To develop and validate a health literacy assessment scale for junior high school students, providing an effective tool for evaluating and monitoring health literacy among Chinese adolescents.

Based on school health education policy documents, a health literacy assessment framework was constructed, comprising five horizontal and four vertical dimensions. From May to June and August to September in 2024, the framework was refined through Delphi expert consultations and focus group discussions, leading to the development of the Health Literacy Assessment Scale for Junior High School Students. In September 2024, a convenience sample of 625 students from three junior high schools in Beijing and Tianjin completed the questionnaire. Item analysis, reliability, and validity tests were conducted to evaluate the scale.

The recovery rate for two rounds of expert consultation questionnaires was 100%. The expert authority coefficients (Cr) were 0.86 and 0.87 respectively (both >0.70), with Kendall W values of 0.34 and 0.27 (P < 0.05). The focus group discussions followed a rigorous structure, and after multiple rounds of item screening and revision, the version 3.0 of the junior high school students' health literacy assessment scale was developed, comprising 57 items. Three items that failed to meet the comprehensive screening criteria were preliminarily removed, and the final scale contained 54 items. The scale demonstrated excellent reliability, with an overall Cronbach's α coefficient of 0.92 and split-half reliability of 0.93. Confirmatory factor analysis [χ²/df=2.094, root mean square error of approximation (RMSEA)=0.042, comparative fit index (CFI)=0.911, Tucker Lewis index (TLI)=0.907] indicated good model fit indices.

The preliminary development of the health literacy assessment scale for junior high school students follows a rigorous item screening process with well-designed dimensions, demonstrating good reliability and validity, thus serving as an appropriate evaluation tool for adolescent health literacy.

To explore the network structure of eating behaviors with anxiety, depression and perceived stress in adolescents, so as to provide a basis for effective prevention and intervention of eating behavior problems and negative emotions in adolescents.

Based on the Psychology and Behavior Investigation of Chinese Residents (2021) database, the study was conducted among 3 087 adolescents. Sakata Eating Behavior Scale Short From(EBS-SF) was used to investigate their eating behaviors. The Patient Health Questionnaire-9(PHQ-9), Generalized Anxiety Disorder Scale-7 Item(GAD-7), and Perceived Stress Questionnaire-3 Item (PSQ-3) were used to evaluate their depression, anxiety and perceived stress. Network analysis method was applied to construct a network of eating behaviors and negative emotional symptoms among adolescents, so as to evaluate the centrality, bridge strength, stability and accuracy of each item.

The total scores of eating behaviors, depression, anxiety and stress perception in adolescents were 17.41±4.53, 6.95±6.08, 4.86±5.03, 9.34±3.80, respectively. The symptom with the highest intensity and expected impact was "I am only satisfied when I buy more food than I need", with a node intensity and expected impact value of 4.37. The nodes Depression and Anxiety were the most closely connected(weight=0.87). There were no statistically significant differences in the network structure(M=0.13, 0.11) and network connection strength(female and male: 4.16, 4.06, s=0.10;urban and rural areas: 4.08, 4.07, s=0.01) between different sexes and residents (P>0.05).

The negative impact of comorbidities such as anxiety, depression, perceived stress and eating behaviors among adolescents can be reduced through targeted prevention and intervention of core symptoms and bridging symptoms.

To investigate the attention cognitive function and symptom correlations of school-aged children with attention deficit hyperactivity disorder (ADHD)using event-related potential (ERP) technology, so as to provide references for the early diagnosis of children with ADHD.

A total of 52 school-aged children diagnosed with ADHD at the outpatient department of the Third Affiliated Hospital of Zhengzhou University from September 2022 to September 2024 and 50 age-/sex-matched healthy controls were selected. The ERP experiment adopted the auditory Oddball task to conduct comparative analyses of the amplitude and latency of the mismatch negative(MMN) at the Fz, Cz, and Pz points of the scalp electrode and the P3a component respectively. The symptom assessment scales adopted the Swanson, Nolan, and Pelham-Ⅳ Rating Scale (SNAP-Ⅳ) and the Parent Symptom Questionnaire (PSQ), which were filled out by the parents. Spearman correlation analysis was used to analyze the correlation between ERP components and symptoms in school-aged children with ADHD.

