| ObjectiveTo study the current situation and influencing factors of early and middle adolescence children’s Knowledge-Attitude-Practice(KAP)related to adolescence and mental health in an area of Chongqing,to explore the effects of peer education and traditional health education intervention on the pubertal KAP and mental health of early and middle adolescence children,and provide theoretical basis for improving mental health of early and middle students in puberty.MethodA baseline survey of 3554 primary and middle school students selected from three towns(including one primary school and one secondary school in every town)by stratified sampling method was conducted in December 2017 to evaluate the current situation and influencing factors of the pubertal KAP and mental health of the early and middle adolescencechildren in an area of Chongqing.The self-designed general questionnaire,the pubertal KAP questionnaire and Mental Health Inventory of Middle-School Students(MMHI-60)Scale were used to collect data.Three towns were divided into peer education group,traditional health education group and control group(each group includes one primary school and one secondary school)randomly.The peer education group accepted peer education based on adolescent health education,the traditional health education group accepted traditional health education based on adolescent health education,and control group did not accept education intervention.During intervention,we supervised and checked these intervention activities every semester,solving the problems of peer educators and health education teachers,and we conducted follow-up survey to evaluate the effects of the interventions on the pubertal KAP and mental health every half year.Results1.Baseline conditionsThe baseline survey showed that the pubertal knowledge score,attitude score,practice score,KAP score of subjects was51.03±27.64,78.46±15.74,53.78±14.44,61.09±15.26,accounting for51.03%,78.46%,53.78%,61.09% of the total score(100scores).The total mean score of mental health was 1.87±0.64,and the incidence of mental health was 34.7%.Among the 10 components form factors of mental health,the top three detection rates were obsessive-compulsive symptom,Emotional imbalance and Study pressure.Multiple linear regression analysis of early and middle adolescence children’s pubertal KAP showed that,the higher the academic stage,the more number of close friends,democratic parenting style,and girls,the higher the score of pubertal knowledge(all P<0.05).The higher the academic stage,the better the relationship of parents,the better the relationship with father,the better the academic performance,the more number of close friends,democratic parenting style,the higher the score of pubertal attitude(all P <0.05).The higher the academic stage,the better the relationship with mother,the better the academic performance,the more number of close friends,democratic parenting style,and girls,the higher the score of pubertal behavior(all P <0.05).The higher the academic stage,the better the relationship with mother,the better the academic performance,the more number of close friends,democratic parenting style,and girls,the higher the score of pubertal KAP(all P <0.05).Multiple linear regression analysis of early and middle adolescence children’s mental health showed that,The higher the academic stage,the worse the relationship of parents,the worse the relationship with father,the worse the relationship with mother,the worse the academic performance,the less number of close friends,not democratic parenting style,the higher the total mean score of mental health(all P <0.05).the worse therelationship with mother,not democratic parenting style,and girls,the higher the mean score of compulsion(all P <0.05).the worse the relationship of parents,the worse the relationship with mother,the worse the academic performance,the less number of close friends,not democratic parenting style,the higher the mean score of paranoia(all P <0.05).the worse the relationship of parents,the worse the relationship with father,the worse the relationship with mother,the worse the academic performance,not democratic parenting style,the higher the mean score of hostility(all P<0.05).The higher the academic stage,the worse the relationship with father,the worse the relationship with mother,the worse the academic performance,the less number of close friends,not democratic parenting style,the higher the mean score of intense and sensitive interpersonal relationship(all P <0.05).The worse the relationship of parents,the worse the relationship with father,the worse the relationship with mother,the worse the academic performance,the less number of close friends,not democratic parenting style,and girls,the higher the mean score of depression(all P <0.05).The higher the academic stage,the worse the relationship of parents,the worse the relationship with father,the worse the relationship with mother,the worse the academic performance,the less number of close friends,not democratic parenting style,and girls,the higher the mean score of anxiety(all P <0.05).The higher the academic stage,the worse the relationship of parents,the worse the relationship withfather,the worse the relationship with mother,the worse the academic performance,the less number of close friends,not democratic parenting style,the higher the mean score of academic stress(all P <0.05).The higher the academic stage,the worse the relationship of parents,the worse the relationship with father,the worse the relationship with mother,the worse the academic performance,the less number of close friends,not democratic parenting style,and