To develop the Adolescent Peer Bullying Knowledge-Attitude-Practice (KAP) Questionnaire and to evaluate its reliability and validity, so as to provide an effective tool for evaluating the KAP level regarding peer bullying among adolescents.

A preliminary framework was developed through literature review, expert consultation, and group discussions. In September 2024, 2 203 students in grades 7 to 9 from two regular junior high schools in Anhui Province were selected using cluster sampling for a preliminary survey aimed at questionnaire development, including item screening and reliability and validity testing.

The initial KAP questionnaire on adolescent peer bullying consisted of 25 items: two items, "Behavior 6" and "Behavior 7", were excluded as their correlation coefficients with the total KAP score being only 0.08 and 0.05, respectively, falling below the preset criteria(0.4). The final questionnaire comprised 23 items, divided into three dimensions: knowledge, attitude, and behavior. Reliability testing showed that the overall Cronbach α coefficient of the questionnaire was 0.89, with Cronbach α coefficients for the knowledge, attitude, and behavior dimensions being 0.91, 0.67 and 0.79, respectively. The overall split-half reliability of the questionnaire was 0.87, with split-half reliabilities for the knowledge, attitude, and behavior dimensions being 0.82, 0.64, and 0.66, respectively. Test-retest reliability ranged from 0.82 to 0.97. Confirmatory factor analysis results indicated that the questionnaire had RMSEA=0.062, NFI=0.924, CFI=0.931, with good discriminant validity.

The developed KAP questionnaire on adolescent peer bullying demonstrates good reliability and validity and can be used as an assessment tool for evaluating the KAP level regarding peer bullying among adolescents.

To evaluate the effectiveness of a family-school-community integrated intervention based on the microsystem theory in reducing peer bullying among junior high school students, so as to provide empirical evidence and feasible pathways for junior high school students bullying prevention and control in China.

A combining convenience with clustering method was employed to select 6 268 students from three regular junior high schools in Fuyang and Anqing cities, Anhui Province, as the study subjects in October 2024, and randomly assigned by drawing lots to three groups: family-school-community integrated intervention (n=2 063), school-only intervention (n=1 864), and control group (n=2 341). From October 10, 2024, to January 10, 2025, the intervention was implemented for three months using posters, brochures, and videos, with one session every half month, each lasting 40 minutes. The family-school-community integrated intervention group received multi-level interventions involving families, schools, and communities, while the school-only intervention group received only school-based interventions. The control group received routine school health education but no other interventions. Before and after the intervention, data on peer bullying among junior high school students were collected using the Peer Bullying Scale, and comparison of detection rate of peer bullying by Chi-square test.

After the intervention, group comparison results showed that the incidence rates of various types of peer bullying in the family-school-community integrated intervention group, the school-only intervention group, and the control group all showed statistically significant differences (χ²=28.61-66.85, all P < 0.05). The detection rates of verbal bullying (7.51%), relational bullying (5.62%), physical bullying (3.34%), cyberbullying (1.75%), being bullied (10.81%), verbal bullying others (2.67%), relational bullying others (1.55%), physical bullying others (1.36%), cyberbullying others (1.41%), and overall peer bullying (3.64%) in the family-school-community integrated intervention group were all lower than those in the control group (12.52%, 11.58%, 6.24%, 5.00%, 19.14%, 7.56%, 4.49%, 4.53%, 3.80%, 9.40%); additionally, the detection rates of verbal bullying others, overall peer bullying, verbal bullying, and being bullied, in the family-school-community integrated intervention group were all lower than those in the school-only intervention group (4.67%, 6.65%, 13.14%, 16.42%), with statistically significant differences (χ²=30.04, 48.49, 19.75, 34.60, 58.89, 52.65, 31.32, 37.37, 24.14, 58.26; 11.25, 18.53, 33.93, 26.41, all P < 0.016 7). Group comparison showed that in both intervention groups, the majority of peer bullying behaviors decreased after the intervention (χ²=4.86-171.01, all P < 0.05).

The family-school-community integrated intervention based on the microsystem can effectively reduce peer bullying among junior high school students, with better efficacy than the single-school intervention. The model can serve as a practical reference for establishing a multi-level prevention and intervention system for junior high school students bullying in China.

