• Xiuqin NI , Liangjia WEI , Jinyu ZHOU , Zhenyi LIANG , Yulin PEI , Fagui WU , Yuanzi NI , Jiale CHEN , Yuxin CHEN , Shengkui TAN
    Chinese Journal of School Health. 2026, 47(3): 347 -350.
    Objective

    To understand the awareness of chikungunya fever knowledge and its related factors among medical college students in Baise City, so as to provide a scientific basis to offer relevant courses and special education.

    Methods

    From July to August 2025, 7 286 enrolled medical students were selected by a sampling method from a medical college in Baise City to participate in the questionnaire survey. The questionnaire covered epidemiological characteristics, clinical symptoms, and prevention/control knowledge of chikungunya fever. Statistical analyses including the Chi-quare test and multivariate Logistic regression models were performed.

    Results

    The overall awareness rate of chikungunya fever knowledge among the medical students was 18.89%. Among the knowledge items, the awareness rate of "the high-incidence season" was the highest (84.05%), while that of "the infectious period" was the lowest (17.80%). Multivariate Logistic regression analysis showed that medical students with female (aOR=1.37, 95%CI=1.20-1.57), the age for over 25 years old (aOR=1.76, 95%CI=1.05-2.93), whose father had a middle school educational level (aOR=1.18, 95%CI=1.05-1.31), and majored in preventive medicine (aOR=1.54, 95%CI=1.10-1.67) had relatively higher awareness rates of chikungunya fever knowledge (all P < 0.05). In contrast, students of Zhuang ethnicity (aOR=0.87, 95%CI=0.76-0.98) and majoring in nursing (aOR=0.74, 95%CI=0.61-0.91) or pharmacy (aOR=0.70, 95%CI=0.52-0.95) had relatively lower awareness rates (all P < 0.05).

    Conclusions

    The awareness rate of chikungunya fever-related knowledge among medical college students in Baise City is relatively low. Schools should take targeted publicity measures to improve medical students' awareness.

  • Susu TIAN , Xinyi HU , Yuxuan LIU , Jiayi TIAN , Yingxue WANG , Yihan WANG , Wei WANG
    Chinese Journal of School Health. 2026, 47(3): 365 -368.
    Objective

    To revise and validate the reliability and validity of Chinese version of the Benevolent Childhood Experiences (BCEs) Scale among college students, so as to provide a scientific and reliable assessment tool for related research.

    Methods

    From April to June 2025, a stratified cluster random sampling method was used to select 1 677 freshmen from a university in Xuzhou City as participants.The survey was conducted by using the revised Benevolent Childhood Experiences (BCEs) Scale, Childhood Trauma Questionnaire (CTQ) and Brief Suicidal Behavior Scale.Reliability analysis, exploratory factor analysis (EFA), confirmatory factor analysis (CFA), Spearman correlation analysis, and hierarchical linear regression analysis were employed to evaluate the scale's reliability, validity, and relationships among variables.

    Results

    The mean scores of the 10 items on the BCEs Scale ranged from 3.97 to 4.46, with standard deviations ranging from 0.88 to 1.07.The Cronbach α coefficient was 0.96.Exploratory factor analysis extracted a single factor, explaining 71.21% of the total variance.Confirmatory factor analysis indicated good model fit (χ2/df=4.81, goodness of fit index=0.99, comparative fit index=0.99, normed fit index=0.99, root mean square error of approximation=0.05, standardized root mean square residual=0.01).BCEs total scores were negatively correlated with CTQ total scores and all its dimensions among college students (r=-0.53 to-0.13, all P < 0.01).Hierarchical regression analysis showed that BCEs moderated the effect of CTQ on suicidal behavior, with a statistically significant interaction (β=-0.11, t=-4.01, P < 0.01).

    Conclusion

    The Chinese revised version of the BCEs Scale demonstrates good reliability and validity, and it is suitable for assessing BCEs among Chinese college students.

  • Xin HU , Wenbin WANG , Wei CAO , Hongliang WANG , Mulei CHEN , Yao LIU , Titi YANG , Hui PAN , Ruihe LUO , Jianfen ZHANG , Qian ZHANG , Juan XU
    Chinese Journal of School Health. 2026, 47(3): 327 -331.
    Objective

    To investigate the prevalence of undernutrition and its associated factors among left-behind and non-left-behind primary and secondary school students in the Nutrition Improvement Program for Rural Compulsory Education Students (NIPRCES) areas of central and western China, so as to provide evidence for improving the nutritional status of children and adolescents.

