Data_Sheet_1_Individual-, Family-, and School-Level Ecological Correlates With Physical Fitness Among Chinese School-Aged Children and Adolescents: A National Cross-Sectional Survey in 2014.DOCX

Introduction: Few studies have examined the association between the individual-, family-, and school-level ecological correlates and physical fitness among Chinese children and adolescents, which is the purpose of the present study.Methods: A total of 157,168 children and adolescents, 10-18 years of age, with physical fitness data in 2014, participated in the study. Physical fitness was assessed, using six tests: forced vital capacity, standing long jump, sit and reach, body muscle strength, 50-m dash, and endurance running. Scores were aggregated to form a summary physical fitness indicator (PFI), which was then classified into five levels: low, low-middle, middle, middle-high, and high. Each option of individual-, family-, and school-level measures were constructed into a positive or negative correlate of physical fitness and then accumulated as a composite ecological score.Results: Among the 20 individual-, family-, and school-level correlates, 18 were found to be significantly associated with PFI, with high PFI levels being correlated with the positive group of correlates and low PFI levels correlated with the negative group of correlates (p < 0.05). High scores of ecological correlates were associated with a high level of PFI [adjusted odds ratio (OR) = 1.06, 95% CI: 1.06, 1.07)] whereas low scores were associated with a low level of PFI (OR = 0.95, 95% CI:0.95, 0.95). The ecological correlates at the individual, school- and family-levels were shown to be significantly related to high PFI among Chinese children and adolescents aged 10-18 years with different ORs of 5.97 (95% CI: 5.51, 6.47), 3.94 (3.66, 4.24), and 1.25 (1.19, 1.31). The PAR% of 20 cumulative factors effects due to the negative and positive responses for low PFI levels were 35.9 and 16.1%, and, for high PFI levels, were 15.3 and 24.1%, among Chinese children and adolescents, respectively. Compared with the correlates at family and school levels, the correlates at individual levels had the largest PAR%.Conclusion: Individual-, family-, and school-multilevel factors had a significant cumulative association with either improving or worsening aspects of physical fitness. Individual level factors remain at the core of physical fitness improvement. Comprehensive policies and measures are urgently needed to enhance the physical fitness of Chinese children and adolescents through involving further individual and environmental factors.

引言：关于中国儿童和青少年个体、家庭和学校层面的生态关联与其身体素质之间的关系，鲜有研究涉猎，这正是本研究的宗旨所在。方法：总计157,168名10至18岁的儿童和青少年参与了本研究，他们在2014年有身体素质数据记录。本研究采用六项测试评估身体素质：包括用力肺活量、立定跳远、坐位体前屈、身体肌肉力量、50米冲刺和耐力跑。测试成绩汇总形成身体素质综合指标（PFI），进而将其划分为五个等级：低、低中、中、中高和高。个体、家庭和学校层面的各项指标被构建为身体素质的正向或负向关联因素，并累积形成综合生态得分。结果：在20项个体、家庭和学校层面的关联因素中，有18项与PFI存在显著关联，其中高PFI水平与正向关联因素群相关，低PFI水平与负向关联因素群相关（p < 0.05）。生态关联因素的高得分与高PFI水平相关[调整后的优势比（OR）= 1.06，95%置信区间：1.06，1.07]，而低得分则与低PFI水平相关（OR = 0.95，95%置信区间：0.95，0.95）。个体、学校和家庭层面的生态关联因素与10至18岁中国儿童和青少年的高PFI水平显著相关，相应的OR值分别为5.97（95%置信区间：5.51，6.47）、3.94（3.66，4.24）和1.25（1.19，1.31）。对于低PFI水平，20项累积因素效应的PAR%因负面和正面反应分别为35.9%和16.1%，而对于高PFI水平，分别为15.3%和24.1%，在中国儿童和青少年中均有所体现。与家庭和学校层面的关联因素相比，个体层面的关联因素具有最大的PAR%。结论：个体、家庭和学校等多层次因素与身体素质的改善或恶化方面存在显著的累积关联。个体层面的因素仍然是身体素质改善的核心。迫切需要制定综合政策与措施，通过纳入更广泛的个体和环境因素，以增强中国儿童和青少年的身体素质。