Article(id=1321170122551710313, tenantId=1146029695717560320, journalId=1319373219989389464, issueId=1321170080579301694, articleNumber=null, orderNo=null, doi=10.11847/zgggws1145331, pmid=null, cstr=null, oa=null, hot=null, price=null, onlineType=0, articleFormat=0, articleType=null, articleTypeStr=null, receivedDate=1719849600000, receivedDateStr=2024-07-02, revisedDate=1729958400000, revisedDateStr=2024-10-27, acceptedDate=1732118400000, acceptedDateStr=2024-11-21, onlineDate=1792921103370, onlineDateStr=2026-10-25, pubDate=1736438400000, pubDateStr=2025-01-10, doiRegisterDate=null, doiRegisterDateStr=null, onlineIssueDate=1792921103370, onlineIssueDateStr=2026-10-25, onlineJustAcceptDate=null, onlineJustAcceptDateStr=null, onlineFirstDate=null, onlineFirstDateStr=null, sourceXml=null, magXml=null, createTime=1792921103370, creator=13701087609, updateTime=1792921103370, updator=13701087609, issue=Issue{id=1321170080579301694, tenantId=1146029695717560320, journalId=1319373219989389464, year='2025', volume='41', issue='1', pageStart='1', pageEnd='128', issueExtLink='null', onlineDate='null', pubDate='1736438400000', pubDateStr='2025-01-10', beforeIssueId=null, nextIssueId=null, price=null, status=1, issueComplete=1, articleOrder=1, issueType=-1, specialIssue=null, createTime=1792921093363, creator='13701087609', updateTime=1792921093363, updator='13701087609', preIssue=null, nextIssue=null, articleTotal=null, ext=null, issueFiles=null, downloadFileDto=null}, startPage=111, endPage=117, ext={EN=ArticleExt(id=1321170124153934442, articleId=1321170122551710313, tenantId=1146029695717560320, journalId=1319373219989389464, language=EN, title=Research progress on the evolution of adolescent health behavior concepts, theoretical models, research methods, and specific categories: a review, columnId=1320427713148597230, journalTitle=Chinese Journal of Public Health, columnName=Review, runingTitle=null, highlight=null, articleAbstract=

Health behavior is not only the cornerstone of the physical and mental development of adolescents, but also the key to shaping the character and happiness of future life. This study employed literature review, content analysis, and logical analysis to examine authoritative research results on adolescent health behaviors in China and abroad, reviewing the literature on adolescent health behaviors, including concept classifications, theories, research methods, tools, and research content dimensions, to provide a basis for domestic research and practice, and to improve adolescent health behavior levels to leverage its leading role in health. The study found that the concept of adolescent health behavior is often used confusingly and lacks uniform classification. The application of health behavior theories in adolescent behavior research in China is relatively scarce. Research methods on adolescent health behaviors are primarily quantitative and cross-sectional, with research tools mainly relying on self-reported questionnaires. There is currently no unified standard for the specific content categories of adolescent health behaviors.

