Association of preschool children behavior and emotional problems with the parenting behavior of both parents

BACKGROUND Parental behaviors are key in shaping children’s psychological and behavioral development,crucial for early identification and prevention of mental health issues,reducing psychological trauma in childhood.AIM To investigate the relationship between parenting behaviors and behavioral and emotional issues in preschool children.METHODS From October 2017 to May 2018,7 kindergartens in Ma’anshan City were selected to conduct a parent self-filled questionnaire-Health Development Survey of Preschool Children.Children’s Strength and Difficulties Questionnaire(Parent Version)was applied to measures the children’s behavioral and emotional performance.Parenting behavior was evaluated using the Parental Behavior Inventory.Binomial logistic regression model was used to analyze the association between the detection rate of preschool children’s behavior and emotional problems and their parenting behaviors.RESULTS High level of parental support/participation was negatively correlated with conduct problems,abnormal hyperactivity,abnormal total difficulty scores and abnormal prosocial behavior problems.High level of maternal support/participation was negatively correlated with abnormal emotional symptoms and abnormal peer interaction in children.High level of parental hostility/coercion was positively correlated with abnormal emotional symptoms,abnormal conduct problems,abnormal hyperactivity,abnormal peer interaction,and abnormal total difficulty scores in children(all P<0.05).Moreover,paternal parenting behaviors had similarly effects on behavior and emotional problems of preschool children compared with maternal parenting behaviors(all P>0.05),after calculating ratio of odds ratio values.CONCLUSION Our study found that parenting behaviors are associated with behavioral and emotional issues in preschool children.Overall,the more supportive or involved the parents are,the fewer behavioral and emotional problems the children experience;conversely,the more hostile or controlling the parents are,the more behavioral and emotional problems the children face.Moreover,the impact of fathers’parenting behaviors on preschool children’s behavior and emotions is no less significant than that of mothers’parenting behaviors.

Research on the Influence of Family Education on Children’s Behavioral Habits

Under the background of the all-round deepening of quality education,the cultivation of comprehensive quality has become the main theme of contemporary education reform.Good behavior and habits are of great significance to children’s future learning,growth,and development.Through literature review and other methods,this paper analyzes the current situation of children’s family education and the influence of family education on the cultivation of children’s behavioral habits and provides some strategies for cultivating children’s good behavioral habits in family education.

Relationship between Parent-Child Attachment and Problem Behaviors among Chinese Firstborn Children in Family Transitions: A Meta-Analysis

The implementation of China’s three-child fertility policy has led to a notable increase in multiple-child families.Notably,firstborn children experience a significant transition from being an only child to a non-only child.This transition is associated with problematic behaviors,affecting their social adjustment,sibling relationships,and family harmony.Although several studies have examined the relationship between parent-child attachment and problem behaviors exhibited byfirstborn children during family transitions,thefindings have been inconsistent.Hence,a meta-analytic study was undertaken to elucidate the inconsistencies in this relationship and explore the moderating factors that may contribute to these discrepancies.Using a systematic literature retrieval and screening method,12 effect sizes were derived from the 10 eligible articles,encompassing a sample size of 5319.The meta-analysis demonstrated a low negative association between parent-child secure attachment and problem behaviors exhibited byfirstborn children during family transitions.Furthermore,the present study investigates potential moderator factors,such as children’s age and geographic region,to gain a more nuanced understanding of the relationship.Consequently,the establishment of parent-child attachment relationships has the potential to mitigate problem behaviors observed infirst-born children during family transitions.The implications of thesefindings indicate that parents can nurture secure attachment bonds with their children by demonstrating sensitive responsiveness,employing positive parenting practices,and fostering emotional availability.These efforts contribute to the cultivation of secure internal working models and positive behavioral manifestations withinfirst-born children,which in turn affect their relationships with siblings.

Psycho-cognitive behavioral problems in sleep disordered children

Sleep disturbances are common in childhood and adolescence. Sleep problems in early infants tend to be persistent and prominent in preschool and school-aged children. Chronic sleep disorders, especially in young children may lead to neurobehavioral problems and psycho-cognitive impairment. Sleep difficulties may be the result of underlying medical conditions, （breathing disorders） or psychological problems. Research studies have shown the association between sleep disorders and day time cognitive impairment, behavioral problems, poor school performance and inattention in children. Appropriate diagnosis and early management of sleep disorders in children lead to improvement of neurocognitive function and behavioral problems in these children.

