To explore impacts of sports games designed based on the information-motivation-behavioral skills model (IMB) on prosocial behavior in children with intellectual and developmental disabilities (IDD) attending regular classes, so as to provide a theoretical basis for promoting the development of prosocial behavior in school-age IDD children.

From February to March 2023, 40 children with intellectual disabilities aged 8-9 who were enrolled in ordinary schools in Beijing were recruited by using WeChat parents to send messages. They were randomly divided into an experimental group (19 before intervention, 17 after intervention) and a control group (19 before intervention, 19 after intervention) by lottery method. During the study period, children in both groups received the same frequency and quality of regular physical activities. The experimental group, in addition, underwent a 13-week sports game intervention based on the IMB model, 4 times a week, each session lasting 50 minutes. The sports game intervention scheme based on IMB model was divided into two modules, including basic training and development training: low-difficulty sports game intervention based on emotion recognition, and medium-low-difficulty and medium-difficulty sports game intervention based on social training such as "prosocial". The Griffith Empathy Measure (GEM) and the Prosocial Behavior Scale for Adolescents (PBSA) were used to assess empathy ability and prosocial behavior levels of children in both groups before and after the intervention.

After intervention, the cognitive empathy dimension, emotional empathy dimension and total score of GEM in the experimental group (39.15±2.85, 38.54±1.94, 77.69±3.95) were higher than control group (32.18±4.18, 32.28±4.28, 64.56±6.48) and before intervention (33.92±4.94, 31.30±4.61, 65.23±8.47), and the differences were statistically significant (F=12.06, 6.99, 14.90; 8.95, 7.36, 13.22, P < 0.05). After intervention, compliance with public welfare factors, trait factors and total score (31.33±1.97, 16.67±1.03, 71.83±2.93) were higher than control group (22.65±1.58, 12.59±0.71, 59.47±2.18) and before intervention (22.00±1.27, 12.17±0.75, 58.00±1.67), and the differences were statistically significant (F=17.00, 36.54, 12.71; 29.87, 13.09, 13.12, P < 0.05).

Sports game intervention based on IMB model can effectively promote the development of prosocial behavior of children with IDD attending regular classes.

To investigate the correlation of emotional and behavioral problems with sleep problems in children with cerebral palsy, so as to provide reference for intervention of emotional and behavioral problems in children.

A cross-sectional survey was conducted, and 402 children aged 6-18 with cerebral palsy who were adopted by social welfare institutions in Guangzhou City from January 2023 to January 2024 were selected to investigate their full-time nurses. The Parents' Strengths and Difficulties Questionnaire (SDQ) was used to assess the emotional and behavioral problems of children with cerebral palsy, and the Children's Sleep Habits Questionnaire (CSHQ) was used to assess sleep problems. Multiple linear regression analysis was used to analyze the correlation between the sleep problem of children with cerebral palsy and the emotional and behavioral problems.

The prevalence of emotional and behavioral difficulties among children with cerebral palsy was 15.7%. The median sleep problem score of children with emotional and behavioral problems [37.0(36.0, 41.0)] was significantly higher than that of children without emotional and behavioral [35.0(34.0, 36.0)] (Z=-5.74, P < 0.01). The results of multiple linear regression analysis showed that after adjusting covariables such as age, gender, cerebral palsy classification, language retardation, visual impairment and epilepsy, the total sleep problem score of children with cerebral palsy was positively correlated with the total difficulty score (β=0.28, 95%CI=0.17-0.34, P < 0.05).

Sleep problems in children with cerebral palsy are associated with emotional and behavioral difficulties. Understanding of the management of sleep problems in children with cerebral palsy should be enhanced to reduce the incidence of emotional and behavioral problems in children with cerebral palsy.

To understand the latent categories of sleep disturbances among children and adolescents with neurodevelopmental disorders (NDDs) in Tianjin and their relationship with behavioral and social issues, so as to provide a basis for preventing and improving sleep disturbances in the population.

