会生态理论发展研究框架及工具。采用分阶段整群抽样方法选择北京市和广东省中山市初一至高三学生,共4 309名,调查其伤害发生现况及影响因素。结果青少年伤害的人数及人次发生率分别为15.53%和22.49%,不同性别、学段和地区伤害人数发生率差异均存在统计学意义(χ~2值分别为15.92,11.45,20.33,P值均<0.05)。青少年伤害的发生受个体心理行为与社会环境等多因素影响,且不同因素对青少年伤害的作用方式和效应大小不同。青少年个体因素和其对环境安全感知度对青少年伤害存在直接作用,其效应值分别为0.29和0.05,差异有统计学意义(P值均<0.05)。结论青少年伤害发生的影响因素和影响路径呈现多样化、协同性和复杂性的特点,对伤害的干预也应采用立体化、多元化的策略。

Objective To explore the related factors and working way of adolescent injury,and to provide a basis for the effective prevention and intervention of adolescent injury. Methods The framework of the questionnaire in this study was developed based on the Social Ecology Model. A cross-sectional survey was conducted on a valid sample of 4 309 students from 8 junior high schools and 8 senior high schools in Beijing and Zhongshan city respectively, using stratified random cluster sampling method. Students from grade 7 to grade 12 were invited to participate and investigated with injury prevalence. Results The incidence of adolescent injury by person and by person-time was 15.53% and 22.49% respectively, and there were differences by sex, age and regions(χ^2=15.92,11.45,20.33,P<0.05). The occurrence of adolescent injury was affected by adolescent psychological behavior and social environment through different underlying pathways. The intrapersonal factors and perception of environmental safety showed direct effects on the adolescents’ injuries(effect size was 0.29 and 0.05 respectively, P<0.05). Conclusion Adolescent injury is associated with diverse factors and pathways in a synergistic and complex manner, suggesting that a three-dimensional and diverse strategy should be taken to intervene the injures.