武陵山区青少年危害健康行为聚集风险的城乡差异

Urban and rural differences in aggregation risk of health risk behaviors among adolescents in Wuling Mountain Area

目的 了解武陵山区青少年危害健康行为聚集风险的城乡差异。方法 于2023年3—5月,采用多阶段分层随机整群抽样法在武陵山区抽取8个县(区)32所中学的初一至初三、高一至高三年级7901名青少年作为调查对象,调查对象年龄(14.82±1.50)岁;男生4047人(51.22%),女生3854人(48.78%);初中5126人(64.88%),高中2775人(35.12%);农村2513人(31.81%),城市5388人(68.19%)。采用《武陵山区青少年危害健康行为调查问卷》对青少年的偏食、吸烟、饮酒等9种危害健康行为进行问卷调查。城乡青少年危害健康行为及其多元聚集发生率的差异性检验采用χ^(2)检验,并计算相对危险度(RR值)和实际预期比(O/E值)。结果 青少年危害健康行为二元至五元聚集发生率农村均低于城市(χ^(2)值分别为60.73、34.97、16.89和9.14,P<0.05);农村青少年饮酒行为RR值最大(18.02),城市青少年失眠行为RR值最大(15.05)。二元聚集模式农村与城市青少年“吸烟+饮酒”O/E值均最大(农村为8.18,城市为6.14);三元聚集模式农村与城市青少年“吸烟+饮酒+打架”O/E值均最大(农村为28.41,城市为18.15);四元聚集模式农村青少年“吸烟+饮酒+失眠+遭受校园欺凌”O/E值最大(95.10),城市青少年“吸烟+饮酒+打架+遭受校园欺凌”O/E值最大(42.97);五元聚集模式农村与城市青少年“吸烟+饮酒+打架+失眠+遭受校园欺凌”O/E值均最大(农村为309.57,城市为129.28)。结论 武陵山区城市青少年比农村青少年危害健康行为更易聚集,危害健康行为及其多元聚集模式的聚集风险存在城乡差异。

OBJECTIVE Understanding urban-rural differences in the risk of aggregation of adolescents' health-risk behaviors in the Wuling Mountain Area.METHODS From March to May 2023,7901 adolescents from junior to junior high school and senior high school grades in 32 middle schools in 8 counties(districts) in the Wuling Mountain Area were selected as survey respondents using the multi-stage stratified random cluster sampling method,with the age of the survey respondents being(14.82±1.50) years old.There were 4047 male students(51.22%) and 3854 female students(48.78%),5126(64.88%) in junior high school and 2775(35.12%) in senior high school.2513(31.81%) in rural schools and 5388(68.19%) in urban schools.The Questionnaire on Health Risky Behaviors of Youth in Wuling Mountain Area was used to investigate 9 health risky behaviors of youth,such as partial feeding,smoking,and drinking alcohol.The χ~2 test was used to test the difference between urban and rural adolescents' risky health behaviors and their multivariate aggregation incidence rates,and to calculate the relative risk(RR) and the actual expected ratio(O/E).RESULTS The incidence of bivariate to quintivariate cluster of adolescent health-risk behaviors was lower in all rural schools than in urban schools(χ~2 were 60.73,34.97,16.89,and 9.14,P<0.05).Rural school adolescents had the highest RR value for alcohol consumption behavior(18.02),while urban school adolescents had the highest RR value for insomnia behavior(15.05).In the bivariate cluster model,the O/E values for “smoking+alcohol consumption” were highest in both rural(8.18) and urban(6.14) school adolescents.In the trivariate cluster model,the O/E values for “smoking+alcohol consumption+fighting” were highest in both rural(28.41) and urban(18.15) school adolescents.In the quadrivariate cluster model,the O/E values for “smoking+alcohol consumption+insomnia+experiencing school bullying” were highest in rural school adolescents(95.10),while the O/E values for “smoking+alcohol consumption+fighting+experiencing school bullying” were highest in urban school adolescents(42.97).In the quintivariate cluster model,the O/E values for “smoking+alcohol consumption+fighting+insomnia+experiencing school bullying” were highest in both rural(309.57) and urban(129.28) school adolescents.CONCLUSION Adolescents in urban schools in the Wuling Mountain Area are more prone to clustering harmful health behaviors compared to those in rural schools,and there are differences in the clustering risks of harmful health behaviors and their diverse clustering patterns between urban and rural areas.