    Methods

    A survey was conducted among 123 782 students selected by random cluster sampling method in grades 3-9 from NIPRCES in central (Hebei, Shanxi, Heilongjiang, Jilin, Anhui, Jiangxi, Henan, Hunan, Hubei, and Hainan) and western (Gansu, Guangxi, Inner Mongolia, Ningxia, Tibet, Shaanxi, Guizhou, Sichuan, Xinjiang, the Xinjiang Production and Construction Corps, Yunnan, Qinghai, and Chongqing) China in 2023. Anthropometric measurements and questionnaires were used to assess nutritional and dietary status. The prevalence of undernutrition was compared between left-behind and non-left-behind students by Chi-square test, and associated factors were analyzed by three-level Logistic mixed effects model.

    Results

    The prevalence of undernutrition was 8.5% (4 326) in left-behind students and 8.1% (5 905) in non-left-behind students. Three-level Logistic mixed-effect model analysis showed that whether left-behind or non-left-behind, the undernutrition rates of primary and secondary students in western regions were higher than those of students in central regions [OR(95%CI)=1.72(1.57-1.87), 2.25(2.07-2.43)]; the undernutrition risk was lower for those whose fathers had a cultural level of high school or above [OR(95%CI)=0.69(0.62-0.77), 0.90(0.82-0.98)] or junior high school [OR(95%CI)=0.72(0.66-0.79), 0.92(0.85-0.99)] compared to those with primary school or below; picky eating or selective eating increased the risk of undernutrition [OR(95%CI)=2.36(2.07-2.68), 2.28(2.04-2.55)], and primary and secondary school students without nutritional content in health education classes had higher rates of undernutrition [OR(95%CI)=1.12(1.03-1.23), 1.09(1.01-1.17)](all P < 0.05).

    Conclusion

    The prevalence of undernutrition is slightly higher in left-behind primary and secondary students than in non-left-behind primary and secondary students in central and western NIPRCES areas, with variations across different characteristics.

  • Jinyi WU , Wanzhu ZHANG , Wenxin ZHAO , Ying GAO , Xiwen DENG , Meiqi XIONG , Jingjing LU
    Chinese Journal of School Health. 2026, 47(3): 360 -364.
    Objective

    To explore the latent profile characteristics of regulatory emotional self-efficacy and its relationship with non-suicidal self-injurious (NSSI) behavior among junior and senior high school students, so as to provide a basis for effectively reducing NSSI behaviors.

    Methods

    From April to October 2023, a total of 1 217 junior and senior high school students were selected from Tongren City, Zunyi City and Qiannan Prefecture of Guizhou Province by stratified cluster random sampling method.The Scale of Regulatory Emotional Self-efficacy and the Adolescent Self-injury Scale were administered.Latent profile analysis (LPA) was employed to explore distinct profiles of regulatory emotional self-efficacy, and the Lanza, Tan, and Bray's method (LTB) was used to analyze the relationship between these profiles and NSSI behavior.

    Results

    The prevalence rate of NSSI behavior among junior and senior high school students was 28.6%.Among males, regulatory emotional self-efficacy was categorized into two types: moderate positive expression-low negative management group (59.1%, n=353) and high-efficacy group (40.9%, n=244);among females, regulatory emotional self-efficacy was classified into three categories: low-efficacy group (18.4%, n=114), high positive expression-low negative management group (56.3%, n=349), and high-efficacy group (25.3%, n=157).There were statistically significant differences in total NSSI scores across different potential categories of regulatory emotional self-efficacy within both males and females (Z/H=-5.75, 57.58, both P < 0.01).The differences in NSSI prevalence rates across the potential categories of regulatory emotional self-efficacy were statistically significant for both males and females (χ2=38.00, 69.14, both P < 0.01), and among females, the differences in NSSI prevalence rates between the high-efficacy group and the low-efficacy group (χ2=60.01) and between the high-efficacy group and the high positive expression-low negative management group (χ2=31.34) were also statistically significant (both P < 0.016 7).Binary Logistic regression analysis revealed that, compared with the high-efficacy group within each gender, the moderate positive expression-low negative management group among males (OR=2.36), and both the low-efficacy group and the high positive expression-low negative management group among females (OR=6.19, 2.97), were at an increased risk of engaging in NSSI (all P < 0.01).