, authors=Yiyi CHEN, Tiancheng ZHANG, Yuanyuan MA, Fulan ZHANG, authorsList=Yiyi CHEN, Tiancheng ZHANG, Yuanyuan MA, Fulan ZHANG, authorCompany=null, correspAuthors=Tiancheng ZHANG, authorNote=null, correspAuthorsNote=
ZHANG Tiancheng, E-mail:
, copyrightStatement=Copyright © 2025 Chinese Journal of Public Health. All rights reserved., 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=1321170124548199019, articleId=1321170122551710313, tenantId=1146029695717560320, journalId=1319373219989389464, language=CN, title=青少年健康行为概念演变、理论模型、研究方法和具体范畴研究进展, columnId=1320427713358312432, journalTitle=中国公共卫生, columnName=综 述, runingTitle=null, highlight=null, articleAbstract=

健康行为不仅是青少年身心发展的基石,更是塑造未来人生品德与幸福福祉的关键。本文运用文献资料法、内容分析法、逻辑分析法等对国内外有关青少年健康行为的概念分类、理论、研究方法、工具、研究内容维度的权威研究成果进行文献综述,梳理主要研究内容与不足并提出展望,以期为国内研究和实践提供依据,提升青少年健康行为水平,切实发挥其健康引领作用。研究表明,当前青少年健康行为概念混淆使用、分类不统一;国内健康行为理论应用在青少年行为的研究比较匮乏;青少年健康行为研究方法单一,主要以定量研究、横断面设计为主,研究工具主要依赖自我报告的问卷调查法;青少年健康行为的具体内容范畴目前尚无统一标准。

, authors=陈依依, 张天成*, *, 马渊源, 张福兰, authorsList=陈依依, 张天成, 马渊源, 张福兰, authorCompany=null, correspAuthors=张天成, authorNote=

陈依依(1997—),博士在读,研究方向:青少年健康行为与健康促进

, correspAuthorsNote=
张天成,E-mail:
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陈依依(1997—),博士在读,研究方向:青少年健康行为与健康促进

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青少年健康行为概念演变、理论模型、研究方法和具体范畴研究进展
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陈依依 , 张天成 *, * , 马渊源 , 张福兰
中国公共卫生 | 综 述 2025,41(1): 111-117
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中国公共卫生 |综 述 2025 , 41 (1) : 111 -117
青少年健康行为概念演变、理论模型、研究方法和具体范畴研究进展
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陈依依, 张天成*, * , 马渊源, 张福兰
作者信息
  • 吉首大学体育科学学院,吉首 416000
通讯作者:
张天成,E-mail:
作者简介:

陈依依(1997—),博士在读,研究方向:青少年健康行为与健康促进

Research progress on the evolution of adolescent health behavior concepts, theoretical models, research methods, and specific categories: a review
Yiyi CHEN, Tiancheng ZHANG , Yuanyuan MA, Fulan ZHANG
Affiliations
  • School of Sports Science, Jishou University, Jishou 416000, China
  • Corresponding Author:
    ZHANG Tiancheng, E-mail:
出版时间: 2025-01-10 doi: 10.11847/zgggws1145331
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健康行为不仅是青少年身心发展的基石,更是塑造未来人生品德与幸福福祉的关键。本文运用文献资料法、内容分析法、逻辑分析法等对国内外有关青少年健康行为的概念分类、理论、研究方法、工具、研究内容维度的权威研究成果进行文献综述,梳理主要研究内容与不足并提出展望,以期为国内研究和实践提供依据,提升青少年健康行为水平,切实发挥其健康引领作用。研究表明,当前青少年健康行为概念混淆使用、分类不统一;国内健康行为理论应用在青少年行为的研究比较匮乏;青少年健康行为研究方法单一,主要以定量研究、横断面设计为主,研究工具主要依赖自我报告的问卷调查法;青少年健康行为的具体内容范畴目前尚无统一标准。

青少年  /  健康行为  /  身心健康  /  概念

Health behavior is not only the cornerstone of the physical and mental development of adolescents, but also the key to shaping the character and happiness of future life. This study employed literature review, content analysis, and logical analysis to examine authoritative research results on adolescent health behaviors in China and abroad, reviewing the literature on adolescent health behaviors, including concept classifications, theories, research methods, tools, and research content dimensions, to provide a basis for domestic research and practice, and to improve adolescent health behavior levels to leverage its leading role in health. The study found that the concept of adolescent health behavior is often used confusingly and lacks uniform classification. The application of health behavior theories in adolescent behavior research in China is relatively scarce. Research methods on adolescent health behaviors are primarily quantitative and cross-sectional, with research tools mainly relying on self-reported questionnaires. There is currently no unified standard for the specific content categories of adolescent health behaviors.

