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.
目的: 调查我国高中生静坐时长与健康素养现状及其影响因素，为提升高中生的身心健康水平提供依据。
方法: 采用分层随机整群抽样法，调查我国31个省、市和自治区(不包括香港、澳门特别行政区和中国台湾省数据)的高一和高二年级学生的静坐时长和健康素养。采用Kruskal-Wallis H法、独立样本Mann-Whitney U检验，并运用多元线性回归模型分析静坐时长与健康素养总分的影响因素。
结果: 健康素养总评分在不同地区、城乡分布、家庭年收入、父母亲学历、年龄、性别的多组间比较，差异均有统计学意义(P < 0.01)；静坐时长在不同地区、家庭年收入、父母亲学历、性别的多组间比较，差异均有统计学意义(P < 0.01)，但在不同年龄、城乡分布的组间比较，差异均无统计学意义(P>0.05)；多元线性回归模型分析提示，健康素养总评分与家庭年收入、母亲学历呈正相关，与父亲学历、静坐时长呈负相关，标准化回归系数β比较显示，父亲学历(-0.32)>家庭年收入(0.15)>母亲学历(0.09)>平均每天静坐时长(-0.02)，即父亲学历的影响最大，家庭年收入次之；静坐时长与家庭年收入、母亲学历呈正相关，与健康素养总评分呈负相关，标准化回归系数β比较显示，家庭年收入(0.14)>母亲学历(0.13)>健康素养总评分(-0.02)，即家庭年收入的影响最大，母亲学历次之。
结论: 我国高一和高二年级学生每天静坐时间总体较长，健康素养水平总体较低，健康素养水平和静坐时长互为负相关，且受高中生父母学历和家庭经济水平的影响较大。
Keywords: Adolescent; Health literacy; Root cause analysis; Sitting time.