Association between health behaviors and depressive symptoms among junior and senior high school students in Heilongjiang Province
10.16835/j.cnki.1000-9817.2026274
- VernacularTitle:黑龙江省中学生健康行为与抑郁症状的关联
- Author:
GAO Fei, XU Yi, LI Jingjing, WANG Haijuan, ZHANG Xiaoyan,〖JZ〗 PENG Bo, YAO Xueke, XU Zihan, ZHANG Yuying, BAO Mingjia, WANG Jia
1
Author Information
1. Heilongjiang Provincial Center for Disease Control and Prevention, Harbin 150036, Heilongjiang Province, China
- Publication Type:Journal Article
- Keywords:
Health behavior;
Depression;
Mental health;
Regression analysis;
Students
- From:
Chinese Journal of School Health
2026;47(9):1293-1297
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To examine the association between health behaviors and depressive symptoms among junior and senior high school students, so as to provide evidence for combined behavioral interventions targeting adolescent mental health.
Methods:From September to November 2023, a stratified cluster random sampling method was used to recruit 104 834 junior and senior high school students from all 13 prefecture level cities (124 districts/counties) in Heilongjiang Province, China. Multivariable Logistic regression models, as well as multiplicative and additive interaction analyses were employed to analyze the associations between health behaviors and depressive symptoms, and Chi-square tests for trend were conducted to explore ,the changing tendency in the risk of depressive symptoms with increasing numbers of health behaviors among junior and senior high school students.
Results:Healthy diet ( OR =0.66, 95% CI =0.63-0.68), healthy physical activity ( OR =0.47, 95% CI =0.45-0.49), healthy outdoor activity ( OR =0.55, 95% CI =0.52-0.57), healthy sleep ( OR =0.72, 95% CI =0.69-0.75), and healthy screen use ( OR =0.79, 95% CI =0.76-0.82) were independently associated with lower rates of depressive symptoms (all P <0.01). The risk of depressive symptoms decreased progressively with an increasing cumulative number of health behaviors ( χ 2 trend =996.73, P <0.01). Except for the interaction between healthy diet and healthy sleep, significant additive interactions were observed among the remaining health behaviors( RERI =0.07-0.23,all P <0.05). The probability of depressive symptoms was lower among girls with 2-3 healthy behaviors than among boys ( Z =2.51, 2.65), lower among urban students with 2-3 healthy behaviors than among suburban county students ( Z =-2.36, -2.04), and lower among senior high school students with 2-4 healthy behaviors than among junior high school students ( Z =2.17, 2.10, 2.04) (all P <0.05).
Conclusions:Health behaviors are significantly associated with depressive symptoms among junior and senior high school students. The probability of depressive symptoms is lower among girls, urban students, and senior high school students who engage in multiple healthy behaviors. Implementing combined interventions targeting multiple health behaviors in these populations may yield greater benefits.