    Conclusion

    Different latent profiles of regulatory emotional self-efficacy among junior and senior high school students are associated with NSSI behavior.

  • Wuyue YANG , Jianping PAN , Xiaomei XIANG , Ning DONG , Xuan XI
    Chinese Journal of School Health. 2026, 47(3): 374 -378.
    Objective

    To understand the current status of neglect among rural preschool children in Xi'an under the multi-child policy and the association with family characteristics, so as to provide a reference for preventing and reducing the occurrence of child neglect.

    Methods

    A total of 7 052 parents of preschool children were selected using stratified cluster sampling across 9 suburban counties/districts in Xi'an from March to April 2025.A questionnaire survey was administered using the Chinese Norm Scale for Neglect Assessment of Rural (Preschool) Children Aged 3-6.The t-test, Chi-quare test, and analysis of variance (ANOVA) were used for inter-group comparisons.

    Results

    The overall prevalence rate and mean score of neglect among rural preschool-aged children in Xi'an were 32.4% and 38.27±6.70, respectively.Statistically significant differences were detected in neglect rates and neglect degrees among preschool children of different genders and grade levels (χ2=30.41, 15.15, t/F=4.92, 7.03, all P < 0.05).Statistically significant differences were also detected in neglect rates and neglect degrees among preschool children from whether only one-child, different family structures, numbers of children in a family and families with different annual incomes (χ2=29.22, 10.41, 31.99, 186.47, t/F=-9.96, 5.50, 33.57, 68.63, all P < 0.05).In multi-child families, there was a statistically significant difference in neglect degree among children with different birth orders (F=4.25, P < 0.05), but there was no statistically significant difference in neglect rate (χ2=5.73, P>0.05).Among all subgroups, the highest neglect rates and neglect degrees were observed in children from multi-child families (35.0%, 39.00±6.71), other family types (50.0%, 42.38±12.34) and families with three children (39.9%, 39.50±7.43).Lower annual family income was associated with higher neglect rates and neglect degrees among preschool children (χtrend2=186.47, F=270.68, both P < 0.05).

    Conclusions

    Under the multiple-child policy, the neglect of preschool children in rural areas of Xi'an is quite severe, particularly in families with multiple children and low-income households.Targeted interventions should be implemented for high-risk groups.

  • Qian SUN , Cui LI , Guangfu ZHAI , Fen LU , Guangbo QU
    Chinese Journal of School Health. 2026, 47(3): 319 -322.
    Objective

    To explore the association between dietary inflammatory index (DII) and elevated blood pressure among primary school students, and to analyze the mediating role of body mass index (BMI) in this association, so as to provide a scientific basis for the early prevention of childhood hypertension and dietary guidance.

    Methods

    Research conducted based on the Ma'anshan Child Growth Cohort in Anhui Province. From April to June 2024, 4 057 primary school students were selected as study subjects using a multi-stage cluster sampling method. Dietary information was collected via Semi-quantitative Food Frequency Questionnaire to calculate the DII score. BMI was obtained by measuring students' height and weight. Elevated blood pressure was defined based on the Blood Pressure Reference Standards for Children Aged 3-17 Years. Logistic regression was used to analyze the association between DII scores and the risk of elevated blood pressure, and the Bootstrap method was employed to test for mediating effects.

    Results

    The detection rate of elevated blood pressure among primary school students was 10.1% (408 cases). Multivariate Logistic regression analysis showed that, after adjusting for covariates such as gender and age, for each standard deviation increase in the DII score (s=1.94), the risk of elevated blood pressure increased by 15% (OR=1.15, 95%CI=1.04-1.28, P < 0.05). Compared with the lowest quartile group of DII scores (Q1), students in the highest quartile group (Q4) had a 1.31-fold higher risk of elevated blood pressure (OR=1.31, 95%CI=1.00-1.76, P < 0.05). Restricted cubic spline results indicated a linear dose-response relationship between DII scores and the risk of elevated blood pressure(Pnonlinear=0.13). The mediation analysis revealed that BMI played a partial mediating role in the association between DII scores and elevated blood pressure. The mediation effect value was 0.06 (95%CI=0.04-0.08), accounting for 44.64% of the total effect.

    Conclusions

    DII scores are associated with elevated blood pressure among primary school students in Ma'anshan City, and BMI plays a partial mediating role in this association. Promoting an anti-inflammatory dietary pattern and weight control in early childhood should be emphasized to reduce the incidence of hypertension among primary school students.

