OBJECTIVE:Mental health in adolescents has been a growing problem in recent decades. However, comprehensive discussion of the research on the distal and proximal factors related to adolescent mental health were limited and the evidence was lacking. This study aimed to explore the result of adverse childhood experiences and biological rhythms for depressive and anxiety symptoms in adolescents. METHODS:The data used in this study were obtained from China in 2021 (as baseline) and 2023 (as follow-up). Participants provided self-reported information through an anonymous questionnaire. Logistic regression, cluster analysis, restriction cubic spline plots and receiver operating characteristic curves were used for statistical analysis. RESULTS:The study involved 2103 teenagers (mean age 15 years old), consisting of 1089 females and 1014 males. Multiple logistic regression results based on this subgroup showed that higher scores on either ACEs or biorhythms were associated with a greater risk of concurrent depressive-anxiety symptoms at baseline and follow-up, the adjusted ORs (95% CI) were 14.46 (7.14-29.26), 12.09 (5.83-22.08), respectively. The area under the receiver operating characteristic curve of the joint predictive effect of the ACEs and biorhythms were 0.664 for depressive symptoms, 0.656 for anxiety symptoms, and 0.667 for co-morbidity. CONCLUSION:These findings emphasize the necessity of balancing past risk factors with emerging risk factors (biorhythms) in the precaution and management of adolescent depression and anxiety symptoms problems.

Sleep is an important part of life and deserves a lot of attention, especially during the teenage years. It is of great significance to analyze the current situation of adolescent sleep and its development trend in order to understand the current students' sleep situation. The participants were 44 609 students aged 9-22 years from the Chinese National Survey on Students' Constitution and Health (CNSSCH). The latest survey data was used to analyze sleep status, while the data from the last three surveys were used to analyze sleep trends. A chi-square test was conducted to examine differences in napping, bedtime, sleep adequacy, social jet lag, sleep debt, and chronotypes among students. Student's t-test and analysis of variance (ANOVA) were applied to analyze the students' rise time and bedtime. Among primary school students, the proportion of those who go to bed late was the highest, with 41.3% staying up late on weekdays and 68.7% on weekends. High-school students had the shortest sleep duration on weekdays (6:47 ± 0:37), while college students had the highest proportion of late type (64.3%). Over the past decade, the proportion of students who have obtained sufficient sleep has been increasing both in the general population and among college students. The research findings indicate that although students' sleep conditions have improved, sleep issues such as insufficient sleep, late bedtime, and large social jet lag still require attention and further study.

OBJECTIVE:To explore the impact of social ecological risk factors (SERFs) from seven dimensions of individual, family, school, community, policy, culture, and chronosystem on suicide-related behavior (SRB) and non-suicidal self-injury (NSSI) among adolescents. METHODS:A longitudinal study was conducted in China. A total of 2114 adolescents (aged 15.25 ± 1.99 years, 48.5 % males) completed questionnaire at baseline and follow-up. Restricted Cubic Spline and logistic regression was performed to identify the association of SERFs with suicidal ideation (SI), suicidal plan (SP), suicidal attempt (SA) and NSSI. Back-propagation artificial neural network was used to test the importance values of SERFs for SRB and NSSI. RESULTS:RCS showed the risk of SI, SP, SA and NSSI among adolescents increased with the increase of cumulative social ecological risk when the risk score exceeded the median (All P for overall<0.001). Logistic regression analysis showed the high cumulative social ecological risk was associated with SI (OR = 3.028, 95 % CI:2.192-4.183), SP (OR = 2.672, 95 % CI:1.738-4.109), SA (OR = 6.267, 95 % CI:3.087-12.723) and NSSI (OR = 3.541, 95 % CI:2.528-4.971). The similar results were also found in the individual, family, school, community, and culture dimensions (All P < 0.05). The individual dimension of social ecological risk was the most important for predicting SRB and NSSI. CONCLUSION:Adolescents with high culminative social ecological risk had higher SRB and NSSI risks. Schools and families could strengthen adolescents' self-efficacy and cultivate positive coping styles on the basis of exerting their own functions. Shaping optimistic personality characteristics and correct cultural values may effectively reduce the risk of SRB and NSSI among adolescents.

