Objective To analyze the effects of outdoor activities,sedentary behaviors and sleep duration on the risk of poor vi-sion among primary and secondary school students after replacing them with each other,so as to provide a reference for precise in-tervention in the prevention and control of myopia among children and adolescents.Methods From March to May 2023,a strati-fied cluster random sampling method was used to select 6 132 students in grades 4 to 12 in Hefei,Wuhu,Suzhou and Chizhou cities in Anhui Province.A questionnaire survey was conducted to collect the basic information,outdoor activities,sedentary behavior,and sleep duration,and a visual inspection was carried out by 5 m standard logarithmic visual acuity chart.The single activity mod-el,segmentation model and isotemporal substitution model were used to analyze the relationship between outdoor activities,sedenta-ry behaviors,sleep,and poor vision,and stratified analysis was performed by gender.Results The detection rate of poor vision a-mong the 6 132 primary and secondary school students was 76.9％,and the detection rate of poor vision was higher for girls(81.1％)than for boys(72.6％),and the difference was statistically significant(x2=61.37,P＜0.01).The results of the single ac-tivity model and segmentation model showed that outdoor activity and sleep duration were correlated with a reduced risk of poor vi-sion in primary and secondary school students(OR=0.87,0.88;0.88,0.91),while sedentary behavior was correlated with an in-creased risk of poor vision(OR=1.05,1.03)(P＜0.05).The results of the isotemporal substitution model showed that replacing the same amount of sedentary behavior with 1 h/d of outdoor activity was associated with 15％reduction in the risk of poor vision(OR=0.85),and replacing the same amount of sedentary behavior with 1 h/d of sleep was associated with a 12％reduction in the risk of poor vision(OR=0.88)(P＜0.05).The results of the isotemporal substitution model stratified by gender showed that replacing the same amount of sedentary behavior with 1 h/d of outdoor activity and 1 h/d of sleep were associated with 22％and 8％reduction in the risk of poor vision in male students(OR=0.78,0.92),and replacing the same amount of sedentary behavior with 1 h/d of sleep was associated with 18％reduction in the risk of poor vision in female students(OR=0.82)(P＜0.05).Conclusion Replacing sedentary behavior with 1 h/d of outdoor activity for boys and 1 h/d of sleep for girls and boys could reduce the risk of poor vision.
Motor activitySedentary lifestyleSleepVision,lowIsotemporal substitutionStudents
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