Journal of Peking University (Health Sciences) ›› 2024, Vol. 56 ›› Issue (2): 239-246. doi: 10.19723/j.issn.1671-167X.2024.02.006

Previous Articles     Next Articles

Investigation on the current situation and influencing factors of sitting time and health literacy among high school students in China

Hejun SHEN1,Chongyan SHI1,Qing ZHENG2,Yu HUANG3,Tao JING4,*()   

  1. 1. School of Physical Education and Humanities, Nanjing Sport Institute, Nanjing 210014, China
    2. Physical Education Teaching and Research Group, Hanjiang Middle School of Jiangsu Province, Yangzhou 225009, Jiangsu, China
    3. Physical Education Teaching and Research Group, Liyang Middle School of Jiangsu Province, Liyang 213300, Jiangsu, China
    4. Department of Rehabilitation Therapy, School of Exercise and Health, Nanjing Sport Institute, Nanjing 210014, China
  • Received:2022-04-07 Online:2024-04-18 Published:2024-04-10
  • Contact: Tao JING E-mail:3361154781@qq.com
  • Supported by:
    the 2019 Pedagogy Project of the 13th Five Year Plan of NSFC(BLA190212)

Abstract:

Objective: To investigate the current situation of sitting time and health literacy among high school students in China, in order to provide a basis for improving their physical and mental health levels. Methods: A stratified random cluster sampling method was used to investigate the length of sitting time and health literacy of first and second grade high school students from 31 provinces, cities, and autonomous regions in China(data did not include that of Hong Kong and Macao Special Administrative Region, and Taiwan Province of China). The Kruskal-Wallis H method, independent sample Mann-Whitney U test, and regression model were used to analyze the influencing factors of sitting time and total health literacy score. Results: (1) The total score of health literacy was statistically significant (P < 0.01) in different regions, urban and rural distribution, annual family income, parents' educational background, age, and gender. (2) The length of sitting was statistically significant (P < 0.01) among multiple groups in different regions, family annual income, parental education, and gender. However, there was no statistically significant difference between groups of different ages and urban-rural distribution (P>0.05). (3) The analysis of multiple linear regression model showed that the total score of health literacy was positively correlated with the family' s annual income and the mother' s education, and negatively correlated with the father' s education and the length of sitting. Standardized regression coefficient β comparison: Father' s education (-0.32) > family annual income (0.15) > mother' s education (0.09) > average daily sitting time (-0.02), with father' s education having the greatest impact, followed by family annual income. The length of sitting was positively related to the family' s annual income and the mother' s educational background, and negatively related to the total score of health literacy. Standardized regression coefficient β comparison: Annual family income (0.14) > education background of mother (0.13)> total score of health literacy (-0.02), with the impact of annual family income the largest, followed by education background of mother. Conclusion: China' s first and second grade high school students generally spend a long time sitting every day, and the level of health literacy is generally low. The level of health literacy and sitting time are negatively correlated with each other, and are most influenced by the educational background of high school students' parents and their family economic levels.

Key words: Adolescent, Sitting time, Health literacy, Root cause analysis

CLC Number: 

  • R179

Table 1

Analysis of age, gender, and urban rural composition ratios of high school students in seven regions of China"