Objective The aim of this study was to analyze changes in height of 7-18-year-old school-age children in China during the year of 2000-2019. Methods We used the survey data from the Chinese National Survey on Students’ Constitution and Health in Henan Province for the years 2000, 2005, 2010, 2014, and 2019. Data were categorized into subgroups based on geographic location, gender, and age; mean, standard deviation, and Pearson's correlation coefficient were used to analyze trends in height change among children and adolescents and the correlation between socioeconomic indicators and height change. Results The height of children and adolescents in Henan has shown a continuous upward trend. The height difference between urban and rural areas has gradually narrowed but has not disappeared. The correlation of height development trends between neighbouring urban areas was higher than in other areas. The level of medical care was significantly associated with the change in height for both boys (r=0.950, p=0.013) and girls (r=0.897, p=0.039); GDP per capita (r=0.940，p=0.018) was significantly associated with the change in height for boys only. Conclusion The height of Chinese children and adolescents will continue to maintain a positive growth trend, but we need to pay attention to the health status and nutritional intake of children and adolescents in economically disadvantaged areas in order to narrow the height disparity between different socio-economic groups.

Suicide and non-suicidal self-injury (NSSI) are preventable concerns in young people. Suicidal ideation (SI), suicidal plans (SP) and suicidal attempt (SA) are closely related to death. Sleep problems are known risk factors for suicide and NSSI. This study aimed to explore the relationship between sleep, suicidality and NSSI. Participants were 3,828 middle school and college students aged 11–23 years from urban and rural areas of Henan Province. Sleep, suicidal phenomena and NSSI were assessed by applying self-reported questionnaires. Chi-squared tests were utilized to demonstrate the demographic data and sleep variables. The correlation between sleep, suicidality and NSSI were explored by using binary logistic regression, while adjusting socio-demographic characteristics with multivariate models. Sleep variables except mid-sleep time were related to suicidal phenomena (P < 0.05). Greater social jet lag (SJL) [≥ 2 h (h)] was associated with increased risk of SI [Odds ratios (OR) = 1.72, 95

With the launch of the COVID-19 vaccines, the vaccination rate has become a hot issue of concern. However, the evidence for the relationship between college students’ attitudes toward vaccines and anxiety and depressive symptoms has been limited. In total, 140,259 college students were recruited using a cluster sampling method in Zhengzhou, Xinxiang, Xinyang city of Henan Province, China, May 21-27, 2021. Anxiety symptoms were determined by the Generalized Anxiety Disorder tool (GAD-7) and depressive symptoms were determined by the Patient Health Questionnaire (PHQ-9). Multiple logistic regression was performed to estimate the association between students’ attitudes toward the vaccines and anxiety and depressive symptoms. The results indicate that 22.45% of students are unclear whether the vaccine can protect them from infection and 45.57% are unclear whether the vaccine is safe and has no side effects. In addition, after adjusting, the model showed that students who think vaccines can protect them and are safe had 0.128 (95%CI 0.110–0.150; Ptrend < 0.001) times lower risk of anxiety compared to their counterparts who think vaccines can neither protect them nor are safe. Similar ORs were found in depression (aOR = 0.157; 95%CI 0.137–0.180). This large-scale study has shown an association between symptoms of anxiety and depression and reluctance to obtain vaccination.

OBJECTIVES:This research aimed to understand the long-term trends in the age of menarche among girls and spermarche among boys, and to analyze the factors that may influence the onset of menarche and first spermarche. METHODS:The study was based on data from 49 566 students in Henan Province collected from the Chinese National Surveys on Students' Constitution and Health (CNSSCH) conducted between 2000 and 2019. Median age at menarche and spermarche was estimated by probit analysis. t-Tests were used to analyze the influence of menarche and first spermarche on physical examination indexes of adolescent children, and the chi-squared test was used to compare whether the differences in physical activity were statistically significant. RESULTS:The age at menarche has decreased from 12.33 years in 2000 to 12.00 years in 2019, and the age at first spermarche has decreased from 14.01 years in 2000 to 13.99 years in 2019. The age at first spermarche in urban boys (13.61 years in 2000; 12.94 years in 2014) was consistently younger than that in rural boys (14.43 years in 2000; aged 13.08 in 2014), except in 2019. The age of menarche in urban girls (12.23 years in 2000; 11.89 years in 2019) was always earlier than that in rural girls (12.44 years in 2000; 12.05 years in 2019). CONCLUSIONS:The age at menarche and spermarche for children in Henan Province generally showed a decreasing trend from 2000 to 2019. The status of BMI is significantly associated with the early onset of puberty in children.

