Current status and influencing factors of screening myopia among children  aged 6 to 9 based on the Health Ecological Model

SUN Xiaochen; HU Huiyu; YANG Shuangpan; GUO Li; FAN Aiping

doi:10.11852/zgetbjzz2025-0865

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Chinese Journal of Child Health Care ›› 2026, Vol. 34 ›› Issue (2) : 145-151. DOI: 10.11852/zgetbjzz2025-0865

Column on Early Development & Nurturing Care

Current status and influencing factors of screening myopia among children aged 6 to 9 based on the Health Ecological Model

SUN Xiaochen¹, HU Huiyu¹, YANG Shuangpan¹, GUO Li², FAN Aiping¹

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Abstract

Objective To analyze the the epidemiological characteristics and influencing factors of screening myopia among children aged 6 - 9 years in Tai'an City based on the Health Ecology Model(HEM), so as to provide evidence for the prevention and control of myopia among young children. Methods In October 2023, a stratified cluster random sampling method was employed to recruit 2 813 children from 6 districts (counties) of Tai'an City.Distance visual acuity tests, non-cycloplegic refraction assessments, and parent-reported questionnaires were conducted.The questionnaire included sociodemographic characteristics,visual behaviors,eye exercises,etc.Screening myopia was defined as uncorrected visual acuity<5.0 and spherical equivalent<-0.50D under non-cycloplegic refraction.Multivariate logistic regression and multiplicative interaction analysis were performed to examine the impacts of factors at the five levels of HEM on screening myopia among young children. Results The detection rate of screening myopia among children aged 6 to 9 was 22.40% (630/2 813) in Tai'an City.Multivariate regression revealed that increasing age (OR=1.696), myopia in one parent (OR=1.382), and myopia in both parents (OR=2.046), average daily close-range eye use of 1 - 2 hours after school (OR=1.536), first eye examination at age ≥4 years(OR=1.445) or never examined (OR=1.491), and residing in suburban counties (OR=1.350) were independent risk factors (P<0.05).Interaction analysis revealed that children living in suburban counties with first examination ≥4 years old, those with parental myopia and ≥1 hour of close-range eye use, and those with parental myopia and first eye examination at age ≥4 years old had a higher risk of screening myopia (OR=1.817,2.413,2.336, P＜0.001). Conclusions Screening myopia among children aged 6 - 9 is influenced by the interaction of multi-level factors within the HEM framework.Special attention should be paid to the management of close-range eye use behaviors and precise prevention and control in families at high genetic risk.Early eye care for children should be vigorously promoted and popularized, especially in suburban and rural areas.

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early-onset myopia / health ecological model / interaction / children

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SUN Xiaochen, HU Huiyu, YANG Shuangpan, GUO Li, FAN Aiping. Current status and influencing factors of screening myopia among children aged 6 to 9 based on the Health Ecological Model[J]. Chinese Journal of Child Health Care. 2026, 34(2): 145-151 https://doi.org/10.11852/zgetbjzz2025-0865

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