Population situation East China(n=2 146) South China(n=777) North China(n=1 263) Central China(n=935) Northwest China(n=1 674) Southwest China(n=1 186) Northeast China(n=1 076) Total 7 regions(n=9 057) χ2 value P value
Urban and rural distribution, n(%) 136.422 < 0.01
  City/County/District 957 (44.6) 498 (64.1) 573 (45.4) 422 (45.1) 925 (55.3) 646 (54.5) 515 (47.9) 4 536 (50.1)
  Town and rural areas 1 189 (55.4) 279 (35.9) 690 (54.6) 513 (54.9) 749 (44.7) 540 (45.5) 561 (52.1) 4 521 (49.9)
Gender, n(%) 58.503 < 0.01
  Male 1 161 (54.1) 346 (44.5) 536 (42.4) 490 (52.4) 853 (51.0) 573 (48.3) 560 (52.0) 4 519 (49.9)
  Female 985 (45.9) 431 (55.5) 727 (57.6) 445 (47.6) 821 (49.0) 613 (51.7) 516 (48.0) 4 538 (50.1)
Age/years, n(%) 629.619 < 0.01
  14 32 (1.5) 8 (1.0) 12 (1.0) 67 (7.2) 25 (1.5) 19 (1.6) 45 (4.2) 208 (2.3)
  15 677 (31.5) 214 (27.5) 276 (21.9) 402 (43.0) 313 (18.7) 277 (23.4) 266 (24.7) 2 425 (26.8)
  16 922 (43.0) 377 (48.5) 520 (41.2) 354 (37.9) 647 (38.6) 465 (39.2) 436 (40.5) 3 721 (41.1)
  17 422 (19.7) 169 (21.8) 343 (27.2) 98 (10.5) 512 (30.6) 355 (29.9) 280 (26.0) 2 179 (24.1)
  18 93 (4.3) 9 (1.2) 112 (8.9) 14 (1.5) 177 (10.6) 70 (5.9) 49 (4.6) 524 (5.8)

Table 2

Comparison of health literacy scores among high school students in different groups of seven regions of China"

Items Health literacy scores, M (P25, P75) H/U value P value
Geographical area 370.51 < 0.01
  East China 39 (22, 45)
  South China 44 (38, 50)
  North China 40 (33, 45)
  Central China 43 (38, 47)
  Northwest China 40 (33, 45)
  Southwest China 41 (36, 46)
  Northeast China 38 (29, 43)
Annual household income/(×10 000 yuan) 284.43 < 0.01
  Below 1 37 (20, 44)
  1-2.49 40 (33, 45)
  2.5-4.99 41 (35, 46)
  5-7.99 42 (36, 47)
  8-9.99 41 (35, 46)
  Above 10 42 (33, 47)
Father’s education level 375.21 < 0.01
  Below junior college 41 (34, 46)
  Junior college 42 (36, 47)
  Undergraduate graduation 37 (18, 45)
  Master’s degree or above 19 (15, 39)
Mother’s education level 20.06 < 0.01
  Below junior college 41 (33, 46)
  Junior college 41 (30, 46)
  Undergraduate graduation 40 (28, 46)
  Master’s degree or above 38 (21, 45)
Age/years 19.72 < 0.01
  14 41 (36, 46)
  15 41 (34, 46)
  16 40 (32, 46)
  17 40 (33, 45)
  18 40 (33, 46)
Urban and rural distribution 8 253 447.50 < 0.01
  City/County/District 42 (36, 47)
  Town and rural areas 39 (29, 44)
Gender 9 212 425.00 < 0.01
  Male 40 (30, 45)
  Female 41 (35, 46)

Table 3

Comparison of average daily sitting time (hours) among high school students in seven regions of China"

Items Average daily sitting time/h, M (P25, P75) H/U value P value
Geographical area 302.06 < 0.01
  East China 10.00 (8.00, 12.00)
  South China 9.00 (7.00, 12.00)
  North China 10.00 (8.00, 12.00)
  Central China 10.00 (8.00, 13.00)
  Northwest China 8.00 (7.00, 10.00)
  Southwest China 9.50 (7.38, 11.00)
  Northeast China 10.00 (8.00, 12.00)
Annual household income/(×10 000 yuan) 306.47 < 0.01
  Below 1 8.00 (6.00, 10.00)
  1-2.49 9.00 (8.00, 11.00)
  2.5-4.99 10.00 (8.00, 12.00)
  5-7.99 10.00 (7.00, 12.00)
  8-9.99 10.00 (8.00, 11.00)
  Above 10 11.00 (8.00, 12.00)
Father’s education level 65.62 < 0.01
  Below junior college 10.00 (8.00, 12.00)
  Junior college 10.00 (8.00, 12.00)
  Undergraduate graduation 10.00 (8.00, 12.00)
  Master’s degree or above 10.00 (7.00, 12.00)
Mother’s education level 183.23 < 0.01
  Below junior college 10.00 (7.00, 12.00)
  Junior college 10.00 (8.00, 12.00)
  Undergraduate graduation 10.00 (8.00, 13.00)
  Master’s degree or above 13.00 (10.00, 15.00)
Age/years 7.85 0.097
  14 9.00 (8.00, 12.00)
  15 10.00 (7.00, 12.00)
  16 10.00 (8.00, 12.00)
  17 10.00 (8.00, 12.00)
  18 10.00 (7.50, 11.00)
Urban and rural distribution 7 997 613.00 0.53
  City/County/District 10.00 (8.00, 12.00)
  Town and rural areas 10.00 (8.00, 12.00)
Gender 6 844 683.00 < 0.01
  Male 10.00 (8.00, 12.00)
  Female 9.00 (7.00, 11.00)