The aim of the study was to investigate independent and joint associations of physical activity and sedentary behavior with psychological distress. In this cross-sectional study, all participants underwent a physical examination and questionnaire survey, including physical activity, sedentary behavior, and psychological distress. The rank-sum test was used to compare the distribution of psychological distress status among students with different characteristics, physical activity levels, and sedentary time. Logistic regression models were used to analyze the independent and joint association between physical activity, sedentary behavior, and psychological distress, stratified by age. The results of the rank sum test and logistic regression showed that students with more sedentary behavior and less physical activity were associated with higher psychological distress generally, but physical activity may attenuate the psychological distress relevant to non-screen-based sedentary behavior on weekdays in middle and high school students and screen-based sedentary behavior on weekends in all participants.

IntroductionThe prevalence of dental caries (DC) among students in developing countries has increased at an alarming rate, and nutritional status has been shown to be associated with DC in children and adolescents with inconsistent conclusions. We aimed to understand the trends of DC prevalence in students aged 7, 9, 12, and 14 years and to explore the relationship between DC prevalence and nutritional status.MethodsWe recruited 16,199 students aged 7, 9, 12, and 14 years in China by multi-stage, stratified, random sampling methods from 2010 to 2019. Permanent caries were measured using the Decay, Loss, and Filling (DMF) index and prevalence rate. Deciduous caries were measured using the decay, loss, and filling (dmf) index and prevalence rate. Nutritional status was assessed using body mass index (BMI) and hemoglobin levels. Logistic regression analysis was used to assess the association between nutritional status and the DC prevalence in children and adolescents, incorporating information concerning family-related factors.ResultsThe results indicated that DC prevalence increased from 39.75% in 2010 to 53.21% in 2019 in Henan province, with deciduous teeth and permanent teeth being 45.96 and 27.18%, respectively, in 2019. The total caries rate decreased with age (p < 0.05), and the caries rate of girls was higher than that of boys in 2019 (55.75% vs. 50.67%) (p < 0.001). The prevalence of dental caries among primary and secondary school students in areas with medium economic aggregate was the highest, followed by cities with the best economic development level, and cities with low economic levels have a lower prevalence of dental caries. The dental caries prevalence was negatively correlated with body mass index. In the fully adjusted model, underweight children had a higher caries prevalence (OR = 1.10, 95%CI: 0.86–1.41). Children with anemia had a higher prevalence of dental caries (OR = 1.18, 95%CI: 0.98–1.42).ConclusionThe DC prevalence of students in Henan Province was high, with a tendency to increase. Females, young individuals, and those with a higher economic level showed a positive correlation with the prevalence of caries. In the process of economic development, particular attention should be paid to early childhood caries prevention. Nutritional status should be taken seriously among children and adolescents, and the oral health system should be improved to keep pace with economic development.

BACKGROUND:The increased trends in psychological distress and mental illness have been of great significance in public health concerns. The study aimed to investigate the proportion and correlates of meeting 24-h movement guidelines (including moderate to vigorous physical activity, screen time and sleep duration) and the associations between 24-h movement guidelines met and mental well-being and psychological distress in a large sample of Chinese students. METHODS:All participants received a physical examination and filled out questionnaires in this study. Chi-square tests were used to analyse the proportion of reaching 24-h guidelines by gender and logistic regression was used to analyse correlates of meeting 24-h guidelines. Two binary logistic regression models were used to analyse the association between meeting 24-h guidelines and mental well-being and psychological distress. The back-propagation artificial neural network was used to describe the importance of the independent variables. RESULTS:The findings revealed a generally low rate of meeting the 24-h movement guidelines, particularly concerning moderate to vigorous physical activity (16.5%). Meeting all three guidelines was related to better mental health in both boys and girls. Particularly, meeting screen time guideline and meeting sleep duration guideline appeared to be more important on mental outcomes, compared to meeting moderate to vigorous physical activity guideline. Compared with boys, girls were more susceptible to the influences of 24-h movement guidelines on mental health. CONCLUSIONS:Meeting all three components of the 24-h movement guidelines was associated with the most favourable mental health outcomes for both boys and girls. Thus, maintaining a daily balance of sufficient physical activity, limited screen time, and adequate sleep is crucial for enhancing the mental health status of students.

