Purpose This study aims to evaluate whether lifestyle factors including media use and social and family environments are associated with elementary school children's feeling of school avoidance.Methods Total study population for this study was 2,057 children in 5 elementary schools in Takaoka city, Toyama prefecture, which participated in the MEXT Super Shokuiku School Project. A questionnaire survey was conducted in July 2014 and 1,936 students responded (Response rate: 94.1%). Of those who responded, data from 1,698 respondents were relevant for this study. The questionnaire included questions on lifestyle factors (e.g., eating habits, media use, exercise habits, and sleep), health status, and the social and family environments. Children responded to questions on lifestyle factors, health status, and feeling of school avoidance with their parents. Parents were asked to only respond to the questions on social and family environments. Logistic regression analysis was performed to evaluate whether the feeling of avoiding school, as the dependent variable, is associated with the independent variables such as social and family environment factors and lifestyle factors. The odds ratios (OR) and their 95% confidence intervals (95%CI) were calculated.Results The percentage of children who had the feeling of avoiding school was 32.2% in the study sample. In comparison with the 6th graders, the 1st, 3rd, 4th, and 5th graders were more likely to have this feeling. Relevant adjusted ORs [95%CI] for Grades 1-5 were found to be 1.48 [1.02-2.13], 1.63 [1.10-2.42], 1.60 [1.08-2.39], and 1.56 [1.03-2.35], respectively. Other factors positively correlated with this feeling were skipping breakfast (OR 1.76, 95%CI [1.12-2.75]), daily snacking (OR 1.64, 95%CI [1.21-2.22]), watching TV for 3 hours or longer (OR 1.55, 95%CI [1.05-2.28]), video gaming for 0.5-2 hours (OR 1.37, 95%CI [1.08-1.74]), feeling sleepy (OR 1.51, 95%CI [1.14-1.99]), not feeling well upon waking up (OR 1.64, 95%CI [1.30-2.06]), being unsatisfied with their own health (OR 1.43, 95%CI [1.10-1.87]), and dislike for playing outside (OR 1.62, 95%CI [1.05-2.52]).Conclusions This study showed that feeling of school avoidance was significantly correlated with several lifestyle factors. School health activities aiming at establishing desirable lifestyles for children could reduce the number of children who have the feeling of school avoidance.
Keywords: Toyama prefecture; elementary school student; lifestyle; non-attendance at school; school avoidance.