Table 4

Regression model equation analysis of influencing factors of total score of health literacy"

Items un-Std β Std-error Std β t value P valueMulticollinearity
Tolerance VIF
Independent variable
  Constant 39.36 1.02 38.55 < 0.01
  Household population 0.15 0.10 0.02 1.59 0.11 0.97 1.029
  Father’s education level -4.18 0.17 -0.32 -24.49 < 0.01 0.65 1.544
  Mother’s education level 1.43 0.22 0.09 6.47 < 0.01 0.62 1.623
  Annual household income 1.01 0.07 0.15 13.85 < 0.01 0.91 1.096
  Average daily sitting time -0.08 0.04 -0.02 -2.09 0.04 0.94 1.061
Control variable
  Urban and rural distribution
    City/County/District 3.39 0.23 0.15 14.54 < 0.01 0.97 1.030
    Town and rural areas (refer to nominal variables) 0
  Gender
    Male -2.36 0.23 -0.11 -10.11 < 0.01 0.98 1.026
    Female (refer to nominal variables) 0
  Age/years
    18 -0.23 0.93 -0.01 -0.24 0.81 0.28 3.626
    17 -1.22 0.83 -0.05 -1.47 0.14 0.10 9.718
    16 -1.13 0.82 -0.05 -1.38 0.17 0.08 12.238
    15 -0.79 0.83 -0.03 -0.96 0.34 0.10 10.049
    14 (refer to nominal variables) 0

Table 5

Regression model equation analysis of influencing factors of average daily sitting time"