To examine the associations between peer bullying and parental phubbing with executive function and their combined effect among primary and secondary school students, so as to provide scientific evidence for promoting healthy development of executive function among primary and secondary school students.

In November 2024, a combining convenience with clustering method was used to select 3 547 primary and secondary school students in Shenzhen City. The Chinese versions of the Delaware Bullying Victimization Scale-Student (DBVS-S), the Parental Phubbing Scale (PPS), and the Teenage Executive Functioning Inventory (TEXI) were used to assess peer bullying, parental phubbing, and executive function, respectively. Generalized linear regression models were applied to analyze the associations of peer bullying and parental phubbing with executive function, and to assess their joint effects. Subgroup analyses were performed by ages and genders, and multiplicative interaction terms were used to test for interactions.

The score for peer bullying among primary and secondary school students was (15.27±5.67), with verbal bullying, physical bullying, and relational bullying scores being (5.64±2.77) (4.70±1.62) (4.93±2.07), respectively. The score for parental phubbing was (13.98±5.00). Executive function score was (47.35±15.89), while inhibitory control and working memory scores were (26.44±9.00) (20.91±7.49), respectively. After adjusting for confounding factors such as age, gender, self-reported family relationship, self-reported family economic status, parental education level, both peer bullying (β=0.75, 95%CI=0.67-0.84), verbal bullying(β=1.41, 95%CI=1.23-1.58), physical bullying (β=2.18, 95%CI=1.87-2.49), relational bullying (β=1.78, 95%CI=1.54-2.01) and parental phubbing (β=0.88, 95%CI=0.79-0.98) were significantly positively associated with the degree of executive function impairment (all P < 0.01). Joint effect analysis showed that, compared with the "no bullying-low phubbing" group, the total executive function scores in other combined exposure groups were all higher (β=6.78-15.96, all P < 0.01). Among them, the "bullying-high phubbing" group exhibited the highest level of executive function impairment (β=14.17, 95%CI=12.61-15.73, P < 0.01). Subgroup analysis indicated significant interactions between verbal bullying and age on total executive function, inhibitory control, and working memory (all P_interaction < 0.01). The association of verbal bullying with executive function was slightly higher in primary and secondary school students younger than 13 years (β=1.80, 95%CI=1.45-2.16) than in those aged 13 years or older (β=1.25, 95%CI=1.05-1.45) (both P < 0.01). Other types of bullying and parental phone neglect showed no statistically significant interaction with age or gender in executive function, inhibitory control, and working memory(all P_interaction>0.05).

Both peer bullying and parental phubbing are significantly associated with impaired executive function among primary and secondary school students, and there is a combined effect between them; among these, the association between verbal bullying and executive function impairment in younger primary and secondary school students is more pronounced.

To understand the association between beverage and snack intake and insufficient serum 25 hydroxyvitamin D [25(OH)D] among primary and secondary school students, so as to provide a scientific basis for targeted intervention measures.

From October to December 2021, a stratified random sampling method was used to select 2 477 primary and secondary school students aged 8 to 15 years old from 9 counties in Yunnan Province implemented the Nutrition Improvement Plan for Rural Compulsory Education Students. The intake of beverages and snacks was investigated using the Rural Student Nutrition Monitoring Questionnaire from Chinese Center for Disease Control and Prevention. The snack intake intensity was calculated and classified into no intake, extremely low, low, medium, and high intensity. Serum 25(OH)D levels were measured in the laboratory, and levels < 20 ng/mL were defined as insufficient. Chi-square tests, LASSO regression, random forest and binary Logistic regression were used to analyze the association between 20 types of beverages and snacks and serum 25(OH)D insufficiency.