adolescents  /  health behavior  /  physical and mental health  /  concept
陈依依, 张天成, 马渊源, 张福兰. 青少年健康行为概念演变、理论模型、研究方法和具体范畴研究进展. 中国公共卫生, 2025 , 41 (1) : 111 -117 . DOI: 10.11847/zgggws1145331
Yiyi CHEN, Tiancheng ZHANG, Yuanyuan MA, Fulan ZHANG. Research progress on the evolution of adolescent health behavior concepts, theoretical models, research methods, and specific categories: a review[J]. Chinese Journal of Public Health, 2025 , 41 (1) : 111 -117 . DOI: 10.11847/zgggws1145331
青少年时期的身体、认知能力和社会心理均在迅速发展,伴随着自我概念和自我意识增强,这可能会提高他们从事增加慢性非传染性疾病风险行为(如吸烟、饮酒等)的可能性,并可能持续至成年期[1]。因此,青少年时期是塑造健康行为的关键时期,对支持青少年健康成长、促进未来成年期的健康与福祉至关重要。当前青少年健康行为研究趋势是将健康促进行为、危害健康行为合并在一个量表中进行评估[2–3]。这种做法虽有助全面了解个体的健康相关行为模式,但是行为改变的复杂性要求我们采用更为细致的方法。例如,用于指导行为改变的跨理论模型(the transtheoretical model,TTM)在设计干预措施时,需要考虑个体的经验、行为活动,并设定多维度的任务[4]。在广义的健康行为概念框架下,干预目标的设定面临挑战。此外,健康促进行为和危害健康行为是否只是同一健康行为现象的不同表现,或者它们是否由通过不同的路径产生或抑制,目前尚无确切研究结果[5]。为明确青少年健康行为的概念和行动范围,本文系统概述了国内外目前关于青少年健康行为的概念分类、理论、研究方法和工具、维度和范围4个方面的研究进展,旨在为国内青少年健康行为的深入研究和实践应用提供科学参考和理论支持。
尽管青少年健康行为研究取得了一定成果,但健康行为概念的不统一和与其他概念的混淆(如将健康行为与健康相关行为视为等同)导致了研究结果难以比较和干预效果评估的复杂性,阻碍了青少年有效健康促进计划的实施。健康行为作为行为学科领域的一个分支,其概念起源于健康心理学。Kasl S V和Cobb S在1966年在《Health Behavior,Illness Behavior,and Sick-Role Behavior》中首次定义了健康行为(health behavior):个人在自认为健康时,为预防疾病或在无症状阶段发现疾病而采取的任何活动[6]。Rice P L[7]在此基础上提出,健康行为是个体为预防疾病、维持健康而采取的积极措施,包括改变不良生活方式、减少健康危害行为、积极采取健康行为及遵医行为。随着研究的深入,健康行为的概念扩展到认知和情感层面。Prohaska T R等[8]在编制健康行为问卷时,不仅包括躯体行为,还纳入了认知–情感行为。Gochman D S等[9–10]认为健康行为包括可观察的外在行为和可测量的心理事件及感受状态,涉及个人属性、个性特征及健康相关的行为模式和习惯。符明秋[11]则从感知角度直接区分了可直接观察的外显健康行为(如锻炼、饮食等)和需间接感知的内隐性健康行为(如情绪调节、压力管理等)。
