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目的探讨同伴影响抵抗和风险决策对青少年问题网络使用的预测效应,为早期发现青少年网络成瘾高危人群及制定有针对性干预措施提供参考依据。方法在广州和沈阳两市分别抽取5所和3所初中。每所初中选取初一年级全体学生为研究对象,对其随访调查12个月。采用同伴影响抵抗问卷(RPIS)和风险决策问卷(YDMQ)评价青少年同伴影响抵抗和风险决策水平及其对问题网络使用的影响。结果基线调查2 103名青少年,问题网络使用发生率为14.3%。1 a后随访1 853名,失访率为11.9%。新发PIU为307名(16.6%),持续PIU为150名(8.1%),116名(6.3%)青少年在基线时报告PIU,1 a随访后报告无PIU(终止组)。与对照组相比,PIU新发组和持续组风险决策得分高、同伴影响抵抗得分低(P值均<0.01)。Logistic回归模型中控制基线PIU、性别、地区、父母文化程度和家庭经济后,风险决策高、同伴影响抵抗低均是随访PIU和新发PIU的危险性预测因素(B值分别为0.904,0.650,0.936,0.741,P值均<0.01),同伴影响抵抗高是PIU中止的保护性预测因素(B=-0.625,P<0.05)。结论同伴影响抵抗能力较差和风险决策较高的青少年可作为健康危害行为早期筛查和干预的重点人群。
Objective To explore the predictive effect of peer influence resistance and risk decision-making on the internet use of adolescents, and to provide a reference for early detection of adolescents at high risk of internet addiction and for the development of targeted interventions. Methods Five cities and three junior high schools were drawn in Guangzhou and Shenyang respectively. Each junior high school selected the first grade of all the students as the research object, followed up for 12 months. RPRS and YDMQ were used to evaluate adolescent peer impact resistance and risk decision-making and their impact on problem network use. Results Based on the baseline survey of 2 103 adolescents, the incidence of problematic internet usage was 14.3%. A total of 1 853 follow-up visits were conducted after 1 year, and the rate of loss to follow-up was 11.9%. Out of a total of 307 new-onset PIUs (16.6%), persistent PIUs were 150 (8.1%) and 116 (6.3%) reported PIU at baseline and no PIU after 1-year follow-up. Compared with the control group, PIU new risk group and persistent group had higher risk decision-making scores and lower companion impact resistance scores (all P <0.01). Logistic regression model of baseline PIU control, gender, region, parental education and family economy, high risk decision-making, peer impact resistance are low risk of follow-up PIU and PIU risk predictors (B values were 0.904,0.650, 0.936, 0.741, both P <0.01). High fecundity was a protective predictor of discontinuation of PIU (B = -0.625, P <0.05). Conclusion Females may be the key population for early screening and intervention of health hazards because they have poor resistance and risk decision-making.