The latency of MMN components in the healthy control group on the Fz lead was (188.30±2.06)ms, and the amplitude was (-15.54±1.35)μV; the latency of the P3a component on the Pz lead was (312.82±7.80)ms, and the amplitude was (3.80±0.18)μV. The latency of MMN components in the ADHD group on the Fz lead was (188.94±1.39)ms, and the amplitude was (-14.78±1.40)μV; the latency of the P3a component on the Pz lead was (317.21±5.65)ms, and the amplitude was (3.70±0.13)μV. Compared with normal children, the MMN of children with ADHD had smaller amplitudes in the Fz and Cz leads, and the P3a had greater latency and smaller amplitudes in the Cz and Pz leads (t=2.79, 2.20;-2.04, -3.25;2.35, 3.21, P < 0.05). Correlation analysis showed that the latency of MMN in children with ADHD was positively correlated with the inattention score in the SNAP-Ⅳ(r=0.22), and the amplitude of MMN was negatively correlated with the inattention score in the SNAP-Ⅳ and the learning problem score in PSQ (r=-0.26, -0.34)(P < 0.05). The latency of P3a was positively correlated with the scores of inattention in the SNAP-Ⅳ and the score of learning problems in the PSQ (r=0.26, 0.24); the amplitude of P3a was negatively correlated with the scores of attention deficit and hyperactivity/impulsivity in the SNAP-Ⅳ and the scores of learning problems and impulsivity/hyperactivity in the PSQ(r=-0.26, -0.22, -0.25, -0.32)(P < 0.05).

School-aged ADHD children exhibit abnormal MMN/P3a components, indicating attention-related cognitive dysfunction. Symptoms such as inattention, learning problems and hyperactivity/impulsivity in children with ADHD are related to abnormal components of MMN and P3a.

To examine the reciprocal relationships of anxiety and depressive symptoms, uncertainty stress with academic buoyancy among college students, providing evidence for mental health promotion and academic resilience enhancement.

A multi-stage cluster random sampling method was used to selected 741 undergraduates from grade 1 to 2 of a university in Xuzhou, Jiangsu Province. Participants completed two waves of surveys (T1: October 2022; T2: October 2023) using the Uncertainty Stress Scale, Patient Health Questionnaire-9 (PHQ-9), Generalized Anxiety Disorder-7 (GAD-7), and Academic Buoyancy Scale. Cross-lagged models analyzed bidirectional relationships between three mental health variables and academic buoyancy, followed by latent variable modeling integrating all mental health dimensions.

Cross-lagged model results revealed that T1 uncertainty stress negatively predicted T2 academic buoyancy (β=-0.14), while T1 academic buoyancy negatively predicted T2 uncertainty stress (β=-0.11); T1 depressive symptom negatively predicted T2 academic buoyancy (β=-0.08), while T1 academic buoyancy negatively predicted T2 depressive symptom (β=-0.09); furthermore, T1 academic buoyancy negatively predicted T2 anxiety symptom(β=-0.10) (P < 0.05). Results from the latent variable cross-lagged model of psychological problems (constructed from the three mental health variables) indicated that T1 psychological problems negatively predicted T2 academic buoyancy (β=-0.09), while T1 academic buoyancy negatively predicted T2 psychological problems (β=-0.09) (P < 0.05).

Longitudinal bidirectional relationships exist between mental health status and academic buoyancy in college students. Better mental health facilitates higher academic buoyancy.

To examine the association between moderate-to-vigorous physical activity (MVPA) and weight-adjusted waist index (WWI) with psychological sub-health in middle school students, so as to provide a basis for mental health intervention and promotion.