目的 了解河南省中小学生的体能状况及影响因素,为提高中小学生的身体素质水平提供理论依据.方法 采用2019年河南省全国学生体质与健康调研数据,共调查42 734人.通过Z分法计算各项体能指标的Z值,相加得出体能指数(PFI),综合反映体能状况.比较不同组别学生的体能指标,并通过多重线性回归对PFI的影响因素进行分析.结果 男生的肺活量、握力、立定跳远、50 m 跑、50 mx8 往返跑、PFI 分别为[(2 552.1±1 226.5)mL、(26.0±13.9)N、(171.0±43.7)cm、(9.3±1.8)s、(132.1±22.6)s、(1.4±3.6)],均优于女生[(1 965.2±765.3)mL、(19.1±8.2)N、(142.4±26.6)cm、(10.5±1.4)s、(136.9±21.1)s、(-1.4±3.2)],差异均有统计学意义(t 值分别为 59.35,62.66,81.87,-74.92,-16.72,85.96,P值均＜0.01);而男生坐位体前屈[(7.0±7.5)cm]低于女生[(11.8±7.1)cm],差异有统计学意义(t =-68.57,P＜0.01).男女生在不同年龄段的各项体能指标的成绩差异均有统计学意义(P值均＜0.01);城市男生在力量素质、耐力素质和柔韧性素质方面与农村男生有一定差距;城市女生的身体素质整体优于农村女生.中小学生视力不良、营养不良、超重肥胖、贫血、血压偏高的检出率分别为68.0％,5.4％,26.0％,15.9％,18.0％.地区、性别、年龄段和营养状况(营养不良、超重肥胖)为PFI的影响因素(β值分别为-0.23,-2.92,-0.11,-1.19,-0.78,P值均＜0.05).结论 河南省中小学生的体能状况在不同性别、不同年龄段、不同地区、不同患病情况之间存在差异.应对农村、女生、高年级、营养不良和超重肥胖的学生重点进行科学的干预和指导,改善体能状况.

This study aimed to estimate temporal trends in physical fitness (PF) by regions, age groups and nutritional status among Chinese children and adolescents and to longitudinally examine PF determinants based on social-ecological model. Participants (n = 68,265) aged 7-18 were from five successive national surveys (2000 to 2019). Six tested items of PF were calculated as PF indicator (PFI), which was used to divide participants into two categories: low vs. moderate/high. One-way analysis of variance was used to compare difference and change trend of PFI. Linear regression evaluated relationship between PFI and body mass index (BMI), and logistic regression assessed association between PFI and factors of behaviours and lifestyles on individual-, family- and school-level based on the social-ecological model. PFI declined sharply from 2000 to 2010, increased slightly from 2010 to 2014 and then edged down in 2019. Students with moderate BMI and students in urban areas tended to have higher PFI, and larger increase of PFI was found in students aged 7-9 and 13-15 after 2010. Several determinants on individual-, family- and school-level related to PFI. Efforts to develop PF mainly include increasing PA and reducing sedentary behaviours by facilitating home-school collaboration and emphasizing age-, region- and BMI-specific actions.

Background Unhealthy lifestyles are risk factors for non-communicable diseases (NCDs) and tend to be clustered, with a trajectory that extends from adolescence to adulthood. This study investigated the association of diets, tobacco, alcohol, physical activity (PA), screen time (ST) and sleep duration (SD) in a total of six lifestyles, separately and as cumulative lifestyle scores, with sociodemographic characteristics among school-aged adolescents in the Chinese city of Zhengzhou. Methods In the aggregate, 3,637 adolescents aged 11–23 years were included in the study. The questionnaire collected data on socio-demographic characteristics and lifestyles. Healthy and unhealthy lifestyles were identified and scored, depending on the individual score (0 and 1 for healthy and unhealthy lifestyles respectively), with a total score between 0 and 6. Based on the sum of the dichotomous scores, the number of unhealthy lifestyles was calculated and divided into three clusters (0–1, 2–3, 4–6). Chi-square test was used to analyze the group difference of lifestyles and demographic characteristics, and multivariate logistic regression was used to explore the associations between demographic characteristics and the clustering status of unhealthy lifestyles. Results Among all participants, the prevalence of unhealthy lifestyles was: 86.4% for diet, 14.5% for alcohol, 6.0% for tobacco, 72.2% for PA, 42.3% for ST and 63.9% for SD. Students who were in university, female, lived in country (OR = 1.725, 95% CI: 1.241–2.398), had low number of close friends (1–2: OR = 2.110, 95% CI: 1.428–3.117; 3–5: OR = 1.601, 95% CI: 1.168–2.195), and had moderate family income (OR = 1.771, 95% CI: 1.208–2.596) were more likely to develop unhealthy lifestyles. In total, unhealthy lifestyles remain highly prevalent among Chinese adolescents. Conclusion In the future, the establishment of an effective public health policy may improve the lifestyle profile of adolescents. Based on the lifestyle characteristics of different populations reported in our findings, lifestyle optimization can be more efficiently integrated into the daily lives of adolescents. Moreover, it is essential to conduct well-designed prospective studies on adolescents.