boys,the higher the mean score of maladjustment(all P <0.05).The higher the academic stage,the worse the relationship of parents,the worse the relationship with father,the worse the relationship with mother,the worse the academic performance,the less number of close friends,not democratic parenting style,the higher the mean score of emotional imbalance(all P <0.05).The lower the academic stage,the worse the relationship of parents,the worse the relationship with father,the worse the relationship with mother,the worse the academic performance,the less number of close friends,not democratic parenting style,and boys,the higher the mean score of psychological imbalance(all P <0.05).Regarding the association between the pubertal KAP and mental health of the early and middle adolescence children,Pearson correlation analysis found that the pubertal KAP and pubertal attitude were negatively related to mental health and it’s 10 factors(all P <0.05),the pubertal behavior was negatively related to mental health and it’s 9 factors withoutcompulsion(all P <0.05),the pubertal knowledge was negatively related to paranoia,hostility,psychological imbalance and positively related to academic stress,emotional imbalance(all P <0.05).2.Evaluation of interventionRegarding the impacts of intervention on pubertal KAP of the early and middle adolescence children,Paired t-test analysis of the growth values of pubertal KAP before and after intervention shown that,after half year of intervention,the scores of knowledge,attitude and total KAP was increased significantly in peer education group(all P <0.05);the scores of knowledge,attitude,practice and total KAP was increased significantly in both traditional health education group and control group(all P <0.05).after 1year and 1.5 years of intervention,significant increases of knowledge,attitude,practice and KAP were found in three groups(all P <0.05).Repeated measures analysis of variance displayed that the increases of knowledge(F=7.265)in peer education group was greater than in control group(P <0.05);the increases of knowledge(F=40.315)and total KAP(F=29.823)in traditional health education group was greater than in control group(all P <0.05);the increases of knowledge(F=23.255),practice dimension(F=16.996)and total KAP(F=19.977)in traditional health education group was greater than in peer education group(all P <0.05).Regarding the impacts of intervention on mental health of the early and middle adolescence children,Paired t-test analysis of the growth values ofmental health before and after intervention shown that,after half year of intervention,the scores of compulsion,intense and sensitive interpersonal relationship and psychological imbalance was decreased significantly in peer education group(all P <0.05),but total mental health and other factors had no significant decrease;the scores of total mental health and all factors in traditional health education group had no significant decrease;the scores of academic stress was increased significantly in control group(P <0.05),but total mental health and other factors had no significant change.after 1year of intervention,the scores of total mental health,compulsion,paranoia and intense and sensitive interpersonal relationship was decreased significantly in peer education group(all P <0.05);the scores of compulsion,paranoia and intense and sensitive interpersonal relationship in traditional health education group had significantly decreased(all P <0.05);the scores of total mental health and all factors except compulsion had significantly increased in control group(all P <0.05).after 1.5 years of intervention,the scores of total mental health,compulsion,paranoia,intense and sensitive interpersonal relationship and emotional imbalance was decreased significantly in peer education group(all P <0.05);the scores of total mental health,compulsion,paranoia and intense and sensitive interpersonal relationship in traditional health education group had significantly decreased(all P <0.05);the scores of compulsion incontrol group had significantly decreased(P <0.05),the scores of hostility,depression and academic stress had significantly increased(all P <0.05).Repeated measures analysis of variance displayed that the improvement of total mental health(F=10.815),compulsion(F=5.539),paranoia(F=7.114),hostility(F=8.549),intense and sensitive interpersonal relationship(F=16.148),depression(F=8.941),anxiety(F=4.813)and psychological imbalance(F=7.417)in peer education group was better than in control group(all P <0.05);the improvement of total mental health(F=8.820),paranoia(F=5.394),hostility(F=6.360),intense and sensitive interpersonal relationship(F=11.229),depression(F=11.746),anxiety(F=6.838),academic stress(F=4.043),maladjustment(F=5.075)and psychological imbalance(F=5.930)in traditional health education group was better than in control group(all P <0.05);The change of total mental health and all factors in traditional health education group has no statistical significance with in peer education group.ConclusionThe puberty KAP and mental health of early and middle adolescence children are not optimistic and have many influencing factors,the mental health of early and middle adolescence children was associated with puberty KAP negatively.The peer education intervention and traditional health education intervention based on adolescent health education can effectively improve the puberty KAP and mental health level of early andmiddle adolescence children.Therefore,it is necessary to strengthen adolescent health education for early and middle adolescence children. |
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