Current research on the physical fitness test scores of high school students is more localized within provinces and cities, with few multicenter, large-sample-size, domain-wide research results. The prevalence of blended online and offline teaching in schools of all types has inevitably prolonged the already long sedentary time of high school students. Whether this trend has some impact on the physical health of high school students is an urgent need for a region-wide study.

To investigate and analyze the levels of physical fitness test scores and related influencing factors of urban and rural high school first- and second-year students in seven regions of China, and to explore the empowering paths for the balanced improvement of physical fitness levels of first- and second-year high school students.

Stratified randomized cluster sampling method was used to conduct stratified sampling according to urban counties and townships and villages in high school schools in seven regions (East China, South China, North China, Central China, Northwest China, Southwest China, Northeast China) of 31 provinces (municipalities directly under the central government and autonomous regions) of China from January to March 2019, and then randomized clusters of 1 high school school in urban counties and 1 high school school in townships and villages in total of 62 schools were selected respectively. A total of 42 523 freshmen and sophomores in high schools were randomly selected to conduct the research, and the data on students' physical fitness test scores were collected at the same time (BMI reflects the level of physical development; lung capacity reflects the level of physical function; sit-and-reach reflects the level of flexibility; pull-up, 50 m run, standing long jump reflects the level of explosive strength of upper and lower limbs; 1 min sit-up reflects the level of core strength of the torso; 800 m run, 1 000 m run reflects the level of cardiorespiratory endurance), and non-parametric tests and multiple linear regression analysis were used to explore the influencing factors of the level of physical fitness test scores.

The age distribution of 42 523 high school students was 16.0 (16.0, 17.0) years; 20 074 (47.2%) boys and 22 449 (52.8%) girls, 21 725 (51.1%) in cities, counties and districts, and 20 798 (48.9%) in towns and villages. Comparison of the gender and urban-rural distribution of high school students in the seven regions showed statistically significant differences (P<0.05). Comparison of male high school students' scores on various physical fitness tests in the seven regions showed statistically significant differences (P<0.05) ; the top three regions in terms of scores on various physical fitness tests were as follows: height (North China>Northeast China>Central China), body mass (Northeast China>North China>Central China), BMI (Central China>Northeast China>North China), lung capacity (Northeast China>Central China>South China), 50 m run (South China>Central China>East China), standing long jump (South China>North China>Northwest China), sit-and-reach (South China>Southwest China>Central China), pull-up (South China>Southwest China>Northwest China), and 1 000 m run (South China>Central China>Southwest China). High school boys in the city, county and districts had higher lung capacity scores than those in the town and country, and lower scores than those in the town and country in the 50 m run, standing long jump, sit-and-reach, pull-up, and 1 000 m run (P<0.001). The differences in height, weight and BMI between high school boys in cities, counties and towns and villages were not statistically significant (P>0.05). The differences in the scores of high school girls in each physical fitness test in the seven regions are statistically significant (P<0.05) ; the top three regions in the scores of each physical fitness test are as follows: height (North China>Northeast China>Northwest China), body mass (Northeast China>North China>Northwest China), BMI (Northeast China>North China>Northwest China), lung capacity (Northeast China>South China>Central China), 50 m run (South China>Central China>East China), standing long jump (South China>North China>Central China), sit-and-reach (Northeast China>Central China>South China), 1 min sit-up (North China>Central China>East China=Southwest China), 800 m run (Northeast>Central China>South China). High school girls in the city and county districts had higher height, body mass, and BMI scores than those in the town and country, and lower scores than those in the town and country in lung capacity, 50 m run, standing long jump, sit-and-reach, 1 min sit-up, and 800 m run (P<0.001). The results of the multiple linear regression analysis showed that boys' pull-up scores were negatively correlated with BMI and the 1 000 m run scores, and positively correlated with the 50 m run, standing long jump and sit-and-reach scores (P<0.05), with sit-and-reach being the most important influence factor, followed by 1 000 m run; 1 000 m run scores were negatively correlated with BMI, lung capacity, and pull-up scores, and positively correlated with 50 m run, standing long jump and sit-and-reach scores (P<0.05), with pull-up being the most important influence factor, followed by sit-and-reach. The girls' 1 min sit-up scores were positively correlated with BMI, lung capacity, standing long jump, and 800 m run scores, and negatively correlated with 50 m run and sit-and-reach scores (P<0.05), with BMI being the most important influence factor, followed by sit-and-reach; the 800 m run scores were negatively correlated with BMI, 50 m run, and sit-and-reach scores, and positively correlated with standing long jump and 1 min sit-up scores (P<0.05), with sit-and-reach being the most important influence factor, followed by BMI.

