Association of health literacy and screen time with depressive symptoms among middle school students

OBJECTIVE: To examine the association of health literacy( HL), screen time and depressive symptoms in middle school students. METHODS: In December 2017, a convenient cluster sampling method was used to select all the students from Junior 1 to Senior 3 in a middle school in Shenyang City in the cooperation area as the subjects. And 1062 valid questionnaires were collected, with the use of the group's self-made questionnaire. The average age of the 1062 students was( 15. 38 ± 1. 74) years old, among which 576 boys and 486 girls were surveyed. Questionnaires survey was conducted to collect information on demographics, health literacy, screen time of study day and depressive symptoms. The Chi-square test was performed according to group differences, and multiple Logistic regression model was used to analyze the association of health literacy( including three dimensions of interpersonal relationship, stress management and mental growth) and screen time and their different combinations and depressive symptoms. RESULTS: The detection rate of depressive symptoms among middle school students was 26. 1%( 277/1062). The prevalence of depressive symptoms among students in high school students, low family income and longer screen time was significantly higher than their peers( χ~2 were 15. 090, 10. 510, 4. 832, P < 0. 05). Data from multiple logistic regression analyses showed that low health literacy, longer screen time and low mental growth were positively correlated with depressive symptoms in middle school students( P < 0. 05). In the same level of health literacy, with the increase of screen time, the higher the detection rate of depressive symptoms of middle school students, the highest detection rate of depressive symptoms of middle school students with longer screen time and low health literacy was 51. 7%( 30/58), and the OR value was 5. 741( 95% CI 2. 999-10. 999). CONCLUSION: Health literacy and screen time are related factors of depressive symptoms. The detection rate of depressive symptoms of middle school students with longer screen time and low health literacy is the highest.