From September 2021 to June 2024, 272 children and adolescents aged 2-23 years with neurodevelopmental disorders were recruited from special education schools and designated rehabilitation institutions in Tianjin. Sleep disturbances were assessed using the Children's Sleep Habits Questionnaire (CSHQ). Behavioral and social issues and severity were evaluated using the Autism Behavior Checklist (ABC) and Childhood Autism Rating Scale (CARS). Latent class analysis (LCA) was employed to categorize the subjects into different sleep disturbances categories. Cochran-Armitage test was used to analyze the trend of detection rate of sleep disturbances in different age groups. Spearman rank correlation was used to analyze the correlation between the scores of each scale. The generalized linear model was used to analyze the influence of CARS and ABC scale scores. Covariance analysis was used to examine differences in behavioral and social issues among the different categories.

Among 272 survey respondents, a total of 197(72.4%) children and adolescents with NDDs were identified with sleep disturbances. The detection rates of sleep disturbances were 88.9% for those aged 2-6 years, 70.6% for aged 7-12, 66.7% for aged 13-18 and 50.0% for 19-23 years old, which was decreased across age group (Z=3.58, P < 0.01). There was a positive correlation between the total CSHQ score and the total ABC score (r=0.16, P=0.01). The generalized linear model analysis showed that after adjusting age, gender, parents' education level and family monthly income, bedtime habit (β=3.60) and sleeping latency disorder (β=3.36) were positively correlated with CARS scores, while the bedtime habit (β=16.73) and waking up at night (β=17.46) were positively correlated with ABC scores (P < 0.05). LCA revealed that sleep disturbances in children and adolescents with NDDs could be classified into four categories. The covariance analysis results showed that there were statistically significant differences in the average scores of CSHQ (70.84±9.05, 50.96±6.64, 50.33±5.82, 43.84±5.44) and ABC (49.44±39.34, 53.04±39.75, 63.51±40.31, 38.14±34.23) among different categories of all partipants (F=92.09, 3.95, P < 0.05).

Sleep disturbances in children and adolescents with NDDs are severe and exhibit distinct categorical characteristics.

To evaluate the comprehensive intervention effect of lunch for primary and secondary school students in Minhang District, so as to provide a theoretical and practical basis for lunch intervention in school.

From October to December 2023, a convenience sampling method was used to select 1 937 students from one primary and secondary school in Minhang District.A comprehensive intervention measure focusing on "reducing oil and salt" for lunch recipe optimization and nutrition education was carried out, and a questionnaire survey was conducted to evaluate the intervention effect three months later. Chi-square test and Wilcoxon rank test were used to compare the data before and after the intervention.

After intervention, the use of cooking oil and salt, the supply of protein and fat in primary and secondary school lunches were reduced, and had no obvious impact on energy and other major nutrients. After intervention, compared to before intervention, the proportion of primary school students who felt that lunch was greasy decreased (8.9%, 6.2%, χ²=4.35), and the proportion of primary and secondary school students who felt that lunch were delicious decreased significantly (33.2%, 23.2%; 63.9%, 53.5%, χ²=26.39, 17.52) (P < 0.05). Secondary school students also felt reduced variety of food ingredients (46.9%, 38.3%, χ²=16.05, P < 0.05). In addition, after intervention, the total surplus rate of primary school students' meals decreased (7.4%, 4.4%, χ²=5.73), mainly reflected in the decrease of the surplus rate of staple foods (7.1%, 2.4%, χ²=17.39), while the surplus rate of vegetable dishes increased (16.0%, 21.2%, χ²=6.01) (P < 0.05). Although there was no significant change in the total surplus rate of meals for secondary school students, the surplus rate of staple foods decreased (12.9%, 5.4%, χ²=33.52), while the surplus rates of meat and vegetable dishes increased (11.2%, 26.9%; 17.5%, 33.2%, χ²=74.26, 61.88) (P < 0.05). After intervention, there was no statistically significant difference in the overweight and obesity rates of primary school students (χ²=0.11, 0.43) and secondary school students (χ²=0.01, 0.00) compared to before intervention(P>0.05). After intervention, the lung capacity of primary school students [1 564 (1 269, 1 890) mL] and sitting forward flexion [11.3 (7.6, 15.2) cm] increased compared to before intervention [1 522 (1 259, 1 819) mL, 10.5 (6.3, 13.5) cm] (Z=2.20, 4.68, P < 0.01), but there was no statistically significant difference in lung capacity and sitting forward flexion of secondary school students before and after intervention (Z=-0.46, -0.08, P>0.05).