The physical development levels of first and second year high school boys in Chinese city, county and districts were comparable to those of town and country, but the physical development levels of first and second year high school girls in the city, county and districts were higher than those of town and country. Upper and lower extremity explosive strength, trunk core strength, and cardiorespiratory endurance levels of first and second year high school students in city, county and districts were significantly lower than those of town and country. In addition to the level of physical development, the dominance of the performance levels of first and second year male high school students on all tests of physical fitness and health was evident in South China.

目前有关高中生体质健康测试成绩的研究以各省、市内局部地区较为多见，多中心大样本量的全域研究甚少。各类学校在普遍开展线上与线下混合式教学时，势必延长了高中生本已较长的静坐时间。这种趋势是否对高中生的体质健康产生一定的影响，亟待开展全域范围的调查研究。

调查并分析我国七大地区城乡高中一、二年级学生的体质健康测试成绩水平及相关影响因素，探索出高中一、二年级学生的体质健康水平均衡提升的赋能路径。

采用分层随机整群抽样方法，于2019年1—3月在我国31个省（直辖市、自治区）七大地区（华东、华南、华北、华中、西北、西南、东北）高中学校按照市区县与乡镇村进行分层抽样，然后随机整群分别选取市区县高中学校和乡镇村高中学校各1所，共62所学校42 523名在读的高一、高二年级学生进行调研，同时收集学生的体质健康测试成绩数据（BMI反映身体发育水平，肺活量反映身体功能，坐位体前屈反映躯体柔韧度，引体向上、50 m跑、立定跳远反映上下肢爆发力量水平，1 min仰卧起坐反映躯体核心力量水平，800 m跑、1 000 m跑反映心肺耐力水平），并运用非参数检验及多元线性回归分析探讨体质健康测试成绩水平的影响因素。

42 523名高中生的中位年龄为16.0（16.0，17.0）岁；男生20 074名（47.2%）、女生22 449名（52.8%），市县区21 725名（51.1%）、镇乡村20 798名（48.9%）。七大地区高中生性别、城乡分布比较，差异有统计学意义（P<0.05）。七大地区高中男生各项体质健康测试成绩比较，差异均有统计学意义（P<0.05）；各项体质健康测试成绩前三的地区如下：身高（华北>东北>华中）、体质量（东北>华北>华中）、BMI（华中>东北>华北）、肺活量（东北>华中>华南）、50 m跑（华南>华中>华东）、立定跳远（华南>华北>西北）、坐位体前屈（华南>西南>华中）、引体向上（华南>西南>西北）、1 000 m跑（华南>华中>西南）。市县区高中男生的肺活量成绩高于镇乡村，50 m跑、立定跳远、坐位体前屈、引体向上、1 000 m跑成绩低于镇乡村（P<0.001）。七大地区高中女生各项体质健康测试成绩比较，差异均有统计学意义（P<0.05）；各项体质健康测试成绩前三的地区如下：身高（华北>东北>西北）、体质量（东北>华北>西北）、BMI（东北>华北>西北）、肺活量（东北>华南>华中）、50 m跑（华南>华中>华东）、立定跳远（华南>华北>华中）、坐位体前屈（东北>华中>华南）、1 min仰卧起坐（华北>华中>华东=西南）、800 m跑（东北>华中>华南）。市县区高中女生的身高、体质量、BMI成绩高于镇乡村，肺活量、50 m跑、立定跳远、坐位体前屈、1 min仰卧起坐、800 m跑成绩低于镇乡村（P<0.001）。多元线性回归分析结果显示，男生引体向上成绩与BMI、1 000 m跑成绩呈负相关，与50 m跑、立定跳远、坐位体前屈成绩呈正相关（P<0.05），坐位体前屈为最主要的影响因素，1 000 m跑次之；1 000 m跑成绩与BMI、肺活量、引体向上成绩呈负相关，与50 m跑、立定跳远、坐位体前屈成绩呈正相关（P<0.05），引体向上为最主要的影响因素，坐位体前屈次之。女生1 min仰卧起坐成绩与BMI、肺活量、立定跳远、800 m跑成绩呈正相关，与50 m跑、坐位体前屈成绩呈负相关（P<0.05），BMI为最主要的影响因素，坐位体前屈次之；800 m跑成绩与BMI、50 m跑、坐位体前屈成绩呈负相关，与立定跳远、1 min仰卧起坐成绩呈正相关（P<0.05），坐位体前屈为最主要的影响因素，BMI次之。

我国市县区高中一、二年级男生的身体发育水平与镇乡村相当，但市县区高中一、二年级女生的身体发育水平高于镇乡村女生。市县区高中一、二年级学生的上下肢爆发力量、躯体核心力量、心肺耐力水平均显著低于镇乡村。除身体发育水平以外，华南地区的高中一、二年级男生的体质健康各项测试成绩水平的优势十分明显。