{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,29]],"date-time":"2026-10-29T22:40:18Z","timestamp":1793313618553,"version":"4.5.0"},"reference-count":23,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2024,6,7]],"date-time":"2024-06-07T00:00:00Z","timestamp":1717718400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2024,6,7]],"date-time":"2024-06-07T00:00:00Z","timestamp":1717718400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["82273655"],"award-info":[{"award-number":["82273655"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Public Health"],"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Background<\/jats:title>\n                <jats:p>To investigate the changes in the unhealthy eye-related behaviors of junior middle school students during the COVID-19 pandemic and the double reduction policy and its relationship with myopia.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>Data were obtained from the 2019\u20132022 Tianjin Children and Youth Myopia, Common Diseases and Health Influencing Factors Survey. Latent profile analysis (LPA) and a generalized linear model (GLM) were applied to analyze the effect of eye-related behavior classes on myopia.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>A total of 2508 junior middle school students were included. The types of eye-related behavior were categorized into the medium-healthy behavior group, heavy academic burden and near-eye behavior group, insufficient lighting group and high-healthy behavior group. Students with heavy academic burdens and near-eye behavior were more likely to develop myopia than were those in the high-healthy group (OR\u2009=\u20091.466, 95% CI\u2009=\u20091.203\u20131.787; <jats:italic>P<\/jats:italic>\u2009&lt;\u20090.001).<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusions<\/jats:title>\n                <jats:p>The dual reduction policy has a positive effect on improving unhealthy eye-related behaviors, and the prevention and control of myopia through the use of different combinations of eye-related behaviors are heterogeneous among junior middle school students. In the post-COVID-19 period, we should continue to implement a double reduction policy and formulate targeted eye-related behavior strategies to provide an important reference for the prevention and control of myopia among children and adolescents during public health emergencies in the future.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1186\/s12889-024-18958-0","type":"journal-article","created":{"date-parts":[[2024,6,7]],"date-time":"2024-06-07T03:32:31Z","timestamp":1717731151000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Influence of eye-related behavior on myopia among junior middle school students under the background of double reduction during the COVID-19 pandemic"],"prefix":"10.1186","volume":"24","author":[{"given":"Fengqin","family":"Li","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yin","family":"Li","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhonghui","family":"Liu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chang","family":"Xu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Huiwen","family":"Li","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ying","family":"Sun","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xin","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lei","family":"Gao","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2024,6,7]]},"reference":[{"issue":"10223","key":"18958_CR1","doi-asserted-by":"publisher","first-page":"497","DOI":"10.1016\/S0140-6736(20)30183-5","volume":"395","author":"C Huang","year":"2020","unstructured":"Huang C, Wang Y, Li X, et al. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet. 2020;395(10223):497\u2013506. https:\/\/doi.org\/10.1016\/S0140-6736(20)30183-5.","journal-title":"Lancet"},{"issue":"10228","key":"18958_CR2","doi-asserted-by":"publisher","first-page":"945","DOI":"10.1016\/S0140-6736(20)30547-X","volume":"395","author":"G Wang","year":"2020","unstructured":"Wang G, Zhang Y, Zhao J, Zhang J, Jiang F. Mitigate the effects of home confinement on children during the COVID-19 outbreak. Lancet. 2020;395(10228):945\u20137. https:\/\/doi.org\/10.1016\/S0140-6736(20)30547-X.","journal-title":"Lancet"},{"key":"18958_CR3","unstructured":"MoE. MOE opens online learning platform to facilitate home study; 2020. [accessed 2020 February 15] Available online at: http:\/\/en.moe.gov.cn\/news\/press_releases\/202002\/t20200201_417275.html."},{"key":"18958_CR4","doi-asserted-by":"publisher","first-page":"645971","DOI":"10.3389\/fpubh.2021.645971","volume":"9","author":"Q Fan","year":"2021","unstructured":"Fan Q, Wang H, Kong W, Zhang W, Li Z, Wang Y. Online learning-related visual function impairment during and after the COVID-19 pandemic. Front Public Health. 