Physical Disorders are Associated with Health Risk Behaviors in Chinese Adolescents: A Latent Class Analysis

Bingdong Song; Weirong Hu; Wanxia Hu; Rong Yang; Danlin Li; Chunyu Guo; Zhengmei Xia; Jie Hu; Fangbiao Tao; Jun Fang; Shichen Zhang

doi:10.3390/ijerph17062139

Physical Disorders are Associated with Health Risk Behaviors in Chinese Adolescents: A Latent Class Analysis

Int J Environ Res Public Health. 2020 Mar 23;17(6):2139. doi: 10.3390/ijerph17062139.

Authors

Bingdong Song^{1

2}, Weirong Hu^{1

2}, Wanxia Hu³, Rong Yang^{1

2}, Danlin Li^{1

2}, Chunyu Guo^{1

2}, Zhengmei Xia^{1

2}, Jie Hu^{1

2}, Fangbiao Tao^{1

2}, Jun Fang^{1

2

4}, Shichen Zhang^{1

2}

Affiliations

¹ Department of Toxicology, School of Public Health, Anhui Medical University, and Key Laboratory of Environmental Toxicology of Anhui Higher Education Institutes, No 81 Meishan Road, Hefei 230032, China.
² Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, and MOE Key Laboratory of Population Health Across Life Cycle/Anhui Provincial Key Laboratory of Population Health and Aristogenics, No 81 Meishan Road, Hefei 230032, Anhui, China.
³ School of Health Management, Anhui Medical University, No.81, MeiShan Road, Hefei 230032, Anhui, China.
⁴ Faculty of Pharmaceutical Science, Sojo University, Ikeda 4-22-1, Kumamoto 860-0082, Japan.

Abstract

It is known that health risk behaviors (HRBs) can lead to a variety of physical and mental health problems among adolescents, but few studies have paid attention to the relationship between latent classes of HRBs and adolescent diseases. The purpose of this study was to use latent class analysis (LCA) to clarify the potential subgroups of HRBs (smoking, drinking, screen time, non-suicidal self-injuries, suicidal behaviors, and unintentional injuries) and examine the association between the subgroups of HRBs and physical disorders (diarrhea, fever, cough, and vomiting) with multiple logistic regression analysis, in Chinese adolescents. Self-reported HRBs and physical disorders were used to evaluate 22,628 middle school students in six cities of China, from November 2015 to January 2016, based on a multistage stratified cluster sampling approach. The prevalence of diarrhea, fever, cough, and vomiting was 23.5%, 15.9%, 50.6%, and 10.7%, respectively. We identified four latent classes of HRBs by LCA, including low-risk class, moderate-risk class 1 (smoking, drinking, and screen time), moderate-risk class 2 (non-suicidal self-injuries and suicidal behaviors, unintentional injuries), and high-risk class (smoking, drinking, screen time, non-suicidal self-injuries, suicidal behaviors, and unintentional injuries), which were 64.0%, 4.5%, 28.8% and 2.7% of participants, respectively. Compared to the low-risk class, all other classes showed higher risk for these physical disorders (P < 0.01 for each). In particular, the high-risk class had the highest risk (diarrhea (odds ratio (OR) = 2.628, 95% confidence interval (CI) 2.219 to 3.113), fever (OR = 3.103, 95% CI 2.591 to 3.717), cough (OR = 2.142, 95% CI 1.805 to 2.541), and vomiting (OR = 3.738, 95% CI 3.081 to 4.536). In conclusion, these results indicated that heterogeneity exists in HRBs, and subgroups of HRBs were correlated to the occurrence of common physical disorders in Chinese adolescents. Therefore, multiple HRBs rather than single factors should be considered for the prevention of common physical disorders in schools.

Keywords: adolescents; health risk behaviors; latent class analysis; physical disorders.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Adolescent
Adolescent Behavior*
China / epidemiology
Female
Health Risk Behaviors*
Humans
Latent Class Analysis
Male
Suicidal Ideation