A Comparative Study On The Relationship Between Physical Health And Mental Sub-health And The Effect Of Exercise Intervention In Xinjiang Han,uyghur And Kazakh Children And Adolescents

The physical and mental health of children and adolescents is not only related to the happiness of families but also the development of the country now and in the future.However,in recent decades,the decline in children and adolescents’physical health and the rise of mental health disorders have become a global public health problem.It was reported that the physical health of children and adolescents in the relatively backward western region is not optimistic and the detection rate of psychological problems is also higher.Xinjiang Uyghur Autonomous Region is located in the northwest of China and is a multi-ethnic inhabited area.Due to the differences of various ethnic groups in genetics,lifestyle,eating habits,traditional ideas and other aspects,as well as the different regional environment and economic development levels,the physical and mental health of children and adolescents in Xinjiang may be complicated.Previous studies on the physical health of children and adolescents in Xinjiang were mostly focused on a certain ethnic group,while the comprehensive comparison of physical health among ethnic groups was scarce.Meanwhile,existing national mental health surveys only involved adults in Xinjiang,and large-scale research on the mental health status of Xinjiang multi-ethnic children and adolescents is scarce.Existing studies mainly use the clinical diagnostic psychological questionnaire for investigation,and few studies focus on the early screening of mental health disorders using the mental sub-health scale for Xinjiang multi-ethnic children and adolescents.Physical and mental health are mutually reinforcing and cannot be achieved without one or the other.It was reported that there is a close link between the physical and mental health of children and adolescents,but the status of this link in Xinjiang’s multi-ethnic groups of children and adolescents is unclear.In recent years,physical exercise has been regarded as an effective means to prevent and alleviate mental health problems.However,very few studies focus on the relationship between physical fitness and mental health and exercise intervention of multi-ethnic children and adolescents in Xinjiang.Based on the above,the present study aimed:（1）to estimate the physical fitness and mental health status;（2）to explore the relationship between physical and mental health;（3）to explore the effect of exercise intervention for Xinjiang Han,Uyghur,and Kazakh children and adolescents,thus providing references for promoting the healthy development of multi-ethnic children and adolescents in Xinjiang.StudyⅠ A comparative study on the physical and mental health of Xinjiang Han,Uyghur,and Kazakh children and adolescentsObjective:To estimate the physical and mental health status of Xinjiang Han,Uyghur,and Kazakh children and adolescents,and to explore the ethnic differences.Method:Using the stratified cluster sampling method,children and adolescents of Han（N=5586）,Uyghur（N=6147）,and Kazakh（N=5759）in Xinjiang were selected as participants and were conducted physical and mental health investigations.The physical health items included height,weight,waist circumference,sit and reach,grip strength,sit-ups,standing long jump,50m run,and 20m shuttle run test（20m SRT）.The Physical Fitness Index（PFI）was used to reflect the overall physical fitness of children and adolescents of the three ethnics and was calculated as:PFI=Z_gripstrength+Zstanding long jump+Zsit-up+Zsit and reach+Z20m SRT-Z50m run).In terms of mental health,the Brief Instrument on Psychological Health of Youths was used to investigate the mental sub-health status of Xinjiang children and adolescents.One-way ANOVA and Chi-square test were used to compare the physical and mental health of children and adolescents.Results:The Body mass index（BMI）of Han,Uyghur,and Kazakh children and adolescents in Xinjiang was 19.59kg/m²,18.46kg/m²,and 19.37kg/m²,respectively,and the difference was statistically significant（F=167.69,P<0.001）.Multiple comparisons show that the BMI was:Han>Kazakh>Uyghur;The waist circumference was 65.53cm,61.96cm,and 67.44cm,respectively,and the difference was statistically significant（F=361.91,P<0.001）.Multiple comparisons showed that the waist circumference was:Kazakh>Han>Uyghur.The physical fitness indexes were 0.22,-1.25,and-0.62,respectively,and the differences were statistically significant（F=396.04,P<0.001）.Multiple comparisons showed that the physical fitness indexes were:Han>Kazakh>Uyghur;The detection rates of mental sub-health were 17.6%,21.3%,and 19.5%,respectively,and the differences were statistically significant（χ²=18.23,P<0.001）.Multiple comparisons showed that the detection rates of mental sub-health were higher in Uyghur than in Han and Kazakh children and adolescents.Summary:（1）There are ethnic differences in BMI,waist circumference,and physical fitness index among Xinjiang children and adolescents.The general trend for BMI and physical fitness index is:Han>Kazakh>Uyghur and the general trend for waist circumference is:Kazakh>Han>Uyghur.