儿童青少年常见病风险评估指标体系

摘要(中文译文)

青少年时期是健康发展的关键阶段。当前，近视、肥胖、龋齿和脊柱弯曲异常等常见病在儿童青少年中高度流行，且呈现明显的低龄化趋势。这些疾病由多维度因素的复杂交互作用所致。然而，现有干预措施多局限于单一疾病，缺乏系统性的防控工具。因此，亟需构建科学的健康影响因素评价指标体系。本研究针对我国国家卫生政策重点关注的四种儿童青少年常见病——近视、肥胖、龋齿和脊柱弯曲异常，以7~19岁儿童青少年为对象，构建了多维度风险评估指标体系，以支持该人群的循证预防和政策制定。以《中国儿童发展纲要（2021—2030年）》和《“健康中国2030”规划纲要》为指导，通过文献研究和专家会议初步拟定三级指标框架。采用德尔菲专家咨询法进行两轮指标筛选与优化。专家从重要性、可行性和敏感性三个方面对每项指标进行1~5分评分，均分<3.5且变异系数>0.3的指标予以剔除。两轮德尔菲咨询的有效回收率均为100.0%，专家熟悉程度系数（Cs）均值为0.83，判断系数（Ca）均值为0.93，专家权威系数（Cr）值为0.88。第二轮咨询中，重要性协调系数为0.284，可行性协调系数为0.185，敏感性协调系数为0.314，均具有统计学意义（P<0.001）。该指标体系共包含55项三级指标。经过两轮专家论证验证，该指标体系具有良好的科学性。儿童青少年常见病风险评估指标体系的初步建立，可在实际应用中经过信效度检验后，用于儿童青少年常见病健康影响因素水平的测量。

Abstract

Adolescence is a critical stage for healthy development. Currently, common diseases such as myopia, obesity, dental caries, and spinal curvature abnormalities are highly prevalent among children and adolescents, with an obvious trend of younger onset. These diseases are caused by the complex interaction of multi-dimensional factors. However, existing interventions are mostly limited to individual diseases, lacking systematic prevention and control tools. Therefore, there is an urgent need to construct a scientific evaluation index system for health-influencing factors. Targeting the four key common diseases emphasized in China's national health policies - myopia, obesity, dental caries, and spinal curvature abnormalities - among children and adolescents aged 7-19 years, this study constructed a multi-dimensional risk assessment indicator system to support evidence-based prevention and policy-making for this population. Guided by the National Program of Action for Children's Development in China (2021-2030) and the "Healthy China 2030" Planning Outline, a three-level indicator framework was initially formulated through literature research and expert meetings. The Delphi expert consultation method was adopted for two rounds of screening and optimization of indicators. Experts scored each indicator on a scale of 1-5 in terms of importance, feasibility, and sensitivity, with indicators excluded if their mean score was < 3.5 and coefficient of variation >0.3. The effective return rate of the two-round Delphi is 100.0%, the mean expert familiarity coefficient (Cs) was 0.83, and the mean judgment coefficient (Ca) was 0.93, and the expert authoritative coefficient (Cr) value is 0.88. In the second round of consultation, the importance coordination coefficient is 0.284, the feasibility coordination coefficient is 0.185, and the sensitivity coordination coefficient is 0.314, all of which are statistically significant (P < 0.001). This indicator system consists of a total of 55 three-level indicators. Validated through two rounds of expert deliberation, the indicator system demonstrates sound scientific rigor. The preliminary development of a risk assessment indicator system for common diseases in children and adolescents can be used for the measurement of the level of factors affecting the health of common diseases in children and adolescents after its reliability and validity are verified in practical applications.

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