国内学者对青少年健康行为的研究也提出了多种定义和分类。张周阳[12]认为健康行为是保护、维持或促进个体健康的各种行为。黄敬亨[13]在《健康教育学》中定义健康行为是朝向健康或被健康结果强化的行为,这些行为客观上对个体和群体健康有益。进一步地,李世明等[14]根据社会环境、价值观念以及WHO对健康的定义,将健康行为分为身体健康行为、心理健康行为和社会健康行为。与此相似,郑家鲲[15]认为健康行为包括为预防疾病、增强体质、维持和促进健康所采取的行为和活动,涵盖生理、心理和社会健康3个方面。李桂玲[16]将健康行为分为基本健康行为(良好的生活习惯、规律体育锻炼等)、避免不利于健康环境和行为(雾霾天气戴口罩等)以及保健行为(体检等)。高雯等[17]则将健康行为分为健康促进行为(锻炼和健康饮食)、健康预防/保护行为(体检、疫苗接种和避孕套使用等)、回避危害健康行为(戒烟或戒酒)和治疗依从性行为(遵医行为等)。教育部在2018年和2022年分别发布的《普通高中体育与健康课程标准》和《义务教育体育与课程标准》中,将健康行为纳入体育与健康学科的核心素养,明确指出健康行为是增进身心健康和积极适应外部环境的综合表现,包括体育锻炼意识与习惯、健康知识掌握与运用、情绪调控、环境适应4个维度[18]。
综上,尽管不同学者因研究背景和经验的差异对健康行为的定义和分类各有理解,但普遍共识认为健康行为是:(1)涵盖所有对个人或群体健康有益的活动;(2)既包括可观察的外显行为,也包括不易观察的内隐行为。基于这些共识,本文提出以下定义:青少年健康行为是指为了预防疾病、维持或促进身心健康而采取的主动或被动活动。具体来说,青少年健康行为可以分为“健康保护行为”——旨在降低危险因素对健康的危害,以维持当前的健康水平(如戒烟戒酒、体检和遵医行为等)以及“健康促进行为”——旨在积极提高健康水平(如体育锻炼、健康饮食、压力管理等)。在健康行为的大背景下,我们倡导青少年采取主动健康行为,这不仅能增强他们对自身健康的控制感,还能培养他们对健康的责任感。
研究表明,采用理论为基础的干预方法较非理论方法更有可能促使人们改变其行为[19],这些理论长期被用来预测和改变健康相关行为[20]。在健康行为理论的研究中,主要分为个体层面和人际层面,个体层面的理论使用最为广泛,主要包括健康信念模型(the health belief model,HBM)、计划行为理论(the theory of planned behavior,TPB)和跨理论模型(the transtheoretical model,TTM)[21];人际层面的健康行为理论主要是社会认知理论(social cognitive theory,SCT)[22]。
HBM由心理学家Hochbaum和Rosenstock 20世纪50年代提出,最初旨在解释预防保健行为,后经Becker等人发展完善。HBM认为个人的行为选择和健康实践受内在信念驱动,包括对健康问题的认知、态度以及自我效能感。个体基于对疾病严重性的认识、预防措施效果的评估以及行动障碍的感知做出健康决策[23]。Carpenter C J[24]的meta分析证实HBM能有效预测健康行为。杜建军等[25]发现,积极的体质健康信念正向预测青少年的锻炼行为,表明强化健康信念是促进青少年体育锻炼行为的有效策略。然而,HBM的构成要素对青少年健康行为的预测效力不同。O′Connell J K等[26]发现,节食的益处是肥胖青少年节食行为最强有力的预测因子,而对于正常体重青少年,肥胖的感知易感性是最关键因素。Jone C J等[27]的综述表明,HBM不仅用于预测健康行为,还可作为设计提高行为改变依从性干预措施的理论基础。此外,还可以根据HBM理论框架构建青少年健康行为认知量表。例如,闫小涛等[28]基于HBM构建了青少年饮酒相关认知量表,包含感知饮酒的易感性、感知饮酒的严重性、感知饮酒的益处、感知饮酒的障碍和饮酒自我效能5个维度,该量表具有良好的信效度。陈天麒等[29]基于HBM理论自行编制了青少年HIV检测意愿的网络问卷以分析学生HIV检测行为现状及检测意愿,发现HBM是影响HIV检测意愿和行为的重要因素。HBM作为一种成熟理论,不仅可以预测和解释青少年健康行为,而且也是指导干预措施以改变青少年危害健康行为的基础,同时可以根据其理论框架构建青少年健康行为认知量表。尽管如此,HBM缺乏统一测量工具,国内针对青少年健康行为的HBM相对较少。