2021;9:645971. https:\/\/doi.org\/10.3389\/fpubh.2021.645971.","journal-title":"Front Public Health"},{"key":"18958_CR5","doi-asserted-by":"publisher","first-page":"646770","DOI":"10.3389\/fpubh.2021.646770","volume":"9","author":"W Wang","year":"2021","unstructured":"Wang W, Zhu L, Zheng S, et al. Survey on the progression of myopia in children and adolescents in Chongqing during COVID-19 pandemic. Front Public Health. 2021;9:646770. https:\/\/doi.org\/10.3389\/fpubh.2021.646770.","journal-title":"Front Public Health"},{"key":"18958_CR6","doi-asserted-by":"publisher","first-page":"333","DOI":"10.1016\/j.ajo.2020.07.034","volume":"223","author":"CW Wong","year":"2021","unstructured":"Wong CW, Tsai A, Jonas JB, et al. Digital screen time during the COVID-19 pandemic: risk for a further myopia boom? Am J Ophthalmol. 2021;223:333\u20137. https:\/\/doi.org\/10.1016\/j.ajo.2020.07.034.","journal-title":"Am J Ophthalmol"},{"issue":"12","key":"18958_CR7","first-page":"1765","volume":"42","author":"Z Fan","year":"2021","unstructured":"Fan Z, Huang X. The effectiveness of 3 years of comprehensive prevention and control of myopia among children and adolescents and the next work priorities. China School Health. 2021;42(12):1765\u20137. (in Chinese).","journal-title":"China School Health"},{"key":"18958_CR8","unstructured":"Dai A. Study on the effects of increasing physical activity hours on elementary school students\u2019 physical health based on the double reduction policy. Shanghai Normal Univ, 2022. (in Chinese)."},{"issue":"1","key":"18958_CR9","doi-asserted-by":"publisher","first-page":"2","DOI":"10.1186\/s12886-019-1281-0","volume":"20","author":"J Wang","year":"2020","unstructured":"Wang J, Ying GS, Fu X, et al. Prevalence of myopia and vision impairment in school students in Eastern China. BMC Ophthalmol. 2020;20(1):2. https:\/\/doi.org\/10.1186\/s12886-019-1281-0.","journal-title":"BMC Ophthalmol"},{"issue":"10","key":"18958_CR10","doi-asserted-by":"publisher","first-page":"1922","DOI":"10.2105\/AJPH.2011.300167","volume":"101","author":"ES Ford","year":"2011","unstructured":"Ford ES, Zhao G, Tsai J, Li C. Low-risk lifestyle behaviors and all-cause mortality: findings from the National Health and Nutrition Examination Survey III Mortality Study. Am J Public Health. 2011;101(10):1922\u20139. https:\/\/doi.org\/10.2105\/AJPH.2011.300167.","journal-title":"Am J Public Health"},{"issue":"2","key":"18958_CR11","doi-asserted-by":"publisher","first-page":"e0212640","DOI":"10.1371\/journal.pone.0212640","volume":"14","author":"W Onetti","year":"2019","unstructured":"Onetti W, Fern\u00e1ndez-Garc\u00eda JC, Castillo-Rodr\u00edguez A. Transition to middle school: self-concept changes. PLoS ONE. 2019;14(2):e0212640. https:\/\/doi.org\/10.1371\/journal.pone.0212640.","journal-title":"PLoS ONE"},{"issue":"11","key":"18958_CR12","doi-asserted-by":"publisher","first-page":"1652","DOI":"10.1016\/j.ophtha.2021.04.001","volume":"128","author":"L Xu","year":"2021","unstructured":"Xu L, Ma Y, Yuan J, et al. Myopic epidemiology and intervention study. COVID-19 Quarantine reveals that behavioral changes have an effect on myopia progression. Ophthalmology. 2021;128(11):1652\u20134. https:\/\/doi.org\/10.1016\/j.ophtha.2021.04.001.","journal-title":"Ophthalmology"},{"key":"18958_CR13","doi-asserted-by":"crossref","unstructured":"Collins LM, Lanza ST. Latent Class and Latent Transition Analysis: With Applications in the Social, Behavioral, and Health Sciences. 2009.","DOI":"10.1002\/9780470567333"},{"key":"18958_CR14","unstructured":"National Health Commission of the PRC. 2019. [accessed 2019 October 15]. Available online at: http:\/\/www.nhc.gov.cn\/jkj\/s5898bm\/201910\/c475e0bd2de444379402f157523f03fe.shtml."},{"key":"18958_CR15","doi-asserted-by":"publisher","first-page":"859285","DOI":"10.3389\/fpubh.2022.859285","volume":"10","author":"J Mu","year":"2022","unstructured":"Mu J, Zhong H, Liu M, et al. Trends in Myopia Development among primary and secondary school students during the COVID-19 pandemic: a large-scale cross-sectional study. Front Public Health. 2022;10:859285. https:\/\/doi.org\/10.3389\/fpubh.2022.859285.","journal-title":"Front Public Health"},{"issue":"5","key":"18958_CR16","doi-asserted-by":"publisher","first-page":"593","DOI":"10.1136\/bjophthalmol-2019-314675","volume":"104","author":"G Lingham","year":"2020","unstructured":"Lingham G, Mackey DA, Lucas R, Yazar S. How does spending time outdoors protect against myopia? A review. Br J Ophthalmol. 