基于熵权TOPSIS法的陕西农村青少年健康结局及其影响因素研究

Health outcomes and their influencing factors in rural adolescents of Shaanxi based on the entropy weight TOPSIS method

摘要

目的 应用熵权逼近理想解排序法(TOPSIS法),构建一个能够整合多维度指标的综合健康评价体系,以克服传统单维度研究的局限性,并分析影响陕西农村地区青少年健康综合得分的因素及其性别差异,为制定针对性健康干预策略提供依据。方法 本研究为一项基于2002—2016年在中国西部农村开展的一项母亲孕期微量营养素干预随机对照试验出生队列的断面随访研究。研究于2016年对队列中的10～14岁青少年进行了调查,收集了包括行为问题、认知能力、肺功能、心率、体质指数、血压等多维度健康指标,运用熵权TOPSIS法计算健康综合得分。采用多元线性回归和Logistic回归分析其影响因素,并按性别进行分层分析。结果 共纳入青少年1 767名,其中男性1 050人(59.4%),青少年的中位年龄为12(11,12)岁。多元回归分析结果显示,年龄增长(β=-0.51,P＜0.001)、就读村级学校(参照组)与较低健康得分相关,而镇级学校(β=1.86,P＜0.001)、高家庭经济水平(β=0.78,P=0.013)与较高的健康得分相关。性别分层显示,与男性相比,年龄对女性青少年的健康得分的负向影响更强(β=-0.69,P=0.002),母亲的多产情况对女性青少年的健康得分有更强的正向影响(β=1.01,P=0.009)。结论 熵权TOPSIS法适用于青少年多维度健康结局的综合评价。青少年的整体健康受年龄、学校类型、家庭经济及母亲生育史等因素影响,且存在性别差异。未来的健康促进策略应关注家庭背景和性别差异,优化资源配置,提供针对性的健康指导,促进青少年身心健康的全面发展。

Abstract

Objective The study aimed to apply the entropy weight Technique for Order of Preference by Similarity to Ideal Solution (TOPSIS) method to construct a comprehensive health evaluation system that integrates multidimensional indicators, in order to overcome the limitations of traditional single-dimension research. It also analyzes the factors influencing the comprehensive health scores of adolescents in rural Shaanxi and their gender differences, thus providing a basis for developing targeted health intervention strategies. Methods This study was a cross-sectional follow-up one based on a birth cohort that originated from a randomized controlled trial of micronutrient supplementation during pregnancy conducted in rural western China from 2002 to 2016. In 2016, we surveyed adolescents aged 10 to 14 years in the cohort, collecting multidimensional health indicators including behavioral problems, cognitive ability, lung function, heart rate, body mass index, and blood pressure. The entropy weight TOPSIS method was used to construct a comprehensive health score. Multiple linear regression and Logistic regression were used to analyze the influencing factors, with stratified analysis by gender. Results In this study we included a total of 1 767 adolescents, of whom 1 050 (59.4%) were male. The median age of the adolescents was 12 (11, 12) years. Multiple regression showed that increasing age (β=-0.51, P＜0.001) and attending village-level schools (reference group) were associated with lower health scores, while attending town-level schools (β=1.86, P＜0.001), high family economic status (β=0.78, P=0.013) were associated with higher health scores. Gender-stratified analysis showed that compared to that of the males, age had a stronger negative impact on the health scores of the female adolescents (β=-0.69, P=0.002), and maternal multiparity had a stronger positive impact on the health scores of the female adolescents (β=1.01, P=0.009). Conclusion The entropy weight TOPSIS method is suitable for the comprehensive evaluation of multidimensional health outcomes in adolescents. The study indicates that overall adolescent health is influenced by factors such as age, school type, family economy, and maternal parity, with gender differences. Future health promotion strategies should focus on family background and gender differences, optimize resource allocation, and provide targeted health guidance to promote the comprehensive physical and mental development of adolescents.

关键词

熵权TOPSIS法 / 青少年健康 / 多维健康结局 / 综合评价 / 社会决定因素 / 性别差异

Key words

entropy weight TOPSIS method / adolescent health / multidimensional health outcome / comprehensive assessment / social determinants of health / gender difference

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基金资助

国家自然科学基金资助项目(82103867)

中央高校基本科研业务费专项资金资助(xxj032025066)

陕西省重点研发计划项目(2024SF-YBXM-310)

陕西省创新能力支撑计划项目(2023-CX-PT-47)

陕西省自然科学基础研究计划项目(2024JC-YBMS-760)