TPB是理性行为理论(the theory of reasoned action,TRA)的延伸,它阐释了个体动机如何影响他们采取健康行为的可能性[30–31]。研究证实,TPB不仅在成人健康改善方面成效显著[32–33],同样适用于青少年群体。meta分析显示,TPB能有效预测和解释健康行为意向,尤其是行为控制和态度这两个关键因素[30]。Riebl S K等[34]的研究也发现,TPB能显著预测和解释青少年的营养行为,且基于TPB的干预措施能有效促进健康饮食行为的养成。Strong C等[35]的纵向研究进一步证实,结合应对策略和行动计划的TPB能显著预测6个月后青少年的睡眠卫生行为。鄢栋等[36]发现计划行为理论要素与社会学习理论要素对青少年新型毒品使用及使用倾向有重要影响。此外,TPB也被用于构建青少年健康行为的干预措施。Lin P[37]强调,在降低青少年危害健康行为和塑造健康行为干预过程中考虑TPB是必要的。Tsorbatzoudis H[38]基于TPB对高中生进行了12周的健康饮食海报和讲座干预,发现该理论显著改善了青少年的健康饮食态度、意图、感知行为控制,进而改变了饮食行为。TPB是识别和理解青少年健康行为的有效根据,有助于为青少年定制健康行为改变的策略。然而目前主要是基于TPB的青少年健康行为预测研究,TPB的健康行为干预研究还较为缺乏。
TTM也称阶段变化模型,由Prochaska和DiClemente于1983年提出,是一个描述行为改变随时间发展和变化的连续过程。TMM将行为开始到维持划分为“无打算、打算、准备、行动和维持”5个阶段[39],最初用于戒烟,目前被认为是促进健康行为改变过程中应用最广泛的理论模型[40]。研究表明,TMM能有效评估青少年健康行为的阶段变化特征,预测和促进青少年的健康行为改变。Alidosti M等[41]利用TTM确定女性青少年的身体活动状况,发现大多数缺乏身体活动(无打算和打算阶段)。Gereklioglu C等[42]发现,只有20%的肥胖青少年处于活动期(行动和维持阶段),80%的处于非活动期(前意向、意向、准备期阶段)。国内也有类似的研究结果。许鸣等[43]根据TTM构建了《青少年运动、饮食行为量表》来确定青少年果蔬摄入行为所处阶段。方敏等[44]采用TTM理论调查中学生锻炼行为的阶段状况,发现46.6%的学生不锻炼(前意向和意向阶段),15.9%的学生规律性锻炼(行动和维持阶段),且锻炼行为阶段呈现明显的性别和年龄差异。在干预研究方面,Frenn M等[45]采用健康促进结合跨理论模型的实验研究发现,干预后初中生的饮食脂肪摄入量减少和体育锻炼增加,表明TMM能有效改善中学生的健康行为。张雪燕等[46]、周乐山等[47]发现6个月的基于TTM的体育锻炼及心理干预策略不仅能降低肥胖儿童的社交焦虑感,还可提高他们的自尊。杜建军[48]发现以TTM为指导,整合体质健康信念和自我效能的体质健康教育干预模式能有效提升中学生的体质健康水平。这些研究结果共同证明了基于TTM的干预措施在促进青少年健康行为方面的积极作用,为理解和预测青少年的行为变化提供了一个动态视角。
SCT由Bandura于1963年提出,它描述了基于个人认知、身体和社会环境动态三要素与行为环境相互作用的行为。该理论得到了研究者的认可并成功运用于青少年的疾病预防和健康行为研究中。研究显示,SCT要素里的自我效能通过影响个体对环境的感知,直接或间接影响健康行为[49]。Wang C W等[50]发现自我效能感与初中生的含糖饮料摄入量相关,建议未来的健康促进计划应提高青少年的自我效能感。Sheikh M等[51]的研究进一步证实,身体自我效能感与青少年的身体活动呈显著正相关,且自我效能在同伴支持与身体活动间起中介作用。然而,Plotnikoff R C等[52]发现,青春期女孩对家庭和学校环境的感知并未调节自我效能感与身体活动和久坐行为之间的关系。