Article(id=1322607932676620711, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1322607837742747790, articleNumber=null, orderNo=null, doi=10.20043/j.cnki.MPM.202503261, pmid=null, cstr=null, oa=null, hot=null, price=null, onlineType=0, articleFormat=0, articleType=null, articleTypeStr=null, receivedDate=1741795200000, receivedDateStr=2025-03-13, revisedDate=null, revisedDateStr=null, acceptedDate=null, acceptedDateStr=null, onlineDate=1793263904017, onlineDateStr=2026-10-29, pubDate=1761321600000, pubDateStr=2025-10-25, doiRegisterDate=null, doiRegisterDateStr=null, onlineIssueDate=1793263904017, onlineIssueDateStr=2026-10-29, onlineJustAcceptDate=null, onlineJustAcceptDateStr=null, onlineFirstDate=null, onlineFirstDateStr=null, sourceXml=null, magXml=null, createTime=1793263904017, creator=13701087609, updateTime=1793263904017, updator=13701087609, issue=Issue{id=1322607837742747790, tenantId=1146029695717560320, journalId=1227665162245664772, year='2025', volume='52', issue='20', pageStart='3649', pageEnd='3840', issueExtLink='null', onlineDate='null', pubDate='1761321600000', pubDateStr='2025-10-25', beforeIssueId=null, nextIssueId=null, price=null, status=1, issueComplete=1, articleOrder=1, issueType=-1, specialIssue=null, createTime=1793263881383, creator='13701087609', updateTime=1793264238791, updator='13701087609', preIssue=null, nextIssue=null, articleTotal=null, ext={EN=IssueExt(id=1322609336933794638, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1322607837742747790, language=EN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=), CN=IssueExt(id=1322609336933794639, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1322607837742747790, language=CN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=)}, issueFiles=null, downloadFileDto=null}, startPage=3712, endPage=3718, ext={EN=ArticleExt(id=1322607934090101161, articleId=1322607932676620711, tenantId=1146029695717560320, journalId=1227665162245664772, language=EN, title=The dose-response associations between physical activity, sedentary behavior, and mental health in primary and secondary school students, columnId=1228016568949474136, journalTitle=Modern Preventive Medicine, columnName=Child and Adolescent health, Maternal and Child Health, runingTitle=null, highlight=null, articleAbstract=
Objective To investigate the dose–response relationship between different levels of physical activity and sedentary time and mental health among primary and secondary school students, thereby providing a robust scientific basis for the effective prevention of mental health problems in children and adolescents.
Methods A health survey was conducted among 3 982 students selected by convenience sampling from eight primary and secondary schools in Haizhu District, Guangzhou. Mental health status was compared between students with and without regular physical activity habits. Zero-inflated negative binomial (ZINB) models and generalized additive models (GAMs) were subsequently employed to analyze the dose–response relationship between physical activity, sedentary behavior, and mental health outcomes.
Results Among the 3 982 participants, only 5.73% met the World Health Organization’s recommended levels of physical activity. Sedentary time was generally excessive, with only 25.24% of students reporting sedentary time of 3 hours or less per day. After stratified propensity score matching, significant differences in the number of days feeling unhappy were observed across all six matched groups between students with and without regular physical activity habits. Compared with ≤10 minutes of daily moderate-to-vigorous physical activity (MVPA), longer durations of MVPA and outdoor activity were associated with improved mental health outcomes, with greater benefits observed as activity duration increased (MVPA: 11–29 minutes: +21.55%, 30–59 minutes: +24.19%, ≥60 minutes: +25.86%; outdoor activity: 11–30 minutes: +23.81%, 31–44 minutes: +19.19%, 45–60 minutes: +25.42%, ≥60 minutes: +28.28%). In contrast, compared with ≤3 hours of sedentary time, longer durations of sedentary behavior were associated with poorer mental health (3–4 hours: -9.40%, 4–5 hours: -15.43%, >5 hours: -44.27%). The GAM analysis further confirmed the findings of the ZINB modeL.
Conclusion A dose–response relationship exists between physical activity, sedentary behavior, and mental health among primary and secondary school students. Longer durations of physical activity are associated with greater mental health benefits, while prolonged sedentary time is linked to poorer mental health outcomes. These findings provide empirical support for optimizing youth-targeted physical activity interventions and mental health promotion policies.
