Analysis Of Risk Factors And Intervention Strategies Of Myopia In Children And Adolescents In Ningxia Region Based On Social Ecological Model

Objective To understand the prevalence of myopia among children and adolescents in Ningxia region,explore the main risk factors of myopia among children and adolescent s in Ningxia region,analyze the risk factors of myo pia among children and ad olescent s in Ningxia region through social ecology model,and provide feasible countermeasures for the prevention and control of myopia among children and adolescent s in Ningxia region.Methods In this study,multi-stage stratified cluster random sampling was adopted.According to the principles of inclusion and exclusion,the survey sites were selected from Yinchuan,Wuzhong,Zhongwei and Guyuan cities in Ningxia.In the survey sites,11,788 subjects were selected by grade level(grade 4-12)and class group,with the age range of 9 to 18 years old.The contents of the survey included questionnaire survey and vision examination.The questionnaire was based on the 2019 National Students’Physique and Health Survey,and the vision examination was based on the 2019 National Students’Physique and Health survey and test card.Epidata3.1 was used for double entry of original data,and Spss26.0was used for data analysis.Frequency and component ratio were used to describe the nearsightedn ess of children and adole scents aged 9-18 years in Ningxia.According to the visual acuity,the object of study is divided into myopia with myopia group,based on the theory of social ecology model compare two groups of social ecological environment usingX~2 inspection at all leve ls of myopia;Logistic regression analysis was used to explore the effect of social and ecological factors on myopia in children and adolescents.Results1.The total myopia detection rate of children and adolescent s aged 9 to 18 in Ningxia was 62.83%(m ale 56.79%,female 68.89%,urban 66.54%,rural 58.78%).The prevalence of myopia in children and adolescents was higher in girls than in boys,and higher in cities than in rural areas.2.Through the analysis of the social ecologi c al model at the individua l level,interpersonal level,social environment level and policy level,the results showed that there were significant differences in children’s myopia at different levels(P<0.01).The single factor analysis was carried out on th e influencing factors of each layer,and it was found that the factors affecting the myopia of children and adolescents at each level were as follows:the individual level included average daily homework time,average daily sleep time;The level of interpe rsonal relationship inclu ded the level of parental support to participate in sports and the average number of daily eye exercises on weekends.Social environment includes places of residence,time spent exercising in school,and number of classes per day.The policy level included the average nu mber of daily eye health exercises in school days and the number of weekly physical education and health education classes(all P values<0.05).3.The regression analysi s of the social ecological model showed that t he individual level,inte rpersonal level,social environment level and policy level had different degrees of influence on the occurrence of myopia in children and adolescents(βvalues were 0.33,0.36,0.59,0.18,p<0.01),and the social environment had t he most significant degre e of influence on myopia in children.The policy level has relatively weak influence on it.Binary Logistic regressio n analysis of all factors showed that age,gender,average daily frequency of eye exercise on weekends,place of r esidence,exercise durati on,weekly number of physical education and health education classes could predict the formation of myopia in children and adolescent s,and the results were statistically significant(P<0.05).Logistic regression model finally pred icted the probability of myopia in children and adolescents reached 71.11%.Conclusion1.The myopia rate of children and adolescents aged 9 to 18 in Ningxia is62.84%,and girls of all ages are higher than boys,and urban is higher than rural.The detection rate of myopia showe d a trend of continuous and rapid development.2.Average daily number of eye exercises on weekends,place of residence,length of exercise,weekly number of physical education and health education classes can positively predict th e myopia of children and adolescents.Schools,parents and relevant departments can pay attention to these variables an d formulate corresponding countermeasures for effective scientific intervention.3.The social ecological model has a good predictive eff ect on the factors affecting myopia in children and adolescent s.This study suggests that researchers can develop comprehensive intervention measures based on the four levels of the socio-ecological model.In particular,attention should be paid to the eff ect of children’s own factors on vision,followed by the positive guidance of family and school to children and adolescents,so as to prevent and control the occurrence and development of myopia to the greatest extent.