青少年健康促进生活方式列线图模型的构建

Construction of a nomogram model for health-promoting lifestyles in adolescents

目的探讨青少年健康促进生活方式的影响因素,并构建列线图风险预测模型。方法2019—2020学年,采用健康促进生活方式量表-Ⅱ修订版(HPLP-ⅡR),对广东省某市1所大专院校、1所中等职业学校和1所普通高中3124名学生进行问卷调查,基于多因素回归模型构建青少年健康促进生活方式的列线图模型。结果多因素回归模型显示,女性(OR=1.30,95%CI:1.18~2.06)、自评健康状况为一般(OR=3.34,95%CI:2.25~4.96)和差(OR=8.56,95%CI:2.38~30.74)是健康促进生活方式得分偏低的危险因素。教育程度为高中(OR=0.42,95%CI:0.26~0.70)、父亲初中学历(OR=0.39,95%CI:0.21~0.73)、母亲高中/中专学历(OR=0.85,95%CI:0.33~0.97)是健康促进生活方式得分偏低的保护因素。基于上述独立危险因素,构建列线图风险预测模型,模型C-index为0.728。结论青少年健康促进生活方式列线图模型具有良好的校准度、区分度和风险预测能力,且有直观、简便和实用性强等优点,有较高的应用价值。

Objective To discuss the risk factors of health-promoting lifestyles(HPL)in adolescents,and to construct a predictive nomogram model.Methods Duing 2019—2020academic year,aquestionnaire survey was conducted among 3124students randomly selected from one junior college,one secondary vocational school and one high school in a city of Guangdong using a revised version of health promoting lifestyle profile-Ⅱ(HPLP-ⅡR)scale.A nomogram model for HPL in adolescents was constructed based on the multivariate regression models.Results Multivariate regression analysis showed that female students(OR=1.30,95%CI:1.18-2.06),medium level of self-perceived health status(OR=3.34,95%CI:2.25-4.96)or low level(OR=8.56,95%CI:2.38-30.74)were risk factors for HPL of adolescents.While,high school education(OR=0.42,95%CI:0.26-0.70),middle school and below degree of fathers′(OR=0.39,95%CI:0.21~0.73),high school and above degree of mothers′(OR=0.85,95%CI:0.33~0.97)were protective factors for HPL of adolescents.Based on the above inflencing factors,we constructed a risk predictive nomogram model with the C-index of 0.728.Conclusions The nomogram model for HPL is able to precisely predict the risk factors of HPL,which is simple and practical and is worth to be proposed for use.