Emotional and Behavioral Problems of Left-Behind Children in Impoverished Rural China:A Comparative Cross-Sectional Study of First Grade Junior High School

Objective:To investigate the prevalence of emotional and behavioral problems and related factors of left-behind children in impoverished rural China(mainly in thefirst grade of junior high school).Methods:A cross-sectional survey of rural households in 27 poverty-stricken counties in 12 provinces across China was conducted using the Strengths and Difficulties Questionnaire(SDQ).Results:The prevalence of emotional and behavioral problems in left-behind children was 11.7%,and that of non-left-behind children was 8.9%.There was statistical difference between the two groups(P<0.01).There are no differences between the two groups in terms of the various factors of SDQ.The incidence of insomnia in the left-behind group was 58.3%,which was higher than that in the non-left-behind group 50.9%(P<0.01);loneliness(62.1%vs.51.8%,P<0.01);running away from home(23.1%vs.18.8%,P<0.01),and self-injury behavior(16.8%vs.12.2%,P<0.01).Left-behind children are more likely to have negative psychological feelings including insomnia,loneliness,self-injury,and run away from home.They also experienced more bullying including maliciously teased by peers,intentionally excluded or isolated,physically threatened or intimidated.All of these factors are associated with their abnormal emotional and behavioural development.Conclusion:The incidence of emotional and behavioral problems of left-behind children in rural areas in poverty-stricken areas is significantly higher than that of non-left-behind children;Logistic regression analysis showed that bullying behavior and abnormal psychological characteristics are significantly associated with left-behind adolescents abnormal emotional and behavioral development.

Behavioral problems and related factors in children of different aged patients with schizophrenia: A cross-sectional study

BACKGROUND： With the age growing, changes of behavioral problems in children whose parents had schizophrenia, differences of related factors and ways for particular intervention should be further studied. OBJECTIVE： To survey the behavioral problems in children of different aged patients with chizophrenia and investigate the correlation between behavioral problems and related factors in different aged groups. DESIGN： Cross-sectional study. SETTING： Shandong Mental Health Center. PARTICIPANTS： A total of 364 patients with schizophrenia were selected from eleven psychiatric hospitals from June 1999 to June 2000. There were 179 males and 185 females, and their ages ranged from 28 to 45 years. All patients met modified diagnostic criteria of schizophrenia （the second edition）, China Classification of Mental Diseases and Diagnostic Criteria. Meanwhile, children of the 364 patients were grouped based on their ages, including 6 - 1 l years old group [n -217; 114 males and 103 females; mean age of （9±2） years] and 12 - 16 years old group [n = 147; 99 males and 48 females; mean age of （14±1） years]. The Chinese norms of Achenbach＇s Child Behavior Check List were regarded as the normal control group. METHODS： Children who received self-made mental health related factors inventory and Achenbach＇s Child Behavior Check List were involved in this study. All children and their parents provided the confirmed consent. Achenbach＇s Child Behavior Check List was used for parents to mainly evaluate children, and the results manifested various behavioral problems based on different sexes and different ages. Self-made mental health related factors inventory contained questionnaires for parents and children, respectively. In this study, home situation of parents as well as personality characteristics and educational styles of children were mainly evaluated. MAIN OUTCOME MEASURES： ① Scores of Achenbach＇s Child Behavior Check List in different aged children; ② Scores of self-made mental health related factors inventory based on different home situations and educational styles. RESULTS： Children of 364 patients were involved in the final analysis. ① There were no significant differences in total score of Achenbach＇s Child Behavior Check List and sex in the two groups （P 〉 0.05）. There were significant differences in schizoid, body recount, aggression, depression, hyperactivity, violating discipline, compulsion and total abnormal rate of boys between the 6 - 11 years old group and the normal control group （P 〈 0.05 - 0.01）. In addition, there were also significant differences in poor communication, depression, hyperactivity, violating discipline, compulsion and total abnormal rate of girls between the 6 - 11 years old group and the normal control group （P 〈 0.05 - 0.01）. ② As compared with normal control group,scores of home environment in the two aged groups demonstrated that educational level was low; interpersonal relationship was poor; relation to children was not closed; relationship between husband and wife was not harmonious; positive rate of family history was high; economic status was poor; family atmosphere was poor. Therefore, there was significant difference （P 〈 0.01）. Educational level in parental generation and single parent family in the 6 - 11 years old group were higher than that in the 12 - 16 years old group, with significant difference （P 〈 0.05）. As compared with the normal control group, results of education demonstrated that children in the two aged groups had poor communication with other children; they had poor behaviors in schools; most of them were boarded and had poor relationship with their parents; teaching styles for children were different. CONCLUSION： All children of different aged patients with schizophrenia had poor home environment and education; and they were often affected by other factors. Behavioral problems were changed with the age growing; in addition, these changes were related to home environment, education and society. Therefore, comprehensive intervention may be an ideal method.