  • Tingjun CHEN , Hui HU , Zidi NING , Ye ZHANG , Ruoyu LU , Xiaoman WANG , Anda ZHAO , Zeyu WANG , Jinzhe LI , Yaping REN , Jiajun YUAN , Ying SUN , Pinqing BAI , Shenghui LI
    Chinese Journal of School Health. 2026, 47(3): 408 -412.
    Objective

    To characterize longitudinal trajectories of testicular development in boys and breast development in girls, so as to provide reference data for understanding patterns of pubertal sexual maturation.

    Methods

    Based on the Shanghai Pudong New Area Cohort Study on Growth, Development and Health in Children and Adolescents, a baseline survey was conducted in 2020 using a mult-stage cluster random sampling method. A total of 2 184 children who completed all follow-ups during the primary school period from 13 elementary schools in Pudong New Area, Shanghai, with annual follow-ups during 2021-2025. Testicular volume and Tanner stage of breast development were assessed by professional physicians using standardized visual inspection and palpation. The age distribution of testicular volume and breast development was fitted by using cumulative link mixed models and Turnbull's nonparametric maximum likelihood estimation method.

    Results

    Median ages for testicular volumes of 2, 3, 4 and 5 mL in boys were 7.07, 9.24, 10.29, and 11.57 years old, respectively. Median ages for Tanner breast stages Ⅱ, Ⅲ, Ⅳ, and Ⅴ in girls were 8.55, 10.17, 11.18, and 13.78 years old, respectively. Based on overweight and obesity, stratified analysis showed that earlier pubertal onset among overweight/obesity children, and the key milestones for pubertal initiation were testicular volume reaching 4 mL in boys and breast Tanner Ⅱ in girls for 10.29, 10.83; 8.18, 9.00 years.

    Conclusion

    Overweight and obesity are associated with earlier pubertal initiation, but there are certain gender and developmental stage-specific patterns.

  • Xuelian SUN , Tingting LI , Shuman TAO , Yang XIE , Yajuan YANG , Liwei ZOU , Fangbiao TAO , Xiaoyan WU
    Chinese Journal of School Health. 2026, 47(3): 369 -373.
    Objective

    To determine the association between exposure to entertainment screen content on mobile phones and symptoms of anxiety-depression co-morbidity among college students, so as to provide evidence for mental health interventions.

    Methods

    A baseline survey was conducted from April to May 2019.A total of 1 135 college students were selected from one university each in Shangrao City, Jiangxi Province and Hefei City, Anhui Province using cluster random sampling method.A follow-up study was conducted in November 2019, resulting in 1 110 matched valid responses.Self-rating questionnaires were used to assess the exposure of entertainment screen content.The Depression Anxiety Stress Scale-21(DASS-21) and the Patient Health Questionnaire-9(PHQ-9) were used to evaluate the anxiety symptoms, depressive symptoms, and symptoms of anxiety-depression co-morbidity among college students.A multivariate binary Logistic regression model was constructed following initial intergroup comparisons with Chi-square test to determine the association between baseline exposure to mobile entertainment screen content and the risk of symptoms of anxiety-depression co-morbidity at baseline and the 6-month follow-up.

    Results

    The prevalence rates of symptoms of anxiety-depression co-morbidity among college students were 25.4% and 20.6% at baseline and follow-up, respectively.After adjusting for confounding factors such as gender, self-rated family economic status and self-rated health status, the results of multivariate binary Logistic regression analysis showed that compared with the appropriate exposure level group, the exposure of entertainment screen content on mobile phones at baseline, including frequent exposure to reading (OR=1.65, 95%CI=1.14-2.39), occasional exposure to other entertainment screen content (OR=1.46, 95%CI=1.01-2.10) and frequent exposure to other entertainment screen content (OR=1.76, 95%CI=1.20-2.60), increased the co-occurrence risk of symptoms of anxiety-depression co-morbidity among college students during the follow-up period (all P < 0.05).

    Conclusion

    Occasional or frequert exposure to mobile entertainment screen content can increase the risk of symptoms of anxiety-depression co-morbidity among college students.

  • Chu'an ZHANG , Lei WEN , Jinmei FU , Zhiyu ZHANG , Shuna ZHANG , Xinghui WEN , Guanggao ZHAO
    Chinese Journal of School Health. 2026, 47(3): 413 -416.
    Objective

    To investigate the relationship between 24-hour activity behaviors and fine motor development in preschool children, and to simulate the effects of reallocating time among different activity behaviors on fine motor development using isotemporal substitution analysis.