2020;104(5):593\u20139. https:\/\/doi.org\/10.1136\/bjophthalmol-2019-314675.","journal-title":"Br J Ophthalmol"},{"key":"18958_CR17","doi-asserted-by":"publisher","first-page":"1014227","DOI":"10.3389\/fpubh.2022.1014227","volume":"10","author":"ZH Liu","year":"2022","unstructured":"Liu ZH, Zhao MF, Ma S, Li Y, Sun ZY, Gao L. Exercise is the dominant factor affecting the development of teenagers\u2019 eyesight-based on the bayesian model averaging. Front Public Health. 2022;10:1014227. https:\/\/doi.org\/10.3389\/fpubh.2022.1014227.","journal-title":"Front Public Health"},{"issue":"6","key":"18958_CR18","doi-asserted-by":"publisher","first-page":"403","DOI":"10.1097\/APO.0000000000000233","volume":"5","author":"KA Rose","year":"2016","unstructured":"Rose KA, French AN, Morgan IG. Environmental factors and myopia: paradoxes and prospects for Prevention. Asia Pac J Ophthalmol (Phila). 2016;5(6):403\u201310. https:\/\/doi.org\/10.1097\/APO.0000000000000233.","journal-title":"Asia Pac J Ophthalmol (Phila)"},{"issue":"6","key":"18958_CR19","doi-asserted-by":"publisher","first-page":"497","DOI":"10.1111\/cxo.12346","volume":"98","author":"D Ramamurthy","year":"2015","unstructured":"Ramamurthy D, Lin Chua SY, Saw SM. A review of environmental risk factors for myopia during early life, childhood and adolescence. Clin Exp Optom. 2015;98(6):497\u2013506. https:\/\/doi.org\/10.1111\/cxo.12346.","journal-title":"Clin Exp Optom"},{"issue":"3","key":"18958_CR20","doi-asserted-by":"publisher","first-page":"329","DOI":"10.1111\/opo.12040","volume":"33","author":"IG Morgan","year":"2013","unstructured":"Morgan IG, Rose KA. Myopia and international educational performance. Ophthalmic Physiol Opt. 2013;33(3):329\u201338. https:\/\/doi.org\/10.1111\/opo.12040.","journal-title":"Ophthalmic Physiol Opt"},{"key":"18958_CR21","doi-asserted-by":"publisher","first-page":"33902","DOI":"10.1038\/srep33902","volume":"6","author":"M Ayaki","year":"2016","unstructured":"Ayaki M, Torii H, Tsubota K, Negishi K. Decreased sleep quality in high myopia children. Sci Rep. 2016;6:33902. https:\/\/doi.org\/10.1038\/srep33902.","journal-title":"Sci Rep"},{"issue":"1","key":"18958_CR22","doi-asserted-by":"publisher","first-page":"812","DOI":"10.1016\/j.chb.2004.11.011","volume":"23","author":"C Chou","year":"2007","unstructured":"Chou C, Tsai MJ. Gender Differences in Taiwan High School Students\u2019 computer game playing. Comput Hum Behav. 2007;23(1):812\u201324.","journal-title":"Comput Hum Behav"},{"issue":"5","key":"18958_CR23","doi-asserted-by":"publisher","first-page":"e398","DOI":"10.1111\/aos.12299","volume":"92","author":"QS You","year":"2014","unstructured":"You QS, Wu LJ, Duan JL, et al. Prevalence of myopia in school children in greater Beijing: the Beijing Childhood Eye Study. Acta Ophthalmol. 2014;92(5):e398\u2013406. https:\/\/doi.org\/10.1111\/aos.12299.","journal-title":"Acta Ophthalmol"}],"container-title":["BMC Public Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12889-024-18958-0.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s12889-024-18958-0\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12889-024-18958-0.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,6,7]],"date-time":"2024-06-07T03:32:51Z","timestamp":1717731171000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmcpublichealth.biomedcentral.com\/articles\/10.1186\/s12889-024-18958-0"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,6,7]]},"references-count":23,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2024,12]]}},"alternative-id":["18958"],"URL":"https:\/\/doi.org\/10.1186\/s12889-024-18958-0","relation":{},"ISSN":["1471-2458"],"issn-type":[{"value":"1471-2458","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,6,7]]},"assertion":[{"value":"1 February 2024","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"27 May 2024","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"7 June 2024","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Data were obtained from the 2019\u20132022 Tianjin Children and Youth Myopia, Common Diseases and Health Influencing Factors Survey. All methods were carried out according to relevant guidelines and regulations. Written informed consent was obtained from all participants. The study was conducted under the Code of Ethics of the World Medical Association (Declaration of Helsinki). Also, the study complied with all relevant national regulations and institutional policies and had been approved by the Ethics Committee of Tianjin Center for Disease Control and Prevention.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable as data do not relate to any individual persons.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"1531"}}