Impact of parenting styles on preschoolers’behaviors

In this editorial,I comment on the article“Association of preschool children behavior and emotional problems with the parenting behavior of both parents”which was published in the latest issue of“World Journal of Clinical Cases”that demonstrates the prevalence of behavioral disorders in preschool children.Therefore I am focused on parenting which is the most effective factor shown to affect the development and continuity of these behaviors.The management of child behavior problems is crucial.Children in early ages,especially preschoolers who are in the first 5 years of life,are influenced by dramatic changes in various aspects of development,such as social,emotional,and physical.Also,children experience many changes linked to different developmental tasks,such as discovering themselves,getting new friendships,and adapting to a new environment.In this period,parents have a critical role in supporting child development.If parents do not manage and overcome their child’s misbehavior,it could be transformed into psychosocial problems in adulthood.Parenting is the most powerful predictor in the social development of preschool children.Several studies have shown that to reduce the child’s emotional and behavioral problems,a warm relationship between parents and children is needed.In addition,recent studies have demonstrated significant relationships between family regulation factors and parenting,as well as with child behaviors.

Relationship between Authoritative Parenting Style and Preschool Children’s Emotion Regulation:A Moderated Mediation Model

An authoritative parenting style has been shown to promote children’s emotion regulation in European-American family studies.However,little is known about how sleep problems and the child’s sibling status in Chinese families affect this relationship.Based on family system theory,this study attempts to better understand the relationship between authoritative parenting style and emotion regulation.Mothers of preschool children in Chinese kindergartens completed questionnaires about their children’s sleep habits,their authoritative parenting styles,and children’s emotion regulation.A total of 531 children participated in this study.Results showed that authoritative parenting was positively associated with emotional regulation.Sleep problems mediated the effects of authoritative parenting style on emotion regulation.The child’s sibling status moderated the mediating effects of sleep problems in authoritative parenting and emotion regulation relationships.Specifically,the relationship between the authoritative parenting style and sleep problems was significant for only children,while birth order had no significant influence on the authoritative parenting style and sleep problems in two-child families.These findings suggest that a lowauthoritative parenting style predicts low emotion regulation through sleep problems,and this depends on the child’s sibling status,indicating that children without siblings may impair emotion regulation due to increased sleep problems.

The Relationships between Executive Function and Problem Behavior of Preschool Children:Contextual Specificity and Gender Differences

This study utilized a longitudinal design to examine the relationships between the specific components of executive function(EF)and the internalizing and externalizing behavior across different genders and contexts in Chinese cultural background.Inhibition,cognitive flexibility,and working memory of EF based on 101 preschool children’s(48 boys and 53 girls)(M_(T1)=4.25,SD=0.76)performances were measured when completing tasks in NIH Toolbox.Twelve months later,boys’and girls’internalizing and externalizing behavior in home-and school-settings was assessed through mother’s feedback on the Strengths and Difficulties Questionnaire and teachers’reports of the Child Behavior Rating Scale.The results show that boys’inhibition,cognitive flexibility,and working memory negatively predict their externalizing behavior in the home context,while their cognitive flexibility negatively predicts externalizing behavior in the school context.Additionally,boys’inhibition positively predicts their internalizing behavior only in the school context.For girls,their cognitive flexibility positively predicts externalizing behavior only in the school context.No significant relationship is found among the girls between EF and problem behavior in the home context.These findings suggest that gender differences and a shift in contexts could alternate the relationship between EF and children’s problem behavior.This study sheds light on targeted preventions and interventions based on contexts and gender.

