Mediator Role of Future Time Perspective in the Longitudinal Effects of Cumulative Ecological Risk on Healthy Lifestyle of Left-behind and Non-left-behind Adolescents in Rural Areas

doi:10.12114/j.issn.1007-9572.2022.0365

Abstract

Abstract:

Background

Exploring the factors influencing healthy lifestyle in adolescents is beneficial to promoting the physical and mental health of adolescents, which is an important initiative to promote the achievement of the goals of Healthy China. Moreover, it is also an important means to achieve the goals of health poverty alleviation and targeted poverty alleviation projects in both left-behind and non-left-behind rural adolescents.

Objective

To investigate the longitudinal effect of cumulative ecological risk on healthy lifestyle and the mediating effect of future time perspective between them in rural left-behind and non-left-behind adolescents.

Methods

Rural left-behind and non-left-behind adolescents from 24 classes in 12 schools in Shijiazhuang, Hebei Province were selected from October 2020 to October 2021. Three surveys (the first, second and third were on cumulative ecological risk, future time perspective and healthy lifestyle, respectively) were conducted with them, and had 1 135, 1 102 and 1 053 responders, respectively. Person correlation analysis was used to analyze the correlation between cumulative ecological risk, future time perspective and healthy lifestyle. Structural equation model was used for mediation analysis, and Bootstrap sampling method was used to further assess the mediating effect of future time perspective.

Results

Finally, 1 053 cases who effectively responded to each of the three surveys were included for analysis, including 335 left-behind adolescents (31.81%) and 718 non-left-behind adolescents (68.19%) . The scores of annual cumulative ecological risk (October 2020) , future time perspective (April 2021) and healthy lifestyle (October 2021) were (2.78±1.45) , (53.40±13.80) and (150.72±24.67) , respectively for left-behind responders, and were (2.34±1.24) , (59.21±8.46) and (159.07±14.43) , respectively for non-left-behind responders. Correlation analysis showed that cumulative ecological risk was negatively correlated with both future time perspective and healthy lifestyle (P<0.05) , and future time perspective was negatively correlated with healthy lifestyle (P<0.05) . Forced regression indicated that the healthy lifestyle was inversely and longitudinally influenced by cumulative ecological risk in rural left-behind adolescents (β=-0.31, P<0.01) , showing a trend of sharp and positively accelerated decline. The healthy lifestyle was also inversely and longitudinally influenced by cumulative ecological risk in non-left-behind adolescents (β=-0.22, P<0.01) , demonstrating a relatively liner trend of mild decline. Mediating analysis using Bootstrap sampling revealed that future time perspective played a mediating role in the longitudinal effect produced by cumulative ecological risk on the healthy lifestyle in both rural left-behind and non-left-behind adolescents (P<0.01) .

Conclusion

The cumulative ecological risk may be a longitudinal predictor of the healthy lifestyle in left-behind and non-left-behind adolescents, and its predictive value was higher in the latter. Future time perspective was a mediator in the relationship between cumulative ecological risk and healthy lifestyle in both left-behind and non-left-behind adolescents.

Key words: Left-behind adolescents, Adolescent health, Cumulative ecological risk, Healthy lifestyle, Future time insight, Mediation analysis

摘要：

背景

探索青少年健康生活方式影响因素，有利于促进青少年身心健康，是推动健康中国战略的重要举措；对于农村留守青少年和非留守青少年而言，还是落实农村"健康扶贫""精准扶贫"的重要手段。

目的

考察累积生态风险对农村留守和非留守青少年健康生活方式的纵向影响，以及未来时间洞察力的中介作用。

方法

于2020年10月至2021年10月，对河北省石家庄市12个学校24个班级的农村留守和非留守青少年进行调查，第1、2、3次调查各调查累积生态风险、未来时间洞察力、健康生活方式，各回收1 135、1 102、1 053份有效问卷。采用Pearson相关分析法分析累积生态风险、未来时间洞察力、健康生活方式的相关性。采用结构方程模型进行中介分析，利用Bootstrap抽样法对未来时间洞察力的中介作用进行进一步检验。

