上海市2004—2019年青少年健康危险行为特征和变化趋势

  目的  分析上海市青少年健康危险行为变化趋势，为中学生健康危险行为综合干预工作提供参考依据。  方法  参考中国疾病预防控制中心的中国青少年健康相关行为调查问卷，根据实际监测需要编制问卷，分初中版、高中版，采用多阶段分层随机整群抽样方法，2004—2019年选取6次上海全市范围调查中问卷填写完整的59 209名中学生为研究对象。  结果  2004—2019年，调查前7 d内，9.2%~50.6%的中学生平均每天喝汽水饮料≥1次，54.2%~76.1%的中学生报告吃甜点≥2次; 48.3%~60.7%的中学生每天运动60 min以上的天数≤3 d，16.1%~35.2%的中学生报告课外学习时间过长且报告率逐年上升，年均百分比变化率(APC)为5.15%(t=9.28，P < 0.01)，长时间上网报告率为6.0%~13.6%，在高中生中呈上升趋势(APC=5.35%，t=3.14，P < 0.05);中学生步行违规行为报告率为从2004年69.1%下降至2019年27.6%(APC=-6.28%，t=-8.18，P < 0.01)，但骑车违规行为近年来有所上升; 故意伤害行为如打架、欺负行为等均在逐年下降; 初次吸烟年龄≤13岁的报告率逐年下降，但尝试饮酒行为报告率在初中生中有所上升，APC为1.61%(t=3.48，P < 0.05);1.6%~3.4%的中学生具有网络成瘾行为倾向，网络成瘾倾向报告率在高中生和女生中呈上升趋势，APC分别为6.59%和10.29%(t值分别为6.37，8.62，P值均 < 0.01)。  结论  2004—2019年间，上海市中学生非故意伤害行为、故意伤害行为、物质成瘾行为得到改善，然而不良饮食和缺乏体力活动行为报告率仍然较高，后续需重点关注不良饮食和缺乏体力活动行为并采取综合性干预手段加以控制。

Characteristics and trends of adolescents health risk behaviors in Shanghai from 2004 to 2019

  Objective  To analyze the trend of adolescent health risk behaviors in Shanghai, and to provide reference for the comprehensive intervention of middle school students' health risk behaviors.  Methods  Based on the health risk behavior questionnaire of Chinese Center for Disease Control and Prevention, the questionnaire was adapted according to the actual monitoring needs. It was divided into junior high school version and senior high school version. From 2004 to 2019, using the method of multistage stratified cluster random sampling, 59 209 middle school students who completed the questionnaire in 6 surveys were selected for analysis.  Results  From 2004 to 2019, in the 7 days prior to the survey, 9.2%-50.6% of middle school students drank a glass of soda more than or equal to once a day and 54.2%-76.1% of middle school students reported eating dessert twice or more. Within 7 days, 48.3%-60.7% of middle school students had≥60 min of exercise per day for less than or equal to 3 days, and 16.1%-35.2% of middle school students reported too much extracurricular activities, and the reporting rate increased year by year with the annual percent change (APC) of 5.15%(t=9.28, P < 0.01). The reporting rate of long-time online learning was 6.0%-13.6%, which showed an upward trend among high school students, with the APC of 5.35%(t=3.14, P < 0.05). The reporting rate of middle school students' pedestrian safety problems decreased from 69.1% in 2004 to 27.6% in 2019, with the APC of -6.28%(t=-8.18, P < 0.01), but the reporting rate of cycling safety problems have increased in recent years. The reporting rate of intentional injury behaviors decreased by year such as fighting, bullying, etc. The reporting rate of initial smoking age ≤13 years old decreased, but attempted drinking behavior increased in junior middle school students, and the APC was 1.61%(t=3.48, P < 0.05). A total of 1.6%-3.4% of middle school students had an Internet addiction behavior tendency. The detection rate of Internet addiction tendency was increasing in high school students and girls, and APC was 6.59% and 10.29% respectively(t=6.37, 8.62, P < 0.01).  Conclusion  From 2004 to 2019, unintentional injury behavior, intentional injury behavior and substance addiction behavior of middle school students in Shanghai have improved. However, unhealthy diet and physical inactivity are still high. In the follow-up. It need to focus on adverse diet and lack of physical activity behavior and take comprehensive intervention measures to control them.