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.
Highlights
The health of adolescents has been becoming a critically important problem which is, always neglected and the health risk behaviors (HRBs) of adolescents has greatly increased the burden of many diseases or physical disorders and resulted in social problems [1,2]
There were very few reports, we found that the prevalence in Chinese adolescent was 10.7%, which is lower than a study in the children of Southeastern Ghana showing a rate of 15% [44]; these differences probably partly due to the difference in the age of the participants, namely children were more likely to develop pneumonia, which could cause fever [45]
When we further analyzed the clusters of HRBs and their association with different physical disorders, we found that in the two categories of moderate risk, namely model risk class 1 and moderate-risk class 2, the Odds ratios (OR) values of the two classes did not change much in the adolescents with diarrhea; regarding fever and vomiting, the OR
Summary
The health of adolescents has been becoming a critically important problem which is, always neglected and the health risk behaviors (HRBs) of adolescents has greatly increased the burden of many diseases or physical disorders and resulted in social problems [1,2]. The physical disorders commonly seen in adolescents include diarrhea, fever, cough, and vomiting [3]. The Global Burden of Disease study reported that, from 1980 to 2016, diarrhea was the eighth leading cause of death worldwide, with more than 16.5 million deaths every year [4]. One third of adolescents suffer from diarrhea in developing countries [5] and a study found that fever and diarrhea often appear together in patients [6]. But it can appear together with a cough [7]. Cough was a common clinical symptom, which was related to pneumonia, bronchial asthma, infection, etc., threatening the health of children and adults [9,10]. The incidence of vomiting which can occur in many cases including drug therapy [12], drinking, etc. [13], should not be ignored
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