结果

最终共纳入1 053例青少年，其中留守青少年335例（31.81%），非留守青少年718例（68.19%）。留守青少年累积生态风险、未来时间洞察力、健康生活方式得分分别为（2.78±1.45）、（53.40±13.80）、（150.72±24.67）分，非留守青少年累积生态风险、未来时间洞察力、健康生活方式得分分别为（2.34±1.24）、（59.21±8.46）、（159.07±14.43）分。Pearson相关分析结果显示，累积生态风险与未来时间洞察力、健康生活方式呈负相关，未来时间洞察力和健康生活方式呈负相关（P<0.05）。强迫回归结果显示，累积生态风险对农村留守青少年和非留守青少年健康生活方式均具有纵向负向预测作用（β=-0.31，P<0.01；β=-0.22，P<0.01）。累积生态风险对留守青少年健康生活方式的纵向影响模式为急剧下降的正加速模式，累积生态风险对非留守青少年健康生活方式的纵向影响模式为较为平缓的线性模式。采用Bootstrap抽样法进一步验证中介效应，结果显示：未来时间洞察力在农村留守和非留守青少年累积生态风险对健康生活方式纵向预测中发挥着中介作用（P<0.01）。

结论

累积生态风险对留守和非留守青少年健康生活方式均有纵向预测效应，相比之下，对留守青少年健康生活方式的纵向预测效应更高；未来时间洞察力在累积生态风险与留守和非留守青少年健康生活方式间均具有中介作用。

关键词: 留守青少年, 青少年健康, 累积生态风险, 健康生活方式, 未来时间洞察力, 中介分析

JIN Ming,JI Huajuan,LI Yachen, et al. Mediator Role of Future Time Perspective in the Longitudinal Effects of Cumulative Ecological Risk on Healthy Lifestyle of Left-behind and Non-left-behind Adolescents in Rural Areas[J]. Chinese General Practice, 2022, 25(31): 3891-3898,3913. DOI: 10.12114/j.issn.1007-9572.2022.0365.
靳明,及化娟,李亚辰等. 累积生态风险对农村留守、非留守青少年健康生活方式的纵向影响：未来时间洞察力的中介作用[J]. 中国全科医学, 2022, 25(31): 3891-3898,3913. DOI: 10.12114/j.issn.1007-9572.2022.0365.

Figures/Tables 8

Table 1 Correlation analysis of cumulative ecological risk，future time perspective and healthy lifestyle in left-behind and non-left-behind adolescents

项目		累积生态风险	未来时间洞察力	健康生活方式
留守青少年
	累积生态风险	1.00	—	—
	未来时间洞察力	-0.39^a	1.00	—
	健康生活方式	-0.34^a	0.23^a	1.00
非留守青少年
	累积生态风险	1.00	—	—
	未来时间洞察力	-0.32^a	1.00	—
	健康生活方式	-0.25^a	0.31^a	1.00

Figure 1 Trend of positively accelerated decline in healthy lifestyle influenced by cumulative ecological risk in rural left-behind adolescents

Figure 2 Liner trend of mild decline in healthy lifestyle influenced by cumulative ecological risk in rural non-left-behind adolescents

Figure 3 Mediating effects of future time perspective on the relationship between cumulative ecological risk and healthy lifestyle in rural left-behind adolescents

Figure 4 Trend of positively accelerated decline in the future time perspective influenced by cumulative ecological risk in rural left-behind adolescents

Figure 5 Mediating effects of future time perspective on the relationship between cumulative ecological risk and healthy lifestyle in rural non-left-behind adolescents

Figure 6 Linear trend of mild decline in future time perspective influenced by cumulative ecological risk in rural non-left-behind adolescents

Table 2 Bootstrap analysis of mediating effect of future time perspective between cumulative ecological risk and healthy lifestyle in both left-behind and non-left-behind adolescents

路径		中介效应值估计	中介效应值的95%CI	P值
留守青少年
	累积生态风险一次项→未来时间洞察力→健康生活方式	-0.42×0.13=-0.06	-0.116，-0.015	<0.01
	累积生态风险二次项→未来时间洞察力→健康生活方式	0.08×0.13=0.01	0.004，0.087	<0.01
非留守青少年
	累积生态风险一次项→未来时间洞察力→健康生活方式	-0.26×0.24=-0.06	-0.144，-0.021	<0.01

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