Clustering of Multilevel Factors Among Children and Adolescents: Associations With Health-Related Physical Fitness.

IF 2.9 4区医学 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Journal of physical activity & health Pub Date : 2023-10-31 Print Date: 2024-01-01 DOI:10.1123/jpah.2023-0051

Shan Cai, Yunfei Liu, Jiajia Dang, Panliang Zhong, Di Shi, Ziyue Chen, Peijin Hu, Jun Ma, Yanhui Dong, Yi Song, Hein Raat

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引用次数: 0

Abstract

Background: To identify the clustering characteristics of individual-, family-, and school-level factors, and examine their associations with health-related physical fitness.

Methods: A total of 145,893 Chinese children and adolescents aged 9-18 years participated in this cross-sectional study. The 2-step cluster analysis was conducted to identify clusters among individual-, family-, and school-level factors. Physical fitness indicator was calculated through sex- and age-specific z scores of forced vital capacity, standing long jump, sit-and-reach flexibility, body muscle strength, endurance running, and body mass index.

Results: Three, 3, and 5 clusters were automatically identified at individual, family, and school levels, respectively. Students with low physical fitness indicator were more likely to be in the "longest sedentary time and skipping breakfast" cluster (odds ratio [OR] = 1.18; 95% confidence interval [CI], 1.12-1.24), and "physical inactivity and insufficient protein consumption" cluster (OR = 1.07; 95% CI, 1.02-1.12) at individual level, the "single children and high parental education level" cluster (OR = 1.15; 95% CI, 1.10-1.21), and "no physical activity support and preference" cluster (OR = 1.30; 95% CI, 1.25-1.36) at family level, and the "physical education occupied" cluster (OR = 1.06; 95% CI, 1.01-1.11), and "insufficient physical education frequency" cluster (OR = 1.16; 95% CI, 1.08-1.24) at school level. Girls were more vulnerable to individual- and school-level clusters, while boys were more susceptible to family clusters; the younger students were more sensitive to school clusters, and the older students were more susceptible to family clusters (P-interaction < .05).

Conclusions: This study confirmed different clusters at multilevel factors and proved their associations with health-related physical fitness, thus providing new perspective for developing targeted interventions.

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儿童和青少年多层次因素的聚类：与健康相关的身体素质的关联。

背景：确定个人、家庭和学校水平因素的聚类特征，并检验它们与健康相关的身体素质的关系。方法：共有145893名9-18岁的中国儿童和青少年参与了这项横断面研究。进行了两步聚类分析，以确定个人、家庭和学校层面的因素之间的聚类。身体素质指标是通过强迫肺活量、站立跳远、坐着和伸展灵活性、身体肌肉力量、耐力跑和体重指数的性别和年龄特异性z得分来计算的。结果：分别在个人、家庭和学校层面自动识别出三个、三个和五个集群。在个体水平上，身体素质指标较低的学生更有可能处于“久坐时间最长、不吃早餐”集群（比值比[OR]=1.18；95%置信区间[CI]，1.12-1.24）和“缺乏运动和蛋白质摄入不足”集群（OR=1.07；95%CI，1.02-1.12），家庭层面的“独生子女和高父母教育水平”集群（OR=1.15；95%置信区间，1.10-1.21）和“没有体育活动支持和偏好”集群（OR=1.30；95%可信区间，1.25-1.36），以及学校层面的“体育教育占位”集群（OR=1.06；95%置信度，1.01-1.11）和“体育教育频率不足”集群（OR=1.16；95%置信指数，1.08-1.24）。女孩更容易受到个人和学校层面集群的影响，而男孩更容易受到家庭集群的影响；年龄较小的学生对学校集群更敏感，年龄较大的学生更容易受到家庭集群的影响（P交互作用<.05）。结论：本研究在多层次因素上证实了不同的集群，并证明了它们与健康相关的身体素质之间的关联，从而为制定有针对性的干预措施提供了新的视角。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of physical activity & health PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH-

CiteScore

5.50

自引率

3.20%

发文量

100

期刊介绍： The Journal of Physical Activity and Health (JPAH) publishes original research and review papers examining the relationship between physical activity and health, studying physical activity as an exposure as well as an outcome. As an exposure, the journal publishes articles examining how physical activity influences all aspects of health. As an outcome, the journal invites papers that examine the behavioral, community, and environmental interventions that may affect physical activity on an individual and/or population basis. The JPAH is an interdisciplinary journal published for researchers in fields of chronic disease.