Abstract With the development of society, the health and well being of children and adolescents are receiving increasing attention from the government and scholars. The implementation of the health (promoting) school construction plan has a significant effect on promoting students health and well being, which is especially important in the normalized stage of COVID-19 epidemic prevention and control. The study summarizes the importance of health (promoting) schools for students health and well being, reviews the development of health (promoting) school construction in China, and proposes countermeasures and recommendations to further promote health (promoting) school construction in China in the light of the new era.

Objective: To understand the current situation regarding sex education in home and school settings in China, and to provide a scientific basis for more effective family and school sex education. Methods: Using a convenient sampling method, a crosssectional survey of students from grade 7 to grade 9 in Beijing, Liaoning, Sichuan, Chongqing, Yunnan and Henan was carried out from September to December 2021. The questionnaire covered general demographic information, sex education at home and school, and the status of comprehensive sexuality education. Finally, 4 109 valid questionnaires were collected. Results: A total of 760(18.50%) middle school students had not received any form of sex education, 923(22.46%) had only received sex education at school, 299(7.28%) had only received sex education at home, and 2 127 (51.76%) had received sex education at home and at school. The scores related to junior middle school students knowledge of comprehensive sexuality education was (12.43±2.89) points, the attitude score was (47.86±5.31) points, the behavior score was (40.44±5.18) points, and the comprehensive level score was (82.02±9.01) points. Junior middle school students who received sex education at home and in school had the highest comprehensive level of sex education( P <0.01). Junior middle school students who only received sex education at school had a higher comprehensive sexuality education knowledge level than those who only received sex education at home( P < 0.01 ). The level of comprehensive sexuality education behavior among junior middle school students who only received family sex education was significantly higher than among those who only received sex education at school( P <0.01). Conclusion Receiving sex education in both home and school settings can effectively improve the comprehensive sexuality education competency among junior middle school students. School based sex education should be further implemented in the future and family sex education should be encouraged.

Endoscopy ; Humans ; Retrospective Studies ; Trachea ; Tracheal Stenosis/surgery* ; Tracheostomy/adverse effects*

Objective: To preliminarily develop the Infectious Disease Prevention Health Literacy Scale for Chinese Middle School Students, as an important measuring tool for assessment of comprehensive abilities in infectious disease prevention of Chinese middle school students. Methods: The basic dimensional framework and item pool were established by literature review in the view of public health. Then Delphi method was used to modify the framework and item pool to scale 1.0. Panel discussion in middle school students was used to adjust the expression and structure of scale 1.0, turning it into scale 2.0. With the confirmation of theory experts subjects, the scale was preliminarily developed. Results: Literature review suggested that the basic dimension framework included five longitudinal dimensions and seven horizontal dimensions. According to Delphi method ( n =18), the Kendall s coefficient of concordance ( W ) of the scale was equal to 0.14 ( P <0.01), the average importance, proportion of full marks, coefficient of variation and weight coefficient of all dimensions and items met the inclusion criteria. According to panel discussion, the scale was finally adjusted into scale 2.0 with 53 items. Conclusion This study preliminarily established the Infectious Disease Prevention Health Literacy Scale for Chinese Middle School Students, which might be applied in both scientific research and practical use.

Objective: To understand comprehensive sexuality education knowledge among junior high school students in China, and to analyze relevant influencing factors to provide scientific basis for the implementation of school based sexuality education or comprehensive sexuality education in the future. Methods: By using convenient sampling method, a cross sectional survey was conducted among 4 545 students at grade 1 to grade 3 from junior middle schools in Beijing, Liaoning, Sichuan, Chongqing, Yunnan, Henan, using an online electronic questionnaire during September to October 2021. The questionnaire included general demographic information, subjective social status, sex education received at home and school, bullying, as well as knowledge, attitude, practice and needs towards comprehensive sexuality education. Results: The average score of the comprehensive sexuality education knowledge was (12.21±3.10) points, which was converted to (71.82±18.21) points based on the percentage based system. The scores varied by grade, sex and sexuality education setting, significantly higher in grade 3 students (12.69±2.99), girls (12.28±3.01) ( P < 0.01), and students who have received sex education at home (12.67±2.88) and students who received sex education at school (12.63±2.91), as well as those who had actively searched for sex information online had a higher score (12.71±2.94) ( t =35.10, 28.78, 10.55, P <0.01).Further analysis using multiple linear regression and Logistic regression, "whether you have received sex education at home" "whether you have received sex education at school" "whether you have searched the Internet actively" and "whether it is necessary to carry out comprehensive sex education" are still correlated with the score of comprehensive sex education knowledge; "self reported bullying" was still associated with "subjective social status" score, correct rate of question 2, and "shyness and inferiority toward the development of secondary sexual characteristics" ( P <0.01). Conclusion The current comprehensive sexuality education knowledge among junior high school students needs to be improved. The level of implementation of sexuality education in different settings varies, but the implementation of sexuality education in schools can help improve students comprehensive sexuality education knowledge level.