研究结果的不同可能因样本特征、变量定义和测量方式的差异。在干预研究方面,李嘉慧等[53]基于SCT的控烟模式有效提升了青少年的自我效能,降低了他们的吸烟意向和行为。Hidayanty H等[54]也发现,采用基于SCT的教育宣讲和宣传单干预有助于减轻超重青少年的体重。Mirzaei A等[55]通过问卷调查验证了SCT在改善青少年早餐行为方面的有效性。Hashemian M等[56]对女性高中生实施的SCT健康教育干预结果显示,干预后学生的健康知识、结果期望、自我效能感和健康饮食行为得分均有显著提升。
综上,HBM、TPB、TTM、SCT是健康行为理论研究的四大支柱。HBM关注个体对健康威胁的感知及健康行为的认知评估,TPB基于行为意向和感知行为控制来预测行为,TTM将行为改变视为一个多阶段的连续过程,而SCT则强调自我效能在行为改变中的核心作用。这些理论不仅能有效预测青少年的健康行为,还为构建青少年健康行为量表和设计干预措施提供了理论基础。尽管有学者对这些理论的普适性和区分行为起始与维持阶段的能力提出了质疑[57],但他们仍为理解和促进健康行为提供了宝贵的系统框架。未来可通过更多的实证研究,将进一步验证这些理论的有效性和实用性。
健康行为的正确评估有助于促进健康生活。尽管目前多数研究依赖横向设计的定量自我报告,尤其是通过问卷调查收集数据,但随着纵向研究的重要性日益凸显,其数量也在稳步增长,为我们提供了深入理解青少年健康行为及其随时间变化的视角。一项基于大样本的队列研究调查了儿童期父母报告的心理健康问题和青少年期自我报告的心理健康问题与青少年期健康行为之间的关系,研究发现,青少年心理健康问题与不健康的生活方式选择有关,强调早期识别和干预儿童青少年心理健康问题以及培养健康行为的必要性[58]。进一步的纵向研究发现,疫情前儿童青少年的体力活动水平与疫情后抑郁症状呈负相关,而疫情前的屏幕时间则预测了疫情后抑郁症状的增加,得出体力活动与儿童青少年的心理健康有显著的关联,且屏幕时间的增加可能会加剧抑郁症状的结论[59]。Xiang Z等[60]研究了抑郁症状与体力活动参数(强度、频率和持续时间)的关联,发现中高水平的体力活动(≥1次/周,≥20 min/次)与降低抑郁症状的风险有关。此外,最新的一项对6~15岁儿童青少年进行3年的跟踪研究,发现长时间屏幕久坐行为与营养摄入存在纵向关联[61]。
青少年健康行为研究虽然依赖自我报告的调查问卷,但这些研究工具的发展已经相当成熟,尤其是在国际上。1987年Walker S N等[62]首次提出的健康促进生活方式量表(health-promoting lifestyles profile,HPLP),因其全面覆盖了多种行为习惯,而被广泛应用于不同人群的健康研究。此外,用于研究自评健康和健康相关生活质量与健康结果关系的学龄儿童健康行为量表(health behaviour in school-aged children,HBSC)[63]和青少年健康促进量表(adolescent health promotion scale,AHPS)[64]也已被证实具有良好的信效度。在中国,季成叶教授主编的《中国城市青少年健康相关行为调查问卷》是国内使用较为普遍的工具[65]。此外,一些学者根据国际量表结合中国青少年的实际情况修订了适合中国青少年的健康行为量表。如田本淳等[66]基于WHO全球学校学生健康调查(GSHS)问卷,修订了中国青少年健康行为调查问卷,以了解初中生的健康行为和保护性因素现状及其变化趋势。王梅等[67]则以WHO的HBSC问卷为基础,修订了青少年健康行为问卷。王冬等[68]则在中国台湾学者陈美燕研制的基础上,修订了中国大陆版的AHPS,该量表能够比较不同特征青少年的健康行为水平,并显示出良好的结构信度和效度。张芳芳等[69]自编的青少年生活方式问卷(Chinese adolescent lifestyles scale,CALS)也在全国范围的青少年学生中进行了应用和信效度检验。