    Methods

    From March to July 2022, a stratified cluster random sampling method was used to recruit 447 preschool children aged 3-6 years (254 boys and 193 girls) from Pingxiang City, Jiangxi Province. The 24-hour activity behaviors in preschool children were measured using ActiGraph wGT3-BT accelerometers and subjective sleep reports. Fine motor development was assessed using the Gesell Developmental Schedules. A component linear regression model was employed to analyze the impact of 24-hour activity behaviors on the development of fine motor activities, and the potential effects of adjusting activity behaviors were simulated through an isochoric substitution model.

    Results

    The daily durations of sedentary behavior (SB) was (572.92±102.96) min (accounting for 39.79% of 24 h), the duration of light physical activity (LPA) was (131.21±38.11) min (9.11%), the duration of moderate-to-vigorous physical activity (MVPA) was (65.61±22.21) min (4.56%), and sleep duration was (670.65±57.58) min (46.82%). Sleep composition was positively associated with fine motor development (β=2.74), while MVPA (β=-0.84) and SB (β=-1.93) compositions were negatively associated with fine motor development (all P < 0.01). Isochoric substitution analysis showed that sleep had positive effects on the development of fine motor skills when replacing other activity behaviors (all P < 0.05), with the substitution effect for MVPA being the most significant and gradually increasing with the duration of substitution (60 min: β=28.66); sleep replacement of SB and LPA also showed positive effects (60 min: β=4.25, 2.00) (all P < 0.05). On the contrary, the substitution of sleep with MVPA showed negative effects (60 min: β=-7.86), and the substitution of LPA and SB with MVPA also showed negative effects (60 min: β=-5.65, -3.40) (all P < 0.05).

    Conclusions

    The overall composition of 24-hour activity behaviors is associated with fine motor development in preschool children, with sleep playing a crucial role. Ensuring adequate sleep and optimizing the structure of activity behaviors may effectively promote the development of fine motor skills in preschool children.

  • Qu LU , Manman CHEN , Jiahui WANG , Yu JIANG , Fang GU , Bin DONG
    Chinese Journal of School Health. 2026, 47(3): 355 -359.
    Objective

    To analyze the associations of physical activity with overweight/obesity, depressive symptoms, and their co-occurrence among junior and senior high school students, so as to provide reference for optimizing physical activity intervention strategies and promoting healthy lifestyles.

    Methods

    From March to November 2023, a cross-sectional survey was conducted among 90 457 junior and senior high school students aged 11-18 years in Zhejiang Province using a stratified cluster random sampling method.Data on physical activity and dietary behavior were collected through questionnaires, height and weight were measured.Depressive symptoms were assessed using the Center for Epidemiologic Studies Depression Scale (CES-D).The Chi-square test was used to examine differences, and Logistic regression was applied to evaluate the associations of physical activity characteristics with overweight/obesity, depressive symptoms, and their co-occurrence.Additionally, the effectiveness of physical activity performed on rest days versus work days was examined.

    Results

    The prevalence of overweight/obesity, depressive symptoms, and their co-occurrence among junior and senior high school students were 25.1%, 27.9%, and 6.7%, respectively, with significant sex differences (χ2=2 005.3, 587.7, 99.6, all P < 0.01).Logistic regression analysis showed that students with insufficient physical activity had a higher risk of overweight/obesity compared with those with sufficient physical activity (OR=1.12, 95%CI=1.06-1.17, P < 0.01).Comparing to students who exercised 0-1 day per week, those who exercised 5-7 days per week were associated with a reduced risk of overweight/obesity and depressive symptoms (OR=0.93, 95%CI=0.90-0.97;OR=0.95, 95%CI=0.91-0.99, both P < 0.05).When total activity volume and frequency were held constant, students with sufficient rest-day physical activity had lower risks of overweight/obesity, depressive symptoms, and their co-occurrence than those with insufficient rest-day activity (all P < 0.01).

    Conclusions

    Sufficient amount of physical activity and higher frequency of rest-day physical activity are significantly associated with lower risks of overweight/obesity, depressive symptoms, and their co-occurrence in adolescents.Physical activity performed on rest days may confer greater health benefits than activity performed on work days.

More