Clustering of multiple lifestyle behaviors among migrant, left-behind and local adolescents in China: a cross-sectional study

Abstract

Background: Influence of migration on externalized behavioral problems (e.g., aggressive) among adolescents has been well assessed, yet lifestyle behaviors of migrant, left-behind and local adolescents have been largely overlooked by researchers and policy-makers. Therefore, this study aimed to identify clustering of multiple lifestyle behaviors and their associations with migrant status among Chinese adolescents.Methods: A cross-sectional survey was conducted in 2015 in Beijing City and Wuwei County. Adolescents self-reported age, gender, family economic status, migrant situation, and lifestyle behaviors (physical activity, sleep, smoke, drink, fruit and vegetable consumption) via a battery of validated questionnaires. Latent class analysis was conducted to identify behavioral clusters using Mplus 7.1. ANOVA, and multivariable logistic regression were used to examine associations between migrant situations and behavioral clusters using SPSS 22.Results: Three distinct behavioral clusters were exhibited among 1,364 students (mean age: 13.41±0.84 years): “low risk” (N=847), “moderate risk” (N=412) and “high risk” (N=105). The “high-risk” cluster had the highest prevalence of adolescents not meeting healthy behavioral recommendations. There were no significant differences in the prevalence of high-risk lifestyle among migrant, left-behind, rural local and urban local adolescents. But migrant adolescents had the lowest prevalence of low-risk lifestyle, followed by left-behind, rural and urban local adolescents. Moreover, compared with urban local, migrant (OR=2.72, 95%CI: 1.88,3.94), left-behind (OR=2.28, 95%CI: 1.46, 3.55), and rural local (OR=1.76, 95%CI:1.03,3.01) adolescents had a higher risk of moderate-risk lifestyle. Conclusions: Clustering of different lifestyles was observed. To achieve the target of a 15% relative reduction in insufficient physical activity by 2030 and to promote health eating, more attention should be paid on the migrant and left-behind adolescents in China.