Prevalence of Suboptimal Health Status and the Relationships between Suboptimal Health Status and Lifestyle Factors among Chinese Adults Using a Multi-Level Generalized Estimating Equation Model

Xu, Tao; Zhu, Guijin

doi:10.3390/ijerph17030763

Cited by 29 publications

(35 citation statements)

References 30 publications

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“…Several studies also found that many lifestyle factors were closely associated with SHS among adults [5,29,30,35]. In our previous study, unhealthy lifestyles were found closely associated with SHS among adults aged above 18 years old, including smoking, drinking alcohol, short sleep duration, poor sleep quality, lack of regular exercise, stress, negative life events, unhealthy diet choices, and irregular meal times [7]. In this study, we found that these lifestyle factors were also closely associated with SHS among children aged 10-17 years old.…”

Section: Discussionmentioning

confidence: 75%

“…In 2007-2011, we conducted a national survey in six provinces or autonomous regions of China to examine SHS among Chinese adults and children across a broad age range and covering dozens of ethnic minorities. And we found that the prevalence of SHS was 69.46% among Chinese adults and the prevalence for male adults (67.74%) was lower than that for female adults (72.67%) [7].…”

Section: Introductionmentioning

confidence: 71%

“…A Delphi self-rating SHS scale was used to assess the SHS of children [7,23]. The scale included 18 symptom items grouped in six dimensions: physical symptoms, psychological symptoms, vigor, social adaptability, immunity, and going to hospital.…”

Section: Suboptimal Health Assessment and Definition Of Covariatesmentioning

confidence: 99%

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Prevalence and Associated Lifestyle Factors of Suboptimal Health Status among Chinese Children Using a Multi-Level Model

Liu

Zhu

2020

IJERPH

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Chinese children are facing health challenges brought by chronic non-communicable diseases, such as physical problems and psychological related health problems. Childhood represents a critical life period when the long-term dietary and lifestyle behaviors are formed. It is necessary to survey the prevalence of suboptimal health status (SHS) among Chinese children and to research the relationship between SHS and lifestyles. This study aimed to examine the prevalence of SHS among Chinese children using a large-scale population survey sample covering school students and nonstudent children, and clarified the relationships between SHS and lifestyle factors using multi-level models controlled for the cluster effect of location and the confounding effect of demographics. Multi-level generalized estimating equation models were used to examine the relationships between SHS and lifestyle factors. Prevalence ratios (PR) and 95% confidence intervals (CI) were used to assess the strength of these relationships. Of the 29,560 children, 14,393 reported one or more SHS symptoms, giving a SHS prevalence of 48.69%. The prevalence of SHS for boys (46.07%) was lower than that for girls (51.05%). After controlling for the cluster effect of living areas and confounding effect of demographic characteristics, lifestyle factors associated with SHS were: less sleep duration, current smokers (PR = 1.085, 95%CI: 1.027–1.147), current drinkers (PR = 1.072, 95%CI: 1.016–1.131), children’ parents suffering from chronic diseases (PR = 1.294, 95%CI: 1.179–1.421), poor sleep quality (PR = 1.470, 95%CI: 1.394–1.550), stress (PR = 1.545, 95%CI: 1.398–1.707), negative life events (PR = 1.237, 95%CI: 1.088–1.406), hypertension (PR = 1.046, 95%CI: 1.009–1.084), unhealthy diet choice (PR = 1.091, 95%CI: 1.051–1.133) and irregular meal time (PR = 1.210, 95%CI: 1.163–1.259). Children who could exercise regularly (PR = 0.897, 95%CI: 0.868–0.927) and those with regular medical checkup (PR = 0.891, 95%CI: 0.854–0.929) were associated with lower prevalence probability of SHS. SHS has become a serious public health challenge for Chinese children. Unhealthy lifestyles were closely associated with SHS. Implementation of preventative strategies are needed to reduce the potential SHS burden associated with these widespread high-risk unhealthy lifestyle behaviors.

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Section: Discussionmentioning

confidence: 75%

Section: Introductionmentioning

confidence: 71%

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Prevalence and Associated Lifestyle Factors of Suboptimal Health Status among Chinese Children Using a Multi-Level Model

Liu

Zhu

2020

IJERPH

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“…Irregular meal time indicated the participant could not have breakfast, lunch and dinner at xed time period. Sub-health status was assessed with the Delphi sub-health scale [19,20].…”

Section: De Nitiona Of Depression and Covariatesmentioning

confidence: 99%

Prevalence of Depression and Associated Relationship with Lifestyles in Chinese Adults with Multi-Level Generalized Estimation Equation Model