（2）There are ethnic differences in the detection rate of mental sub-health among Xinjiang children and adolescents,and the detection rate is higher in Uyghur children and adolescents than in Han and Kazakh children and adolescents.Ⅱ The relationship between physical fitness and mental health of Xinjiang Han,Uyghur,and Kazakh children and adolescentsObjective:To explore the relationship between physical and mental health for Han,Uyghur,and Kazakh children and adolescents in Xinjiang.Methods:Based on studyⅠ,Spearman correlation analysis was used to explore the correlation between the physical and mental health of children and adolescents of three ethnic groups in Xinjiang.The Chi-square test was used to compare the detection rates of mental sub-health among children and adolescents of different physical health levels in three ethnic groups in Xinjiang.With the detection rates of mental sub-health as the dependent variable and physical health indicators as independent variables,Logistic regression was carried out in three models to explore the relationship between the physical and mental health of Xinjiang Han,Uyghur,and Kazakh children and adolescents.Results:（1）Spearman correlation analysis showed that BMI and waist circumference were positively correlated with mental sub-health scores（r=0.19,0.13,P<0.01）,while sit and reach,grip strength,sit-ups,standing long jump,20m SRT and physical fitness index was negatively correlated with mental sub-health scores（r=-0.20～-0.02,all P values<0.01）.（2）Chi-square test showed that there were significant differences in the detection rates of mental sub-health among children and adolescents with different nutritional status,waist circumference,grip strength,standing long jump,50m run 20m SRT and physical fitness index（all P values<0.05）.（3）Logistic regression analysis showed that after adjusting for covariates,compared with thinner children and adolescents,obese Han（OR=3.56,95%CI:2.00～6.31,P<0.001）,Uyghur（OR=9.03,95%CI:4.94～16.51,P<0.001）,Kazakh（OR=2.01,95%CI:1.22～3.32,P<0.001）children and adolescents have an increased risk of mental sub-health（P for trend<0.001）.Compared with the children and adolescents with lower waist circumference,Xinjiang Han children and adolescents with higher waist circumference（OR=3.07,95%CI:2.06～4.58,P<0.001）have an increased risk of mental sub-health（P for trend<0.001）,while the relationship between waist circumference and mental sub-health in Uyghur and Kazakh children and adolescents were not significant（P for trend>0.05）.Compared with children and adolescents with lower fitness index,Xinjiang Han（OR=0.26,95%CI:0.19～0.36,P<0.001）,Uyghur（OR=0.23,95%CI:0.18～0.31,P<0.001）,Kazakh（OR=0.25,95%CI:0.18～0.33,P<0.001）children and adolescents with high fitness index have a decreased risk of mental sub-health（P for trend<0.001）.Summary:（1）The detection rate of mental sub-health was higher in the Han,Uyghur,and Kazakh children and adolescents with higher BMI in Xinjiang.（2）The detection rate of mental sub-health was higher in Han children and adolescents with higher waist circumferences.（3）The detection rate of mental sub-health was lower in Han,Uyghur,and Kazakh children and adolescents with higher physical fitness in Xinjiang.Ⅲ A comparative study on the effect of the intervention on the physical and mental health of Xinjiang Han,Uyghur,and Kazakh children and adolescentsObjective:To explore the effect of the intervention on the physical and mental health of Xinjiang Han,Uyghur,and Kazakh children and adolescents.Methods:647 students in Grade Two of junior high school participated in the study,and were divided into intervention group（N=321）and control group（N=326）.Students in the intervention group received 36 exercise interventions in 12 weeks,while students in the control group continued to implement the normal school teaching plan.All the students were tested and investigated for physical and mental health before and after the intervention.Taking the group（control and intervention）and ethnicity（Han,Uyghur,and Kazakh）as independent