尽管问卷调查是评估青少年健康行为的主要手段,但越来越多的研究开始采用“以个体为中心”的定性研究方法,如行为观察法、访谈法和日志法等。特别是日志法,因其能显著减少因回顾性偏差、自我概念和社会期望的影响,被认为是行为报告的“金标准”[70]。例如,Irvin R L等[71]通过2周的日志报告研究发现,健康能力较高的个体更倾向于采取健康行为。Valeriani B等[72]通过24 h饮食回顾访谈法,详细了解了儿童青少年的食物和饮料摄入量,包括类型、数量、制作方法等,以评估他们的能量摄入。Ryan F A等[73]结合访谈、观察和实地记录研究了电子时代青少年色情内容暴露的环境因素。此外,一些研究采用主观和客观测量相结合的方法来评估青少年的健康行为,尤其是在体力活动方面。Patnode C D等[74]使用自我报告和加速度计来确定美国青少年的活动相关行为类型,发现了活跃型、久坐型、低媒体/中等活动型和低媒体/功能性活动型4种行为模式。类似地,Parker K E等[75]结合主观和客观测量,识别了3种青少年的行为类型:适度运动长时间屏幕组、缺乏运动久坐组和高运动低久坐组,并发现年龄大的青少年较年龄小的青少年更倾向不活跃和久坐。这些研究展示了多种方法在评估青少年健康行为中的互补性,为未来研究提供了更全面的视角。
青少年健康行为的研究方法正在从单一传统的横向定量问卷调查向更多元化的方法发展,这种转变包括了对定性研究方法的采纳,如访谈、观察,以及对纵向研究设计的重视,旨在捕捉个体行为随时间的动态变化。此外,研究者们也在尝试结合使用主观和客观的测量工具,如生理监测设备和行为观察,以提高数据的准确性和可靠性。
健康行为的维度和范围有助于构建一个综合性的框架,以应对复杂的健康问题,并促进个体和社会层面的健康和福祉。目前,研究者们关注的青少年健康行为涵盖营养、锻炼、睡眠、卫生习惯、成瘾行为、性行为和健康责任等几个维度。早期,Donovan J E等[76]采用结构方程模型分析了中学生的健康促进行为,涵盖了使用安全带、充足睡眠、健康饮食、适量运动、减少久坐及定期刷牙等行为。Jessor R等[77]则探讨了青少年健康行为的保护因素,将定期锻炼、健康饮食、良好牙齿卫生、使用安全带和充足睡眠作为衡量青少年健康行为的标准,并强调早期养成健康行为对延缓或预防成年期主要致残和死亡原因的重要性。Torres R M R等[78]研究了个性属性(如自尊和价值观)与青少年健康行为的关系,涉及了营养、个人健康、心理健康、药物使用、安全和社会健康等多个方面的健康行为。张春晓等[79]以体育与健康课程标准为依据,构建了中学生健康行为的维度评价指标,包括锻炼习惯、情绪调控和适应能力。
明确青少年健康行为的具体范畴对于精确评估青少年的健康行为具有重要意义。He K等[80]对青少年的健康行为定义了严格和宽泛的范围,严格范围包括过去30 d内未饮酒;从未吸烟、未使用过硬性毒品、大麻、无性行为;过去12个月未尝试过自杀。宽泛范围包括过去30 d未连续饮用≥5杯,且未出现醉酒或兴奋状态;过去30 d内未使用烟草、未使用硬性毒品、未使用大麻;过去3个月未超过1个性伴侣,且坚持采取安全措施 ;过去12个月未尝试过自杀。Levin-Zamir D等[81]基于WHO的HBSC问卷,并根据情况调整确定了不同阶段青少年的健康行为范围。7、9和11年级:不吸烟、每周至少4~6次体力活动、每天校外久坐时间<4 h、使用安全带、从不参与欺凌、从不造成故意伤害、不节食、不经常吃零食、不每天喝加糖饮料;其中7、9年级还包括无性行为,11年级包括使用预防受孕和性疾病传播的方法。Frech A[82]采用国家青少年健康纵向研究数据评估了心理健康资源、社会支持和家庭特征与成年早期健康行为轨迹之间的关系,包括充足的运动和睡眠、吃早餐、保持健康的体重、不吸烟和不酗酒。Marques A等[83]调查了37个国家儿童青少年的健康行为,包括每天体力活动、每天食用水果蔬菜、每天<2 h的屏前久坐行为、从不喝酒、从不吸烟,并将5种健康行为组合起来作为健康生活方式的综合评分。Fava G A等[84]认为健康行为还应包括参与健康筛查和接种疫苗。Gautam N等[85]综述了3~18岁儿童青少年的社会经济地位与健康行为之间的关系,包括食用水果蔬菜、食用乳制品、规律早餐以及在闲暇时间参与体育锻炼。
