Epidemiological Investigation Of Behavior Problems And Related Factors Of Children Aged 6-11 Years In Shandong Province

Objective:To investigate the prevalence of behavior problems and explore their relevant factors in children aged 6-11 years in Shandong Province,so as to provide the evidence for the formulation of prevention and intervention measures.Methods:By multi-stage stratified random sampling,a total of 2635 children aged 6-11 years from 16 cities and rural areas of Shandong Province were investigated in their homes using a general information questionnaire and Achenbach Child Behavior Checklist(CBCL).Microsoft Excel 2007 software was used to establish database and input data by programmers.Descriptive statistical analysis,?~2 test and Logistic regression analysis were used to analyze the prevalence of children's behavior problems and related influencing factors.All analysis were performed using SPSS 21.0 and significance was set at the p<0.05 level.Results:1.The prevalence of behavior problems was 11.08%in children,and there was no statistically significant difference between 10.80%in boys and 11.38%in girls(?~2=0.225,P>0.05).However,the differences in the prevalence of behavior problems among different age groups were significant(?~2=19.324,P<0.05).The incidence of behavior problems was higher in the 6-year-old group,and an increasing of age,the prevalence of behavior problems was decreasing accordingly.The prevalence of internalizing behavior problems was 7.67%in children in total and was 7.69%in boys and 7.64%in girls respectively.There was no significant difference in the prevalence of internalized behavior problems between different genders and ages(?~2=0.003?6.702,P>0.05).The prevalence of externalizing behavior problems was 5.69%in total,and there was no statistically significant difference between 5.33%in boys and 6.08%in girls(?~2=0.697,P>0.05).The differences of externalizing behavior problem among ages were significant(?~2=25.726,P<0.05).The incidence of externalizing behavior problems was higher in the 6-year-old group,and was deceasing with the increase of age.The prevalence of mixed behavior problems was 2.43%in total,and 2.51%in boys and 2.34%in girls respectively.There was no significant difference in the prevalence of mixed behavior problems between genders and among age groups(?~2=0.087?9.901,P>0.05).2.The prevalence of single behavior problems ranged from 0.53%to 3.76%,with hyperactive was the highest(3.76%),followed by depression(2.16%)and somatic complaints 1.78%.The prevalence of single behavior problems in boys ranged from 1.04%to 4.59%,and that in girls was between 1.09%to 3.04%.There were significant differences in the prevalence of hyperactive?depression and somatic complaints behavior factors between different genders(?~2=4.881-8.872,P<0.05),while the prevalence of other factors was not significant.3.There was a significant difference in the prevalence of behavior problems among children with different mothers'educational levels(?~2=14.818;P<0.05).the prevalence of behavior problems in children with unhealthy parents was higher than that in children with healthy parents(?~2=10.856?11.195,P<0.05).There were significant differences in the prevalence of behavior problems among children with different family income status(?~2=18.438,P<0.05).There were also significant differences in the prevalence of behavior problems among children with different computer usage time,peer relationships,sibling relationship and number of close friends(?~2=7.975-16.184,P<0.05).For internalizing behavior,there was a significant difference in the prevalence of internalizing behavior problems among children with different mothers' educational level(?~2=12.629,P<0.05).The prevalence of internalizing behavior problems in children with unhealthy parents was higher than that in children with healthy parents(?~2=11.996?7.936,.P<0.05).There are differences in the prevalence of internalizing behavior problems among children with different fathers'time spent at home(?~2=6.707,P<0.05).There were also significant differences in the prevalence of internalizing behavior problems among children with different computer usage time,peer relationships,sibling relationship and the number of close friends(?~2=7.975-16.184,P<0.05).For externalizing behavior,children whose fathers had unhealthy lifestyle and poor health conditions had higher prevalence of externalizing behavior problems,with significant differences(?~2 = 3.924.?3.886,P<0.05).There were significant differences in the prevalence of externalizing behavior problems among children with different fathers'education level and family economic status(?~2?8.522,11.579,P<0.05).There were also significant differences in the prevalence of externalizing behavior problems among children with different peer relationships,sibling relationships and number of close friends(P<0.05).For mixed behavior problems,the prevalence of mixed behavior problems in children with unhealthy parents was higher than that in children with healthy parents,with statistical significance(?~2=4.217,P<0.05);the prevalence of mixed behavior problems in children whose parents'marital problems was higher(P<0.05);There were significant differences in the prevalence of mixed behavior problems among children with different peer relationships,sibling relationships and number of close friends(P<0.05).4.The Logistic regression revealed that peer relationships,the number of close friends,the father's health condition,the family income status and father's unhealthy lifestyle might contribute to the behavior problems of children.Peer relationships and the father's health condition were the main risk factors affecting children's internalizing behavior problems.Peer relationships,the number of close friends,paternal rearing style and father's unhealthy lifestyle were the main risk factors for children's externalizing behavior problems.Peer relationships and the number of close friends were the main risk factors for mixed behavior problems in children.Conclusions1.The prevalence of behavior problems among children aged 6-11 in Shandong Province is 11.08%,which is lower than that in 1990s,but still at a higher level.The prevalence of internalizing?externalizing and mixed behavior problems were 7.67%?5.69%and 2.43%.The internalization behavior problems of children in our province is more prominent.2.The distribution of behavior problems is different in different age groups.Children in the 6-year-old age group is the group with high incidence of behavior problems,which should be paid special attention to.3.The prominent behavior problems of boys include hyperactivity,schizoid,uncommunicative and obsessive-compulsive.The prominent behavior problems of girls include schizophrenic compulsion,hyperactivity,depression,somatic complaints,etc.4.The main influencing factors of children's behavior problems include father's lifestyle,family income status,parents' health conditions,mother's educational level,etc.