From September to November 2023, a stratified cluster random sampling method was used to survey 47 372 middle school students aged 12-17 in Jiangsu, Xinjiang, Guangdong, Jilin and Henan provinces from eastern, western, southern, northern and central of China. MVPA, WWI, and psychological subhealth were assessed, with WWI categorized into quartiles (Q1-Q4). Data were analyzed using χ² test, Logistic regression analysis and Logistic regression analysis of generalized linear models.

The overall prevalence of psychological sub-health among middle school students was 21.0%, with higher rates in boys(21.4%) than girls(20.5%) (χ²=6.49, P < 0.05). The detection rates of emotional problems, behavioral problems and social adaptation difficulties in middle school students were 27.8%, 26.9% and 17.5%, respectively. The combination of MVPA and WWI groups was used as independent variables, and the covariates were adjusted to perform Logistic regression analysis of generalized linear model; while the Q1 group with MVPA>60 min/d was used as the reference group, the Q4 group with MVPA < 30 min/d had the highest risk of psychological sub-health detection(OR=1.58, 95%CI=1.38-1.81), and the detection risks of psychological sub-health among middle school students in Q1-Q3 groups were 1.34(1.17-1.53), 1.30(1.13-1.49) and 1.42(1.24-1.62)(P < 0.01).

MVPA and WWI are significantly associated with psychological sub-health in middle school students. Lower MVPA and higher WWI in middle school students correlate with increased sub-health risks. Interventions should aim to enhance MVPA levels and reduce WWI to improve mental well-being in middle school students.

To explore the latent class characteristics of depressive symptoms in adolescents and their association with sleep quality and psychological resilience, so as to provide references for identifying high-risk groups and developing tiered intervention strategies.

From March to May 2024, 3 155 students from grade 5-9 of five primary and secondary schools in Shihezi and Changji, Xinjiang, were selected via convenience sampling. Anonymous self-report questionnaires were administered using 10-item Center for Epidemiological Studies Depression Scale (CES-D-10), 10-item Connor-Davidson Resilience Scale (CD-RISC-10), and Pittsburgh Sleep Quality Index (PSQI). Latent profile analysis (LPA) was conducted for depressive symptoms, and multivariate Logistic regression models were used to examine associations of latent classes with sleep quality and psychological resilience of adolescents.

The CES-D-10 score of adolescents was 7.0 (4.0, 12.0), and the PSQI score was 5.0 (3.0, 7.0). LPA identified four subgroups: low depressive symptom group (57.7%), moderate depressive-typical symptom group (15.2%), moderate depressive-functional retention group (16.6%) and high depressive symptom group (10.5%). Logistic regression revealed that compared to the low-symptom group, moderate depressive-typical symptom group, moderate depressive-functional retention group and high depressive symptom group exhibited poorer sleep quality (OR=1.54, 1.51, 1.77) and lower psychological resilience (OR=0.94, 0.96, 0.92) (P < 0.05).

Poor sleep quality and insufficient psychological resilience are universal risk factors for adolescent depression, with younger age associated with higher vulnerability.

To analyze the association and dose-response relationship between physical activity and inflammatory markers in college students, so as to provide a reference for promoting cardiometabolic health in college students.

A cluster random sampling method was used to select 747 college students from two universities in Hefei, Anhui Province and Shangrao, Jiangxi Province from April to May 2019. Physical activity was assessed by using the International Physical Activity Questionnaire-Short Form (IPAQ-SF), and peripheral blood was collected to detect plasma inflammatory factor levels [including hypersensitive C-reactive protein (hsCRP), interleukin-10 (IL-10), interleukin-1β (IL-1β), interleukin-6 (IL-6), tumor necrosis factor-α (TNF-α)]. The differences between the groups were compared by using the χ² test and the Kruskal-Wallis rank sum test, and the association between physical activity and inflammatory markers was analyzed by using the Generalized Linear Model. The dose-response relationship between physical activity and inflammatory markers was analyzed using the Restricted Cubic Spline Model.

