| 617 | 2 | 123 |
| 下载次数 | 被引频次 | 阅读次数 |
目的 探讨中学生健康素养和不安全交通行为的交互作用与非故意伤害的关联。方法 2017年11月—2018年1月采用多阶段方便整群抽样方法，在安徽省合肥市、广东省阳江市、辽宁省沈阳市和重庆市4座城市抽取18 900名中学生进行问卷调查，平均年龄(15.09±1.75)岁，男生8986人，女生9914人；高中生8514人，初中生10 386人。采用自编问卷和《中国青少年互动性健康素养问卷》收集研究对象的人口统计学特征、非故意伤害、不安全交通行为和健康素养等资料。采用Logistic回归模型分析健康素养水平和不安全交通行为及其之间的交互作用与非故意伤害的关联。结果 非故意伤害的发生率为39.13%(7396/18 900),走路/骑车戴耳机、走路玩手机和不遵守交通规则的比例分别为48.16%(9104/18 900)、56.87%(10 748/18 900)和23.76%(4491/18 900)。有不安全交通行为和中、低水平健康素养的中学生非故意伤害的发生率更高(P<0.001)。走路/骑车戴耳机[OR=1.428(95%CI 1.345～1.517)]、走路玩手机[OR=1.457(95%CI 1.369～1.551)]和不遵守交通规则[OR=1.488(95%CI 1.388～1.595)]和中、低水平健康素养[(OR=1.202(95%CI 1.102～1.311)、OR=1.242(95%CI 1.154～1.337)]均与非故意伤害呈正相关(P<0.001);相对于高水平健康素养中学生，中、低水平健康素养与走路/骑车戴耳机[OR=1.332 (95%CI 1.214～1.462)、OR=1.483 (95%CI 1.383～1.591)]、走路玩手机[OR=1.324 (95%CI 1.214～1.445)、OR=1.451 (95%CI 1.356～1.552)]和不遵守交通规则[OR=1.484 (95%CI 1.325～1.662)、OR=1.548 (95%CI 1.416～1.693)]对非故意伤害均存在相乘交互作用(P<0.001)。结论 通过提高中学生健康素养水平并减少不安全交通行为的出现，可降低道路交通碰撞等非故意伤害的发生风险。
Abstract：OBJECTIVE To examine the interaction of health literacy and unsafe traffic behaviors on unintentional injuries in middle school students. METHODS From November 2017 to January 2018, 18 900 middle school students were enrolled by using multistage cluster sampling method in Chongqing Municipality, Hefei City of Anhui Province, Yangjiang City of Guangdong Province, and Shenyang City of Liaoning Province, the average age of the 18 900 students was(15.09±1.75) years old, among whom 8986 were boys and 9914 were girls; 8514 were high school students and 10 386 were junior high students. A questionnaires survey was conducted to collect demographic information, health literacy, unsafe traffic behaviors and occurrence of unintentional injuries. Multivariate logistic regression analyses were used to examine the associations between them. RESULTS The incidence of unintentional injuries was 39.13%, and the proportion of wearing earphones while walking or cycling, playing on the mobile phones while walking and breaking traffic rules was 48.16%(9104), 56.87%(10 748), and 23.76%(4491), respectively. Middle school students with unsafe traffic behaviors and low levels of health literacy have higher incidence rate of unintentional injuries(P<0.001).Wearing earphones while walking or cycling(OR=1.428, 95%CI 1.345-1.517), playing on the mobile phones while walking(OR=1.457, 95%CI 1.369-1.551) and breaking traffic rules(OR=1.488, 95%CI 1.388-1.595) between medium and low levels of health literacy were positively related to unintentional injuries in middle school students(OR=1.202, 95%CI 1.102-1.311 and OR=1.242, 95%CI 1.154-1.337) respectively. Compared with high health literacy level of middle school students, the multiplicative interaction between medium and low levels of health literacy, wearing earphones while walking or cycling(OR=1.332, 95%CI 1.214-1.462, OR=1.483, 95%CI 1.383-1.591), playing on the mobile phones while walking(OR=1.324, 95%CI 1.214-1.445, OR=1.451, 95%CI 1.356-1.552) and breaking traffic rules(OR=1.484, 95%CI 1.325-1.662, OR=1.548, 95%CI 1.416-1.693) on unintentional injuries was noticed significant respectively(P<0.001). CONCLUSION Health literacy improvement and decrease the emergence of unsafe traffic behaviors may reduce the incidence of unintentional injuries among middle school students.
