Background Adolescent non-suicidal self-injury (NSSI) is common and adolescence is the most common period of first self-injury, and the occurrence of NSSI is influenced by negative life events and emotional symptoms. The mediating role of emotional symptoms in the interaction between negative life events and NSSI has not been carefully investigated yet. Methods For middle school students in three schools in a Chinese province, the Adolescents Self-Harm Scale was used to investigate NSSI, the Adolescent Self-Rating Life Events Check List was used to investigate adolescent negative life events, and the Self-Rating Anxiety Scale and Self-Rating Depression Scale were used to assess their emotional symptoms. After the description of general data and the test for differences between groups, the relationship between negative life events, emotional symptoms and NSSI was analyzed using Pearson correlation analysis. Structural equation modeling was used to analyze the mediating role of emotions in negative life events and NSSI. Results A total of 2376 junior high school students completed this survey, which revealed an annual NSSI prevalence of 37.1% (n = 881) and a higher prevalence of NSSI among girls and rural adolescents. Among adolescents who developed NSSI, 67.4% (N = 594) used multiple means of self-injury. The most common means of self-injury was hair pulling (51.0%), and the most common NSSI purpose and external factors/events were venting bad emotions or feelings (57.5%) and poor academic performance (44.9%), respectively. Negative life events, emotional symptoms and NSSI were positively associated (P < 0.05). Structural equation modeling with negative life events, emotional symptoms and NSSI as variables showed that the model-fit index matched the data well, with RMSEA = 0.073, AGFI = 0.945, GFI = 0.980, CFI = 0.985, NFI = 0.982, TLI = 0.968, IFI = 0.985, and negative life events, emotional symptoms (anxiety, depression) and NSSI all had direct effects with standardized path coefficients of 0.16, 0.19, and 0.23, respectively, with negative life events playing an indirect role in NSSI through emotional symptoms and emotional symptoms playing an incomplete mediating role in negative life events and NSSI. Conclusion The prevalence of NSSI was higher among Chinese junior high school students. Both negative life events and emotional symptoms were direct risk factors for NSSI. In addition, negative life events were also indirect risk factors for NSSI, and emotional symptoms played an incomplete mediating role in the relationship between the effects of negative life events and NSSI. This indicates that the combination of reducing the frequency of negative life events while maintaining individual emotional stability during adolescent development can effectively reduce the prevalence of NSSI in adolescents.
The aim of the current study was to provide new evidence for the associations between physical activity (PA), sedentary behavior (SB), and fear of falling (FOF) by investigating the impact of replacing 30 min SB with both light-intensity PA (LPA) and moderate-to-vigorous PA (MVPA) on FOF in older Chinese women. Cross-sectional data from a Physical Activity and Health in Older Women Study (PAHIOWS) were analyzed for 1114 Chinese community-dwelling older women. Variables of focus were demographics, FOF, objectively measured PA and SB. Three different logistic models were used to examine the associations between PA, SB, and FOF (a single parameter model, a partition model and an isotemporal substitution). The results showed that reallocating 30 min/day of MVPA by SB was significantly associated with higher FOF (OR = 1.37; 95%CI: 1.04–1.79; p = 0.024), reallocating 30 min/day of SB by MVPA was significantly associated with a reduction of FOF (OR = 0.73; 95%CI: 0.56–0.96; p = 0.024). No significant associations were found between FOF with reallocating other activities by LPA and vice versa (p > 0.05). Subgroup analysis showed the isotemporal-substituted effects of MVPA and SB on FOF were stronger in older women with fall experience. In conclusion, the current findings showed that the increase of MVPA engagement and reduction of SB engagement may be most beneficial for FOF management and should be involved in public health guidelines, especially for older women with fall experience.
Aims and objectives To investigate the association between sedentary behaviour (SB), physical activity (PA), and frailty and frailty subdomains in community‐dwelling older women. Background Frailty is associated with numerous adverse health outcomes in older people, and women had a higher prevalence than men. However, older adults may face different health risks due to different combinations of frailty subdomains; therefore, specific studies on frailty subdomains are needed. Design A cross‐sectional study guided by the STROBE. Methods In total, 1099 community‐dwelling older Chinese women (60–70 years) were included. SB and PA were objectively obtained using a validated triaxial accelerometer. Frailty was defined using the Fried Phenotype (FP) Model. Results After adjusting for confounders, a significant association was found between SB, PA and the prevalence of frailty. The optimal cut‐off values of total SB time, light PA (LPA) time, and moderate‐to‐vigorous PA (MVPA) time to discriminate between frailty and non‐frailty were 625.4 min/day, 379.3 min/day and 20.1 min/day, respectively. For frailty subdomains, total SB time was positively associated with low PA. When it comes to total LPA time, the association with low PA was negative. Total MVPA time was significantly and negatively associated with exhaustion, weakness, slowness and low PA, and the optimal cutoff value was 24.4 min/day, 26 min/day, 29.5 min/day and 20.8 min/day, respectively. Conclusions Effective management of frailty requires consideration of different combinations of frailty subdomains. Increasing MVPA and limiting SB may help deal with frailty for community‐dwelling older Chinese women. Additional research is needed to determine whether PA are useful for prevention of frailty. Relevance to clinical practice The results of this study could help caregivers provide professional and specific physical activity guidance for order women, who are on a risk of or already suffered frailty.
Background Traditional interventions such as education and counseling are successful in increasing physical activity (PA) participation, but are usually labor and resource intensive. Wearable activity trackers can objectively record PA and provide feedback to help users to achieve activity goals and are an increasingly popular tool among adults used to facilitate self-monitoring of PA. However, no reviews systematically explored the roles of wearable activity trackers in older populations. Methods We searched PubMed, Web of Science, Google Scholar, Embase, Cochrane Library, and Scopus from inception to September 10, 2022. Randomized controlled trials were included. Two reviewers independently conducted study selection, data extraction, risk of bias, and certainty of evidence assessment. A random-effects model was used to evaluate the effect size. Results A total of 45 studies with 7144 participants were included. A wearable activity tracker was effective in increasing daily steps (standard mean differences (SMD) = 0.59, 95% confidence interval (CI) (0.44, 0.75)), weekly moderate-to-vigorous PA (MVPA) (SMD = 0.54, 95% CI (0.36, 0.72)), and total daily PA (SMD = 0.21, 95% CI (0.01, 0.40)) and reducing sedentary time (SMD = −0.10, 95% CI (−0.19, −0.01)). Subgroup analysis showed that the effectiveness of wearable activity trackers for daily steps was not influenced by participants and intervention features. However, wearable activity trackers seemed more effective in promoting MVPA of participant's age <70 than participant's age ≥70. In addition, wearable activity trackers incorporated with traditional intervention components (e.g. telephone counseling, goal setting, and self-monitoring) could better promote MVPA than alone use. Short-term interventions potentially achieve better MVPA increase than long-term. Conclusion This review showed that wearable activity trackers are an effective tool to increase PA for the old population and also favor reducing sedentary time. When used together with other interventions, wearable activity trackers can achieve better MVPA increase, especially in the short term. However, how to more effectively improve the effectiveness of wearable activity trackers is an important direction of future research.
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