Items un-Std β Std-error Std β t value P valueMulticollinearity
Tolerance VIF
Independent variable
  Constant 7.67 0.33 23.16 < 0.01
  Total score of health literacy -0.01 0.00 -0.02 -2.09 0.04 0.86 1.16
  Household population -0.02 0.03 -0.01 -0.74 0.46 0.97 1.03
  Father’s education level -0.07 0.05 -0.02 -1.34 0.18 0.60 1.66
  Mother’s education level 0.63 0.07 0.13 9.20 < 0.01 0.62 1.61
  Annual household income 0.28 0.02 0.14 12.52 < 0.01 0.91 1.10
Control variable
  Urban and rural distribution
    City/County/District -0.15 0.07 -0.02 -2.05 0.04 0.95 1.06
    Town and rural areas (refer to nominal variables) 0
  Gender
    Male 0.78 0.07 0.12 10.88 < 0.01 0.98 1.02
    Female (refer to nominal variables) 0
  Age/years
    18 -0.14 0.29 -0.01 -0.48 0.63 0.28 3.63
    17 0.22 0.26 0.03 0.85 0.40 0.10 9.72
    16 0.21 0.25 0.03 0.85 0.40 0.08 12.24
    15 -0.02 0.25 0.00 -0.08 0.94 0.10 10.05
    14 (refer to nominal variables) 0
1 Chen ST , Liu Y , Tremblay MS , et al.Meeting 24-h movement guidelines: Prevalence, correlates, and the relationships with overweight and obesity among Chinese children and adolescents[J].J Sport Health Sci,2021,10(3):349-359.
doi: 10.1016/j.jshs.2020.07.002
2 Dong B , Zou Z , Song Y , et al.Adolescent health and healthy China 2030: A review[J].J Adolesc Health,2020,67(5S):S24-S31.
3 Chu-Ko F , Chong ML , Chung CJ , et al.Exploring the factors related to adolescent health literacy, health-promoting lifestyle profile, and health status[J].BMC Public Health,2021,21(1):2196.
doi: 10.1186/s12889-021-12239-w
4 Albuquerque JV , Chen Y , Moir F , et al.School-based interventions to improve health literacy of senior high school students: A scoping review protocol[J].JBI Evid Synth,2022,20(4):1165-1173.
doi: 10.11124/JBIES-21-00333
5 杨剑, 吴铭, 邱服冰, 等.12~17岁儿童青少年健康相关久坐行为研究[J].中国康复理论与实践,2020,26(12):1365-1372.
doi: 10.3969/j.issn.1006?9771.2020.12.001
6 张可云, 李晨.新中国70年行政区划调整的历程、特征与展望[J].社会科学辑刊,2021,252(1):118-128.
7 王佃利, 于棋.国家空间的结构调试: 中国行政区划70年的变迁与功能转型[J].行政论坛,2019,26(4):5-12.
8 杨沁杰, 庄汝龙.近二十年行政区划研究知识图谱: 基于CSSCI数据库的CiteSpace Ⅲ分析[J].世界地理研究,2018,27(1):141-150.
9 梁进社, 刘洋.论中国城市规模划分[J].城市发展研究,2020,27(3):13-18.
10 杨振, 雷军.中国地级及以上城市城镇化发展的时空格局及影响因素[J].中国科学院大学学报,2019,36(1):82-92.
11 曾琳, 陶立元, 赵英帅.健康管理学研究中的样本量估计[J].中华健康管理学杂志,2021,15(2):205-208.
12 李康, 贺佳.医学统计学[M].北京: 人民卫生出版社,2018:168.
13 中国健康教育中心.中国居民健康素养监测报告[M].北京: 人民卫生出版社,2018.
14 杜修本, 韩铁光, 荆春霞, 等.全国居民健康素养监测快速评估调查问卷(HLSRAQ)的构建与验证[J].健康教育与健康促进,2019,14(4):310-313.
15 熊家豪, 牟劲松, 赵淑英, 等.我国大学生健康素养问卷的研制及信度和效度评价[J].中国卫生统计,2018,35(4):518-521.
16 Zhu X , Haegele JA , Sun H .Health-related fitness knowledge growth in middle school years: Individual-and school-level correlates[J].J Sport Health Sci,2020,9(6):664-669.
doi: 10.1016/j.jshs.2019.04.005
17 Kern BD , Imagbe S , Bellar D , et al.Health-related fitness content knowledge, physical activity, and instructional practices among U.S. physical educators[J].Res Q Exerc Sport,2020,91(1):92-101.
doi: 10.1080/02701367.2019.1648744
18 Ruiz LD , Zuelch ML , Dimitratos SM , et al.Adolescent obesity: diet quality, psychosocial health, and cardiometabolic risk factors[J].Nutrients,2019,12(1):43.
doi: 10.3390/nu12010043
19 Fleary SA , Joseph P .Adolescents' health literacy and decision-making: A qualitative study[J].Am J Health Behav,2020,44(4):392-408.
doi: 10.5993/AJHB.44.4.3