[1] World Health Organization.Global accelerated action for the health of adolescents (AA-HA!):guidance to support country implementation [EB/OL].[2020-10-25].https://www.who.int/maternal_child_adolescent/topics/adolescence/framework-accelerated-action/en/.
[2] Institution for Health Metrics and Evaluation.Global health data exchange [EB/OL].[2020-10-25].http://ghdx.healthdata.org/gbd-results-tool.
[3] 李粉粉，王书梅，叶周丰，等.某职业高中学生危险交通行为与交通伤害相关性研究[J].伤害医学(电子版),2019,8(3):30-35.
[4] KOEKEMOER K,GESSELLEEN M V,NIEKERK A V,et al.Child pedestrian safety knowledge,behavior and road injury in Cape Town,South Africa[J].Accid Anal Prev,2017,99:202-209.
[5] 全球儿童安全组织.青少年步行使用电子设备分心现状报告[EB/OL].[2020-10-26].http://www.safekidschina.org/themes/172/userfiles/download/2018/6/5/xuylxjh5bmzenlf.pdf.
[6] SUKA M,ODAJIMA T,OKAMOTO M,et al.Relationship between health literacy,health information access,health behavior,and health status in Japanese people[J].Patient Educ Couns,2015,98(5):660-668.
[7] FLEARY S A,JOSEPH P,PAPPAGIANOPOULOUS J E.Adolescent health literacy and health behaviors:a systematic review[J].J Adolesc,2018,62:116-127.
[8] 刘小娜，常春，孙昕霙.健康素养全球研究概况及其在中国的发展展望[J].中国健康教育，2012,28(2):150-153.
[9] 中国健康教育中心.2017年中国居民健康素养监测结果发布(图解)[EB/OL].[2021-06-28].http://www.nihe.org.cn/news.php?id=60289.
[10] NABIPOUR A R,NAKHAEE N,KHANJANI N,et al.The road user behaviour of school students in Iran[J].Accid Anal Prev,2015,75:43-54.
[11] SULLMAN M J,THOMAS A,STEPHENS A N.The road user behavior of school students in Belgium[J].Accid Anal Prev,2012,48:495-504.
[12] FENG W,GONG Q H,LIU K,et al.Analysis of behavioral characteristics related to unintentional injury in southeast Chinese adolescents:evidence from a school-based survey[J].Int J Environ Res Public Health,2017,14(3):241-249.
[13] 张诗晨，杨蓉，万宇辉，等.中国5省份中学生健康素养与伤害发生的关联分析[J].中华预防医学杂志，2018,52(8):785-790.
[14] 张诗晨，杨蓉，李丹琳，等.中学生健康素养和手机依赖行为的交互作用与意外伤害的关联[J].中华流行病学杂志，2018,39(12):1549-1554.
[15] 张诗晨，万宇辉，陶舒曼，等.中国青少年互动性健康素养问卷的信度和结构效度评价[J].中国学校卫生，2014,35(3):332-336.
[16] ZHANG S C,TAO F B,WU X Y,et al.Low health literacy and psychological symptoms potentially increase the risks of non-suicidal self-injury in Chinese middle school students[J].BMC Psychiatry,2016,16(1):327-335.
[17] 中华人民共和国国家质量监督检验检疫总局，中国国家标准化管理委员会.儿童青少年伤害监测方法：GB/T 31180—2014 [S].北京：中国标准出版社，2015.
[18] KANN L,MCMANUS T,HARRIS W A,et al.Youth risk behavior surveillance-United States,2015[J].MMWR Surveill Summ,2016,65(6):1-174.
[19] FANG Y,ZHANG X,CHEN W,et al.Epidemiological characteristics and burden of childhood and adolescent injuries:a survey of elementary and secondary students in Xiamen,China[J].BMC Public Health,2015,15(10):357-367.