The comprehensive intervention of school lunch has promoted a significant decrease in the use of oil and salt in lunch and improved the quality of recipes, and has a positive impact on the situation of leftover lunch and the health of students to a certain extent.

To explore the effectiveness of smoking control intervention guided by social network theory at a vocational college in Guangzhou City, so as to provide a reference for school smoking control intervention.

From April to May 2023, a combination of convenience sampling and cluster random sampling method was adopted to select 781 students from different majors in 4 campuses of a certain vocational college. They were randomly divided into a control group (422 students before intervention, 399 students after intervention) and an intervention group (359 students before intervention, 329 students after intervention). Based on social network theory, a 6-month tobacco control intervention was carried out in the intervention group by strengthening the existing tobacco control network connections in schools, establishing new control smoking social networks, and enhancing the role of the new control smoking social networks by members of the project team. Both the control group and intervention group received smoking control intervention in the school environment. The difference was compared by t test andχ² test.

After intervention, the knowledge score of the intervention group (8.9±4.8) was higher than that of the control group (7.6±5.0) and before intervention (7.0±5.0) (t=3.30, 4.91, P < 0.01). After intervention, the current smoking rate (4.0%) in the intervention group was lower than before intervention (8.1%, χ²=5.10), and the number of half or more smoking peers (11.2%) was lower than before intervention(16.7%) (χ²=4.24)(P < 0.05); and there was no statistically significant difference between the control group before and after intervention (χ²=1.49, 0.16, P>0.05). The proportion of holding a negative attitude to school smokers was higher than before intervention (χ²=12.34, P < 0.05), with the proportion of "strongly negative and suggest no smoke around oneself" increasing from 25.1% before intervention to 35.9% after intervention; and the proportion of student who kept a distance from smokers was higher than before intervention (χ²=18.21, P < 0.05), with the proportion of "maintaining a distance of 3 m" increasing from 30.4% before the intervention to 40.1% after the intervention. There was no statistically significant difference in the control group before and after intervention (χ²=3.89, 2.50, P>0.05).

The smoking control intervention at vocational colleges based on social network theory improve the correct tobacco knowledge, attitudes and practice of vocational college students, and reduce the smoking rates.

To explore the longitudinal associations between dietary macronutrients and lung function in school-aged children, so as to provide the nutritional research evidence for promoting children's lung health.

In November 2021, two primary schools located in Chengdu, Sichuan Province were selected from the Southwest China Childhood Nutrition and Growth (SCCNG) cohort by a stratified cluster random sampling method, enrolling a total of 1 112 school-aged children aged 8 to 13 years. At baseline, the dietary and sociodemographic characteristics of the children were assessed. One year later, the forced vital capacity (FVC) of the children was measured and converted into Z-scores (FVC-Z), while the vital capacity index (VCI) was also calculated. Generalized linear regression analysis was employed to examine the associations between dietary macronutrients and lung function, considering interactions with gender and age, followed by stratified analysis.

After adjusting for confounding factors, the analysis results of the generalized linear regression model showed that the carbohydrate energy ratio was negatively correlated with FVC-Z (β=-0.02) and VCI (β=-0.16), while the fat energy ratio showed a positive correlation with FVC-Z (β=0.03) and VCI (β=0.23) (P < 0.05). The protein energy ratio was positively correlated with FVC-Z (β=0.09) and VCI (β=0.60) specifically in girls (P < 0.05). Additionally, there was an interaction effect of age on the associations between macronutrients and lung function (P < 0.01); in children aged 8-9 and 10-11, the carbohydrate energy supply ratio was negatively correlated with FVC-Z (β=-0.04, -0.03) and VCI (β=-0.29, -0.21), and fat energy supply ratio was positively correlated with FVC-Z (β=0.07, 0.05) and VCI (β=0.46, 0.32) (P < 0.05).