Han

2021

Preprint

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BackgroundMost epidemiological surveys paid more attention to the occurrence of depression in the elderly and adolescents, while ignored the young and middle-aged people. Besides, depression resulted from a complex interaction of heredity, biochemistry, social, psychological and biological factors. The aim of our study was to examine the prevalence of depression and the relationship between depression and lifestyle factors in Chinese adults based on a large-scale cross-sectional survey. MethodsThe Composite International Diagnostic Interview Short Form for Major Depression was used to assess the depression status of all subjects. We used multi-level generalized estimating equation model to determine the relationship between depression and lifestyles. ResultsOf the 7985 respondents, 4252 were considered as being depressive with a prevalence of 53.25%. After controlling for the cluster effect of living environment and confounding effect of demographic characteristics, the following factors increased the risk of depression: overweight(OR=1.269, 95% CI: 1.117-1.444), obesity(OR=1.415, 95%CI: 1.152-1.740), single status(OR=2.003, 95% CI: 1.635-2.457), alcohol drinking(OR=1.333, 95%CI: 1.137-1.563), sleeping less than 6h a day(OR=1.485, 95% CI: 1.267-1.743), poor sleep quality (OR=1.553, 95% CI: 1.392-1.732), feeling stressed(OR=2.133, 95% CI: 1.744-2.621), adverse life events(OR=1.513, 95% CI: 1.333-1.718),unhealthy dietary patterns(OR=1.472, 95% CI: 1.324-1.638), irregular meal times (OR=2.482, 95% CI: 2.138-2.887) and suboptimal health status(OR=7.919, 95% CI: 6.843-9.185). Those with medical insurance (OR=0.774, 95% CI: 0.649-0.921) was less likely to have depression.ConclusionsUnhealthy lifestyles were found closely associated with depression. By altering lifestyle behaviors for the better, the depressive symptoms could be effectively improved.

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“…SHS is becoming a global health issue. The SHS prevalence took up 71.7% in nurses [8], 69.46% in Chinese adults [9] and 55.9% in Chinese students [10], and SHS had adverse effects on metabolic syndrome [3], cognitive impairment [7], oxidative stress in pregnant women [2]. Thus, it might be of great importance for medicine staff to early detect and prevent SHS resulting in chronic disease and other adverse impacts.…”

Section: Introductionmentioning

confidence: 99%

Psychometric Properties of The Sub-Health Measurement Scale V1.0 for Assessing Suboptimal Health Status of Midwives: A Multi-Centre Cross-Sectional Study

Chen

Jiang²,

Zheng

et al. 2020

Preprint

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Purpose Midwives with high work stress are prone to suboptimal health status (SHS). However, there is a lack of unified measurement standard for SHS. Sub-Health Measurement Scale V1.0 (SHMS V1.0) is a multidimensional inventory that has been proved to have adequate psychometric properties in other populations. Therefore, this study aimed to evaluate validity and reliability of SHMS V1.0 in midwives.Methods In this cross-sectional study, 842 midwives from 46 midwifery institutions completed the SHMS V1.0. Internal consistency and test-retest reliability of SHMS V1.0 were assessed with Cronbach's alpha and Pearson correlation coefficient. Project analysis and confirmatory factor analysis (CFA) were performed to assess construct validity. Concurrent validity of SHMS V1.0 was evaluated by Pearson correlation analysis with the 14-item Fatigue Scale (FS-14).Results The total Cronbach's alpha and test-retest reliability coefficient of SHMS V1.0 was 0.908 and 0.804, respectively. The correlation coefficients between each item and its corresponding dimension, and those between each dimension and its corresponding subscale were all greater than 0.4. The CFA supported the structure of SHMS V1.0 with strong factor loadings and excellent fit indexes in the first-order and modified second-order factor model. The concurrent validity for SHMS V1.0 showed large correlation with FS-14, but social subscale showed medium correlations with total fatigue, physical fatigue and mental fatigue. Conclusions The SHMS V1.0 is a valid and reliable instrument for measuring SHS for midwives. Given the severity and harmfulness of SHS in midwives, SHMS V1.0 is recommended as an important tool for clinical practice and research.

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Prevalence of Suboptimal Health Status and the Relationships between Suboptimal Health Status and Lifestyle Factors among Chinese Adults Using a Multi-Level Generalized Estimating Equation Model

Cited by 29 publications

References 30 publications

Prevalence and Associated Lifestyle Factors of Suboptimal Health Status among Chinese Children Using a Multi-Level Model

Prevalence and Associated Lifestyle Factors of Suboptimal Health Status among Chinese Children Using a Multi-Level Model

Prevalence of Depression and Associated Relationship with Lifestyles in Chinese Adults with Multi-Level Generalized Estimation Equation Model

Psychometric Properties of The Sub-Health Measurement Scale V1.0 for Assessing Suboptimal Health Status of Midwives: A Multi-Centre Cross-Sectional Study

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