Risk Factors of Learning Disabilities in Chinese Children in Wuhan

Objective To investigate prevalence rate of learning disabilities (LD) in Chinese children, and to explore related risk factors, and to provide theoretical basis for preventing such disabilities. Methods One thousand and one hundred fifty one children were randomly selected in primary schools. According to criteria set by ICD-10, 118 children diagnosed as LD were classified into the study group. Four hundred and ninety one children were classified into the normal control group. Five hundred and forty two children were classified into the excellent control group. The study instruments included PRS (The pupil rating scale revised screening for learning disabilities), Conners' children behavior check-list taken by parents and YG-WR character check-list. Results The prevalence rate of LD in Chinese children was 10.3%. Significant differences were observed between LD and normally learning children, and between the LD group and the excellent group, in terms of scores of Conners' behavior check-list (P<0.05). The study further showed that individual differences in character between the LD group and the control groups still existed even after controlling individual differences in age, IQ, and gender. Some possible causal explanations contributing to LD were improper teaching by parents, low educational level of the parents, and children's characteristics and social relationships. Conclusion These data underscore the fact that LD is a serious national public health problem in China. LD is resulted from a number of factors. Good studying and living environments should be created for LD children.

Nature or Nurture—On the Development of Children's Language

Referring to children's development,especially the development of children's language,there is a question that people are very interested in,that is,does the development of children's language on earth depend on innate inheritance or postnatal environment? In order to answer this question,this paper begins with the definition of the development of children's language,then,expounds some theories on language acquisition,finally,finds out the crucial factors influencing the development of children's language.

屏幕暴露与学龄前孤独症谱系障碍儿童情绪行为问题相关性研究

背景既往已有多项研究证实屏幕暴露现象在学龄前儿童中普遍存在,并且与儿童情绪行为问题相关,现有研究多集中在正常学龄前儿童,有关屏幕暴露与学龄前孤独症谱系障碍(ASD)儿童情绪行为问题相关的研究较为罕见。目的 调查学龄前ASD儿童屏幕暴露情况及情绪行为问题异常检出情况,探究屏幕暴露与学龄前ASD儿童情绪行为问题有无相关。方法 选择2022年2—8月在郑州大学第三附属医院儿童发育行为科就诊的符合《精神障碍诊断和统计手册》(DSM-V)孤独症诊断标准的ASD学龄前儿童为ASD组,同期选取郑州市某幼儿园正常发育儿童为对照组。由两组儿童主要照护人进行填写屏幕暴露问卷及长处与困难问卷(家长版)。结果 两组儿童屏幕接触时间、家长对屏幕管理、“屏幕剥夺”反应比较,差异无统计学意义(P<0.001);ASD组儿童亲社会行为、困难总分及各个分维度(情绪症状、品行问题、多动/注意缺陷问题、同伴交往问题)异常检出率均高于对照组(P<0.001);Logistic回归分析发现电子设备放置在睡觉或玩耍空间、观看时照护人是否互动讲解、照护人对孩子观看电子屏幕态度、接触电子屏幕是主动要求还是被动参与、强制关掉电子屏幕孩子反应是学龄前ASD儿童情绪行为问题的影响因素(P<0.05)。结论 屏幕暴露可能对ASD儿童情绪行为问题产生影响,家长应合理管理学龄前ASD儿童屏幕使用。

Effects of parental empathy and emotion regulation on social competence and emotional/behavioral problems of school‐age children

Importance Parents take the lead in parent–child interactions and their emotion regulation ability and empathy during parenting may be associated with children’s emotional/behavioral problems.However,the specific mechanisms underlying these associations remain unclear.Objective The present study aimed to explore the effect of parental empathy and emotional regulation on social competence and emotional/behavioral problems in school‐age children.Methods A questionnaire‐based survey was conducted with 274 parents of 8–11‐year‐old children using Achenbach’s Child Behavior Checklist,the Emotion Regulation Questionnaire,and the Questionnaire of Cognitive and Affective Empathy.Results Children with emotional/behavioral problems(n=37)had relatively lower social competence than children in a matched control group(n=37).Compared with the parents of children in the control group,parents of children with emotional/behavioral problems had significantly lower cognitive empathy scores,mainly manifested by low perspective‐taking and online simulation abilities.Mediation analysis showed that parental cognitive empathy had an indirect effect on children’s emotional/behavioral problems through children’s social competence.Interpretation Parental empathy may have a subtle influence on the social competence of school‐aged children,which further affects the severity of children’s emotional/behavioral problems.