There are age and sex differences in the association of dietary macronutrients with lung function, with a low-carbohydrate, high-fat diet promoting lung function in children. Additionally, protein intake appears to have a positive influence on the lung function of girls. The early school-age period may represent a critical window for dietary interventions aimed at promoting lung health.

To understand the changing trends and related factors of knowledge, attitude and practice (KAP) regarding the three major infectious diseases (acquired immunodeficiency syndrome, tuberculosis, hepatitis B) among freshmen in Jiangsu from 2019 to 2022, so as to provide a reference basis for the health education of infectious diseases in schools.

From 2019 to 2022, a total of 33 944 freshmen from 20 universities in Jiangsu Province were randomly selected for four consecutive years to investigate their KAP levels online through self-designed questionnaires on three major infectious diseases. The multiple linear regression model was used to analyze the changing trends of students' KAP levels of the three major infectious diseases, and to explore the influencing factors of KAP.

From 2019 to 2022, the knowledge scores(18.0±3.1, 18.4±3.2, 18.7±3.2, 18.8±3.2), related to the three major infectious diseases showed an upward trend (F=436.50, P<0.01), and the positive attitude reporting rates were 81.77%, 81.46%, 82.68% and 81.74%, respectively. The reporting rates of positive practice were 80.11%, 79.25%, 79.08% and 79.04%, respectively. Multiple linear regression showed that school type, parental education level, mother's occupation, average income per person in family and living arrangements during high school all had an impact on the knowledge (β=-1.510-0.559), attitudes (β=-0.043-0.065) and practice (β=-0.028-0.027) of the three major infectious diseases (P<0.05). The family residence areas only affected the reporting rate of positive attitude scores (β=0.002-0.065), and whether only-children or not affected the reporting rate of positive practice scores (β=0.009)(P<0.05). The knowledge score showed an upward trend (β=0.297, P<0.01), the positive attitude reporting rate showed no statistically significant change (β=0.001, P=0.22), and the positive practice reporting rate showed a downward trend (β=-0.005, P<0.01).

Freshman in Jiangsu Province from 2019 to 2022 have shown a separation in KAP scores regarding the three major infectious diseases. Targeted measures should be taken to improve their health practice level.

To evaluate the application effect of oral health management program based on behavior change wheel (BCW) theory, so as to provide a reference for improving children's awareness of oral self-management and the development of healthy oral behaviors.

A total of 120 children aged 5-6 from 2 kindergartens in Yubei District in Chongqing City, selected by convenience sampling method from September 2023 to March 2024, were divided into a experimental group and a control group (60 each). Children in the experimental group were given an oral health education programme based on BCW theory (promoted health awareness, cultivated healthy behavior ability, strengthened awareness and ability, and provided opportunitiess) on the basis of conventional oral health education, and children in the control group were given conventional oral health education; data were collected before and 3 months after the intervention, respectively. Comparisons between groups were made using the Mann-Whitney U test and χ² test.

Before intervention, there were no significant differences in plaque index [2.00(1.00, 2.00), 2.00(1.00, 2.00)] and the number of filled teeth [0.00(0.00, 1.00), 0.00(0.00, 1.00)] between the experimental group and the control group (Z=-0.88, -0.42, P>0.05). After intervention, the plaque index of the experimental group [1.00(0.00, 1.00)] was lower than that of the control group [1.00(0.25, 2.00)] and before intervention, and the number of filling teeth in the experimental group [1.00(0.00, 2.00)] was higher than that of the control group [1.00(0.00, 1.00)] and before intervention, the differences were statistically significant (Z=-3.14, -5.48; -2.08, -3.02, P<0.05). Before intervention, there were no significant differences in oral health behavior report rate and oral health knowledge mastery rate between the two groups (χ²=0.30-0.91, 0.15-1.43, P>0.05). After intervention, the report rates of health tooth brushing (method, frequency and duration) and preventive behavior (using fluoride toothpaste, pit and fissure sealing prevention and fluoride application prevention) in the experimental group were better than those in the control group and before intervention, and the differences were statistically significant (χ²=4.88-9.38, 9.13-22.63, P<0.05). The mastery rates of oral health knowledge in the experimental group were better than that in the control group, and the differences were statistically significant (χ²=4.62-8.54, P<0.05).