, authors=Peng XU
1, Jing-yi FAN
2, Li-sha DUAN
1, Li-ping XUE
3, Yan-hui GAO
4, Su-xia WANG
1, authorsList=Peng XU, Jing-yi FAN, Li-sha DUAN, Li-ping XUE, Yan-hui GAO, Su-xia WANG, authorCompany=null, correspAuthors=Yan-hui GAO, Su-xia WANG, authorNote=null, correspAuthorsNote=null, copyrightStatement=null, copyrightOwner=null, extLink=null, articleAbsUrl=null, sourceXml=null, magXml=null, pdfUrl=null, pdf=null, pdfFileSize=null, pdfExtLink=null, richHtmlUrl=null, mobilePdfUrl=null, reviewReport=null, pdfFirstPage=null, abstractGraph=null, abstractGraphContent=null, abstractVideo=null, citation=null, cebUrl=null, magXmlContent=null, mapNumber=null, fund=null), CN=ArticleExt(id=1322607938695446964, articleId=1322607932676620711, tenantId=1146029695717560320, journalId=1227665162245664772, language=CN, title=中小学生身体活动和久坐时间与心理健康剂量反应关系研究, columnId=1228016570031604578, journalTitle=现代预防医学, columnName=儿少卫生与妇幼保健, runingTitle=null, highlight=null, articleAbstract=
目的 探索不同身体活动和久坐时间与中小学生心理健康之间的剂量反应关系,为有效预防儿童青少年心理健康问题提供充实的科学依据。
方法 采用便利抽样法选取广州市海珠区8所中小学3 982名学生进行健康调查,比较心理健康在是否有规律运动的中小学生之间是否有差别;最后使用零膨胀负二项模型及广义加性模型分析中小学生身体活动和久坐时间与心理健康剂量反应关系。
结果 3 982名中小学生仅有5.73%的达到世界卫生组织身体活动指南的推荐量;中小学生久坐时间普遍过长,3小时及以下仅占25.24%;进行倾向性评分分层匹配后,6组内的不开心天数在是否规律运动之间均有差别;与10分钟及以内相比,每天中高强度身体活动和户外时间增加均能改善中小学生的心理健康状况,同时随着时间增加,改善中小学生心理健康收益越大(中高强度身体活动:11~29分钟收益21.55%、30~59分钟收益24.19%和1小时及以上收益25.86%,户外活动:11~30分钟收益23.81%、31~44分钟收益19.19%、45~60分钟收益25.42%和1小时及以上收益28.28%);相反,与3小时及以下相比,中小学生随着静坐时间增加心理健康状况越差(3~4小时收益-9.40%、4~5小时收益-15.43%和5小时以上收益-44.27%)。广义加性模型的结果进一步验证了零膨胀负二项模型的结果。
结论 中小学生身体活动和久坐时间与心理健康呈剂量反应关系,运动时间越长心理健康收益越大,久坐越长心理健康状况越差。本研究为优化青少年运动干预策略和心理健康促进政策提供了实证支持。
, authors=徐鹏
1, 范静宜
2, 段丽莎
1, 薛丽萍
3, 郜艳晖
4, 王素侠
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徐鹏(1993—),男,硕士,研究实习员,研究方向:公共卫生与预防医学
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本刊刊出的所有文章不代表中华预防医学会和本刊编委会的观点,除非特别声明。, copyrightOwner=中华预防医学会和四川大学华西公共卫生学院, extLink=null, articleAbsUrl=null, sourceXml=s2jEgF5IEwzeALz6oB4LnA==, magXml=htfv4MD0ni8a0A2AS6qbrg==, pdfUrl=null, pdf=LKTyHR6C20dWPsiKwxCukQ==, pdfFileSize=744325, pdfExtLink=null, richHtmlUrl=null, mobilePdfUrl=null, reviewReport=null, pdfFirstPage=null, abstractGraph=9K34zoX2pXSoL8YHATsUtA==, abstractGraphContent=null, abstractVideo=null, citation=null, cebUrl=null, magXmlContent=kORz96H+/AWPCg1TdEx7ZQ==, mapNumber=null, fund=null)}, authors=[Author(id=1322607940213785025, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1322607932676620711, orderNo=0, firstName=null, middleName=null, lastName=null, nameCn=null, orcid=null, stid=null, country=null, authorPic=null, dead=0, email=null, emailSecond=null, emailThird=null, correspondingAuthor=0, authorType=1, ext={EN=AuthorExt(id=1322607940322836931, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1322607932676620711, authorId=1322607940213785025, language=EN, stringName=Peng XU, firstName=Peng, middleName=null, lastName=XU, prefix=null, suffix=null, authorComment=null, nameInitials=null, affiliation=null, department=null, xref=