Conners儿童行为问卷在内蒙4～6岁儿童中的应用研究

采用Ｃｏｎｎｅｒｓ儿童行为问卷父母用量表调查了４２４名内蒙古４～６岁蒙古族和汉族儿童并与美国常模和上海常模比较。结果显示：年长儿童的品行、冲动、焦虑和多动因子分低于年幼儿童，部分年龄段汉族儿童的学习问题和心身障碍因子分高于蒙族儿童。内蒙儿童各项因子分均高于上海儿童，心身障碍因子分也高于美国儿童；品行和学习问题因子分与美国儿童无明显差异，冲动、焦虑和多动因子分低于美国儿童。文章对影响差异的可能有关因素作了探讨。内蒙４－６岁儿童行为问题总检出率为１３．２％，以心身障碍居首位。

SOS儿童村儿童与单亲家庭和完整家庭儿童行为问题的对照研究

目的:探讨SOS儿童村儿童的心理行为状况及其相关因素。方法:以在某市SOS儿童村至少入住1年以上的8～16岁汉族儿童61人(SOS组)为研究对象,方便选取SOS儿童村儿童就读较集中的小学和中学各一所,选取年龄和性别相匹配的单亲家庭和完整家庭儿童各61人为对照组(分别简称为单亲组和完整组),采用Achenbach儿童行为量表(Child Behavioral Checklist,CBCL)、Achenbach教师报告表(Teacher's Report Form,TRF)及自制一般情况调查表进行评定。结果:(1)SOS组儿童TRF行为问题检出率高于完整组儿童(37.7%vs.3.3%,P<0.001)。三组儿童的CBCL行为问题检出率差异无统计学意义(11.5%,24.6%,16.4%,P=0.156)。(2)SOS组男童TRF的社交问题、注意、违纪、攻击、外化性问题分和总分均高于完整组同龄男童(如,总分30.83vs.12.67,P<0.01),违纪分高于单亲组同龄男童(32.33vs.19.83,P<0.01),退缩分低于单亲组同龄男童(16.87vs.33.33,P<0.001)。8～11岁SOS组男童CBCL的分裂样、抑郁、强迫性、社交退缩、攻击性分及总分均低于单亲组同龄男童(如,总分15.70vs.30.80,P<0.01);SOS组女童与单亲组和完整组女童CBCL各项行为问题因子分及总分差异均无统计学意义(P>0.05)。(3)回归分析结果显示儿童有数个好朋友、学业成绩良好是其行为问题的保护因素,生活在非完整家庭是儿童行为问题的危险因素(B=-1.356～1.947)。结论:SOS儿童村是一种较好的抚养孤儿的方式。SOS儿童村男童Achenbach教师报告表行为问题较突出,女童行为表现较适切。儿童行为问题与其学业表现、同伴关系及家庭环境等因素有关。

Conners父母症状量表在ADHD患儿中的应用

目的了解儿童注意缺陷多动障碍患者合并其他行为问题的情况。方法采用Conners儿童行为问卷（父母用），对符合美国精神病协会《精神障碍诊断和统计手册》第4版（DSM—Ⅳ）注意缺陷多动障碍诊断标准的1006例患者进行了合并行为问题的研究，分析不同性别、不同亚型患儿Conners量表测试结果，以分析注意缺陷多动障碍合并其他行为障碍的特点。结果多动／冲动为主型、注意缺陷为主型和混合型行为问题各占18．3％、55．9％和25．9％，其分布经比较有显著性差异（X2=9．054，P〈0．05）；1006例患者主要分布在7～11岁之间，占总人次的78．1％，其中以9岁组为最多；合并学习问题者占57．6％、品行问题占50．1％，焦虑占36．2％，心身障碍占17．3％；女性患儿各因子异常率和总分异常率均高于男性，除心身障碍因子外，其余因子异常率性别间经比较差异有统计学意义（X2=11．148，P〈0．01）；多动／冲动为主型行为问题发生率由高到低为品行问题、学习问题、焦虑和心身障碍；注意缺陷为主型和混合型行为问题发生率顺序均为学习问题、品行问题、焦虑和心身障碍；以上4种障碍发生率均以混合型行为问题最高，不同亚型各因子异常率经比较均存在显著性的差异。结论注意缺陷多动障碍患儿合并行为问题较多，性别和亚型间存在差异；症状愈严重，合并障碍比例愈高。