The proportions of low physical activity, moderate physical activity, and high physical activity groups of college students were 15.9%, 53.7% and 30.4%, respectively. The levels of hsCRP, IL-10, IL-1β, IL-6 and TNF-α in the high physical activity group were 0.38(0.21, 1.10)mg/L, 70.74(47.90, 116.43)pg/mL, 1.75(1.21, 2.64)pg/mL, 4.33(2.93, 6.82)pg/mL, 5.27(3.89, 7.30)pg/mL, the levels in the low physical activity group were 0.80(0.31, 1.30)mg/L, 73.88(47.90, 124.24)pg/mL, 1.88(1.42, 2.81) pg/mL, 4.82 (3.64, 6.67) pg/mL, 5.63 (4.34, 7.62)pg/mL, the levels in the moderate physical activity group were 0.63(0.25, 1.30)mg/L, 89.78(58.21, 127.65)pg/mL, 2.21(1.59, 3.27)pg/mL, 5.15(3.72, 7.72)pg/mL, 5.87(4.63, 8.00)g/mL, and the differences were statistically significant (H=10.66, 11.38, 27.79, 14.13, 9.44, P < 0.05). After adjusting for variables such as gender, body mass index, smoking, alcohol consumption and health status, the results of Generalized Linear Model showed that compared with the high physical activity group, the low physical activity group (OR=2.20, 95%CI=1.46-3.31) and the moderate physical activity group (OR=1.65, 95%CI=1.22-2.25) were more likely to have high levels of hsCRP, and the moderate physical activity group was more likely to have high levels of IL-1β (OR=1.85, 95%CI=1.36-2.51), IL-6 (OR=1.44, 95%CI=1.06-1.96), and TNF-α (OR=1.43, 95%CI=1.05-1.94) (P < 0.05). The Restricted Cubic Spline Model showed that there was no linear dose-response relationship between the time of moderate-to-vigorous physical activity weekly and IL-10, IL-6, II-1β, and TNF-α (P < 0.05).

There is an association between physical activity and inflammation in college students, and moderate to high intensity per week could reduce inflammation levels to promote cardiometabolic health in college students.

To analyze the current status and influencing factors of psychological crisis among college students, so as to provide a scientific basis for the formulation of psychological crisis intervention plans in colleges and universities.

From September to December 2024, 645 college students from a medical undergraduate university in Heilongjiang Province were selected with a convenience sampling method. A convergent mixed analysis design was used. Quantitative analysis was conducted using College Students' Psychological Crisis Screening Scale, Emotion Regulation Questionnaire, Short-Egna Minnen av Barndoms Uppfostran and Perceived School Climate Scale. Binary Logistic regression analysis was used to explore the related factors of psychological crisis among college students. Qualitative research was conducted on 15 college students with psychological crisis identified in the quantitative analysis by a purposive sampling method. The interview data were organized and analyzed using the thematic framework analysis method.

Among the surveyed college students, 92 (14.3%) had psychological crisis. Binary Logistic regression analysis results showed that positive parenting style (OR=0.97, 95%CI=0.95-0.99), negative parenting style (OR=1.01, 95%CI=1.00-1.02), cognitive reappraisal (OR=0.88, 95%CI=0.83-0.92), expressive suppression (OR=1.08, 95%CI=1.02-1.15), and perceived campus atmosphere (OR=0.97, 95%CI=0.95-0.98) were all related factors of psychological crisis among college students (P < 0.05). The qualitative analysis results showed that there were three themes for the influencing factors of college students' psychological crisis, including differential impact of emotion regulation strategies on psychological state, shaping of psychological state of college students by family and bidirectional effect of perceived campus atmosphere on psychological state. Mixed analysis results showed that the influencing factors of college students' psychological crisis were consistent in terms of emotion regulation strategies, and were expansive in terms of parenting style and perceived campus atmosphere.

