A SEM-based Study To Explore The Factors Influencing Myopia In Adolescents And Its Correlation With Mental Health

Objective: To investigate the current situation of myopia among secondary school students in Urumqi,Xinjiang,to construct a structural equation model(SEM)between the influencing factors of myopia and mental health,to explore the correlation between the influencing factors of myopia and their mental health among secondary school students,and to provide a scientific basis for improving the evaluation scheme of the influencing factors of myopia.Methods: A questionnaire survey was conducted from December 2021 to January 2022 on 3379 secondary school students in Urumqi using a stratified whole-group random sampling method,including: general demographic characteristics(such as gender,whether he is an only child,whether he is congenitally myopic,sleep duration,parental myopia,etc.);physical activity levels;the phenomenon of sedentary behavior;parental support environment(maternal support,paternal support);social anxiety status;and life satisfaction status.A structural equation model was constructed to analyze the factors influencing myopia among secondary school students and its correlation with mental health.Results:(1)A total of 3379 secondary school students were surveyed in this study,of whom 2424(71.7%)were myopic and 955(28.3%)were non-myopic;778(23.0%)slept <6h/d,2092(61.9%)slept 6～8h/d,487(14.4%)slept8～10h/d,and 22(0.7%)slept >10h/d;1881 students(55.7%)had no myopia in either parent,843 students(24.9%)had myopia in either mother or father,405 students(12.0%)had myopia in both parents,and a total of 250 students(7.4%)were unaware of their parents’ myopia.(2)The findings of the study on the analysis of visual acuity status and different demographic characteristics showed that myopia among secondary school students was associated with gender,only child,congenital myopia,hours of sleep,and parental myopia(P<0.05).(3)The differences between secondary school students in the myopic group and those in the non-myopic group were statistically significant(P<0.01)in terms of different types of physical activity levels.The differences between secondary school students in the myopic group and those in the non-myopic group were statistically significant(P<0.01)in terms of scores on different dimensions of the physical activity scale and in terms of total physical activity level scores.Statistically significant differences were found between the myopic and non-myopic groups of secondary school students in their scores on various dimensions of the life satisfaction scale including friendship satisfaction dimension score,family satisfaction score,school satisfaction score,freedom satisfaction score,academic satisfaction score,environment satisfaction score,and total life satisfaction score(P<0.05).402.50(150.00,840.00)min/week,660.00(312.50,1170.00)min/week,540.00(300.00,900.00)min/week,and 1260.00(690.00,2010.00)min/week for sedentary activities in the educational category,daily sedentary activities,weekend sedentary activities,and overall sedentary activities,respectively,for secondary school students in the myopic group.The differences were all statistically significant(P<0.01)compared to the non-myopic group of secondary school students.Statistically significant differences(P<0.001)were found between the myopic and non-myopic groups of secondary school students in their scores on various dimensions of the Social Anxiety Scale including the Fear of Negativity Rating score,the Social Avoidance/Distress score and the Total Social Anxiety score.(4)The structural equation model was fitted and modified with findings such as x~2/df=4.485,RMSEA=0.032 and GFI=0.967,indicating a good model fit.Parents Support played a role in social anxiety23.6% was mediated through physical activity.The role of physical activity in life satisfaction 34.2% was mediated through social anxiety.The role of parental support in life satisfaction 8.0% was mediated through physical activity.The role of parental support in life satisfaction was mediated by social anxiety in 12.5% of cases.Conclusion: General demographic characteristics,physical activity,sedentary behavior,parental support,social anxiety and life satisfaction are directly or indirectly related to myopia,and there are also associations between the factors,so that myopia prevention should be considered as a whole.The results of structural equation modelling effectively complement the single approach and provide additional information for practical disease prevention efforts.