This study aimed to investigate the association between sleep behaviors and body composition, which was measured by bioelectrical impedance analysis (BIA) among Chinese adolescents. Overall, 444 students (65.3% females, 19.12 ± 1.177 years) completed questionnaires describing sleep characteristics. Sleep characteristics were derived from subjective means. Body composition was obtained from BIA by InBody 720 (Biospace Co. Ltd., Seoul, Republic of Korea). Regression models tested relationships between sleep and body composition after adjustment for covariates. Students with weekday nap duration (>30 min/d) exerted higher waist-height ratio (WHtR) (B = 0.013, FDR-corrected p = 0.080). Average sleep duration (≤7 h/d) was linked to more WHtR (B = 0.016, FDR-corrected p = 0.080). People with high social jetlag showed gained visceral fat area (B = 7.475), WHtR (B = 0.015), waist to hip ratio (B = 0.012), fat mass index (B = 0.663) and body fat percentage (B = 1.703) (all FDR-corrected p < 0.1). Individuals with screen time before sleep (>0.5 h) exhibited higher visceral fat area (B = 7.934, FDR-corrected p = 0.064), WHtR (B = 0.017, FDR-corrected p = 0.080), waist to hip ratio (B = 0.016, FDR-corrected p = 0.090), fat mass index (B = 0.902, FDR-corrected p = 0.069) and body fat percentage (B = 2.892, FDR-corrected p = 0.018). We found poor sleep characteristics were closely related to general and abdominal obesity.

OBJECTIVE:The aim was to investigate the association of multidimensional sleep indicators with high blood pressure (HBP) of Chinese students. METHODS:Participants in this cross-sectional study included 11561 students aged 9-18. Sleep was characterized by sleep timing (e.g., bedtime), sleep duration and sleep consistency (e.g., bedtime/wake-up time deviations and social jet lag (SJL)). We used odds ratios (OR) and 95% confidence intervals (95% CI) to assess the relationship between sleep and HBP. RESULTS:Primary school students who slept 8.00-9.00h had a lower risk of HBP compared with sleeping >10h (OR 0.370, 95%CI 0.208, 0.658), while junior middle school students reporting ≤8.00h on weekday night had a lower risk of HBP compared with sleeping >10h (OR 0.303, 95%CI 0.111, 0.829). Moreover, compared with deviations = 0h, the OR (95%CI) for wake-up time deviations <0h and bedtime deviations >0h in primary school students with HBP were 0.314 (0.125, 0.790) and 2.155 (1.205, 3.853). Furthermore, compared with SJL = 0h, senior high school students reporting SJL = 0.01-0.50h, SJL = 0.51-1.00h and SJL = 1.01-2.00h had greater risk of HBP (OR 1.566, 95%CI 1.039, 2.361; OR 1.760, 95%CI 1.177, 2.631; OR 1.660, 95%CI 1.124, 2.452, respectively). Bedtime at night was associated with HBP for three educational periods students, however, there was no significant association between mid-day nap and HBP. CONCLUSIONS:Sleep timing, sleep duration and sleep consistency are associated with high blood pressure in children and adolescents.

High screen time and smartphone multitasking are ever-increasing phenomena among children and adolescents, which cause growing concern regarding potential impacts on mental health. The purpose of this study was to examine the relationship between weekday/weekend screen time, smartphone multitasking, and mental health. A total of 4024 students free of certain physical disease and mental disorders (aged 11–23 years) participated in this cross-sectional study. The Brief Instrument on Psychological Health of Youths (BIOPHY) was administered to assess psychological health. Apart from screen time, college students were requested to complete questionnaires on smartphone multitasking. Logistic regression analyses were used to examine the relationship between screen time/different types of smartphone multitasking activities and mental health. Of the participants, 29.52

