Abstract: Background　In the process of achieving Healthy China 2030，one target of urbanization promotion is healthy urbanization. The national evaluation and prevention of sub-health of urban residents is of great significance for healthy urbanization. Although there have been some regional studies on sub-health status of Chinese urban residents，similar national studies are rather sparse. Objective　To explore the reliability and validity of Sub-health Measurement Scale Version 1.0（SHMS V1.0） in assessing the sub-health status of urban residents in China，and to analyze the sub-health status of this population. Methods　Multi-stage stratified sampling was used to select 17 339 urban residents from 6 geographical regions of China （East China，North China，Northeast China，South-central China，Southwest China and Northwest China） from December 2017 to October 2018. All participants attended a survey with the SHMS V1.0 scale，by which reliability and validity of the scale was assessed，and the sub-health status of this group was measured. The response rate of the survey was 86.89%（15 066/17 339）. Results　The Cronbach's α coefficient of the SHMS V1.0 was 0.922，and that of each of its three subscales was higher than 0.800，and that of every dimension was higher than 0.690. The odd-even reliability and front-rear reliability of the SHMS V1.0 were 0.955 and 0.822，respectively. Also，we found the scale had good discriminant validity and convergent validity. Exploratory factor analysis found that the cumulative variance explained by nine common factors was 64.16%，and these factors were completely consistent with the theoretical structure of the scale. Confirmatory factor analysis revealed good fitting effect. The detection rates of general，physical，mental and social sub-health were 68.06%（10 254/15 066），67.47%（10 165/15 066），65.96%（9 938/15 066） and 70.76%（10 660/15 066），respectively. There was significant regional difference in the detection rate of general，physical or social sub-health among the urban residents（P<0.05）. Women had a higher detection rate of mental sub-health，but a lower detection rate of social sub-health than men（P<0.05）. The detection rate of mental sub-health differed significantly across age groups（P<0.05）. And that of social sub-health also varied significantly across age groups（P<0.05）. Conclusion　The SHMS V1.0 scale demonstrated high reliability and validity for sub-health assessment of Chinese urban residents. The detection rate of sub-health differed by region，sex and age group，hence，targeted interventions are needed to improve sub-health.

Key words: Urban residents, Sub-health Measurement Scale, Reliability, Validity

摘要： 背景　健康城镇化是健康中国背景下推进城镇化的重要目的。全国城镇居民亚健康的评价和预防对于健康城镇化有重要意义。目前虽然已有对部分地区城镇居民亚健康状况的研究，但缺少对全国城镇居民亚健康状况的报道。目的　探讨亚健康评定量表（SHMS V1.0）用于我国城镇居民亚健康评价的信效度，并了解我国城镇居民亚健康状况。方法　2017年12月—2018年10月，采用多阶段分层抽样方法从华东、华北、东北、中南、西南和西北6个地区抽取17 339例城镇居民进行问卷调查。共回收有效问卷15 066份，问卷有效回收率为86.89%。利用SHMS V1.0对15 066例城镇居民进行亚健康状况测量，并评价量表信效度。结果　SHMS V1.0总量表的Cronbach's α系数最高，为0.922，3个子量表的Cronbach's α系数均高于0.800，各维度的Cronbach's α系数均高于0.690。SHMS V1.0总量表的奇偶折半信度为0.955，前后折半信度为0.822。此外，研究发现量表有较好的区分效度和聚合效度。探索性因子分析发现9个公因子的方差解释度为64.16%，且与量表理论结构完全吻合。验证性因子分析显示有较好的拟合效果。我国六省市城镇居民总体亚健康检出率为68.06%（10 254/15 066），生理亚健康检出率为67.47%（10 165/15 066），心理亚健康检出率为65.96%（9 938/15 066），社会亚健康检出率为70.76%（10 660/15 066）。六省市城镇居民总体亚健康、生理亚健康和社会亚健康检出率比较，差异有统计学意义（P<0.05）。女性心理亚健康检出率高于男性，男性社会亚健康检出率高于女性，差异有统计学意义（P<0.05）。不同年龄组城镇居民心理亚健康和社会亚健康检出率比较，差异有统计学意义（P<0.05）。结论　SHMS V1.0用于我国城镇居民亚健康评价具有较高的信效度；不同地区、性别和年龄段城镇居民的亚健康检出率不同，需要制定针对性的亚健康促进方案。

关键词: 城镇居民, 亚健康评定量表, 信度, 效度