[20] ALONSO-FERNANDEZ N,JIMENEZ-GARCIA R,ALONSO-FERNANDEZ L,et al.Unintentional injuries and associated factors among children and adolescents.An analysis of the Spanish National Health Survey[J].Int J Public Health,2017,62(9):961-969.
[21] HE S,LUNNEN J C,PUVANACHANDRA P,et al.Global childhood unintentional injury study:multisite surveillance data[J].Am J Public Health,2014,104(3):e79-84.
[22] MA W J,NIE S P,XU H F,et al.Socioeconomic status and the occurrence of non-fatal child pedestrian injury:results from a cross-sectional survey[J].Safety Sci,2010,48(6):823-828.
[23] 董智强，马文军，许燕君，等.广东省学龄前儿童非致死性伤害流行特征及影响因素分析[J].华南预防医学，2005,31(2):15-17.
[24] 余小鸣，张译天，黄思哲，等.青少年意外伤害与健康危险行为的关联研究[J].中华行为医学与脑科学杂志，2017,26(2):163-166.
[25] 刘秀荣，张晨，李玉青，等.中学生预防道路交通伤害知识、信念和行为调查[J].实用预防医学，2006,13(5):1148-1150.
[26] ALONSO F,GONZALEZ-MARIN A,ESTEBAN C,et al.Behavioral health at school:do three competences in road safety education impact the protective road behaviors of Spanish children[J].Int J Environ Res Public Health,2020,17(3):935-951.
[27] 丘志坚，邱宗耀，苏绮雯，等.广州市番禺区12320名小学生步行安全教育干预效果评价[J].医学动物防制，2018,34(8):752-755.
[28] WAARD D D,SCHEPCRS P,ORMEL W,et al.Mobile phone use while cycling:incidence and effects on behavior and safety[J].Ergonomics,2010,53(1):30-42.
[29] 王圣贤，姜宪尘，焦仕林，等.柯城区中学生步行交通伤害影响因素多重对应分析[J].预防医学，2019,31(8):798-801.
[30] SIMMONS S M,CAIRD J K,TA A,et al.Plight of the distracted pedestrian:a research synthesis and meta-analysis of mobile phone use on crossing behavior[J].Inj Prev,2020,26(2):170-176.
[31] 李凤娟，孙经，何健，等.2013年河南省中学生道路交通违规行为现况调查[J].预防医学论坛，2017,23(11):849-851.
[32] WANG C,ZHANG W,FENG Z,et al.Exploring factors influencing the risky cycling behaviors of young cyclists aged 15-24 years:a questionnaire-based study in China[J].Risk Anal,2020,40(8):1554-1570.
[33] USECHE S A,ALONSO F,MONTORO L,et al.Explaining self-reported traffic crashes of cyclists:an empirical study based on age and road risky behaviors[J].Safety Sci,2019,113:105-114.
[34] LIN M B,HUANG Y P.The impact of walking while using a smartphone on pedestrians’ awareness of roadside events[J].Accid Anal Prev,2017,101:87-96.
[35] MISSINNE S,NEELS K,BRACKE P.Reconsidering inequalities in preventive health care:an application of cultural health capital theory and the life-course perspective to the take-up of mammography screening[J].Soc Health Illness,2014,36(8):1259-1275.
[36] DONG X,PEEK-ASA C,YANG J,et al.The association of road safety knowledge and risk behavior with paediatric road traffic injury in Guangzhou,China[J].Inj Prev,2011,17(1):15-20.
[37] RAN M,PENG L,LIU Q,et al.The association between quality of life (QOL) and health literacy among junior middle school students:a cross-sectional study[J].BMC Public Health,2018,18(1):1183-1193.
基本信息:
DOI：10.19813/j.cnki.weishengyanjiu.2022.02.005
中图分类号:G637.9;R195
引用信息:
[1]黄雪雪,胡婕,李丹琳,等.四城市中学生健康素养和不安全交通行为对非故意伤害的交互作用[J].卫生研究,2022,51(02):202-209.DOI:10.19813/j.cnki.weishengyanjiu.2022.02.005.
基金信息:
国家自然科学基金(No.81402699); 省级大学生创新创业训练计划(No.S201910366109)
2022-03-28
2022-03-28