综上,青少年健康行为维度和范围的研究强调了从多维度促进健康的重要性,包括生活习惯、心理健康和社会支持等维度,具体覆盖了营养、锻炼、卫生习惯、睡眠、成瘾行为、性行为、避孕和安全等多个方面。目前,国内关于青少年健康行为具体范围的研究相对较少,而国际上对此领域的研究则更为丰富。但全球尚未就青少年健康行为的具体范畴达成共识。这可能与研究目的、文化和社会背景、研究方法和工具、理论框架、政策需求等因素有关。
青少年健康行为是一个涉及复杂而多元的领域,其研究对于促进青少年健康发展并提升整个社会的健康水平至关重要。当前,青少年健康行为研究面临定义不统一和分类不明确的问题。国内青少年健康行为理论研究相对薄弱,且研究多以横向定量自我报告为主。健康行为的测量和评估通常依赖国际量表或自编量表,缺乏统一标准,虽然一级指标较统一,但二级指标差异显著。这些局限可能影响研究结果的一致性、干预措施的有效性评估,以及对青少年健康发展的全面促进。因此,后续研究应结合国际理论与国内实际,创新本土化模型。采用定性、定量及混合的多元研究方法深入探讨,开发标准化测量工具,提高研究准确性。基于研究结果,设计并实践验证干预措施。开展纵向跟踪研究,分析健康行为的演变和影响因素。通过跨学科合作,全面理解青少年健康行为形成机制,为我国青少年健康行为研究提供循证支持。

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doi: 10.11847/zgggws1145331
  • 接收时间:2024-07-02
  • 首发时间:2026-10-25
  • 出版时间:2025-01-10
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  • 收稿日期:2024-07-02
  • 修回日期:2024-10-27
  • 录用日期:2024-11-21
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    吉首大学体育科学学院,吉首 416000

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2种不同金属材料的力学参数
科
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属数
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genus
种数
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species
占总种数比例
Percentage of
total species (%)
属
Genus
种数
Number of
species
占总种数比例
Percentage of total
species (%)
鹅膏菌科Amanitaceae 2 11 5.26 鹅膏菌属 Amanita 10 4.78
小菇科 Mycenaceae 2 12 5.74 丝盖伞属 Inocybe 5 2.39
多孔菌科 Polyporaceae 8 14 6.70 蜡蘑属 Laccaria 5 2.39
红菇科 Russulaceae 3 23 11.00 小皮伞属 Marasmius 6 2.87
小菇属 Mycena 11 5.26
光柄菇属 Pluteus 5 2.39
红菇属 Russula 17 8.13
栓菌属 Trametes 5 2.39
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