Abstract: Objective To explore the modifiable determinants of the lack of outdoor after-school activities, prolonged screen time and insufficient sleep duration in preschoolers, in order to provide scientific reference for health education and intervention. Method From September 2020 to September 2021, a total of 819 parents of preschool children (3-6 years old) were recruited in this study and were investigated twice by 1-year interval, and the longitudinal data were statistically analyzed by multivariate Logistic regression model. Results Insufficient outdoor activities, prolonged screen time and insufficient sleep duration of preschool-aged children were correlated with their baseline levels (χ²=4.68,19.74,8.74,P<0.001). The maternal screen time (OR=2.01,95%CI:1.36 - 2.99) and screen accessibility (OR=1.62,95%CI:1.14 - 2.31) at baseline were correlated with the follow-up screen time of preschool-aged children. Lack of maternal outdoor activities (OR=2.17,95%CI:1.48 - 3.18) and fewer outdoor venues (OR=1.55,95%CI:1.11 - 2.17) at baseline were associated with the follow-up insufficient outdoor activities in preschoolers. Insufficient outdoor activities (OR=1.42,95%CI:1.01 - 1.99) and non-maternal caregivers of preschoolers (OR=1.63,95%CI:1.16 - 2.30) at baseline were related to the lack of sleep duration in preschoolers. Conclusions Adverse maternal behaviors, poor home-based physical environments and caregivers who are not mothers are the modifiable determinants of insufficient outdoor after-school activities, prolonged screen time and insufficient sleep duration in preschool children.

Key words: preschool children, insufficient physical activity, screen time, sleep duration, maternal care

摘要： 目的 基于随访数据探讨学龄前儿童园外户外活动不足、视屏时间过长及睡眠时间不充分的可变决定因素,为开展相关健康教育和干预措施提供科学依据。方法 2020年9月—2021年9月对4所幼儿园的819名学龄前儿童(3~6岁)父母/监护人进行了1年随访调查,调查了学龄前儿童的园外户外活动时间、视屏时间、睡眠时长及母亲/家庭相关因素等,并通过多因素Logistic回归模型等进行统计分析。结果 当调整了相关因素之后,学龄前儿童随访户外活动、视屏时间及睡眠时间都与其自身的基线水平密切相关(χ²=4.68、19.74、8.74,P<0.05);并且,基线母亲视屏时间(OR=2.01,95%CI:1.36~2.99)、屏幕可及性好(OR=1.62,95%CI:1.14~2.31)与学龄前儿童随访视屏时间超标有关;基线母亲户外活动不足(OR=2.17,95%CI:1.48~3.18)、户外活动场所较少(OR=1.55,95%CI:1.11~2.17)与学龄前儿童随访户外活动不足有关;基线学龄前儿童户外活动不足(OR=1.42,95%CI:1.01~1.99)、非母亲照护者(OR=1.63,95%CI:1.16~2.30)与学龄前儿童随访睡眠时长不足有关。结论 母亲不良的相关行为、物理环境及照护人非母亲等因素是学龄前儿童园外户外活动不足、视屏时间过长以及睡眠时间不充足的可变决定因素。

关键词: 幼儿, 体力活动不足, 屏幕时间, 睡眠时间, 母亲照护