Zhongguo quanke yixue (Oct 2022)
Hospital-school-based Posture Assessment, Vision Screening and Health Management for Children and Adolescents
Abstract
Background The prevalence of health problems in Chinese children and adolescents is high. The mention of myopia, obesity, caries, scoliosis and other health problems in adolescents in the Healthy China 2030 Initiative Indicates that these problems have become the national concerns. The establishment of a long-term, standardized disease screening and management mode by the community health center (CHC) in combination with schools in service coverage areas of the CHC will provide a new idea for strengthening the health management of children and adolescents by the CHC. Objective To perform posture assessment and vision screening in full-time students receiving the nine-year compulsory education in schools in the service coverage area of Chaohe Community Health Center of Zhengzhou Economic-Technological Development Area using a CHC-school-based approach, to identify problems in disease screening and management for children and adolescents, to analyze the practice and advantages of CHC-school-based disease screening and management, and to develop a CHC-school-based health management model for children and adolescents. Methods This study was conducted from May to November 2021. Cluster sampling was used to select grades 1-9 full-time students (n=11 318) in 225 classes of 6 primary schools and 3 middle schools in the areas covered with health services delivered by the Chaohe Community Health Center of Zhengzhou Economic-Technological Development Area. All of them received posture assessment and vision screening. Results Among the participants, 6 260 were male and 5 058 were female; 7 979 were pupils, and 3 339 were junior high school students. The prevalence of abnormal posture was 41.34% (4 679/11 318) . With the increase of grade, the prevalence of uneven shoulders, thoracic kyphosis, scoliosis, O-shaped legs, and toe valgus increased, while that of knee hyperextension, flat feet and pes valgus decreased (P<0.05) . The prevalence of 1, 2, 3 and 4 or more abnormal postures was 29.13% (3 297/11 318) , 8.60% (973/11 318) , 3.01% (341/11 318) , and 0.60% (68/11 318) , respectively. Male students had higher prevalence of thoracic kyphosis, scoliosis, flat feet and toe valgus, and lower prevalence of knee hyperextension, X-shaped legs, O-shaped legs and foot valgus than female students (P<0.05) . The prevalence of abnormal vision was 74.99% (8 486/11 318) . The prevalence of myopia, hyperopia, and astigmatism was 41.75% (4 725/11 318) , 26.14% (2 959/11 318) , and 7.09% (802/11 318) , respectively. With the increase of grade, the prevalence of myopia increased and that of hyperopia decreased (P<0.05) . Conclusion At present, the abnormal posture rate of children and adolescents in Zhengzhou is about 40%, and the myopia rate exceeds 40%. With the increase of grade, the prevalence of uneven shoulders, thoracic kyphosis, scoliosis, O-shaped legs, toe valgus and the prevalence of myopia increased, but there is a lack of effective and normal screening and health management systems. As the hospital-school approach could improve the effectiveness and normalization of the health screening and management for children and adolescents, so this approach is recommended to be used in further improvement of the top-level design and efficacy assessment of health management in children and adolescents. In addition to CHC school-based management, the health management of children and adolescents also involves the efforts of themselves and their families, which is equally important as the former two.
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