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5: 56., articleTitle=A comparison of direct versus self-report measures for assessing physical activity in adults: a systematic review, refAbstract=null)], funds=[Fund(id=1322607949126681080, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1322607932676620711, awardId=2023byzd152sk, language=CN, fundingSource=蚌埠医科大学科研课题(2023byzd152sk), fundOrder=null, country=null), Fund(id=1322607949458031097, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1322607932676620711, awardId=B2022035, language=CN, fundingSource=广东省医学科研基金(B2022035), fundOrder=null, country=null)], companyList=[AuthorCompany(id=1322607939064545719, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1322607932676620711, xref=1., ext=[AuthorCompanyExt(id=1322607939077128632, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1322607932676620711, companyId=1322607939064545719, language=EN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=The First Affiliated Hospital of Bengbu Medical University, Clinical Trial Research Center, Bengbu Medical University, Bengbu, Anhui 233000, China), AuthorCompanyExt(id=1322607939089711545, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1322607932676620711, companyId=1322607939064545719, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=
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Frequency distribution of unhappiness days, figureFileSmall=sXmLaobRqCOl8V4TZ+eU7g==, figureFileBig=9K34zoX2pXSoL8YHATsUtA==, tableContent=null), ArticleFig(id=1322607945687351790, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1322607932676620711, language=CN, label=图1, caption=
不开心天数频数分布, figureFileSmall=sXmLaobRqCOl8V4TZ+eU7g==, figureFileBig=9K34zoX2pXSoL8YHATsUtA==, tableContent=null), ArticleFig(id=1322607947482513904, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1322607932676620711, language=EN, label=Fig.2, caption=
Frequency distribution of unhappiness days, figureFileSmall=jvSIk0kkxh5m6PMdohm13g==, figureFileBig=MFSflV4eNZ6LMK4NxLtO2Q==, tableContent=null), ArticleFig(id=1322607947839029745, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1322607932676620711, language=CN, label=图2, caption=
不开心天数在各组间的比较, figureFileSmall=jvSIk0kkxh5m6PMdohm13g==, figureFileBig=MFSflV4eNZ6LMK4NxLtO2Q==, tableContent=null), ArticleFig(id=1322607948191351282, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1322607932676620711, language=EN, label=Fig.3, caption=
Smoothing curves of daily MVPA, sedentary time, and unhappiness days among primary and secondary school students, figureFileSmall=6QqjMHp6kpAEIFXnvpE+/w==, figureFileBig=y7ST2HYKzY7PNi/4W6dhnw==, tableContent=null), ArticleFig(id=1322607948262654451, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1322607932676620711, language=CN, label=图3, caption=