20 Rueda-Medina B , Gómez-Urquiza JL , Tapia-Haro R , et al.Assessing health science students' health literacy and its association with health behaviours[J].Health Soc Care Community,2020,28(6):2134-2139.
doi: 10.1111/hsc.13024
21 An R , Shen J , Yang Q , et al.Impact of built environment on physical activity and obesity among children and adolescents in China: A narrative systematic review[J].J Sport Health Sci,2019,8(2):153-169.
doi: 10.1016/j.jshs.2018.11.003
22 McLellan G , Arthur R , Donnelly S , et al.Segmented sedentary time and physical activity patterns throughout the week from wrist-worn ActiGraph GT3X+ accelerometers among children 7-12 years old[J].J Sport Health Sci,2020,9(2):179-188.
doi: 10.1016/j.jshs.2019.02.005
23 Jones M , Defever E , Letsinger A , et al.A mixed-studies syste-matic review and meta-analysis of school-based interventions to promote physical activity and/or reduce sedentary time in children[J].J Sport Health Sci,2020,9(1):3-17.
24 Xu Y , Mei M , Wang H , et al.Association between weight status and physical fitness in Chinese mainland children and adolescents: A cross-sectional study[J].Int J Environ Res Public Health,2020,17(7):2468.
doi: 10.3390/ijerph17072468
25 Kanellopoulou A , Notara V , Antonogeorgos G , et al.Inverse association between health literacy and obesity among children in Greece: A school-based, cross-sectional epidemiological study[J].Health Educ Behav,2022,49(1):54-65.
26 Melton KK , Caldwell EP .Home environment influence on adolescent health literacy[J].Fam Community Health,2022,45(1):1-9.
27 陈杰. 健康中国背景下呼和浩特市中学生体育健康素养的影响因素研究[D]. 呼和浩特: 内蒙古师范大学, 2021.
28 Guo S , Yu X , Naccarella L , et al.Health literacy and health-related quality of life in Beijing adolescents: A path analysis[J].Health Lit Res Pract,2022,6(4):e300-e309.
[1] Meng-jie CUI,Qi MA,Man-man CHEN,Tao MA,Xin-xin WANG,Jie-yu LIU,Yi ZHANG,Li CHEN,Jia-nuo JIANG,Wen YUAN,Tong-jun GUO,Yan-hui DONG,Jun MA,Yi XING. Association between different growth patterns and metabolic syndrome in children and adolescents aged 7 to 17 years [J]. Journal of Peking University (Health Sciences), 2023, 55(3): 415-420.
[2] Jia-jia DANG,Shan CAI,Pan-liang ZHONG,Ya-qi WANG,Yun-fei LIU,Di SHI,Zi-yue CHEN,Yi-hang ZHANG,Pei-jin HU,Jing LI,Jun MA,Yi SONG. Association of outdoor artificial light at night exposure with overweight and obesity among children and adolescents aged 9 to 18 years in China [J]. Journal of Peking University (Health Sciences), 2023, 55(3): 421-428.
[3] Dan-feng ZHENG,Jun-yu LI,Jia-xi LI,Ying-shuang ZHANG,Yan-feng ZHONG,Miao YU. Pathologic features of paraspinal muscle biopsies in patients with adolescent idiopathic scoliosis [J]. Journal of Peking University (Health Sciences), 2023, 55(2): 283-291.
[4] Yun-fei LIU,Jia-jia DANG,Pan-liang ZHONG,Ning MA,Di SHI,Yi SONG. Injury mortality among Chinese aged 5 to 24 years from 1990 to 2019 [J]. Journal of Peking University (Health Sciences), 2022, 54(3): 498-504.
[5] CHEN Man-man,YANG Zhao-geng,SU Bin-bin,LI Yan-hui,GAO Di,MA Ying,MA Tao,DONG Yan-hui,MA Jun. Analysis on the law of height growth spurt in adolescence of children and adolescents in Zhongshan City [J]. Journal of Peking University (Health Sciences), 2021, 53(3): 506-510.
[6] WANG Xiao-qi,CHEN Mei-jun,YUN Qing-ping,SUN Si-wei,WANG Xi-kai,SHI Yu-hui,JI Ying,GUAN Zhong-jun,CHANG Chun. Impact of health literacy on patient experience of outpatients in China and its mechanism [J]. Journal of Peking University (Health Sciences), 2021, 53(3): 560-565.
