基于熵权TOPSIS法的陕西农村青少年健康结局及其影响因素研究

Objective The study aimed to apply the entropy weight Technique for Order of Preference by Similarity to Ideal Solution (TOPSIS) method to construct a comprehensive health evaluation system that integrates multidimensional indicators, in order to overcome the limitations of traditional single-dimension research. It also analyzes the factors influencing the comprehensive health scores of adolescents in rural Shaanxi and their gender differences, thus providing a basis for developing targeted health intervention strategies. Methods This study was a cross-sectional follow-up one based on a birth cohort that originated from a randomized controlled trial of micronutrient supplementation during pregnancy conducted in rural western China from 2002 to 2016. In 2016, we surveyed adolescents aged 10 to 14 years in the cohort, collecting multidimensional health indicators including behavioral problems, cognitive ability, lung function, heart rate, body mass index, and blood pressure. The entropy weight TOPSIS method was used to construct a comprehensive health score. Multiple linear regression and Logistic regression were used to analyze the influencing factors, with stratified analysis by gender. Results In this study we included a total of 1767 adolescents, of whom 1050 (59.4%) were male. The median age of the adolescents was 12 (11, 12) years. Multiple regression showed that increasing age (β=-0.51, P<0.001) and attending village-level schools (reference group) were associated with lower health scores, while attending town-level schools (β=1.86, P<0.001), high family economic status (β=0.78, P=0.013) were associated with higher health scores. Gender-stratified analysis showed that compared to that of the males, age had a stronger negative impact on the health scores of the female adolescents (β=-0.69, P=0.002), and maternal multiparity had a stronger positive impact on the health scores of the female adolescents (β=1.01, P=0.009). Conclusion The entropy weight TOPSIS method is suitable for the comprehensive evaluation of multidimensional health outcomes in adolescents. The study indicates that overall adolescent health is influenced by factors such as age, school type, family economy, and maternal parity, with gender differences. Future health promotion strategies should focus on family background and gender differences, optimize resource allocation, and provide targeted health guidance to promote the comprehensive physical and mental development of adolescents.