Association Of Health Literacy,Mobile Phone Use Dependence And Psychosomatic Symptoms In Adolescents

ObjectiveThe aim of this study was to clarify the actual state of adolescents' psychosomatic symptoms,and to examine the associations of health literacy and mobile phone use dependence with psychosomatic symptoms in Chinese adolescents.MethodsA total of 22 628 middle school students in six cities(Shenyang,Bengbu,Xinxiang,Ulanqab,Chongqing and Yangjiang)were enrolled by multistage stratified cluster sampling from November 2015 to January 2016.The measurement of health literacy,mobile phone use dependence and psychosomatic symptoms of subjects were based on the Chinese Adolescent Interactive Health Literacy Questionnaire(CAIHLQ),Self-rating Questionnaire for Adolescent Problematic Mobile Phone Use(SQAPMPU)and Multidimensional Sub-health Questionnaire of Adolescents(MSQA),respectively.The t-test,Chi-square test and one-way analysis of variance were used to compare the detection rate in health literacy,mobile phone use dependence and psychosomatic symptoms among different groups.Multivariate logistic regression model was used to analyze the correlation of health literacy,mobile phone use dependence with psychosomatic symptoms.P < 0.05 was considered statistically significant.ResultsThe mean age of the 22 628 participants was 15.4 years(SD=1.8),and 10 990 weremales(48.6%)and 11 638 were females(51.4%).The overall CHIHLQ scores for all participants were 104.1±18.7.Adolescents who were junior school students,developing area,urban residence,only children in family,non-resident students,higher parental education level and lower family income had significantly higher health literacy scores than the corresponding groups(P < 0.001 for each).The prevalence of mobile phone use dependence was 25.4%(5 752 / 22 628).Adolescents who were male,junior school students,developed area,only children in family,resident students,and lower family income had higher detection rate of mobile phone use dependence than those of the corresponding groups(P < 0.01 for each).The detection rate of physical and psychological symptoms was 30.1%(6 822 / 22 628)and 29.1%(6 581 / 22 628),respectively.The detection rate of psychosomatic symptoms in high school students,developed area,being only children,resident students,with low socio-economic status(SES)was significantly higher than their peers(P < 0.001 for each).Compared to high health literacy,middle and low health literacy were related factors of the physical symptoms,with OR(95%CI)values were 1.72(1.59-1.86)and 3.47(3.17-3.79).Compared with no dependence on mobile phone use,mobile phone use dependence was associated with physical symptoms,OR(95%CI)value was 3.45(3.23-3.67).The adolescents with mobile phone use dependence and low health literacy had the highest prevalence of physical symptoms [63.0%(1 246/1 977)],OR(95%CI)value was 8.72(7.71-9.86).Compared to high health literacy,middle and low health literacy were related factors of the psychological symptoms,with OR(95%CI)values were 2.51(2.29-2.74)and 6.44(5.84-7.09).Compared with no dependence on mobile phone use,mobile phone use dependence was associated with physical symptoms,OR(95%CI)value was 4.06(3.81-4.33).The adolescents with mobile phone use dependence and low health literacy had the highest prevalence of psychological symptoms [68.0%(1345/1 977)],OR(95%CI)value was 9.49(16.98-22.36).ConclusionThe present study highlights the importance of the associations of health literacy and mobile phone use dependence with psychosomatic symptoms in Chinese adolescents.Our results indicate that low health literacy is significantly positively correlated with mental health problems.Furthermore,low health literacy and mobile phone use dependence are associated with increased risks of psychosomatic symptoms.