中小学生每天中高强度、久坐时间与不开心天数的平滑曲线, figureFileSmall=6QqjMHp6kpAEIFXnvpE+/w==, figureFileBig=y7ST2HYKzY7PNi/4W6dhnw==, tableContent=null), ArticleFig(id=1322607948317180404, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1322607932676620711, language=EN, label=Table 1, caption=
Basic characteristics of primary and secondary school students
, figureFileSmall=null, figureFileBig=null, tableContent=
| 项目 | 例数(%) | 项目 | 例数(%) |
|---|
| 年级 | | 身体状态 | |
| 1~3年级 | 1 715(43.07) | 好 | 3 590(90.16) |
| 4~6年级 | 1 411(35.43) | 一般或较差 | 392(9.84) |
| 7~9年级 | 856(21.50) | 家庭平均月收入(元) | |
| 性别 | | ≤8 000 | 1 001(25.14) |
| 男 | 2 111(53.01) | 8 001~16 000 | 1 205(30.26) |
| 女 | 1 871(46.99) | >16 000 | 1 776(44.60) |
| 家庭结构 | | 每周剧烈运动天数(天) | |
| 核心家庭 | 2 440(61.28) | 0 | 736(18.48) |
| 主干家庭 | 1 130(28.38) | 1 | 1 003(25.19) |
| 联合/重组/单亲 | 412(10.35) | 2~3 | 1 341(33.68) |
| 家长教育程度 | | ≥4 | 902(22.65) |
| 初中及以下 | 562(14.11) | 平均每天户外活动时间(min) | |
| 高中/中专 | 766(19.24) | ≤10 | 445(11.18) |
| 大专 | 937(23.53) | 11~30 | 1 404(35.26) |
| 本科及以上 | 1 717(43.12) | 31~44 | 784(19.69) |
| 辅导班 | | 45~60 | 469(11.78) |
| 上辅导班 | 3 353(84.20) | ≥60 | 880(22.10) |
| 不上辅导班 | 629(15.80) | 平均每天静坐时间(放学后)(h) | |
| 规律运动 | | ≤3 | 1 005(25.24) |
| 是 | 2 610(65.54) | 3~4 | 1 062(26.67) |
| 否 | 1 372(34.46) | 4~5 | 909(22.83) |
| 接触二手烟 | | >5 | 1 006(25.26) |
| 是 | 827(20.77) | 每天中高强度时间(min) | |
| 否 | 3 155(79.23) | ≤10 | 1 659(41.66) |
| 照顾孩子起居 | | 11~29 | 1 534(38.52) |
| 父母照顾 | 3 297(82.80) | 30~59 | 561(14.09) |
| 祖父母照顾 | 596(14.97) | ≥60 | 228(5.73) |
| 其他人照顾 | 89(2.24) | | |
), ArticleFig(id=1322607948669501941, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1322607932676620711, language=CN, label=表1, caption=
中小学生基本特征
, figureFileSmall=null, figureFileBig=null, tableContent=
| 项目 | 例数(%) | 项目 | 例数(%) |
|---|
| 年级 | | 身体状态 | |
| 1~3年级 | 1 715(43.07) | 好 | 3 590(90.16) |
| 4~6年级 | 1 411(35.43) | 一般或较差 | 392(9.84) |
| 7~9年级 | 856(21.50) | 家庭平均月收入(元) | |
| 性别 | | ≤8 000 | 1 001(25.14) |
| 男 | 2 111(53.01) | 8 001~16 000 | 1 205(30.26) |
| 女 | 1 871(46.99) | >16 000 | 1 776(44.60) |
| 家庭结构 | | 每周剧烈运动天数(天) | |
| 核心家庭 | 2 440(61.28) | 0 | 736(18.48) |
| 主干家庭 | 1 130(28.38) | 1 | 1 003(25.19) |
| 联合/重组/单亲 | 412(10.35) | 2~3 | 1 341(33.68) |
| 家长教育程度 | | ≥4 | 902(22.65) |
| 初中及以下 | 562(14.11) | 平均每天户外活动时间(min) | |
| 高中/中专 | 766(19.24) | ≤10 | 445(11.18) |
| 大专 | 937(23.53) | 11~30 | 1 404(35.26) |
| 本科及以上 | 1 717(43.12) | 31~44 | 784(19.69) |
| 辅导班 | | 45~60 | 469(11.78) |
| 上辅导班 | 3 353(84.20) | ≥60 | 880(22.10) |
| 不上辅导班 | 629(15.80) | 平均每天静坐时间(放学后)(h) | |
| 规律运动 | | ≤3 | 1 005(25.24) |
| 是 | 2 610(65.54) | 3~4 | 1 062(26.67) |
| 否 | 1 372(34.46) | 4~5 | 909(22.83) |
| 接触二手烟 | | >5 | 1 006(25.26) |
| 是 | 827(20.77) | 每天中高强度时间(min) | |