Insufficient serum 25(OH)D was detected in 564 boys (45.9%) and 855 girls (68.5%), with a total of 1 419 cases (57.3%). Binary Logistic regression results showed that extremely low intake intensity of carbonated beverages (OR=1.51), plant protein beverages (OR=1.61), and milk tea beverages (OR=1.39) increased the risk of insufficient serum 25(OH)D, while protective factors were fruits and vegetables (OR=0.77) and pure milk and yogurt (OR=0.74) (all P < 0.05). Subgroup analysis showed that extremely low intake intensity of carbonated beverages, milk-containing beverages, tea beverages, fruit and vegetable juices, and plant protein beverages increased the risk of insufficient serum 25(OH)D in girls (OR=2.22, 1.72, 1.67, 1.74, 1.92), and high intake intensity increased the risk of insufficient serum 25(OH)D in boys (OR=1.73, 1.48, 1.52, 1.49, 1.97) (all P < 0.05). Extremely low intake intensity of carbonated beverages, plant protein beverages, and milk tea beverages in junior high school students (OR=1.92, 2.54, 1.68) and low intake intensity in primary school students (OR=1.40, 1.33, 1.45) increased the risk of insufficient serum 25(OH)D (all P < 0.05).

Frequent intake of beverages and highly processed snacks increases the risk of insufficient serum 25(OH)D in primary and secondary school students, while natural foods such as fruits, vegetables, pure milk and yogurt can reduce the risk. Girls and junior high school students are more susceptible to these effects.

To understand the current status of tuberculosis prevention and control knowledge and perceived stress among college and middle school students with pulmonary tuberculosis (PTB) in Yantai City, and to analyze the related factors, so as to provide a basis for the school to carry out health education and psychological counseling.

A matched case-control study was conducted, with 100 PTB student patients in junior high school and above who were diagnosed at designated medical institutions from October 2020 to October 2024. Four healthy control students of the same gender, same dormitory, or same class were selected for each case. Therefore, 100 cases and 400 controls were investigated by questionnaire. The following information was collected: personal basic information; tuberculosis prevention and control awareness; and scores of the Chinese Perceived Stress Scale (CPSS). Conditional Logistic regression model and mixed linear models were used to compare the PTB prevention and control awareness rate, as well as the perceived stress between the case and control groups. Multiple linear regression analysis was used to analyze the factors that may affect the perceived stress of students with PTB.

The awareness rates of four tuberculosis knowledge items (symptoms of PTB, main causes of onset after infection, consequences of PTB patients not receiving standardized and complete treatment, the most important method to prevent PTB) were higher in the case group (40.00%, 72.00%, 38.00%, 49.00%) than the control group (21.50%, 57.50%, 22.25%, 31.25%) and the differences were statistically significant (Wald χ²=18.44, 8.78, 13.20, 16.89, all P < 0.01). The tension score (10.49±4.20), loss of control score (11.21±4.58), and total score (21.70±6.88) in the case group were higher than the control group (9.35±4.73, 9.75±5.60, 19.09±8.36) and the differences were statistically significant (t=2.21, 2.42, 2.88, all P < 0.05). The results of multiple linear regression analysis showed that age ≥18 years and family history of tuberculosis were the related factors affecting the overall perceived stress and tension of college and middle school students with PTB (B_{total scores}=4.50, 5.91; B_{tension score}=2.39, 3.23, all P < 0.05).

The tuberculosis prevention and control awareness rate, and the perceived stress of college and middle school students with PTB in Yantai are both higher than students without tuberculosis. Moreover, the perceived stress of students with PTB who are aged ≥18 years or have a family history of tuberculosis is even higher.

To explore the network structure of dietary intake and physical fitness subtypes among junior and senior high school students, so as to provide precise and efficient intervention guidance for improving abnormal physical health issues in adolescents.

Based on the 2020-2021 Database of Youth Health (DYH), a total of 9 730 junior and senior high school students in Shandong Province were included for analysis. Dietary intake was assessed using a modified Chinese Dietary Quality Questionnaire, and physical fitness was evaluated according to the "2014 National Student Physical Fitness Standard". The K-means clustering algorithm was employed to identify potential subtypes of physical fitness in junior and high school students. Network analysis was used to construct a network linking dietary intake and physical fitness symptoms and to identify clusters of dietary behaviors and physical fitness symptoms among adolescents of different genders.