宁夏农村留守儿童行为问题影响因素的Logistic回归分析

目的了解宁夏农村留守儿童心理行为问题现况及其影响因素。方法采用分层随机整群抽样方法,应用一般情况调查表、父母养育方式问卷(EMBU)、艾森克人格问卷(EPQ儿童版)、Piers-Harri儿童自我意识量表(PHCSS)和Achenbach儿童行为量表(CBCL家长版),对宁夏南部山区所抽取班级的1905名中小学生进行调查。结果①儿童行为问题总检出率为18%(343/1905);留守与非留守儿童行为问题检出率分别为20.9%和16.0%,两者比较有显著统计学差异(χ2=7.66,P=0.006);汉族留守与非留守儿童行为问题检出率分别为17.0%和11.2%,两者比较有显著统计学差异(χ2=6.64,P=0.010);回族留守儿童行为问题检出率为25.1%显著高于汉族留守儿童检出率17.0%(χ2=7.51,P=0.006);②多因素非条件Logistic回归分析显示父母外出打工情况(OR=1.239)、内外向人格(OR=0.807)、神经质人格(OR=1.310)、父亲过度保护(OR=1.727)、母亲拒绝否认(OR=1.561)和自我意识总分(OR=0.613)最终进入方程,可以直接预测留守儿童心理行为问题的发生,其中情绪不稳定、父亲过度保护、母亲拒绝否认以及父母均外出打工是危险因素,而性格外向(高分特征)和自我意识良好是保护因素。结论宁夏农村留守儿童行为问题发生率较高,影响因素较多,应从社会、家庭、个性塑造等方面着手进行预防。

Conners父母问卷对少年儿童行为问题的研究

目的：探讨少年儿童的行为状况。方法：用Conners父母问卷调查表（VSQ），对182例3～17岁淮安市少年儿童的行为等问题进行调查，并与Conners常模比较。结果：独生子女的冲动-多动行为问题显著多于多子女家庭的男性少年儿童（P〈0．01）。6-11岁儿童的品行问题、冲动．多动、焦虑及多动指数因子分显著低于Conners常模（P〈0．05～0．01），而12-17岁少年的VSQ各因子分均显著低于Conners常模（P〈0．05—0．01），仅学习问题显著多于Conners常模（P〈0．05），且男生冲动一多动行为问题显著多于女生（P〈0．01）。6-11岁女性儿童的冲动．多动因子分显著高于12—17岁少年。结论：独生子的冲动．多动行为问题多于多子女家庭的男性少年儿童。淮安市区少年儿童行为问题少于美国，但青少年学习问题较多。随年龄增长，少年儿童行为问题有所改善。

功能性行为评估对孤独症儿童问题行为的个案干预研究——Tau-U指标的应用

孤独症儿童问题行为相当普遍,其中自伤性行为、攻击性行为和自我刺激行为发生频率高,其破坏性和危险性令人担忧。研究通过功能性行为评估,分析学前(2-5岁)孤独症儿童三种典型问题行为背后的功能原因,设计相应的干预方案,采用单一被试A-B-A倒返实验设计对问题行为进行干预。采用单一被试研究数据分析指标Tau-U进行分析,数据显示,经过4周干预,三名学前孤独症儿童问题行为的发生频率显著降低,干预有效。研究表明应用功能性行为评估诊断孤独症儿童问题行为,据此实施干预可有效减少问题行为,促进其适应性行为建立。

运动能力与留守儿童问题行为的关系:身体活动和久坐行为的中介作用

为探讨运动能力与留守儿童问题行为的关系及身体活动和久坐行为在其中的作用,采用加速度计、大肌肉群动作发展测评工具、长处和困难问卷对327名儿童进行测量,其中留守儿童149人,非留守儿童178人。结果发现:(1)运动能力是留守儿童问题行为的显著负向预测因子;(2)中高强度身体活动与久坐行为在留守儿童运动能力与问题行为之间起部分中介作用。研究结果强调在制定留守儿童问题行为干预措施时应鼓励以发展其运动能力为基础的活动,使其参与更多的身体活动和减少久坐行为。