Schools and mental health service departments can reduce the risk of psychological crisis by optimizing cognitive reappraisal and reducing expressive suppression, improve the level of psychological crisis by strengthening positive family interaction and blocking negative parenting style, and maintain the mental health level of college students by building a supportive campus environment and alleviating high pressure.

To analyze the status and trends of physical fitness test data among college freshmen with different body mass index (BMI) groups from 2014 to 2024, providing the scientific evidence for monitoring and intervening in college students' physical health.

A census was conducted on all 67 949 freshmen at Civil Aviation University of China from 2014 to 2024. Physical tests included vital capacity, sit-and-reach, sit-ups, 50 m sprint, standing long jump, pull-ups, and 800 m/1 000 m run. Freshmen were divided into underweight, normal weight, overweight and obese groups according to WHO BMI standards. The Kruskal-Wallis H test was used to compare differences in physical fitness indicators across gender and BMI groups, while the Mann-Kendall trend test was employed to detect upward or downward trends in physical indicators over time.

From 2014 to 2024, statistically significant differences were observed in vital capacity, 50 m sprint, standing long jump, and sit-and-reach among different BMI groups for both genders (boy: Z=2 396.40, 4 160.33, 4 662.23, 531.85; girl: Z=593.37, 308.86, 499.37, 128.70). Significant differences were also found in 1 000 m run and pull-ups for boys, and 800 m run and sit-ups for girls across BMI groups (boy: Z=6 574.80, 6 880.48; girl: Z=528.56, 146.18) (P < 0.01). Overall physical test scores showed a declining trend during 2014-2024, particularly pronounced in overweight and obese groups. Male vital capacity in 2014 exceeded national survey data(d=320 mL), with the gap widening to 734 mL by 2019, while the female vital capacity difference increased from 271 mL in 2014 to 576 mL in 2019. Male 1 000 m run times were 23.0 s and 17.5 s faster than national data in 2014 and 2019 respectively, while female 800 m run times were 22.3 s and 21.5 s faster than corresponding national data.

Physical health status among freshmen at this university varies across BMI groups and changes over time. Although overall test scores remain higher than national levels, the declining trend in physical fitness performance requires attention.

To understand the prevalence of elevated blood pressure and its association with dietary patterns in children and adolescents in China, providing evidence for developing dietary intervention of hypertension in children and adolescents.

Data were derived from the China Children's Nutrition and Health System Survey and Application Project(2019-2021). A stratified cluster random sampling method was used to include 7 933 participants from 28 survey sites in seven major regions of Northeast, North, Northwest, East, Central, South and Southwest China. Multivariate Logistic regression models were used to analyze associations between demographic characteristics, nutritional status and elevated blood pressure. Exploratory factor analysis identified dietary patterns, which were divided into three quartile groups (T3, T2, T1) based on factor scores (compliance for dietary pattern) from high to low, and multivariate Logistic regression model assessed the correlation between elevated blood pressure and dietary patterns.

The prevalence of elevated blood pressure was 15.4% among Chinese children aged 7-17 years. Significant differences were observed across nutritional status (reference: underweight; normal weight: OR=1.57; overweight: OR=2.61; obesity: OR=3.85), urban/rural residence (reference: rural; urban: OR=0.86), and paternal education (reference: junior high school and below; bachelor degree or above: OR=0.68) (P < 0.05). The detection rates of high blood pressure in T3 group children and adolescents with four dietary patterns (staple food, animal based food, snacks, vegetables and fruits) were 15.7%, 14.6%, 16.8%, and 15.8%, respectively. After adjusting for residence, paternal education, and nutritional status, the "snack dietary pattern" (mainly candy, sugar-sweetened beverages, and processed snacks) showed positive associations with elevated blood pressure in T2 (OR=1.21) and T3 (OR=1.19) tertiles (P < 0.05).

The snack dietary pattern is a related factor for elevated blood pressure in children and adolescents. Restricting unhealthy snack intake may promote cardiovascular health.