Abstract: Objective To examine the association of 24-hour movements with negative emotions in adolescents in Shanghai, in order to provide theoretical reference for the integration of medical-educational practice in 24-hour activity interventions for adolescent mental health. Methods Middle school students from 6 sample districts in Shanghai were selected by multi-stage stratified random cluster sampling method during November 2017 and January 2018. Standardized questionnaires were used to assess meeting 24-hour movement guidelines on nightly sleep duration, screen exposure time, and moderate-to-vigorous physical activity as well as negative emotions of depression, anxiety and stress. The association between 24-hour movements and negative emotions was analyzed by Logistic regression. Results Overall, 2 312 students were enrolled in this study, of whom 1 113(48.1%) were female students and 1 267 (54.8%) were junior-middle school students, with an average age of (14.84±2.09) years old. The prevalence rates of junior-middle school students and senior-middle school students meeting all the 24-hour movement guidelines were 14.4% and 3.5%, while the prevalence of negative emotions in junior-middle school students and senior-middle school students was 11.4% - 35.8% and 19.5% - 51.6%, respectively. There was a dose-dependent association between the number of meeting the 24-hour movement guidelines and negative emotions. Meeting more 24-hour movement guidelines was related to a lower risk of negative emotions. Compared with those meeting none of the guidelines, the risk of negative emotions decreased by 78% to 79% for junior-middle school students who met all 24-hour of activity (anxiety OR=0.21, 95%CI:0.11 - 0.39; depression OR=0.22, 95%CI:0.17 - 0.51), and by 49% to 50% for senior-middle school students (stress OR=0.50, 95%CI:0.29 - 0.86; depression OR=0.51, 95%CI:0.30 - 0.87). Conclusions The prevalence of Shanghai adolescents meeting the 24-hour movement guidelines is low and meeting more 24-hour movement guidelines is associated with lower risk of negative emotions. This study highlights the importance of enhancing 24-hour movement intervention for supporting mental health in adolescents.

Key words: adolescents, 24-hour movement, negative emotions, sleep, screen time, anxiety, depression

摘要： 目的 探索上海市青少年24小时活动情况及其与负性情绪的相关性,以期为24小时活动干预促进青少年心理健康的医教结合实践提供理论参考。方法 采用多阶段分层整群随机抽样方法,于2017年11月—2018年1月抽取上海市6个行政区(县)6～12年级学生作为研究对象。通过学生自填标准化问卷评估睡眠时长、屏幕暴露时间和中高强度身体活动三项24小时活动达标情况,以及抑郁、焦虑和压力三种负性情绪。采用Logistic回归分析探索24小时活动达标情况与负性情绪的相关性。结果 共入选2 312名青少年,平均年龄为(14.84±2.09)岁,其中女生1 113名(48.1%),初中生1 267名(54.8%)。初中生和高中生24小时活动全部达标率分别为13.4%和3.5%,而负性情绪发生率分别为11.4%～35.8%和19.5%～51.6%。24小时活动达标项目数量与负性情绪存在剂量-效应关系,达标项目数越多,负性情绪发生风险越低。与无一项达标者相比,初中生24小时活动全部达标者负性情绪发生风险下降78%～79%(焦虑OR=0.21,95%CI:0.11～0.39;抑郁OR=0.22,95%CI:0.09～0.51),而高中生下降49%~50% (压力OR=0.50,95%CI:0.29～0.86;抑郁OR=0.51,95%CI:0.30～0.87)。结论 上海市青少年24小时活动达标情况不容乐观,而达标项目数越多的学生,负性情绪发生风险越低,提示加强24小时活动干预对提高青少年心理健康的重要性。

关键词: 青少年, 24小时活动, 负性情绪, 睡眠, 视屏时间, 焦虑, 抑郁