[7] YANG Xue,SUN Wei,WANG Zhe,JI Ai-ping,BAI Jie. Clinical analysis of children and adolescents emergency dental trauma cases [J]. Journal of Peking University (Health Sciences), 2021, 53(2): 384-389.
[8] ZHOU Jing,LIU Yi. Cone-beam CT evaluation of temporomandibular joint in skeletal class Ⅱ female adolescents with different vertical patterns [J]. Journal of Peking University (Health Sciences), 2021, 53(1): 109-119.
[9] Dong-mei LUO,Xiao-jin YAN,Pei-jin HU,Jing-shu ZHANG,Yi SONG,Jun MA. Subnational inequalities of early marriage and fertility among Chinese females from 1990 to 2010 [J]. Journal of Peking University (Health Sciences), 2020, 52(3): 479-485.
[10] Chun-yan TAO,Hong-xia LI,Xue-ying LI,Chao-shu TANG,Hong-fang JIN,Jun-bao DU. Hemodynamic changes in standing-up test of children and adolescents with postural tachycardia syndrome [J]. Journal of Peking University(Health Sciences), 2019, 51(3): 414-421.
[11] LI Xin, WANG Xin, WU Di, CHEN Zhi-bin, WANG Meng-xing, GAO Yan-xia, GONG Chun-xiu, QIN Man. Interleukin-1β and C-reactive protein level in plasma and gingival crevicular fluid in adolescents with diabetes mellitus [J]. Journal of Peking University(Health Sciences), 2018, 50(3): 538-542.
[12] CHEN Tian-qi, DONG Bin, ZHANG Wen-jing, GAO Di-si, DONG Yan-hui, MA Jun, MA Ying-hua. Association between speed and endurance performance with sleep duration in children and adolescents [J]. Journal of Peking University(Health Sciences), 2018, 50(3): 429-435.
[13] DONG Yan-hui, SONG Yi, DONG Bin, ZOU Zhi-yong, WANG Zheng-he, YANG Zhao-geng, WANG Xi-jie, LI Yan-hui, MA Jun. Association between the blood pressure status and nutritional status among Chinese students aged 7-18 years in 2014: based on the national blood pressure reference for Chinese children and adolescents [J]. Journal of Peking University(Health Sciences), 2018, 50(3): 422-428.
[14] WANG Nan, ZHAO Yu-ming. Retrospective study of dental treatment under general anesthesia of 62 disabled children and adolescents [J]. Journal of Peking University(Health Sciences), 2018, 50(2): 293-299.
[15] DONG Yan-hui, WANG Zheng-he, YANG Zhao-geng, WANG Xi-jie, CHEN Yan-jun, ZOU Zhi-yong, MA Jun. Epidemic status and secular trends of malnutrition among children and adolescents aged 7-18 years from 2005 to 2014 in China [J]. Journal of Peking University(Health Sciences), 2017, 49(3): 424-432.
Viewed
Full text


Abstract

Cited

  Shared   
  Discussed   
[1] . [J]. Journal of Peking University(Health Sciences), 2009, 41(3): 297 -301 .
[2] . [J]. Journal of Peking University(Health Sciences), 2009, 41(5): 516 -520 .
[3] . [J]. Journal of Peking University(Health Sciences), 2007, 39(3): 310 -314 .
[4] . [J]. Journal of Peking University(Health Sciences), 2007, 39(3): 333 -336 .
[5] . [J]. Journal of Peking University(Health Sciences), 2007, 39(3): 225 -328 .
[6] Author. English Title Test[J]. Journal of Peking University(Health Sciences), 2010, 42(1): 1 -10 .
[7] . [J]. Journal of Peking University(Health Sciences), 2009, 41(1): 52 -55 .
[8] . [J]. Journal of Peking University(Health Sciences), 2009, 41(4): 459 -462 .
[9] . [J]. Journal of Peking University(Health Sciences), 2010, 42(1): 82 -84 .
[10] . [J]. Journal of Peking University(Health Sciences), 2007, 39(3): 329 -332 .