variables,the pre-measured values of indicators as covariables,and the post-measured values of indicators as dependent variables,covariance analysis was used to compare the physical health indicators.The Chi-square test was used to compare the detection rate of mental sub-health before and after the intervention and the non-parametric test was used for comparison between groups.Results:（1）The results of covariance analysis showed that,after eliminating the influence of pre-measured BMI,compared with the control group,BMI in the intervention group of Han（F=138.82,P<0.001）,Uyghur（F=156.75,P<0.001）and Kazakh（F=153.24,P<0.001）have significant differences,and the difference values were 1.80kg/m²,1.90kg/m²and 1.94kg/m²,respectively.In the intervention group,there was no significant difference in BMI among the three ethnic groups（F=0.30,P>0.05）.（2）After eliminating the influence of pre-measured waist circumference,compared with the control group,waist circumference in the intervention group of Han（F=499.09,P<0.001）,Uyghur（F=248.78,P<0.001）,Kazakh（F=454.40,P<0.001）had a significant difference,and the difference was5.86cm,4.21cm,15.86cm,respectively.In the intervention group,there were significant differences in waist circumference among the three ethnic groups（F=26.04,P<0.001）.Pairwise comparison showed that the Han and Kazakh junior middle school students have a lower waist circumference than that of Uyghur（P<0.001）,and the difference values were 1.67cm and 1.70cm,respectively,which showed that the effect of an exercise intervention on waist circumference of Xinjiang Han and Kazakh junior middle school students was better than that of Uyghur.（3）After eliminating the influence of the pre-measured physical fitness index,compared with the control group,the physical fitness index in the intervention group of Han（F=137.75,P<0.001）,Uyghur（F=198.89,P<0.001）,Kazakh（F=99.53,P<0.001）had significant differences,and the difference values were 2.07,2.48,1.80,respectively.In the intervention group,there was a significant difference in the physical fitness index of junior middle school students among the three ethnic groups（F=8.48,P<0.001）.Pairwise comparison showed that the Uyghur junior middle school students have a lower physical fitness index than that of Kazakh（P<0.001）,and the difference value was 0.73.After eliminating the influence of pre-measured,the scores of sit and reach,grip strength,sit-up,standing long jump,and 20m SRT of junior middle school students in the intervention group were higher than those in the control group（all P values<0.05）.（4）After the intervention,the detection rate of mental sub-health of Han,Uyghur and Kazakh students in the intervention group decreased from 18.3%,21.8%,and 21.6%to 5.6%,7.2%,and5.9%,respectively（all P values<0.05）.Comparison between groups showed that,in the aspect of group comparison,the difference between post and pre-measured psychological sub-health scores in the intervention group was significantly higher than that in the control group for the three ethnic（H=12.02,16.08,11.18,respectively,all P values<0.05）;In the aspect of ethnic comparison,there was no significant difference among the three ethnic groups in the intervention group（H=1.15,P>0.05）.Summary:（1）Exercise intervention can improve the physical health status of junior middle school students of Han,Uyghur,and Kazakh in Xinjiang.Among them,the waist circumference of Han and Kazakh,and the physical fitness of Uyghur improved better.（2）Exercise intervention can improve the mental sub-health status of Han,Uyghur,and Kazakh junior middle school students in Xinjiang,and there is no ethnic difference in the improvement effect.Conclusions:（1）Ethnic differences exist in the physical fitness and mental health of children and adolescents of Han,Uyghur,and Kazakh in Xinjiang.The BMI and physical fitness index of Han children and adolescents are higher;the waist circumference of Kazakh children and adolescents is higher;compared with Han and Kazakh children and adolescents,the physical fitness and mental sub-health status of Uyghur children and adolescents are not optimistic.（2）The detection rate of mental sub-health is higher among Xinjiang Han,Uyghur,and Kazakh children and adolescents with higher BMI;the detection rate of mental sub-health is lower among Xinjiang children and adolescents with higher physical fitness.（3）After the exercise intervention,the physical and mental health of Xinjiang Han,Uyghur,and Kazakh junior middle school students improved,among which,the waist circumference of Han and Kazakh and the physical fitness of Uyghur middle school students improved better.