The physical fitness among junior and senior high school students of different genders were categorized into two subtypes: the baseline steady type (3 427 male students, 4 039 female students) and the morphological deviation type (1 294 male students, 970 female students). Statistically significant differences were observed in network strength and network connectivity strength among different genders and physical fitness subtypes (all P < 0.05). Connections between food intake and physical health symptom clusters across different genders and physical health types among junior and senior high school students were primarily achieved through instant noodle intake and physical fitness (males of morphological deviation type, weight=0.06), fruit intake and physical fitness (males of baseline steady type, weight=-0.07), potato intake and vital capacity (females of morphological deviation type, weight=0.09), and processed meat intake and vital capacity (females of baseline steady type, weight=0.05).

Dietary intake serves as a significant modifiable risk factor for the physical fitness of junior and high school students. Interventions should focus on promoting healthy eating habits.

To explore the intervention effects of high-intensity interval training (HIIT) on glucose metabolism, cortisol (Cor), and sleep quality among college students with comorbid depressive symptoms and obesity, so as to provide a reference for improving sleep quality among college students with comorbid depressive symptoms and obesity.

In March 2023, 45 college students with comorbid depressive symptoms and obesity were recruited and randomly assigned to an exercise group (n=23) and a control group (n=22) by random number table method. The exercise group received HIIT intervention for 12 weeks, three times a week, while the control group received no intervention. Blood samples were collected from participants to measure fasting insulin (FINS), fasting blood glucose (FBG), homeostatic model assessment of insulin resistance (HOMA-IR), Cor, and Pittsburgh Sleep Quality Index (PSQI) before and after intervention. Statistical analysis was performed using t-test, repeated measures analysis of variance (ANOVA), simple effect analysis.

The repeated measures ANOVA revealed statistically significant time×group interaction effects for body composition (weight, body mass index, percentage of body fat, fat mass, waist-to-hip ratio), depressive symptoms, PSQI scores and its sub-dimensions (subjective sleep quality, sleep onset time, sleep efficiency, sleep disorders, daytime dysfunction), as well as FBG, FINS, and HOMA-IR between the exercise group and control group before and after intervention (F=7.10-53.38, all P < 0.05). Simple effect analysis showed that compared to the control group, the exercise group demonstrated significant improvements in body composition (body mass index, fat mass, waist-to-hip ratio), depressive symptoms, PSQI scores and its sub-dimensions (subjective sleep quality, sleep onset time, sleep efficiency, sleep disorders, daytime dysfunction), FBG, FINS, HOMA-IR, and Cor (all P < 0.05).

HIIT can improve the sleep quality of college students with comorbid depressive symptoms and obesity by enhancing glucose metabolism and regulating Cor levels.

To investigate the association between emotional intelligence and sleep problems at the symptom level among junior and senior high school students, so as to provide new insights for interventions targeting junior and senior high school students sleep disorders.

From November 2023 to May 2024, a stratified cluster random sampling method was employed to select 3 531 first-year junior high school and first-year senior high school students from 6 schools in Guangyuan City and Liangshan Yi Autonomous Prefecture in Sichuan Province, as well as Lhasa City in Tibet Autonomous Region. The Insomnia Severity Index Scale and the Wong and Law Emotional Intelligence Scale(WLEIS) were used to assess sleep problems and emotional intelligence. A network analysis was performed to explore the relationship between emotional intelligence and sleep disorders, and a gender-based network comparison analysis was conducted.

The reported rate of sleep problems among junior and senior high school students was 47.3%, with severe sleep problems of 2.2%. Difficulty maintaining sleep, worry about sleep, and emotional application were the core symptoms in the network (node strength values: 1.11, 0.98, and 0.82, respectively). Dissatisfaction with sleep and emotional application served as bridge symptoms connecting emotional intelligence and sleep problems (bridge strength values: 1.77 and 1.59, respectively). The edge weights of the emotional intelligence and sleep problems network differed significantly between genders (maximum difference in edge weight values was 0.13, P < 0.05).

Emotional application ability and dissatisfaction with sleep are the key nodes in the network connecting emotional intelligence and sleep problems. Targeted efforts to enhance emotional application ability may effectively reduce the risk of sleep problems among junior and senior high school students.