Objective To determine the current prevalence of health risk behaviors among college students in Henan Province,and to conduct an in-depth analysis of the impact of cumulative ecological risks on health risk behaviors,so as to provide scientific basis for promoting healthy development of adolescents.Methods Using a multi-stage stratified cluster sampling method,9 743 college students from six universities in Henan Province were included as the research subjects from April to June 2023.A question-naire survey was conducted using the College Student Cumulative Ecological Risk Scale and the China Urban Adolescent Health Re-lated Behavior Survey Questionnaire(University Version).Data were analyzed by descriptive statistical analysis,Chi-square test and binary Logistic regression.Results The reporting rates of unhealthy eating behavior,unhealthy weight loss behaviors,lack of physical activity,daily risk behaviors,negative emotions,current smoking behavior current drinking behaviors,Internet addiction emotions and dangerous sexual behaviors among college students in Henan Province were 40.2％,39.5％,76.0％,13.7％,28.1％,11.3％,12.7％,5.9％and 2.2％,respectively.The reporting rates of negative emotions,current smoking behaviors,current drink-ing behaviors,dangerous sexual behaviors and daily risk behaviors of college students were higher in boys than in girls(x2=44.00,995.20,902.49,121.95,103.09,P＜0.05).In terms of reporting rates of unhealthy diet,unhealthy weight loss and lack of exer-cise behavior,girls were higher than boys(x2=107.59,13.01,145.83,P＜0.05).Cumulative ecological risk was positively corre-lated with overall health risk behaviors.For every unit increase in the cumulative ecological risk index,the risk of health risk behav-iors among college students increased by 48％.Conclusions The prevalence of health risk behaviors among college students is rel-atively common.It should adrocate for a healthy lifestyle,reduce the cumulative ecological risk and the occurrence of health risk be-haviors to promote the healthy development of adolescents.

Background The relationship of insufficient sleep with the increased risk of obesity has been reported, but less is known about other sleep dimensions in the sleep-obesity associations. Objectives To assess the associations of multiple sleep dimensions with overall and abdominal obesity among Chinese students. Methods This was a cross-sectional study involving 10,686 Han students aged 9–18 from Chinese National Survey on Students’ Constitution and Health (CNSSCH). We collected sex, age, regions, parental educational levels, physical activity duration and sleep-related information by questionnaire survey, and also conducted anthropometric measurements including height, weight and waist circumference (WC). Unadjusted and adjusted binary logistic regression models were used to estimate the associations of sleep-related dimensions with obesity-related indicators. Results Short sleep duration was associated with higher body mass index (BMI), larger WC and higher waist-to-height ratio (WHtR) in 9–12 and 16–18 age groups, whereas prolonged sleep duration on weekday was associated with higher BMI in 13–15 age group. Non-habitual midday napping and midday napping ≤0.5 h/d (vs 0.5 to 1 h/d) increased the risk of higher BMI in 13–15 age group, and the former was also associated with larger WC in 9–12 age group. Late bedtime was associated with larger WC and higher WHtR in 9–12 age group and with higher BMI and WHtR in 13–15 age group. Students aged 9–12 with social jet lag ≥2 h were found to have greater BMI after adjustment (Odds Ratio: 1.421; 95% confidence interval: 1.066–1.894). Conclusions Short or overlong sleep duration, late bedtime and great social jet lag were associated with higher prevalence of overall or abdominal obesity, while moderate midday napping can effectively decrease the risk. Those findings may assist in developing preventive strategies to combat obesity epidemic.

It is worth paying attention to the level of worry and fear of students during the normalization of the epidemic. We conducted the cross-sectional study that included 182,991 high school students using an online survey to assess worry and fear levels and its influencing factors in three cities in Henan Province, China, from May 21 to May 27, 2021. Worry and fear levels were measured using a five-item Likert-type scale. Multinomial logistic regression was used to analyze the risk factors. Approximately 65.42% of students reported being high worry about the coronavirus disease 2019 (COVID-19) epidemic, and about 41.44% of students reported being high fear about the COVID-19 epidemic. In addition, compared with female, male had lower odds of suffering from a high worry, and compared with senior high school students, junior high school students were more likely to suffer from a high worry. Students lived in rural had highest odds increased likelihood of high worry. Similar results in fear levels. During the normalization period of the COVID-19 epidemic, many students have high levels of worry and fear. This study has implications for potential influencers of worry and fear levels in follow-up work.