| 否 | 3 155(79.23) | ≤10 | 1 659(41.66) |
| 照顾孩子起居 | | 11~29 | 1 534(38.52) |
| 父母照顾 | 3 297(82.80) | 30~59 | 561(14.09) |
| 祖父母照顾 | 596(14.97) | ≥60 | 228(5.73) |
| 其他人照顾 | 89(2.24) | | |
), ArticleFig(id=1322607948736610806, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1322607932676620711, language=EN, label=Table 2, caption=
Zero-Inflated Negative Binomial Model
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| 模型a | 计数模型 | 零模型 |
|---|
| 收益(%)b | β系数 | 标准误 | P值 | 收益(%) | β系数 | 标准误 | P值 |
|---|
| 模型1 | | | | | | | | |
| 中高强度时间(min) | | | | | | | | |
| ≤10 | Ref | Ref | | | Ref | Ref | | |
| 11~29 | 21.55 | -0.24 | 0.06 | 5.74×10-5 | 83.12 | -1.78 | 0.83 | 0.03 |
| 30~59 | 24.19 | -0.28 | 0.08 | 8.56×10-4 | 95.36 | -3.07 | 1.96 | 0.12 |
| ≥60 | 25.86 | -0.30 | 0.12 | 0.02 | -55.59 | 0.44 | 1.16 | 0.70 |
| 模型2 | | | | | | | | |
| 户外活动时间(min) | | | | | | | | |
| ≤10 | Ref | Ref | | | Ref | Ref | | |
| 11~30 | 23.81 | -0.27 | 0.09 | 3.06×10-3 | -10.10 | 0.10 | 0.77 | 0.90 |
| 31~44 | 19.19 | -0.21 | 0.10 | 0.04 | -29.23 | 0.26 | 0.97 | 0.79 |
| 45~60 | 25.42 | -0.30 | 0.11 | 7.13×10-3 | 18.74 | -0.21 | 1.07 | 0.85 |
| ≥60 | 28.28 | -0.33 | 0.10 | 1.14×10-3 | -56.02 | 0.44 | 0.78 | 0.57 |
| 模型3 | | | | | | | | |
| 每天静坐时间(h) | | | | | | | | |
| ≤3 | Ref | Ref | | | Ref | Ref | | |
| 3~4 | -9.40 | 0.09 | 0.08 | 0.26 | 36.21 | -0.45 | 0.76 | 0.55 |
| 4~5 | -15.43 | 0.14 | 0.08 | 0.07 | 92.05 | -2.53 | 2.84 | 0.37 |
| >5 | -44.27 | 0.37 | 0.08 | 4.45×10-6 | 58.71 | -0.88 | 0.66 | 0.18 |
), ArticleFig(id=1322607949034406391, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1322607932676620711, language=CN, label=表2, caption=
零膨胀负二项模型
, figureFileSmall=null, figureFileBig=null, tableContent=
| 模型a | 计数模型 | 零模型 |
|---|
| 收益(%)b | β系数 | 标准误 | P值 | 收益(%) | β系数 | 标准误 | P值 |
|---|
| 模型1 | | | | | | | | |
| 中高强度时间(min) | | | | | | | | |
| ≤10 | Ref | Ref | | | Ref | Ref | | |
| 11~29 | 21.55 | -0.24 | 0.06 | 5.74×10-5 | 83.12 | -1.78 | 0.83 | 0.03 |
| 30~59 | 24.19 | -0.28 | 0.08 | 8.56×10-4 | 95.36 | -3.07 | 1.96 | 0.12 |
| ≥60 | 25.86 | -0.30 | 0.12 | 0.02 | -55.59 | 0.44 | 1.16 | 0.70 |
| 模型2 | | | | | | | | |
| 户外活动时间(min) | | | | | | | | |
| ≤10 | Ref | Ref | | | Ref | Ref | | |
| 11~30 | 23.81 | -0.27 | 0.09 | 3.06×10-3 | -10.10 | 0.10 | 0.77 | 0.90 |
| 31~44 | 19.19 | -0.21 | 0.10 | 0.04 | -29.23 | 0.26 | 0.97 | 0.79 |
| 45~60 | 25.42 | -0.30 | 0.11 | 7.13×10-3 | 18.74 | -0.21 | 1.07 | 0.85 |
| ≥60 | 28.28 | -0.33 | 0.10 | 1.14×10-3 | -56.02 | 0.44 | 0.78 | 0.57 |
| 模型3 | | | | | | | | |
| 每天静坐时间(h) | | | | | | | | |
| ≤3 | Ref | Ref | | | Ref | Ref | | |
| 3~4 | -9.40 | 0.09 | 0.08 | 0.26 | 36.21 | -0.45 | 0.76 | 0.55 |
| 4~5 | -15.43 | 0.14 | 0.08 | 0.07 | 92.05 | -2.53 | 2.84 | 0.37 |
| >5 | -44.27 | 0.37 | 0.08 | 4.45×10-6 | 58.71 | -0.88 | 0.66 | 0.18 |
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