Abstract Subjective social status and life skill level are important influencing factors of adolescent health risk behaviors, and they interact with each other and jointly act on adolescent health risk behaviors, which make the mechanism of adolescent health risk behaviors become more diverse and complex. The current paper reviews the correlations among subjective social status, life skill level and adolescent health risk behaviors, in order to explore the joint influence of subjective social status and life skill level on adolescent health risk behaviors, then provides future directions for exploring possible mechanisms, and proposes recommendations for effective prevention strategies of adolescent health risk behaviors.

Objective: To understand knowledge of comprehensive sexuality education and its associated factors among junior high school teachers in six provinces in China, in order to provide a scientific basis for teacher training. Methods: From June to December 2021, a convenience sampling method was used to select 1 016 junior high school teachers from Beijing, Chongqing, Liaoning, Sichuan, Yunnan and Guangdong provinces. A structured questionnaire was used to investigate teachers knowledge of comprehenswe sexuality education. Binary Logistic regression was used to analyze the related influencing factors of the knowledge of comprehensive sexuality education among junior high school teachers. Results: The study showed that the knowledge rate of comprehensive sexuality education among middle school teachers was 58.1%, and the knowledge rate was higher in teachers who had conducted sexuality education to students( χ 2=9.42, P <0.01). The percentage of the correct answer on the prevention and control of sexually transmitted diseases(26.0%), the impact of inequality on love relationships( 33.6 %), and the impact of mass media on sexual cognition(68.8%) was the lowest. Regardless of whether they had implemented sexuality education for students, the knowledge and awareness rate of sexual knowledge among biology teachers, school doctors/health teachers and mental health teachers was higher( OR=2.32, 4.17, P <0.05). Conclusion Knowledge of comprehensive sexuality education among middle school teachers still needs to be improved. It is advisable to strengthen the training of comprehensive sexuality education for middle school teachers and focus on teachers of subjects related to comprehensive sexuality education.

Abstract Improving health literacy can effectively reduce the risk of health risk behaviors and adverse health outcomes in children and adolescents. Global research on health literacy of children and adolescents has been increasing in recent years. The paper reviews the existing research and proposes that there is no universal definition and connotation of health literacy for children and adolescents, most of the studies use or make some revisions on the definition of adult health literacy in child and adolescent health literacy, failing to consider developmental characteristics and unique health needs of children and adolescents. Moreover, the assessment index system and instruments are diversified, making the research findings from different studies difficult to compare, and to obtain consistent and reliable conclusions. Future endeavors are encoouraged to expand health literacy researches and to update more comprehensive and practical definition, and to develop a standardized assessment instrument that can be validated in Chinese culture.

Objective: To explore the relationship between depressive symptoms, negative life events and resilience among primary and secondary school teachers, so as to provide a reference for mental health promotion in school teachers. Methods: During November to December 2022, a questionnaire survey was conducted using convenient cluster sampling method to select 11 332 in service teachers from 38 schools in 8 provinces (cities) including Beijing, Guangdong, Anhui, Hubei, Sichuan, Xinjiang, Liaoning, and Heilongjiang. The Patient Health Questionnaire-9 items, a self developed 21-item Adverse Life Events questionnaire, and a 10-item Conner-Davidson Resilience Scale were used to assess depressive symptoms, experiences of negative life events, and resilience levels of the teachers, respectively. The relationship between depressive symptoms, negative life events and psychological resilience were analyzed by multiple linear regression and stratified regression. Results: The detection rate of depressive symptoms among primary and secondary school teachers was 14.0%. Negative life events of primary and secondary school teachers were positively correlated with depressive symptoms ( r =0.35), while psychological resilience was negatively correlated with depressive symptoms ( r =-0.45) ( P <0.05). After adjusting for possible covariates including gender and marital status, negative life events were positively correlated with depressive symptoms ( β=0.22, P <0.01). Resilience played a moderating role in the association of negative life events with depressive symptoms among primary and secondary school teachers ( B=-0.15, P <0.01). Conclusions Negative life events experiences are associated with higher level of depressive symptoms among school teachers. However, resilience might mitigate the negative effects of negative life events on depressive symptoms, playing a protective role in teachers mental health.

Objective: To preliminarily develop Health Literacy Scale for pupils, providing a tool for dynamic monitoring and related health literacy research among pupils. Methods: Through policy and literature review, the health literacy evaluation index system of pupils was established. Through two rounds of expert consultation, the evaluation index system and scale item pool of three levels in primary school were formed, and "Evaluation Scale 1.0" was developed. Through two panel discussions, health education experts, teachers and students were invited to provide advices on the content, expression and structure of scale 1.0, turning it into "Evaluation Scale 2.0", and completing the preliminary development of the scale. Results: The health literacy assessment index system of primary school students includes three levels，including level-1 was Grade 1-2, level-2 was Grade 3-4,level-3 was Grade 5-6, covering two level indexes. The scale for primary school students contained five horizontal dimensions and four vertical dimensions. In the Delphi consultation, the response rate was 100%, and the authority coefficient was 0.85. After item selection and modification, the final version of level-1, level-2 and level-3 scales contained 36, 44 and 50 items respectively. Conclusion The development of Health Literacy Evaluation Scale for pupils has high applicability and practical value.