Oral health management programs based on the BCW theory are more conducive to improving children's oral hygiene, as well as enhancing children's basic oral knowledge and promoting the development of oral health behaviors.

To understand the unhealthy listening habits and related factors hearing on impairment among primary and middle school students in Jilin Province, so as to provide a scientific basis for the prevention of hearing impairment in children and adolescents.

From September to November 2021, a stratified cluster random sampling method was employed to select 12 847 primary and middle school students in nine cities of Jilin Province who use headphones for more than 0.5 hours daily for a questionnaire survey. Data on unhealthy listening habits, lifestyle habits and hearing impairment were collected. The data were analyzed using the χ² test and Logistic regression.

Totally 1 702 students(13.25%) experienced hearing impairment within the last month. There were statistical differences between the sexes with the average daily headphone use, the times of using headphones ≥1 h every day for one week use in all environment or noisy environment (χ²=47.86, 57.60, 66.31, P<0.01). Logistic regression analysis results showed that factors related to the occurrence of hearing impairment among primary and secondary school students included: average daily headphone use of 1-2 h and more than 2 h (OR=1.74, 95%CI=1.60-1.90; OR=1.73, 95%CI=1.59-1.90), times of using headphones ≥1 h every day for one week were 1-2 times and >2 times (OR=1.71, 95%CI=1.59-1.84; OR=1.83, 95%CI=1.71-1.97), the times of using headphones≥1 h every day for one week being 1-2 times and >2 times in noisy environment per week (OR=1.48, 95%CI=1.40-1.56; OR=1.72, 95%CI=1.61-1.86), economic underdevelopment (OR=1.85, 95%CI=1.76-1.96), boarding (OR=1.78, 95%CI=1.69-1.89), single-parent family (OR=1.72, 95%CI=1.60-1.87), daily activity duration less than 1 h (OR=1.71, 95%CI=1.63-1.81), sedentary behavior duration more than 6 h per day (OR=1.88, 95%CI=1.79-1.98) (P<0.05).

The behavior of ear protection among primary and middle school students in Jilin Province needs to be enhanced, focusing on students in economically underdeveloped areas, boarding schools and single-parent families. It is necessary to guide primary and middle school students to improve their bad ear habits, increase outdoor activities and reduce the time of sitting.

To understand the prevalence and related factors of depressive symptoms among primary and secondary school students in the in-depth monitoring counties of China's Rural Compulsory Education Nutrition Improvement Program, so as to provide a basis for prevention and psychological intervention of depressive symptoms among children and adolescents in rural areas.

In November 2022, a stratified random sampling method was adopted to collect height and weight data, basic personal and family information of 7 949 primary and secondary school students from grade three to grade nine through physical measurements and questionnaires in 56 key monitoring schools implementing the Student Nutrition Improvement Program in 7 in-depth monitoring counties (Jalaid Banner in Inner Mongolia, Jinzhai County in Anhui, Mao Xian in Sichuan, Tiandeng County in Guangxi, Mian County in Shaanxi, Zhaozhou County in Heilongjiang and Youxi County in Fujian), and to obtain the information related to their depressive symptoms through the self-assessment questionnaire on depression. Multivariate Logistic regression analysis was conducted to analyze the prevalence of depressive symptoms among primary and secondary school students, as well as their related factors.

The detection rate of depressive symptoms among primary and secondary school students in the in-depth monitored counties was 23.5%. Logistic regression analysis showed that the probability of detecting depressive symptoms was higher among female students, middle school students, students whose video screen duration per day was >2 h, and students whose parents' marital status was divorced or widowed (OR=1.40, 1.64, 1.60, 1.24), and students whose sleep duration reached the recommended standard, whose parents usually accompanied them daily for time was 60-<120 min and ≥120 min, and students whose mothers' literacy level was middle school graduation had lower probability of detecting depressive symptoms (OR=0.85, 0.84, 0.71, 0.76) (P<0.05).

The detection rate of depressive symptoms among students in the in-depth monitoring area is high, and targeted interventions need to be developed for students to reduce the risk of mental health problems.